Sample records for kalimer upper internal

  1. Upper internals arrangement for a pressurized water reactor

    DOEpatents

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

    2013-07-09

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

  2. PWR upper/lower internals shield

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

    Homyk, W.A.

    1995-03-01

    During refueling of a nuclear power plant, the reactor upper internals must be removed from the reactor vessel to permit transfer of the fuel. The upper internals are stored in the flooded reactor cavity. Refueling personnel working in containment at a number of nuclear stations typically receive radiation exposure from a portion of the highly contaminated upper intervals package which extends above the normal water level of the refueling pool. This same issue exists with reactor lower internals withdrawn for inservice inspection activities. One solution to this problem is to provide adequate shielding of the unimmersed portion. The use ofmore » lead sheets or blankets for shielding of the protruding components would be time consuming and require more effort for installation since the shielding mass would need to be transported to a support structure over the refueling pool. A preferable approach is to use the existing shielding mass of the refueling pool water. A method of shielding was devised which would use a vacuum pump to draw refueling pool water into an inverted canister suspended over the upper internals to provide shielding from the normally exposed components. During the Spring 1993 refueling of Indian Point 2 (IP2), a prototype shield device was demonstrated. This shield consists of a cylindrical tank open at the bottom that is suspended over the refueling pool with I-beams. The lower lip of the tank is two feet below normal pool level. After installation, the air width of the natural shielding provided by the existing pool water. This paper describes the design, development, testing and demonstration of the prototype device.« less

  3. Heat up and failure of BWR upper internals during a severe accident

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

    Robb, Kevin R.

    In boiling water reactors, the shroud dome, separators, and dryers above the core are made of approximately 100,000 kg of stainless steel. During a severe accident in which the coolant boils away and exothermic oxidation of zirconium occurs, gases (steam and hydrogen) are superheated in the core region and pass through the upper internals. In this scenario, the upper internals can also be heated by thermal radiation from the hot degrading core. Historically, models of the upper internals have been relatively simple in severe accident codes. The upper internals are typically modeled in MELCOR as two lumped volumes with simplifiedmore » heat transfer characteristics and no structural integrity considerations, and with limited ability to oxidize, melt, and relocate. The potential for and the subsequent impact of the upper internals to heat up, oxidize, fail, and relocate during a severe accident was investigated. A higher fidelity representation of the shroud dome, steam separators, and steam driers was developed in MELCOR v1.8.6 by extending the core region upwards. The MELCOR modeling effort entailed adding 45 additional core cells and control volumes, 98 flow paths, and numerous control functions. The model accounts for the mechanical loading and structural integrity, oxidation, melting, flow area blockage, and relocation of the various components. Consistent with a previous study, the results indicate that the upper internals can reach high temperatures during a severe accident sufficient to lose their structural integrity and relocate. Finally, the additional 100 metric tons of stainless steel debris influences the subsequent in-vessel and ex-vessel accident progression.« less

  4. Heat up and failure of BWR upper internals during a severe accident

    DOE PAGES

    Robb, Kevin R.

    2017-02-21

    In boiling water reactors, the shroud dome, separators, and dryers above the core are made of approximately 100,000 kg of stainless steel. During a severe accident in which the coolant boils away and exothermic oxidation of zirconium occurs, gases (steam and hydrogen) are superheated in the core region and pass through the upper internals. In this scenario, the upper internals can also be heated by thermal radiation from the hot degrading core. Historically, models of the upper internals have been relatively simple in severe accident codes. The upper internals are typically modeled in MELCOR as two lumped volumes with simplifiedmore » heat transfer characteristics and no structural integrity considerations, and with limited ability to oxidize, melt, and relocate. The potential for and the subsequent impact of the upper internals to heat up, oxidize, fail, and relocate during a severe accident was investigated. A higher fidelity representation of the shroud dome, steam separators, and steam driers was developed in MELCOR v1.8.6 by extending the core region upwards. The MELCOR modeling effort entailed adding 45 additional core cells and control volumes, 98 flow paths, and numerous control functions. The model accounts for the mechanical loading and structural integrity, oxidation, melting, flow area blockage, and relocation of the various components. Consistent with a previous study, the results indicate that the upper internals can reach high temperatures during a severe accident sufficient to lose their structural integrity and relocate. Finally, the additional 100 metric tons of stainless steel debris influences the subsequent in-vessel and ex-vessel accident progression.« less

  5. Heat up and potential failure of BWR upper internals during a severe accident

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

    Robb, Kevin R

    2015-01-01

    In boiling water reactors, the steam dome, steam separators, and dryers above the core are comprised of approximately 100 tons of stainless steel. During a severe accident in which the coolant boils away and exothermic oxidation of zirconium occurs, gases (steam and hydrogen) are superheated in the core region and pass through the upper internals. Historically, the upper internals have been modeled using severe accident codes with relatively simple approximations. The upper internals are typically modeled in MELCOR as two lumped volumes with simplified heat transfer characteristics, with no structural integrity considerations, and with limited ability to oxidize, melt, andmore » relocate. The potential for and the subsequent impact of the upper internals to heat up, oxidize, fail, and relocate during a severe accident was investigated. A higher fidelity representation of the shroud dome, steam separators, and steam driers was developed in MELCOR v1.8.6 by extending the core region upwards. This modeling effort entailed adding 45 additional core cells and control volumes, 98 flow paths, and numerous control functions. The model accounts for the mechanical loading and structural integrity, oxidation, melting, flow area blockage, and relocation of the various components. The results indicate that the upper internals can reach high temperatures during a severe accident; they are predicted to reach a high enough temperature such that they lose their structural integrity and relocate. The additional 100 tons of stainless steel debris influences the subsequent in-vessel and ex-vessel accident progression.« less

  6. Internal gravity waves in the upper atmosphere, generated by tropospheric jet streams

    NASA Technical Reports Server (NTRS)

    Chunchuzov, Y. P.; Torgashin, Y. M.

    1979-01-01

    A mechanism of internal gravity wave generation by jet streams in the troposphere is considered. Evaluations of the energy and pulse of internal gravity waves emitted into the upper atmosphere are given. The obtained values of flows can influence the thermal and dynamic regime of these layers.

  7. Jacking mechanism for upper internals structure of a liquid metal nuclear reactor

    DOEpatents

    Gillett, James E.; Wineman, Arthur L.

    1984-01-01

    A jacking mechanism for raising the upper internals structure of a liquid metal nuclear reactor which jacking mechanism uses a system of gears and drive shafts to transmit force from a single motor to four mechanically synchronized ball jacks to raise and lower support columns which support the upper internals structure. The support columns have a pin structure which rides up and down in a slot in a housing fixed to the reactor head. The pin has two locking plates which can be rotated around the pin to bring bolt holes through the locking plates into alignment with a set of bolt holes in the housing, there being a set of such housing bolt holes corresponding to both a raised and a lowered position of the support column. When the locking plate is so aligned, a surface of the locking plate mates with a surface in the housing such that the support column is then supported by the locking plate and not by the ball jacks. Since the locking plates are to be installed and bolted to the housing during periods of reactor operation, the ball jacks need not be sized to react the large forces which occur or potentially could occur on the upper internals structure of the reactor during operation. The locking plates react these loads. The ball jacks, used only during refueling, can be smaller, which enable conventionally available equipment to fulfill the precision requirements for the task within available space.

  8. Biometric study of the internal dimensions of subglottis and upper trachea in adult Indian population.

    PubMed

    Prasanna Kumar, S; Ravikumar, A

    2014-01-01

    The anatomy of the larynx and trachea is well described in literature, however the intraluminal dimensions and contour of the subglottis has not been well documented. Subglottis and trachea are dynamic structures and the internal dimensions and contours have been studied only on cadavers or by plain radiograph which has many technical and measurement errors. No data is available about the internal dimensions of the subglottic and trachea in Indian population. This is the first documented study to measure the dimensions of the trachea and subglottis in Indian population. The aim of this study is to measure the internal dimensions and contour of the subglottis and upper trachea of adult Indian population. We conducted cross-sectional, observational study in a university hospital in south India to measure the dimensions of the internal subglottic and upper tracheal lumen. CT scan with 3D reconstruction with multiplanar sections was used for precise measurements. Forty-eight subjects (30 male and 18 female) who had undergone CT scan of the neck and thorax for reasons other than airway compromise were included in the study. The internal coronal diameter (CD), sagittal diameter (SD), and circumference was measured at various levels from 5 to 70 mm below the level of glottis, in the subglottis and upper trachea. Measurements of the scan for each subject were done independently by a radiologist and ENT surgeon and average of the two were documented values of each subject. These measurements were then statistically analyzed using SSPS software. The mean CD of adult Indian male ranged from 13.18 to 17.68 mm. The average intraluminal circumference ranged from 48.82 mm at the subglottis 5 mm from the glottis to a maximum of 54.96 at 30 mm. The mean CD of adult Indian female ranged from 8.7 to 15.34 mm The average intraluminal circumference ranged from 36.5 at 5 mm and a maximum of 43.05 at 70 mm. The 95% CI for the coronal, sagittal and circumference of the subglottis

  9. WOrk-Related Questionnaire for UPper extremity disorders (WORQ-UP): Factor Analysis and Internal Consistency.

    PubMed

    Aerts, Bas R; Kuijer, P Paul; Beumer, Annechien; Eygendaal, Denise; Frings-Dresen, Monique H

    2018-04-17

    To test a 17-item questionnaire, the WOrk-Related Questionnaire for UPper extremity disorders (WORQ-UP), for dimensionality of the items (factor analysis) and internal consistency. Cross-sectional study. Outpatient clinic. A consecutive sample of patients (N=150) consisting of all new referral patients (either from a general physician or other hospital) who visited the orthopedic outpatient clinic because of an upper extremity musculoskeletal disorder. Not applicable. Number and dimensionality of the factors in the WORQ-UP. Four factors with eigenvalues (EVs) >1.0 were found. The factors were named exertion, dexterity, tools & equipment, and mobility. The EVs of the factors were, respectively, 5.78, 2.38, 1.81, and 1.24. The factors together explained 65.9% of the variance. The Cronbach alpha values for these factors were, respectively, .88, .74, .87, and .66. The 17 items of the WORQ-UP resemble 4 factors-exertion, dexterity, tools & equipment, and mobility-with a good internal consistency. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  10. 77 FR 58204 - International Joint Commission Invites Public Comment on Upper Great Lakes Report via...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-19

    ... of its International Upper Great Lakes Study Board, Lake Superior Regulation: Addressing Uncertainty... for comments has also been extended to September 30, 2012. The Study examines whether the regulation of outflows from Lake Superior through the compensating works and power dams on the St. Marys River...

  11. The development of the NZ-based international upper limb surgery registry.

    PubMed

    Sinnott, K A; Dunn, J A; Rothwell, A G; Hall, A S; Post, M W M

    2014-08-01

    Implementation study. To describe the development and potential value of the New Zealand (NZ) upper limb surgery registry and report the demographic and spinal cord injury characteristics of individuals with tetraplegia collated to date. Multi Center-coordinated from Burwood Spinal Unit, NZ. Following discussions with eight international units, clinical information and outcomes measures were agreed upon for use in this specific population. To implement this consensus, a web-based upper limb surgery registry was developed in NZ. Inclusion criteria included referral to a hand clinic for clinical assessment for suitability for tendon transfer surgery. Clinical data were collected regardless of acceptance of surgery thereby creating a self-selected control group. Twenty-eight years of retrospective NZ data was entered into the registry, as well as 3 years of prospective data collected in NZ. From 1982 to 2013, a total of 357 persons with tetraplegia were assessed as suitable for surgery. Of those, 223 individuals underwent surgery and 134 declined the intervention(s). The prospective group currently comprises 55 assessments with 23 surgery individuals and 32 who have declined surgery to date. Clinical information is now available within a web-based registry for all individuals reviewed in hand clinics from when upper limb surgery was first introduced. A broad range of outcomes of interest can easily be reported directly from the registry. The self-selected control group will allow comparative studies to be explicitly linked to the specific interventions of interest.

  12. Nonvariceal upper gastrointestinal bleeding: differences in outcome for patients admitted to internal medicine and gastroenterological services.

    PubMed

    Sandel, M H; Kolkman, J J; Kuipers, E J; Cuesta, M A; Meuwissen, S G

    2000-09-01

    It has been suggested that admission to a gastroenterology service (GAS) is associated with a better prognosis and lower cost for treatment of gastrointestinal (GI) diseases, such as upper GI bleeding (UGB). However, a large potential bias by higher comorbidity on internal medicine services (MED) could not be excluded from these studies. We therefore compared patients with upper GI bleeding admitted to a gastroenterology or internal medicine department, with special emphasis on prognostic factors, such as comorbidity, and outcome. Between 1991 and 1995, 322 patients were admitted to our hospital for UGB. Forty-five patients had variceal and 277 patients had nonvariceal upper GI bleeding (NUGB). Of 232 patients with primary NUGB, 125 were admitted to GAS and 93 to MED. The charts of these patients were revised, comorbidity was carefully recorded, and the Rockall risk score was calculated. All deaths were individually classified as unavoidable, mostly due to severe underlying illness, or potentially avoidable. No differences in delay for endoscopy or treatment were observed between GAS and MED. The rebleeding, surgery, and mortality rates in GAS and MED patients were 11.6% versus 11.5% (NS), 7.8% versus 7.3% (NS), and 2.4% versus 10.8% (p = 0.02), respectively. Rockall scores differed between GAS and MED patients (3.1 +/- 1.8 vs 3.7 +/- 1.7, p = 0.02). The mortality rate stratified by Rockall score was lower for the GAS patients. However, individual analysis revealed that only three of 13 deaths were potentially avoidable: two of 10 at the MED and one of three at the GAS. The lower mortality among nonvariceal upper GI bleeding patients admitted to a gastroenterological service compared to an internal medicine service was mainly due to lesser comorbidity. This effect was not detected by stratification according to Rockall, but shown with analysis of individual patient charts only. The latter underscores the potential pitfalls when comparing outcome or cost of

  13. Formation of an internal model of environment dynamics during upper limb reaching movements: a fuzzy approach.

    PubMed

    MacDonald, Chad; Moussavi, Zahra; Sarkodie-Gyan, Thompson

    2007-01-01

    This paper presents the development and simulation of a fuzzy logic based learning mechanism to emulate human motor learning. In particular, fuzzy inference was used to develop an internal model of a novel dynamic environment experienced during planar reaching movements with the upper limb. A dynamic model of the human arm was developed and a fuzzy if-then rule base was created to relate trajectory movement and velocity errors to internal model update parameters. An experimental simulation was performed to compare the fuzzy system's performance with that of human subjects. It was found that the dynamic model behaved as expected, and the fuzzy learning mechanism created an internal model that was capable of opposing the environmental force field to regain a trajectory closely resembling the desired ideal.

  14. [COMPLICATIONS OF STENTINGOF UPPER URINARY TRACT].

    PubMed

    Shkodkin, S V; Kogan, M I; Lyubushkin, A V; Miroshnichenko, O V

    2015-01-01

    Restoring the passage of urine through the upper urinary tract routinely is achieved by installing of external or internal drainage. Due to its objective advantages, internal drainage has been successfully used in surgery of the upper urinary tract. This review outlines the problems associated with the use ofinternal stents, namely difficultyin installation, migration, and reflux and stent obstruction, bacterial colonization of the stent, the development of functional and morphological changes in the drained segment of urinary tract.

  15. Internal performance of a nonaxisymmetric nozzle with a rotating upper flap and a center-pivoted lower flap

    NASA Technical Reports Server (NTRS)

    Wing, David J.; Leavitt, Laurence D.; Re, Richard J.

    1993-01-01

    An investigation was conducted at wind-off conditions in the static-test facility of the Langley 16-Foot Transonic Tunnel to determine the internal performance characteristics of a single expansion-ramp nozzle with thrust-vectoring capability to 105 degrees. Thrust vectoring was accomplished by the downward rotation of an upper flap with adaptive capability for internal contouring and a corresponding rotation of a center-pivoted lower flap. The static internal performance of configurations with pitch thrust-vector angles of 0 degrees, 60 degrees, and 105 degrees each with two throat areas, was investigated. The nozzle pressure ratio was varied from 1.5 to approximately 8.0 (5.0 for the maximum throat area configurations). Results of this study indicated that the nozzle configuration of the present investigation, when vectored, provided excellent flow-turning capability with relatively high levels of internal performance. In all cases, the thrust vector angle was a function of the nozzle pressure ratio. This result is expected because the flow is bounded by a single expansion surface on both vectored- and unvectored-nozzle geometries.

  16. 77 FR 39560 - International Joint Commission

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-03

    ... DEPARTMENT OF STATE [Public Notice 7945] International Joint Commission International Joint Commission Invites Public Comment on Upper Great Lakes Report The International Joint Commission (IJC) announced today that it is inviting public comment on the final report of its International Upper Great...

  17. The Profile of Patients and Current Practice of Treatment of Upper Limb Muscle Spasticity with Botulinum Toxin Type A: An International Survey

    ERIC Educational Resources Information Center

    Bakheit, Abdel Magid

    2010-01-01

    To document the current practice in relation with the treatment of patients with upper limb spasticity with botulinum toxin type A to inform future research in this area. We designed an international, cross-sectional, noninterventional survey of current practice. Nine hundred and seventy-four patients from 122 investigational centres in 31…

  18. Does internal climate variability overwhelm climate change signals in streamflow? The upper Po and Rhone basin case studies.

    PubMed

    Fatichi, S; Rimkus, S; Burlando, P; Bordoy, R

    2014-09-15

    Projections of climate change effects in streamflow are increasingly required to plan water management strategies. These projections are however largely uncertain due to the spread among climate model realizations, internal climate variability, and difficulties in transferring climate model results at the spatial and temporal scales required by catchment hydrology. A combination of a stochastic downscaling methodology and distributed hydrological modeling was used in the ACQWA project to provide projections of future streamflow (up to year 2050) for the upper Po and Rhone basins, respectively located in northern Italy and south-western Switzerland. Results suggest that internal (stochastic) climate variability is a fundamental source of uncertainty, typically comparable or larger than the projected climate change signal. Therefore, climate change effects in streamflow mean, frequency, and seasonality can be masked by natural climatic fluctuations in large parts of the analyzed regions. An exception to the overwhelming role of stochastic variability is represented by high elevation catchments fed by glaciers where streamflow is expected to be considerably reduced due to glacier retreat, with consequences appreciable in the main downstream rivers in August and September. Simulations also identify regions (west upper Rhone and Toce, Ticino river basins) where a strong precipitation increase in the February to April period projects streamflow beyond the range of natural climate variability during the melting season. This study emphasizes the importance of including internal climate variability in climate change analyses, especially when compared to the limited uncertainty that would be accounted for by few deterministic projections. The presented results could be useful in guiding more specific impact studies, although design or management decisions should be better based on reliability and vulnerability criteria as suggested by recent literature. Copyright © 2013

  19. Validation of the Omron M6 (HEM-7001-E) upper arm blood pressure measuring device according to the International Protocol in elderly patients.

    PubMed

    Altunkan, Sekip; Iliman, Nevzat; Altunkan, Erkan

    2008-04-01

    Despite the widespread use of automated self-measurement monitors, there is limited published evidence on their accuracy and reliability on different patient groups. The objective of this study was to evaluate the accuracy and reliability of the Omron M6 (HEM-7001-E) upper-arm blood pressure (BP) device against mercury sphygmomanometer on elderly patients according to the criteria of the International Protocol. Thirty-three patients above 65 years of age, who were classified based on the BP categories of the International Protocol, were recruited for the study. BP measurements at the upper arm with the Omron M6 were compared with the results obtained by two trained observers using a mercury sphygmomanometer. Nine sequential BP measurements were taken. During the validation study, 99 measurements were obtained from 33 patients for comparison. The first phase was carried out on 15 patients and if the device passed this phase, 18 more patients were selected. Mean discrepancies and standard deviations of the device sphygmomanometer were 1.4+/-5.3 mmHg for systolic BP (SBP) and -1.4+/-4.5 mmHg for diastolic BP (DBP) in the study group. The device passed phase 1 in 15 patients. In phase 2.1, from the total 99 comparisons, 76, 92, and 97 for SBP and 77, 94, and 99 for DBP were less than 5, 10, and 15 mmHg, respectively. The Omron M6 passed phases 2.1 and 2.2 in the elderly group of patients. The Omron M6 (HEM-7001-E) upper-arm BP monitor passed according to the International Protocol criteria and can be recommended for use in elderly patients.

  20. Nuclear reactor internals alignment configuration

    DOEpatents

    Gilmore, Charles B [Greensburg, PA; Singleton, Norman R [Murrysville, PA

    2009-11-10

    An alignment system that employs jacking block assemblies and alignment posts around the periphery of the top plate of a nuclear reactor lower internals core shroud to align an upper core plate with the lower internals and the core shroud with the core barrel. The distal ends of the alignment posts are chamfered and are closely received within notches machined in the upper core plate at spaced locations around the outer circumference of the upper core plate. The jacking block assemblies are used to center the core shroud in the core barrel and the alignment posts assure the proper orientation of the upper core plate. The alignment posts may alternately be formed in the upper core plate and the notches may be formed in top plate.

  1. Trajectory Software With Upper Atmosphere Model

    NASA Technical Reports Server (NTRS)

    Barrett, Charles

    2012-01-01

    The Trajectory Software Applications 6.0 for the Dec Alpha platform has an implementation of the Jacchia-Lineberry Upper Atmosphere Density Model used in the Mission Control Center for International Space Station support. Previous trajectory software required an upper atmosphere to support atmosphere drag calculations in the Mission Control Center. The Functional operation will differ depending on the end-use of the module. In general, the calling routine will use function-calling arguments to specify input to the processor. The atmosphere model will then compute and return atmospheric density at the time of interest.

  2. Benefits of maxillectomy with internal dissection of the masticator space by transmandibular approach in the surgical management of malignant tumours of the upper gingiva and hard palate: a clinical review of 10 cases.

    PubMed

    Yanamoto, S; Yamada, S; Takahashi, H; Naruse, T; Shigeta, T; Minamikawa, T; Shibuya, Y; Komori, T; Umeda, M

    2014-11-01

    The aim of this study was to review patients with tumours extending to the posterior portion of the upper gingiva and hard palate, and to evaluate the postoperative outcomes. Ten consecutive patients with tumours in the upper gingiva and hard palate, who underwent maxillectomy with internal dissection of the masticator space by the transmandibular approach, were reviewed retrospectively. Among the 10 patients, the pathological diagnosis was squamous cell carcinoma in seven, adenoid cystic carcinoma in one, malignant melanoma in one, and osteosarcoma in one. Loco-regional control was achieved in eight of nine patients (88.9%). Three patients had residual moderate trismus. Cosmetic issues were not noted in any patient. En bloc resection of the maxilla with the internal portion of the masticator space and neck through the parapharyngeal space by the transmandibular approach is a useful and satisfactory technique for the excision of a tumour with involvement of the posterior portion of the upper gingiva and hard palate. Copyright © 2014 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  3. International cooperation between Japanese IUGONET and EU ESPAS projects on development of the metadata database for upper atmospheric study

    NASA Astrophysics Data System (ADS)

    Yatagai, Akiyo; Ritschel, Bernd; Iyemori, Tomohiko; Koyama, Yukinobu; Hori, Tomoaki; Abe, Shuji; Tanaka, Yoshimasa; Shinbori, Atsuki; UeNo, Satoru; Sato, Yuka; Yagi, Manabu

    2013-04-01

    The upper atmospheric observational study is the area which an international collaboration is crucially important. The Japanese Inter-university Upper atmosphere Global Observation NETwork project (2009-2014), IUGONET, is an inter-university program by the National Institute of Polar Research (NIPR), Tohoku University, Nagoya University, Kyoto University, and Kyushu University to build a database of metadata for ground-based observations of the upper atmosphere. In order to investigate the mechanism of long-term variations in the upper atmosphere, we need to combine various types of in-situ observations and to accelerate data exchange. The IUGONET institutions have been archiving observed data by radars, magnetometers, photometers, radio telescopes, helioscopes, etc. in various altitude layers from the Earth's surface to the Sun. The IUGONET has been developing systems for searching metadata of these observational data, and the metadata database (MDB) has already been operating since 2011. It adopts DSPACE system for registering metadata, and it uses an extension of the SPASE data model of describing metadata, which is widely used format in the upper atmospheric society including that in USA. The European Union project ESPAS (2011-2015) has the same scientific objects with IUGONET, namely it aims to provide an e-science infrastructure for the retrieval and access to space weather relevant data, information and value added services. It integrates 22 partners in European countries. The ESPAS also plans to adopt SPASE model for defining their metadata, but search system is different. Namely, in spite of the similarity of the data model, basic system ideas and techniques of the system and web portal are different between IUGONET and ESPAS. In order to connect the two systems/databases, we are planning to take an ontological method. The SPASE keyword vocabulary, derived from the SPASE data model shall be used as standard for the description of near-earth and space data

  4. A principal component analysis of the relationship between the external body shape and internal skeleton for the upper body.

    PubMed

    Nerot, A; Skalli, W; Wang, X

    2016-10-03

    Recent progress in 3D scanning technologies allows easy access to 3D human body envelope. To create personalized human models with an articulated linkage for realistic re-posturing and motion analyses, an accurate estimation of internal skeleton points, including joint centers, from the external envelope is required. For this research project, 3D reconstructions of both internal skeleton and external envelope from low dose biplanar X-rays of 40 male adults were obtained. Using principal component analysis technique (PCA), a low-dimensional dataset was used to predict internal points of the upper body from the trunk envelope. A least squares method was used to find PC scores that fit the PCA-based model to the envelope of a new subject. To validate the proposed approach, estimated internal points were evaluated using a leave-one-out (LOO) procedure, i.e. successively considering each individual from our dataset as an extra-subject. In addition, different methods were proposed to reduce the variability in data and improve the performance of the PCA-based prediction. The best method was considered as the one providing the smallest errors between estimated and reference internal points with an average error of 8.3mm anterior-posteriorly, 6.7mm laterally and 6.5mm vertically. As the proposed approach relies on few or no bony landmarks, it could be easily applicable and generalizable to surface scans from any devices. Combined with automatic body scanning techniques, this study could potentially constitute a new step towards automatic generation of external/internal subject-specific manikins. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Cross-cultural adaptation, reliability, internal consistency and validation of the Hand Function Sort (HFS©) for French speaking patients with upper limb complaints.

    PubMed

    Konzelmann, M; Burrus, C; Hilfiker, R; Rivier, G; Deriaz, O; Luthi, F

    2015-03-01

    Functional evaluation of upper limb is not only based on clinical findings but requires self-administered questionnaires to address patients' perspective. The Hand Function Sort (HFS©) was only validated in English. The aim of this study was the French cross cultural adaptation and validation of the HFS© (HFS-F). 150 patients with various upper limbs impairments were recruited in a rehabilitation center. Translation and cross-cultural adaptation were made according to international guidelines. Construct validity was estimated through correlations with Disabilities Arm Shoulder and Hand (DASH) questionnaire, SF-36 mental component summary (MCS),SF-36 physical component summary (PCS) and pain intensity. Internal consistency was assessed by Cronbach's α and test-retest reliability by intraclass correlation. Cronbach's α was 0.98, test-retest reliability was excellent at 0.921 (95 % CI 0.871-0.971) same as original HFS©. Correlations with DASH were-0.779 (95 % CI -0.847 to -0.685); with SF 36 PCS 0.452 (95 % CI 0.276-0.599); with pain -0.247 (95 % CI -0.429 to -0.041); with SF 36 MCS 0.242 (95 % CI 0.042-0.422). There were no floor or ceiling effects. The HFS-F has the same good psychometric properties as the original HFS© (internal consistency, test retest reliability, convergent validity with DASH, divergent validity with SF-36 MCS, and no floor or ceiling effects). The convergent validity with SF-36 PCS was poor; we found no correlation with pain. The HFS-F could be used with confidence in a population of working patients. Other studies are necessary to study its psychometric properties in other populations.

  6. Small scale wind tunnel model investigation of hybrid high lift systems combining upper surface blowing with the internally blown flap

    NASA Technical Reports Server (NTRS)

    Waites, W. L.; Chin, Y. T.

    1974-01-01

    A small-scale wind tunnel test of a two engine hybrid model with upper surface blowing on a simulated expandable duct internally blown flap was accomplished in a two phase program. The low wing Phase I model utilized 0.126c radius Jacobs/Hurkamp flaps and 0.337c radius Coanda flaps. The high wing Phase II model was utilized for continued studies on the Jacobs/Hurkamp flap. Principal study areas included: basic data both engines operative and with an engine out, control flap utilization, horizontal tail effectiveness, spoiler effectiveness, USB nacelle deflector study and USB/IBF pressure ratio effects.

  7. [The "window" surgical exposure strategy of the upper anterior cervical retropharyngeal approach for anterior decompression at upper cervical spine].

    PubMed

    Wu, Xiang-Yang; Zhang, Zhe; Wu, Jian; Lü, Jun; Gu, Xiao-Hui

    2009-11-01

    To investigate the "window" surgical exposure strategy of the upper anterior cervical retropharyngeal approach for the exposure and decompression and instrumentation of the upper cervical spine. From Jan. 2000 to July 2008, 5 patients with upper cervical spinal injuries were treated by surgical operation included 4 males and 1 female with and average age of 35 years old ranging from 16 to 68 years. There were 2 cases of Hangman's fractures (type II ), 2 of C2.3 intervertebral disc displacement and 1 of C2 vertebral body tuberculosis. All patients underwent the upper cervical anterior retropharyngeal approach through the "window" between the hypoglossal nerve and the superior laryngeal nerve and pharynx and carotid artery. Two patients of Hangman's fractures underwent the C2,3 intervertebral disc discectomy, bone graft fusion and internal fixation. Two patients of C2,3 intervertebral disc displacement underwent the C2,3 intervertebral disc discectomy, decompression bone graft fusion and internal fixation. One patient of C2 vertebral body tuberculosis was dissected and resected and the focus and the cavity was filled by bone autografting. C1 anterior arch to C3 anterior vertebral body were successful exposed. Lesion resection or decompression and fusion were successful in all patients. All patients were followed-up for from 5 to 26 months (means 13.5 months). There was no important vascular and nerve injury and no wound infection. Neutral symptoms was improved and all patient got successful fusion. The "window" surgical exposure surgical technique of the upper cervical anterior retropharyngeal approach is a favorable strategy. This approach strategy can be performed with full exposure for C1-C3 anterior anatomical structure, and can get minimally invasive surgery results and few and far between wound complication, that is safe if corresponding experience is achieved.

  8. Upper Limit of Weights in TAI Computation

    NASA Technical Reports Server (NTRS)

    Thomas, Claudine; Azoubib, Jacques

    1996-01-01

    The international reference time scale International Atomic Time (TAI) computed by the Bureau International des Poids et Mesures (BIPM) relies on a weighted average of data from a large number of atomic clocks. In it, the weight attributed to a given clock depends on its long-term stability. In this paper the TAI algorithm is used as the basis for a discussion of how to implement an upper limit of weight for clocks contributing to the ensemble time. This problem is approached through the comparison of two different techniques. In one case, a maximum relative weight is fixed: no individual clock can contribute more than a given fraction to the resulting time scale. The weight of each clock is then adjusted according to the qualities of the whole set of contributing elements. In the other case, a parameter characteristic of frequency stability is chosen: no individual clock can appear more stable than the stated limit. This is equivalent to choosing an absolute limit of weight and attributing this to to the most stable clocks independently of the other elements of the ensemble. The first technique is more robust than the second and automatically optimizes the stability of the resulting time scale, but leads to a more complicated computatio. The second technique has been used in the TAI algorithm since the very beginning. Careful analysis of tests on real clock data shows that improvement of the stability of the time scale requires revision from time to time of the fixed value chosen for the upper limit of absolute weight. In particular, we present results which confirm the decision of the CCDS Working Group on TAI to increase the absolute upper limit by a factor of 2.5. We also show that the use of an upper relative contribution further helps to improve the stability and may be a useful step towards better use of the massive ensemble of HP 507IA clocks now contributing to TAI.

  9. Timed activity performance in persons with upper limb amputation: A preliminary study.

    PubMed

    Resnik, Linda; Borgia, Mathew; Acluche, Frantzy

    55 subjects with upper limb amputation were administered the T-MAP twice within one week. To develop a timed measure of activity performance for persons with upper limb amputation (T-MAP); examine the measure's internal consistency, test-retest reliability and validity; and compare scores by prosthesis use. Measures of activity performance for persons with upper limb amputation are needed The time required to perform daily activities is a meaningful metric that implication for participation in life roles. Internal consistency and test-retest reliability were evaluated. Construct validity was examined by comparing scores by amputation level. Exploratory analyses compared sub-group scores, and examined correlations with other measures. Scale alpha was 0.77, ICC was 0.93. Timed scores differed by amputation level. Subjects using a prosthesis took longer to perform all tasks. T-MAP was not correlated with other measures of dexterity or activity, but was correlated with pain for non-prosthesis users. The timed scale had adequate internal consistency and excellent test-retest reliability. Analyses support reliability and construct validity of the T-MAP. 2c "outcomes" research. Published by Elsevier Inc.

  10. Validation of the SEJOY BP-1307 upper-arm blood pressure monitor for home blood pressure monitoring according to the European Society of Hypertension International Protocol revision 2010.

    PubMed

    Lei, Lei; Chen, Yi; Chen, Qi; Li, Yan; Wang, Ji-Guang

    2017-12-01

    The present study aimed to evaluate the accuracy of the automated oscillometric upper-arm blood pressure monitor SEJOY BP-1307 (also called JOYTECH DBP-1307) for home blood pressure monitoring according to the International Protocol of the European Society of Hypertension revision 2010. Systolic and diastolic blood pressures were sequentially measured in 33 adult Chinese individuals (13 women, 45.1 years of mean age) using a mercury sphygmomanometer (two observers) and the SEJOY BP-1307 device (one supervisor). Ninety-nine pairs of comparisons were obtained from 33 participants for judgments in two parts with three grading phases. The average±SD of the device-observer differences was 0.2±4.1 and -1.7±4.7 mmHg for systolic and diastolic blood pressure, respectively. The SEJOY BP-1307 device achieved the criteria in both part 1 and part 2 of the validation study. The SEJOY upper-arm blood pressure monitor BP-1307 has passed the requirements of the International Protocol revision 2010, and hence can be recommended for home use in adults.

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

    PubMed Central

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

    2016-01-01

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

  12. Cross-National Achievement Comparisons of Upper-Secondary Students: A Swiss Perspective.

    ERIC Educational Resources Information Center

    Ramseier, Erich

    This paper shows how the Third International Mathematics and Science Study (TIMSS) can be carried out in a country with a very complicated upper-secondary educational system. The difficulties are not linked to the measurement of achievement, since the international project provides a common achievement scale. The challenge lies in the design of…

  13. Validation of the Omron M6 (HEM-7001-E) upper-arm blood pressure measuring device according to the International Protocol in adults and obese adults.

    PubMed

    Altunkan, Sekip; Ilman, Nevzat; Kayatürk, Nur; Altunkan, Erkan

    2007-08-01

    Electronic blood pressure (BP) measurement devices are the preferred choice of patients owing to their user-friendly nature; however, there is a requirement to investigate the accuracy and reliability of these devices. The objective of this study is to evaluate the accuracy of the Omron M6 upper-arm BP device against the mercury sphygmomanometer in adults and obese adults according to the International Protocol criteria. One hundred and twenty-one patients, older than 30 years of age, were studied and classified on the basis of the range of the International Protocol. BP measurements at the upper arm with the Omron M6 were compared with the results obtained by two trained observers using a mercury sphygmomanometer. Nine sequential BP measurements were taken. A total of 33 participants were selected for each validation study. During the validation study, 99 measurements were performed on 33 participants for comparison. The first phase was performed on 15 participants, and if the device passed this phase, 18 more participants were selected. Having a two-fold purpose, this study was conducted on both adult and obese adult patients. Mean discrepancies and standard deviations of the monitor-mercury sphygmomanometer were 1.1+/-4.0 mmHg for systolic BP (SBP) and -0.5+/-3.5 mmHg for diastolic BP (DBP) in the adult group. The device passed phase 1 in 15 participants. In phase 2.1, out of a total of 99 comparisons, 88, 96, and 97 for SBP, and 88, 98, and 99 for DBP were <5, <10, and <15 mmHg, respectively. Mean discrepancies and standard deviations of the monitor-mercury sphygmomanometer were 1.7+/-4.8 mmHg for SBP and -0.8+/-4.3 mmHg for DBP in the obese adult group. The device passed phase 1 in 15 participants. In phase 2.1, out of a total of 99 comparisons, 82, 90, and 97 for SBP, and 80, 97, and 99 for DBP were <5, <10, and <15 mmHg, respectively. It was found that the Omron M6 automatic monitor, which measures BP at the upper arm, produced results in accordance with the

  14. A Rasch-validated version of the upper extremity functional index for interval-level measurement of upper extremity function.

    PubMed

    Hamilton, Clayon B; Chesworth, Bert M

    2013-11-01

    The original 20-item Upper Extremity Functional Index (UEFI) has not undergone Rasch validation. The purpose of this study was to determine whether Rasch analysis supports the UEFI as a measure of a single construct (ie, upper extremity function) and whether a Rasch-validated UEFI has adequate reproducibility for individual-level patient evaluation. This was a secondary analysis of data from a repeated-measures study designed to evaluate the measurement properties of the UEFI over a 3-week period. Patients (n=239) with musculoskeletal upper extremity disorders were recruited from 17 physical therapy clinics across 4 Canadian provinces. Rasch analysis of the UEFI measurement properties was performed. If the UEFI did not fit the Rasch model, misfitting patients were deleted, items with poor response structure were corrected, and misfitting items and redundant items were deleted. The impact of differential item functioning on the ability estimate of patients was investigated. A 15-item modified UEFI was derived to achieve fit to the Rasch model where the total score was supported as a measure of upper extremity function only. The resultant UEFI-15 interval-level scale (0-100, worst to best state) demonstrated excellent internal consistency (person separation index=0.94) and test-retest reliability (intraclass correlation coefficient [2,1]=.95). The minimal detectable change at the 90% confidence interval was 8.1. Patients who were ambidextrous or bilaterally affected were excluded to allow for the analysis of differential item functioning due to limb involvement and arm dominance. Rasch analysis did not support the validity of the 20-item UEFI. However, the UEFI-15 was a valid and reliable interval-level measure of a single dimension: upper extremity function. Rasch analysis supports using the UEFI-15 in physical therapist practice to quantify upper extremity function in patients with musculoskeletal disorders of the upper extremity.

  15. Science Choices in Norwegian Upper Secondary School: What Matters?

    ERIC Educational Resources Information Center

    Boe, Maria Vetleseter

    2012-01-01

    There is international concern about young people's participation in science. This study investigated the relevant importance of various issues in 1628 Norwegian upper secondary students' choices of postcompulsory subject combinations: natural science and mathematics (henceforth Science) or languages, social science and economics (henceforth…

  16. Static internal performance of single-expansion-ramp nozzles with various combinations of internal geometric parameters

    NASA Technical Reports Server (NTRS)

    Re, R. J.; Leavitt, L. D.

    1984-01-01

    The effects of five geometric design parameters on the internal performance of single-expansion-ramp nozzles were investigated at nozzle pressure ratios up to 10 in the static-test facility of the Langley 16-Foot Transonic Tunnel. The geometric variables on the expansion-ramp surface of the upper flap consisted of ramp chordal angle, ramp length, and initial ramp angle. On the lower flap, the geometric variables consisted of flap angle and flap length. Both internal performance and static-pressure distributions on the centerlines of the upper and lower flaps were obtained for all 43 nozzle configurations tested.

  17. Structural controls on submarine-fan geometry and internal architecture: upper La Jolla fan system, offshore Southern California

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

    Graham, S.A.; Buchman, S.B.

    1983-01-01

    La Jolla fan, offshore of San Diego, California, is a well-studied example of submarine-fan sedimentation, yet the internal architecture of the fan has remained poorly known. High-resolution seismic data, recorded in a 1 by 2 mi (1.6 by 3.3 km) grid, over much of the fan, allow better understanding of upper and middle fan features and processes, and of structural controls on fan sedimentation. Three bathymetrically prominent conduits supply sediment to the upper La Jolla fan system from stream and nearshore littoral drift-cell sources. La Jolla canyon (and contiguous La Jolla fan valley) is the main feeder to the fan.more » Seismic profiling data confirm the previously reported erosional character of the channel and constructional nature of flanking levees. These data also reveal that the position of the channel is controlled by the geometry of a buried, hard-rock structure. Seismic data demonstrate that the La Jolla fan system comprises a complex interleaved set of sediment wedges derived from multiple sources and woven around the wrench tectonic fabric of uplifts and basins of the southern California borderland. Thus, La Jolla fan system presents an expansion from the simple radial growth pattern of fan sedimentation to a complex fan system built of a number of smaller interwoven radial growth components. Despite these complexities, lithofacies patterns are in part predictable for the La Jolla fan system. Faultbounded uplifts form long-lived barriers to sediment dispersal and enhance channel development along their flanks. Multistory channel complexes, detectable seismically, commonly occur in these structurally controlled positions adjacent to wrench related uplifts.« less

  18. Directional Characteristics of Inner Shelf Internal Tides

    DTIC Science & Technology

    2007-06-01

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

  19. Salinity Processes in the Upper Ocean Regional Study (SPURS)

    NASA Image and Video Library

    2012-09-04

    International maritime signal flags are seen on the bridge of the Woods Hole Oceanographic Institution's research vessel Knorr on Tuesday, Sept. 4, 2012, in Woods Hole, Mass. Knorr is scheduled to depart on Sept. 6 to take part in the Salinity Processes in the Upper Ocean Regional Study (SPURS). The NASA-sponsored expedition will sail to the North Atlantic's saltiest spot to get a detailed, 3-D picture of how salt content fluctuates in the ocean's upper layers and how these variations are related to shifts in rainfall patterns around the planet. Photo Credit: (NASA/Bill Ingalls)

  20. Service Learning in Domestic and International Settings

    ERIC Educational Resources Information Center

    Miller, Kari Knutson; Gonzalez, Amber M.

    2009-01-01

    This paper examines pre-service teacher outcomes associated with service learning in domestic and international settings. One group of upper-division undergraduate level pre service teachers participated in supervised experiences in domestic settings. A second group of upper-division undergraduate level pre-service teachers participated in…

  1. Is arthroplasty preferable to internal fixation for the treatment of extracapsular fracture of the upper femur in the elderly?

    PubMed

    Duriez, P; Devaux, T; Chantelot, C; Baudrier, N; Hery, J-Y; Mainard, D; Favier, T; Massin, P

    2016-10-01

    Although internal fixation is the reference treatment for extracapsular fracture of the upper femur, indications for arthroplasty are broadening, especially in unstable comminutive fracture in fragile bone. The present study hypothesis was that arthroplasty reduces early mortality and morbidity and provides better recovery of autonomy in over-80 year-old patients than does internal fixation. A prospective multicenter study was conducted on 8 sites. Internal fixation was systematically used in 5 centers; arthroplasty was used systematically in 1 center, and reserved for unstable fracture in 2 centers. A total of 697 patients aged over 80 years (mean age, 85±5 years), presenting with extracapsular fracture, were included; 521 were treated by internal fixation and 176 by arthroplasty. Results were studied on multivariate analysis of ASA score, blood loss, transfusion, and also of treatment modality as an independent factor for early (first 6 months) mortality and morbidity (mechanical, general and nutritional complications) and functional outcome (autonomy and dependence). Overall mortality was 19.2%. Autonomy deteriorated in 56% of patients alive at 6 months and dependence worsened in 44%. Two percent of those managed by internal fixation underwent revision for disassembly (n=8) or infection (n=1). Eight percent of those managed by arthroplasty underwent revision for dislocation (n=4), implant loosening (n=3) or infection (n=7). On univariate analysis, mortality was higher in the arthroplasty group (25%) than with internal fixation (17%; P=0.002), as were blood loss (425±286mL versus 333±223mL; P<0.0001), transfusion rate (61% versus 32%; P<0.0001) and infection (4% versus 0.2%; P<0.001). On multivariate analysis, however, treatment modality no longer showed impact on mortality or on morbidity and autonomy at 6 months. Nutritional status was better conserved at 6 months following arthroplasty, but dependence worsened. Poor preoperative autonomy, ASA score, and

  2. A Rasch-Validated Version of the Upper Extremity Functional Index for Interval-Level Measurement of Upper Extremity Function

    PubMed Central

    Chesworth, Bert M.

    2013-01-01

    Background The original 20-item Upper Extremity Functional Index (UEFI) has not undergone Rasch validation. Objective The purpose of this study was to determine whether Rasch analysis supports the UEFI as a measure of a single construct (ie, upper extremity function) and whether a Rasch-validated UEFI has adequate reproducibility for individual-level patient evaluation. Design This was a secondary analysis of data from a repeated-measures study designed to evaluate the measurement properties of the UEFI over a 3-week period. Methods Patients (n=239) with musculoskeletal upper extremity disorders were recruited from 17 physical therapy clinics across 4 Canadian provinces. Rasch analysis of the UEFI measurement properties was performed. If the UEFI did not fit the Rasch model, misfitting patients were deleted, items with poor response structure were corrected, and misfitting items and redundant items were deleted. The impact of differential item functioning on the ability estimate of patients was investigated. Results A 15-item modified UEFI was derived to achieve fit to the Rasch model where the total score was supported as a measure of upper extremity function only. The resultant UEFI-15 interval-level scale (0–100, worst to best state) demonstrated excellent internal consistency (person separation index=0.94) and test-retest reliability (intraclass correlation coefficient [2,1]=.95). The minimal detectable change at the 90% confidence interval was 8.1. Limitations Patients who were ambidextrous or bilaterally affected were excluded to allow for the analysis of differential item functioning due to limb involvement and arm dominance. Conclusion Rasch analysis did not support the validity of the 20-item UEFI. However, the UEFI-15 was a valid and reliable interval-level measure of a single dimension: upper extremity function. Rasch analysis supports using the UEFI-15 in physical therapist practice to quantify upper extremity function in patients with musculoskeletal

  3. Upper limb injury in rugby union football: results of a cohort study.

    PubMed

    Usman, Juliana; McIntosh, Andrew Stuart

    2013-04-01

    There have been few in-depth studies of upper limb injury epidemiology in rugby union football, despite reports that they accounted for between 14% and 28% of all rugby injuries. To report on upper limb injury incidence, injury severity and to identify the risk factors associated with upper limb injuries, for example, level of play, season (years) and playing position. Prospective cohort study across five rugby seasons from 2004 to 2008. Formal rugby competitions-suburban, provincial and international. 1475 adult male rugby players in Colts, Grade and Elite competitions. An upper limb injury resulting in a missed game and its characteristics. A total of 61 598 athletic exposures (AE) and 606 upper limb injuries were recorded. About 66% of the injuries were to the shoulder. The overall upper limb injury incidence rate (IIR) was 9.84 injuries/1000 AE (95% CI 9.06 to 10.62). Statistically significant associations were found between upper limb injuries and level of play; and between shoulder injuries and playing position (p<0.05). No association was found between upper limb and shoulder injuries and study year. The overall upper limb IIR decreased as the level of play increased; 10.74 upper limb injuries/1000 AE (95% CI 9.93 to 11.56) in Colts to 6.07 upper limb injuries/1000 AE (95% CI 5.46 to 6.69) in Elite. The upper limb IIR decreased as the level of play increased indicating that age, level of skill and playing experience may be risk factors for upper limb injury.

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

    PubMed

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

    2017-06-01

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

  5. Seeking realistic upper-bounds for internal reliability of systems with uncorrelated observations

    NASA Astrophysics Data System (ADS)

    Prószyński, Witold

    2014-06-01

    From the theory of reliability it follows that the greater the observational redundancy in a network, the higher is its level of internal reliability. However, taking into account physical nature of the measurement process one may notice that the planned additional observations may increase the number of potential gross errors in a network, not raising the internal reliability to the theoretically expected degree. Hence, it is necessary to set realistic limits for a sufficient number of observations in a network. An attempt to provide principles for finding such limits is undertaken in the present paper. An empirically obtained formula (Adamczewski 2003) called there the law of gross errors, determining the chances that a certain number of gross errors may occur in a network, was taken as a starting point in the analysis. With the aid of an auxiliary formula derived on the basis of the Gaussian law, the Adamczewski formula was modified to become an explicit function of the number of observations in a network. This made it possible to construct tools necessary for the analysis and finally, to formulate the guidelines for determining the upper-bounds for internal reliability indices. Since the Adamczewski formula was obtained for classical networks, the guidelines should be considered as an introductory proposal requiring verification with reference to modern measuring techniques. Z teorii niezawodności wynika, że im większy jest nadmiar obserwacyjny w sieci, tym wyższy poziom jej niezawodności wewnętrznej. Biorąc jednakże pod uwagę fi zykalną naturę procesu pomiaru można zauważyć, że projektowane dodatkowe obserwacje mogą zwiększyć liczbę potencjalnych błędów grubych w sieci, nie podnosząc niezawodności wewnętrznej do oczekiwanego według teorii poziomu. Niezbędne jest zatem ustalenie realistycznych poziomów górnych dla liczby obserwacji w sieci. W niniejszym artykule podjęta jest próba sformułowania zasad ustalania takich poziom

  6. The deep thermal field of the Upper Rhine Graben

    NASA Astrophysics Data System (ADS)

    Freymark, Jessica; Sippel, Judith; Scheck-Wenderoth, Magdalena; Bär, Kristian; Stiller, Manfred; Fritsche, Johann-Gerhard; Kracht, Matthias

    2017-01-01

    The Upper Rhine Graben has a significant socioeconomic relevance as it provides a great potential for geothermal energy production. The key for the utilisation of this energy resource is to understand the controlling factors of the thermal field in this area. We have therefore built a data-based lithospheric-scale 3D structural model of the Upper Rhine Graben and its adjacent areas. In addition, 3D gravity modelling was performed to constrain the internal structure of the crystalline crust consistent with seismic information. Based on this lithosphere scale 3D structural model the present-day conductive thermal field was calculated and compared to measured temperatures. Our results show that the regional thermal field is mainly controlled by the configuration of the upper crust, which has different thermal properties characteristic for the Variscan and Alpine domains. Temperature maxima are predicted for the Upper Rhine Graben where thick insulating Cenozoic sediments cause a thermal blanketing effect and where the underlying crustal units are characterised by high radiogenic heat production. The comparison of calculated and measured temperatures overall shows a reasonable fit, while locally occuring model deviations indicate where a larger influence of groundwater flow may be expected.

  7. Validation of the Andon KD-5851 upper arm blood pressure monitor, for self-measurement according to the European Society of Hypertension International Protocol revision 2010.

    PubMed

    Wu, Lili; Jiao, Yinghui; Wang, Chengdong; Chen, Lei; Di, Dalin; Zhang, Haiyan

    2015-08-01

    This study aimed to validate the Andon KD-5851 upper arm blood pressure (BP) monitor according to the European Society of Hypertension International Protocol (ESH-IP) revision 2010. A total of 33 eligible participants were included in the study. Sequential measurements of BPs were performed using a mercury sphygmomanometer and the device, and the data analysis was carried out following precisely the ESH-IP revision 2010. The device had 82, 98, and 99 measurements within 5, 10, and 15 mmHg for systolic blood pressure and 85, 95, and 99 measurements for diastolic blood pressure, respectively. The average device-observer difference was -0.53±4.00 mmHg for systolic blood pressure and -1.15±4.06 mmHg for diastolic blood pressure. The device passed all the criteria according to the ESH-IP revision 2010. According to the validation results on the basis of the ESH-IP revision 2010, the Andon KD-5851 upper arm BP monitor can be recommended for self/home measurement in adults. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.

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

    PubMed

    Erdem, Emre; Aydogdu, Türkan; Akpolat, Tekin

    2011-02-01

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

  9. Reliability of the Melbourne assessment of unilateral upper limb function.

    PubMed

    Randall, M; Carlin, J B; Chondros, P; Reddihough, D

    2001-11-01

    This study examines the reliability of the Melbourne Assessment of Unilateral Upper Limb Function: a quantitative test of quality of movement in children with neurological impairment. The assessment was administered to 20 children aged from 5 to 16 years (mean age 9 years 10 months, SD 2 years 10 months) who had various types and degrees of cerebral palsy (CP). The performances of the 20 children during assessment were videotaped for subsequent scoring by 15 occupational therapists. Scores were analyzed for internal consistency of test items, inter- and intrarater reliability of scorings of the same videotapes, and test-retest reliability using repeat videotaping. Results revealed very high internal consistency of test items (alpha=0.96), moderate to high agreement both within and between raters for all test items (intraclass correlations of at least 0.7) apart from item 16 (hand to mouth and down), and high interrater reliability (0.95) and intrarater reliability (0.97) for total test scores. Test-retest results revealed moderate to high intrarater reliability for item totals (mean of 0.83 and 0.79) for each rater and high reliability for test totals (0.98 and 0.97). These findings indicate that the Melbourne Assessment of Unilateral Upper Limb Function is a reliable tool for measuring the quality of unilateral upper-limb movement in children with CP.

  10. Validation of the Andon KD-5917 automatic upper arm blood pressure monitor, for clinic use and self-measurement, according to the European Society of Hypertension International Protocol revision 2010.

    PubMed

    Guo, Wan-Gang; Li, Bing-Ling; He, Yong; Xue, Yu-Sheng; Wang, Hai-Yan; Zheng, Qiang-Sun; Xiang, Ding-Cheng

    2014-08-01

    To validate the Andon KD-5917 automatic upper arm blood pressure monitor according to the European Society of Hypertension International Protocol revision 2010. Sequential same-left-arm measurements of systolic blood pressure (SBP) and diastolic blood pressure (DBP) were obtained in 33 participants using the mercury sphygmomanometer and the test device. According to the validation protocol, 99 pairs of test device and reference blood pressure measurements (three pairs for each of the 33 participants) were obtained in the study. The device produced 73, 98, and 99 measurements within 5, 10, and 15 mmHg for SBP and 86, 98, and 99 for DBP, respectively. The mean ± SD device-observer difference was 3.07 ± 3.68 mmHg for SBP and -0.89 ± 3.72 mmHg for DBP. The number of patients with two or three of the device-observer difference within 5 mmHg was 26 for SBP and 29 for DBP, and no patient had a device-observer difference within 5 mmHg. The Andon KD-5917 automatic upper arm blood pressure monitor can be recommended for clinical use and self-measurement in an adult population on the basis of the European Society of Hypertension International Protocol revision 2010.

  11. Palliative Surgery in Treating Painful Metastases of the Upper Cervical Spine

    PubMed Central

    Wu, Xinghuo; Ye, Zhewei; Pu, Feifei; Chen, Songfeng; Wang, Baichuan; Zhang, Zhicai; Yang, Cao; Yang, Shuhua; Shao, Zengwu

    2016-01-01

    Abstract Increased incidence of upper cervical metastases and higher life expectancy resulted in higher operative rates in patients. The purpose of this study was to explore the methods and the clinical outcomes of palliative surgery for cervical spinal metastases. A systematic review of a 15-case series of upper cervical metastases treated with palliative surgery was performed. All cases underwent palliative surgery, including anterior tumor resection and internal fixation in 3 cases, posterior tumor resection and internal fixation in 10 cases, and combined anterior and posterior tumor resection and internal fixation in 2 cases. Patients were followed-up clinically and radiologically after the operation, and visual analog scale (VAS) and activities of daily living scores were calculated. In addition, a literature review was performed and patients with upper cervical spine metastases were analyzed. The mean follow-up period was 12.5 months (range, 3–26 months) in this consecutive case series. The pain was substantially relieved in 93.3% (14/15) of the patients after the operation. The VAS and Japanese Orthopedic Association scores showed improved clinical outcomes, from 7.86 ± 1.72 and 11.13 ± 2.19 preoperatively to 2.13 ± 1.40 and 14.26 ± 3.03 postoperatively, respectively. The mean survival time was 9.5 months (range, 5–26 months). Dural tear occurred in 1 patient. Wound infections, instrumentation failure, and postoperative death were not observed. Among our cases and other cases reported in the literature, 72% of the patients were treated with simple anterior or posterior operation, and only 12% of the patients (3/25) underwent complex combined anterior and posterior operation. Metastatic upper cervical spine disease is not a rare occurrence. Balancing the perspective of patients on palliative surgery concerning the clinical benefits of operation versus its operative risks can assist the decision for surgery. PMID:27149472

  12. NASA Ares I Crew Launch Vehicle Upper Stage Overview

    NASA Technical Reports Server (NTRS)

    Davusm Daniel J.; McArthur, J. Craig

    2008-01-01

    By incorporating rigorous engineering practices, innovative manufacturing processes and test techniques, a unique multi-center government/contractor partnership, and a clean-sheet design developed around the primary requirements for the International Space Station (ISS) and Lunar missions, the Upper Stage Element of NASA's Crew Launch Vehicle (CLV), the "Ares I," is a vital part of the Constellation Program's transportation system.

  13. NASA Ares I Crew Launch Vehicle Upper State Overview

    NASA Technical Reports Server (NTRS)

    Davis, Daniel J.

    2008-01-01

    By incorporating rigorous engineering practices, innovative manufacturing processes and test techniques, a unique multi-center government/contractor partnership, and a clean-sheet design developed around the primary requirements for the International Space Station (ISS) and Lunar missions, the Upper Stage Element of NASA s Crew Launch Vehicle (CLV), the "Ares I," is a vital part of the Constellation Program s transportation system.

  14. Validation of the Rossmax CF175 upper-arm blood pressure monitor for home blood pressure monitoring according to the European Society of Hypertension International Protocol revision 2010.

    PubMed

    Zhang, Lu; Kang, Yuan-Yuan; Zeng, Wei-Fang; Li, Yan; Wang, Ji-Guang

    2015-04-01

    The present study aimed to evaluate the accuracy of the Rossmax CF175 upper-arm blood pressure monitor for home blood pressure monitoring according to the International Protocol of the European Society of Hypertension revision 2010. Systolic and diastolic blood pressures were sequentially measured in 33 adult Chinese (17 women, mean age 46 years) using a mercury sphygmomanometer (two observers) and the Rossmax CF175 device (one supervisor). A total of 99 pairs of comparisons were obtained from 33 participants for judgments in two parts with three grading phases. All the blood pressure requirements were fulfilled. The Rossmax CF175 device achieved the targets in part 1 of the validation study. The number of absolute differences between the device and observers within 5, 10, and 15 mmHg was 78/99, 94/99, and 98/99, respectively, for systolic blood pressure, and 81/99, 96/99, and 97/99, respectively, for diastolic blood pressure. The device also achieved the criteria in part 2 of the validation study. Twenty-nine participants, for both of systolic and diastolic blood pressure, had at least two of the three device-observers differences within 5 mmHg (required ≥24). Only one participant for diastolic blood pressure had all three device-observers comparisons greater than 5 mmHg. The Rossmax automated oscillometric upper-arm blood pressure monitor CF175 fulfilled the requirements of the International Protocol revision 2010, and hence can be recommended for blood pressure measurement in adults.

  15. Validation of the AVITA BPM64 upper-arm blood pressure monitor for home blood pressure monitoring according to the European Society of Hypertension International Protocol revision 2010.

    PubMed

    Kang, Yuan-Yuan; Chen, Qi; Liu, Chang-Yuan; Li, Yan; Wang, Ji-Guang

    2018-02-01

    The aim of this study was to evaluate the accuracy of the automated oscillometric upper arm blood pressure (BP) monitor AVITA BPM64 for home BP monitoring according to the International Protocol of the European Society of Hypertension revision 2010. Systolic and diastolic BPs were measured sequentially in 33 adult Chinese (14 women, mean age 47.0 years) using a mercury sphygmomanometer (two observers) and the AVITA BPM64 device (one supervisor). A total of 99 pairs of comparisons were obtained from 33 participants for judgments in two parts with three grading phases. The AVITA BPM64 device achieved the targets in part 1 of the validation study. The number of absolute differences between device and observers within 5, 10, and 15 mmHg was 91/99, 98/99, and 98/99, respectively, for systolic BP and 92/99, 99/99, and 99/99, respectively, for diastolic BP. The device also fulfilled the criteria in part 2 of the validation study. Thirty-two participants for both systolic and diastolic BP had at least two of the three device-observer differences within 5 mmHg (required ≥24). Only one participant for systolic BP had all three device-observer comparisons greater than 5 mmHg. The AVITA upper arm BP monitor BPM64 has passed the requirements of the International Protocol revision 2010, and hence can be recommended for home use in adults.

  16. ENVIRONMENTAL SCREENING MODELING OF MERCURY IN THE UPPER EVERGLADES OF SOUTH FLORIDA

    EPA Science Inventory

    This screening modeling analysis examines mercury sources and fate in the upper canals of the South Florida Everglades. Mass balance modeling techniques are applied along with available data to examine the relative importance of external sources and internal cycling of mercury an...

  17. Reliability and validity of the closed kinetic chain upper extremity stability test.

    PubMed

    Lee, Dong-Rour; Kim, Laurentius Jongsoon

    2015-04-01

    [Purpose] The purpose of this study was to examine the reliability and validity of the Closed Kinetic Chain Upper Extremity Stability (CKCUES) test. [Subjects and Methods] A sample of 40 subjects (20 males, 20 females) with and without pain in the upper limbs was recruited. The subjects were tested twice, three days apart to assess the reliability of the CKCUES test. The CKCUES test was performed four times, and the average was calculated using the data of the last 3 tests. In order to test the validity of the CKCUES test, peak torque of internal/external shoulder rotation was measured using an isokinetic dynamometer, and maximum grip strength was measured using a hand dynamometer, and their Pearson correlation coefficients with the average values of the CKCUES test were calculated. [Results] The reliability of the CKCUES test was very high (ICC=0.97). The correlations between the CKCUES test and maximum grip strength (r=0.78-0.79), and the peak torque of internal/external shoulder rotation (r=0.87-0.94) were high indicating its validity. [Conclusion] The reliability and validity of the CKCUES test were high. The CKCUES test is expected to be used for clinical tests on upper limb stability at low price.

  18. Current Evaluation of Upper Oesophageal Sphincter Opening in Dysphagia Practice: An International SLT Survey

    ERIC Educational Resources Information Center

    Regan, Julie; Walshe, Margaret; McMahon, Barry P.

    2012-01-01

    Background: The assessment of adequate upper oesophageal sphincter (UOS) opening during swallowing is an integral component of dysphagia evaluation. Aims: To ascertain speech and language therapists' (SLTs) satisfaction with current methods for assessing UOS function in people with dysphagia and to identify challenges encountered by SLTs with UOS…

  19. [Epidemiology of upper gastrointestinal bleeding in Gabon].

    PubMed

    Gaudong Mbethe, G L; Mounguengui, D; Ondounda, M; Magne, C; Bignoumbra, R; Ntsoumou, S; Moussavou Kombila, J-B; Nzenze, J R

    2014-01-01

    The department of internal medicine of the military hospital of Gabon managed 92 cases of upper gastrointestinal bleeding from April 2009 to November 2011. The frequency of these hemorrhages in the department was 8.2%; they occurred most often in adults aged 30-40 years and 50-60 years, and mainly men (74%). Erosive-ulcerative lesions (65.2%) were the leading causes of hemorrhage, followed by esophageal varices (15.2%). These results underline the importance of preventive measures for the control of this bleeding.

  20. Specialized connective tissue: bone, the structural framework of the upper extremity

    PubMed Central

    Weatherholt, Alyssa M.; Fuchs, Robyn K.; Warden, Stuart J.

    2011-01-01

    Bone is a connective tissue containing cells, fibers and ground substance. There are many functions in the body in which the bone participates, such as storing minerals, providing internal support, protecting vital organs, enabling movement, and providing attachment sites for muscles and tendons. Bone is unique because its collagen framework absorbs energy, while the mineral encased within the matrix allows bone to resist deformation. This article provides an overview of the structure and function of bone tissue from a macroscopic to microscopic level and discusses the physiological processes contributing to upper extremity bone health. It concludes by discussing common conditions influencing upper extremity bone health. PMID:22047807

  1. An internally consistent pressure calibration of geobarometers applicable to the Earth’s upper mantle using in situ XRD

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

    Beyer, Christopher; Rosenthal, Anja; Myhill, Robert

    We have performed an experimental cross calibration of a suite of mineral equilibria within mantle rock bulk compositions that are commonly used in geobarometry to determine the equilibration depths of upper mantle assemblages. Multiple barometers were compared simultaneously in experimental runs, where the pressure was determined using in-situ measurements of the unit cell volumes of MgO, NaCl, Re and h-BN between 3.6 and 10.4 GPa, and 1250 and 1500 °C. The experiments were performed in a large volume press (LVPs) in combination with synchrotron X-ray diffraction. Noble metal capsules drilled with multiple sample chambers were loaded with a range ofmore » bulk compositions representative of peridotite, eclogite and pyroxenite lithologies. By this approach, we simultaneously calibrated the geobarometers applicable to different mantle lithologies under identical and well determined pressure and temperature conditions. We identified discrepancies between the calculated and experimental pressures for which we propose simple linear or constant correction factors to some of the previously published barometric equations. As a result, we establish internally-consistent cross-calibrations for a number of garnet-orthopyroxene, garnet-clinopyroxene, Ca-Tschermaks-in-clinopyroxene and majorite geobarometers.« less

  2. Wave-mean flow interactions in the upper atmosphere

    NASA Technical Reports Server (NTRS)

    Lindzen, R. S.

    1973-01-01

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

  3. Furniture dimensions and postural overload for schoolchildren's head, upper back and upper limbs.

    PubMed

    Batistão, Mariana Vieira; Sentanin, Anna Cláudia; Moriguchi, Cristiane Shinohara; Hansson, Gert-Åke; Coury, Helenice Jane Cote Gil; de Oliveira Sato, Tatiana

    2012-01-01

    The aim of this study was to evaluate how the fixed furniture dimensions match with students' anthropometry and to describe head, upper back and upper limbs postures and movements. Evaluation was performed in 48 students from a Brazilian state school. Furniture dimensions were measured with metric tape, movements and postures by inclinometers (Logger Tecknologi, Åkarp, Sweden). Seat height was high for 21% and low for 36% of the students; seat length was short for 45% and long for 9% and table height was high for 53% and low for 28%. Regression analysis showed that seat/popliteal height quotient is explained by 90th percentile of upper back inclination (β=0.410) and 90th percentile of right upper arm elevation (β=-0.293). For seat/thigh length quotient the significant variables were 90th percentile of upper back velocity (β=-0.282) and 90th percentile of right upper arm elevation (β=0.410). This study showed a relationship between furniture mismatch and postural overload. When the seat height is low students increase upper back left inclination and right upper arm elevation; when the seat is short students decrease the upper back flexion velocity and increase right upper arm elevation.

  4. Validation of the Andon KD-5965 upper-arm blood pressure monitor for home blood pressure monitoring according to the European Society of Hypertension International Protocol revision 2010.

    PubMed

    Huang, Jinhua; Li, Zhijie; Li, Guimei; Liu, Zhaoying

    2015-10-01

    This study aimed to evaluate the accuracy of the Andon KD-5965 upper-arm blood pressure monitor according to the European Society of Hypertension International Protocol revision 2010. Systolic and diastolic blood pressures were sequentially measured in 33 adults, with 20 women using a mercury sphygmomanometer (two observers) and the Andon KD-5965 device (one supervisor). A total of 99 pairs of comparisons were obtained from 33 participants for judgments in two parts with three grading phases. The device achieved the targets in part 1 of the validation study. The number of absolute differences between the device and observers within 5, 10, and 15 mmHg was 70/99, 91/99, and 98/99, respectively, for systolic blood pressure and 81/99, 99/99, and 99/99, respectively, for diastolic blood pressure. The device also fulfilled the criteria in part 2 of the validation study. Twenty-five and 29 participants, for systolic and diastolic blood pressure, respectively, had at least two of the three device-observers differences within 5 mmHg (required≥24). Two and one participants for systolic and diastolic blood pressure, respectively, had all three device-observers comparisons greater than 5 mmHg. According to the validation results, with better performance for diastolic blood pressure than that for systolic blood pressure, the Andon automated oscillometric upper-arm blood pressure monitor KD-5965 fulfilled the requirements of the European Society of Hypertension International Protocol revision 2010, and hence can be recommended for blood pressure measurement in adults.

  5. Oncoplastic Surgery for Upper/Upper Inner Quadrant Breast Cancer.

    PubMed

    Lin, Joseph; Chen, Dar-Ren; Wang, Yu-Fen; Lai, Hung-Wen

    2016-01-01

    Tumors located in the upper/upper inner quadrant of the breast warrant more attention. A small lesion relative to the size of breast in this location may be resolved by performing a level I oncoplastic technique. However, a wide excision may significantly reduce the overall quality of the breast shape by distorting the visible breast line. From June 2012 to April 2015, 36 patients with breast cancer located in the upper/upper inner quadrant underwent breast-conservation surgery with matrix rotation mammoplasty. According to the size and location of the tumor relative to the nipple-areola complex, 11 patients underwent matrix rotation with periareolar de-epithelialization (donut group) and the other 25 underwent matrix rotation only (non-donut group). The cosmetic results were self-assessed by questionnaires. The average weights of the excised breast lumps in the donut and non-donut groups were 104.1 and 84.5 g, respectively. During the 3-year follow-up period, local recurrence was observed in one case and was managed with nipple-sparing mastectomy followed by breast reconstruction with prosthetic implants. In total, 31 patients (88.6%) ranked their postoperative result as either acceptable or satisfactory. The treated breasts were also self-evaluated by 27 patients (77.1%) to be nearly identical to or just slightly different from the untreated side. Matrix rotation is an easy breast-preserving technique for treating breast cancer located in the upper/upper inner quadrant of the breast that requires a relatively wide excision. With this technique, a larger breast tumor could be removed without compromising the breast appearance.

  6. Upper And Lower Limbs Disability And Personality Traits.

    PubMed

    Jabeen, Tahira; Kazmi, Syeda Farhana; Rehman, Atiq Ur; Ahmed, Sajjad

    2016-01-01

    It is believed that the study of personality has the potentials to enhance our prognostic abilities and can better to expose the etiology of mental illness through the relationship of revealed mechanisms. The focus of this study was to investigate and compare the habitual patterns of behavior, thought and emotions of upper and lower limb physically disabled students in terms of personality traits. This cross sectional study consisted of 100 upper limbs and lower limbs disabled students taken from Kingston school Inclusive Education System Abottabad, Mashal special education system Haripur, Syed Ahmed Shaheed special education center Abottabad, Al-Munir Foundation Mansehra and Hera Special Education System Haripur and 100 normal students taken from Islamic International School Abottabad, Falcon Public School Haripur, Iqra Academy Mansehra and Alhamd International School Haripur of Hazara Division by purposive sampling technique. This study was conducted during the month of June 2013 to May 2014. Goldberg five big personality scale was used for measuring personality traits of physically disabled and normal students. The significant difference of personality traits scores between physically disabled students (M = 139.2, SD=12.0) and normal students (M=184.5, SD=13.2), t (198) =25.3, p<.05 was observed. Normal students have high scores as compared to physically disabled students on big five traits, i.e., Extraversion, Agreeableness, Conscientiousness, Emotional Stability and Openness to Experience.

  7. [Peculiarities of upper urinary tract drainage during surgical treatment of staghorn and multiple nephrolithiasis].

    PubMed

    Imamverdiev, S B; Talybov, T A; Mamedov, R N

    2014-01-01

    This work was designed to evaluate methods of kidney drainage used in the surgical treatment of 250 patients with staghorn and multiple nephrolithiasis (SMN). All of them underwent open surgery that was followed by drainage of the upper urinary tract in 192 patients. Internal stenting was used in 111 cases, pyelostomy in 28, nephrostomy in 47, and internal stenting with nephrostoma in 6 cases. 91 and 20 patients had a stent inserted into the upper urinary tract in a retrograde and antegrade manner respectively. Retrograde stenting was bilateral in 14 and unilateral in 66 cases. 85% of the cases with ureter stents were followed up as outpatients for 4-5 weeks and only 10% for 6-7 weeks. Forty and ten patients with stents presented with marked dysuria and hematuria respectively. On the whole, combined antibacterial treatment with drainage of the upper urinary tract significantly improved long-term results of SMN treatment. It is concluded that nephrostomy and pyelostomy should be performed on days 14-18 and 10-12 respectively whereas the stent needs to be removed between weeks 2 and 8 after surgery.

  8. The Effect of Shoulder Plyometric Training on Amortization Time and Upper-Extremity Kinematics.

    PubMed

    Swanik, Kathleen A; Thomas, Stephen J; Struminger, Aaron H; Bliven, Kellie C Huxel; Kelly, John D; Swanik, Charles B

    2016-12-01

    Plyometric training is credited with providing benefits in performance and dynamic restraint. However, limited prospective data exist quantifying kinematic adaptations such as amortization time, glenohumeral rotation, and scapulothoracic position, which may underlie the efficacy of plyometric training for upper-extremity rehabilitation or performance enhancement. To measure upper-extremity kinematics and plyometric phase times before and after an 8-wk upper-extremity strength- and plyometric-training program. Randomized pretest-posttest design. Research laboratory. 40 recreationally active men (plyometric group, age 20.43 ± 1.40 y, height 180.00 ± 8.80 cm, weight 73.07 ± 7.21 kg; strength group, age 21.95 ± 3.40 y, height 173.98 ± 11.91 cm, weight 74.79 ± 13.55 kg). Participants were randomly assigned to either a strength-training group or a strength- and plyometric-training group. Each participant performed the assigned training for 8 wk. Dynamic and static glenohumeral and scapular-rotation measurements were taken before and after the training programs. Dynamic measurement of scapular rotation and time spent in each plyometric phase (concentric, eccentric, and amortization) during a ball-toss exercise were recorded while the subjects were fitted with an electromagnetic tracking system. Static measures included scapular upward rotation at 3 different glenohumeral-abduction angles, glenohumeral internal rotation, and glenohumeral external rotation. Posttesting showed that both groups significantly decreased the time spent in the amortization, concentric, and eccentric phases of a ball-toss exercise (P < .01). Both groups also exhibited significantly decreased static external rotation and increased dynamic scapular upward rotation after the training period (P < .01). The only difference between the training protocols was that the plyometric-training group exhibited an increase in internal rotation that was not present in the strength-training group (P < .01

  9. Development of a prognostic nomogram for cirrhotic patients with upper gastrointestinal bleeding.

    PubMed

    Zhou, Yu-Jie; Zheng, Ji-Na; Zhou, Yi-Fan; Han, Yi-Jing; Zou, Tian-Tian; Liu, Wen-Yue; Braddock, Martin; Shi, Ke-Qing; Wang, Xiao-Dong; Zheng, Ming-Hua

    2017-10-01

    Upper gastrointestinal bleeding (UGIB) is a complication with a high mortality rate in critically ill patients presenting with cirrhosis. Today, there exist few accurate scoring models specifically designed for mortality risk assessment in critically ill cirrhotic patients with upper gastrointestinal bleeding (CICGIB). Our aim was to develop and evaluate a novel nomogram-based model specific for CICGIB. Overall, 540 consecutive CICGIB patients were enrolled. On the basis of Cox regression analyses, the nomogram was constructed to estimate the probability of 30-day, 90-day, 270-day, and 1-year survival. An upper gastrointestinal bleeding-chronic liver failure-sequential organ failure assessment (UGIB-CLIF-SOFA) score was derived from the nomogram. Performance assessment and internal validation of the model were performed using Harrell's concordance index (C-index), calibration plot, and bootstrap sample procedures. UGIB-CLIF-SOFA was also compared with other prognostic models, such as CLIF-SOFA and model for end-stage liver disease, using C-indices. Eight independent factors derived from Cox analysis (including bilirubin, creatinine, international normalized ratio, sodium, albumin, mean artery pressure, vasopressin used, and hematocrit decrease>10%) were assembled into the nomogram and the UGIB-CLIF-SOFA score. The calibration plots showed optimal agreement between nomogram prediction and actual observation. The C-index of the nomogram using bootstrap (0.729; 95% confidence interval: 0.689-0.766) was higher than that of the other models for predicting survival of CICGIB. We have developed and internally validated a novel nomogram and an easy-to-use scoring system that accurately predicts the mortality probability of CICGIB on the basis of eight easy-to-obtain parameters. External validation is now warranted in future clinical studies.

  10. Did the Vikings Really Have Helmets with Horns? Sources and Narrative Content in Swedish Upper Primary School History Teaching

    ERIC Educational Resources Information Center

    Stolare, Martin

    2017-01-01

    The topic of this article is history education in upper primary school. Traditionally, the history subject has had a narrative orientation at this school level in Sweden, but it is also pattern that is discernible internationally. The recent Swedish upper primary school syllabus places more emphasis on the procedural aspects of the subject. In…

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

    ERIC Educational Resources Information Center

    Judy, Mark A.

    1987-01-01

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

  12. Racial differences in the outcome of patients with urothelial carcinoma of the upper urinary tract: an international study.

    PubMed

    Matsumoto, Kazumasa; Novara, Giacomo; Gupta, Amit; Margulis, Vitaly; Walton, Thomas J; Roscigno, Marco; Ng, Casey; Kikuchi, Eiji; Zigeuner, Richard; Kassouf, Wassim; Fritsche, Hans-Martin; Ficarra, Vincenzo; Martignoni, Guido; Tritschler, Stefan; Rodriguez, Joaquin Carballido; Seitz, Christian; Weizer, Alon; Remzi, Mesut; Raman, Jay D; Bolenz, Christian; Bensalah, Karim; Koppie, Theresa M; Karakiewicz, Pierre I; Wood, Christopher G; Montorsi, Francesco; Iwamura, Masatsugu; Shariat, Shahrokh F

    2011-10-01

    •To assess the impact of differences in ethnicity on clinico-pathological characteristics and outcomes of patients with upper urinary tract urothelial carcinoma (UTUC) in a large multi-center series of patients treated with radical nephroureterectomy (RNU). •We retrospectively collected the data of 2163 patients treated with RNU at 20 academic centres in America, Asia, and Europe. •Univariable and multivariable Cox regression models addressed recurrence-free survival (RFS) and cancer-specific survival (CSS). •In all, 1794 (83%) patients were Caucasian and 369 (17%) were Japanese. All the main clinical and pathological features were significantly different between the two ethnicities. •The median follow-up of the whole cohort was 36 months. At last follow-up, 554 patients (26%) developed disease recurrence and 461 (21%) were dead from UTUC. •The 5-year RFS and CSS estimates were 71.5% and 74.2%, respectively, for Caucasian patients compared with 68.8% and 75.4%, respectively, for Japanese patients. •On univariable Cox regression analyses, ethnicity was not significantly associated with either RFS (P= 0.231) or CSS (P= 0.752). •On multivariable Cox regression analyses that adjusted for the effects of age, gender, surgical type, T stage, grade, tumour architecture, presence of concomitant carcinoma in situ, lymphovascular invasion, tumour necrosis, and lymph node status, ethnicity was not associated with either RFS (hazard ratio [HR] 1.1; P= 0.447) or CSS (HR 1.0; P= 0.908). •There were major differences in the clinico-pathological characteristics of Caucasian and Japanese patients. •However, RFS and CSS probabilities were not affected by ethnicity and race was not an independent predictor of either recurrence or cancer-related death. © 2011 THE AUTHORS; BJU INTERNATIONAL © 2011 BJU INTERNATIONAL.

  13. Validation of the AVITA BPM63S upper arm blood pressure monitor for home blood pressure monitoring according to the European Society of Hypertension International Protocol revision 2010.

    PubMed

    Kang, Yuan-Yuan; Zeng, Wei-Fang; Liu, Ming; Li, Yan; Wang, Ji-Guang

    2014-02-01

    The present study aimed to evaluate the accuracy of the AVITA BPM63S upper arm blood pressure monitor for home blood pressure monitoring according to the International Protocol of the European Society of Hypertension revision 2010. Systolic and diastolic blood pressures were sequentially measured in 33 adult Chinese (14 women, mean age of 47 years) using a mercury sphygmomanometer (two observers) and the AVITA BPM63S device (one supervisor). Ninety-nine pairs of comparisons were obtained from 33 participants for judgments in two parts with three grading phases. All the blood pressure requirements were fulfilled. The AVITA BPM63S device achieved the targets in part 1 of the validation study. The number of absolute differences between device and observers within 5, 10, and 15 mmHg was 68/99, 89/99, and 96/99, respectively, for systolic blood pressure, and 75/99, 95/99, and 97/99, respectively, for diastolic blood pressure. The device also achieved the criteria in part 2 of the validation study. Twenty-four and 25 participants for systolic and diastolic blood pressure, respectively, had at least two of the three device-observers differences within 5 mmHg (required ≥24). One and two participants for systolic and diastolic blood pressure, respectively, had all three device-observers differences greater than 5 mmHg. The AVITA BPM63S automated oscillometric upper arm blood pressure monitor has passed the requirements of the International Protocol revision 2010, and hence can be recommended for blood pressure measurement at home in adults.

  14. Ares I Crew Launch Vehicle Upper Stage/Upper Stage Engine Element Overview

    NASA Technical Reports Server (NTRS)

    McArthur, J. Craig

    2008-01-01

    The Ares I upper stage is an integral part of the Constellation Program transportation system. The upper stage provides guidance, navigation and control (GN and C) for the second stage of ascent flight for the Ares I vehicle. The Saturn-derived J-2X upper stage engine will provide thrust and propulsive impulse for the second stage of ascent flight for the Ares I launch vehicle. Additionally, the upper stage is responsible for the avionics system of the the entire Ares I. This brief presentation highlights the requirements, design, progress and production of the upper stage. Additionally, test facilities to support J-2X development are discussed and an overview of the operational and manufacturing flows are provided. Building on the heritage of the Apollo and Space Shuttle Programs, the Ares I Us and USE teams are utilizing extensive lessons learned to place NASA and the US into another era of space exploration. The NASA, Boeing and PWR teams are integrated and working together to make progress designing and building the Ares I upper stage to minimize cost, technical and schedule risks.

  15. Endoscopic vacuum therapy for various defects of the upper gastrointestinal tract.

    PubMed

    Kuehn, Florian; Loske, Gunnar; Schiffmann, Leif; Gock, Michael; Klar, Ernst

    2017-09-01

    Postoperative, iatrogenic or spontaneous upper gastrointestinal defects result in significant morbidity and mortality of the patients. In the last few years, endoscopic vacuum therapy (EVT) has been recognized as a new promising method for repairing upper gastrointestinal defects of different etiology. However, probably due to insufficient data and no commercially available system for EVT of the upper gastrointestinal tract, until the end of 2014, covering of esophageal defects with self-expanding metal stents (SEMS) were still the mainstay of endoscopic therapy. The aim of this article is to review the data available about EVT for various upper gastrointestinal defects. A selective literature search was conducted in Medline and PubMed (2007-2016), taking into account all the published case series and case reports reporting on the use of EVT in the management of upper gastrointestinal defects. EVT works through intracorporal application of negative pressure at the defect zone with an electronic controlled vacuum device along a polyurethane sponge drainage. This results in closure of the esophageal defect and internal drainage of the septic focus, simultaneously. Compared to stenting, EVT enables regular viewing of wound conditions with control of the septic focus and adjustment of therapy. Moreover, endoscopical negative pressure is applicable in all esophageal regions (cricopharygeal, tubular, gastroesophageal junction) and in anastomotic anatomic variants. EVT can be used solely as a definite treatment or as a complimentary therapy combined with operative revision. In total, there are published data of more than 200 patients with upper gastrointestinal defects treated with EVT, showing succes rates from 70-100%. The available data indicate that EVT is feasible, safe and effective with good short-term and long-term clinical outcomes in the damage control of upper GI-tract leaks. Still, a prospective multi-center study has to be conducted to proof the definite

  16. Study of a High-Energy Upper Stage for Future Shuttle Missions

    NASA Technical Reports Server (NTRS)

    Dressler, Gordon A.; Matuszak, Leo W.; Stephenson, David D.

    2003-01-01

    Space Shuttle Orbiters are likely to remain in service to 2020 or beyond for servicing the International Space Station and for launching very high value spacecraft. There is a need for a new STS-deployable upper stage that can boost certain Orbiter payloads to higher energy orbits, up to and including Earth-escape trajectories. The inventory of solid rocket motor Inertial Upper Stages has been depleted, and it is unlikely that a LOX/LH2-fueled upper stage can fly on Shuttle due to safety concerns. This paper summarizes the results of a study that investigated a low cost, low risk approach to quickly developing a new large upper stage optimized to fly on the existing Shuttle fleet. Two design reference missions (DRMs) were specified: the James Webb Space Telescope (JWST) and the Space Interferometry Mission (SIM). Two categories of upper stage propellants were examined in detail: a storable liquid propellant and a storable gel propellant. Stage subsystems 'other than propulsion were based largely on heritage hardware to minimize cost, risk and development schedule span. The paper presents the ground rules and guidelines for conducting the study, the preliminary conceptual designs margins, assessments of technology readiness/risk, potential synergy with other programs, and preliminary estimates of development and production costs and schedule spans. Although the Orbiter Columbia was baselined for the study, discussion is provided to show how the results apply to the remaining STS Orbiter fleet.

  17. Liquid interfacial water and brines in the upper surface of Mars

    NASA Astrophysics Data System (ADS)

    Moehlmann, Diedrich

    2013-04-01

    Liquid interfacial water and brines in the upper surface of Mars Diedrich T.F. Möhlmann DLR Institut für Planetenforschung, Rutherfordstr. 2, D - 12489 Berlin, Germany dirk.moehlmann@dlr.de Interfacial water films and numerous brines are known to remain liquid at temperatures far below 0° C. The physical processes behind are described in some detail. Deliquescence, i.e. the liquefaction of hygroscopic salts at the threshold of a specific "Deliquescence Relative Humidity", is shown to be that process, which on present Mars supports the formation of stable interfacial water and bulk liquids in form of temporary brines on and in a salty upper surface of present Mars in a diurnally temporary and repetitive process. Temperature and relative humidity are the governing conditions for deliquescence (and the counterpart "efflorescence") to evolve. The current thermo-dynamical conditions on Mars support these processes to evolve on present Mars. The deliquescence-driven presence of liquid brines in the soil of the upper surface of Mars can expected to be followed by physical and chemical processes like "surface cementation", down-slope flows, and physical and chemical weathering processes. A remarkable and possibly also biologically relevant evolution towards internally interfacial water bearing structures of dendritic capillaries is related to their freezing - thawing driven formation. The internal walls of these network-pores or -tubes can be covered by films of interfacial water, providing that way possibly habitable crack-systems in soil and rock. These evolutionary processes of networks, driven by their tip-growth, can expected to be ongoing also at present.

  18. NASA's upper atmosphere research satellite: A program to study global ozone change

    NASA Technical Reports Server (NTRS)

    Luther, Michael R.

    1992-01-01

    The Upper Atmosphere Research Satellite (UARS) is a major initiative in the NASA Office of Space Science and Applications, and is the prototype for NASA's Earth Observing System (EOS) planned for launch in the 1990s. The UARS combines a balanced program of experimental and theoretical investigations to perform diagnostic studies, qualitative model analysis, and quantitative measurements and comparative studies of the upper atmosphere. UARS provides theoretical and experimental investigations which pursue four specific research topics: atmospheric energy budget, chemistry, dynamics, and coupling processes. An international cadre of investigators was assembled by NASA to accomplish those scientific objectives. The observatory, its complement of ten state of the art instruments, and the ground system are nearing flight readiness. The timely UARS program will play a major role in providing data to understand the complex physical and chemical processes occurring in the upper atmosphere and answering many questions regarding the health of the ozone layer.

  19. Responsiveness of outcome measures for upper limb prosthetic rehabilitation.

    PubMed

    Resnik, Linda; Borgia, Matthew

    2016-02-01

    There is limited research on responsiveness of prosthetic rehabilitation outcome measures. To examine responsiveness of the Box and Block test, Jebsen-Taylor Hand Function tests, Upper Extremity Functional Scale, University of New Brunswick skill and spontaneity tests, Activity Measure for Upper Limb Amputation, and the Patient-Specific Functional Scale. This was a quasi-experimental study with repeated measurements in a convenience sample of upper limb amputees. Measures were collected before, during, and after training with the DEKA Arm. Largest effect sizes were observed for Patient-Specific Functional Scale (effect size: 1.59, confidence interval: 1.00, 2.14), Activity Measure for Upper Limb Amputation (effect size: 1.33, confidence interval: 0.73, 1.90), and University of New Brunswick skill test (effect size: 1.18, confidence interval: 0.61, 1.73). Other measures that were responsive to change were Box and Block test, Jebsen-Taylor Hand Function light and heavy can tests, and University of New Brunswick spontaneity test. Responsiveness and pattern of responsiveness varied by prosthetic level. The Box and Block test, Jebsen-Taylor Hand Function light and heavy can tests, University of New Brunswick skill and spontaneity tests, Activities Measure for Upper Limb Amputation, and the Patient-Specific Functional Scale were responsive to change during prosthetic training. These findings have implications for choice of measures for research and practice and inform clinicians about the amount of training necessary to maximize outcomes with the DEKA Arm. Findings on responsiveness of outcome measures have implications for the choice of measures for clinical trials and practice. Findings regarding the responsiveness to change over the course of training can inform clinicians about the amount of training that may be necessary to maximize specific outcomes with the DEKA Arm. © The International Society for Prosthetics and Orthotics 2014.

  20. Comparison of risk scoring systems for patients presenting with upper gastrointestinal bleeding: international multicentre prospective study.

    PubMed

    Stanley, Adrian J; Laine, Loren; Dalton, Harry R; Ngu, Jing H; Schultz, Michael; Abazi, Roseta; Zakko, Liam; Thornton, Susan; Wilkinson, Kelly; Khor, Cristopher J L; Murray, Iain A; Laursen, Stig B

    2017-01-04

     To compare the predictive accuracy and clinical utility of five risk scoring systems in the assessment of patients with upper gastrointestinal bleeding.  International multicentre prospective study.  Six large hospitals in Europe, North America, Asia, and Oceania.  3012 consecutive patients presenting over 12 months with upper gastrointestinal bleeding.  Comparison of pre-endoscopy scores (admission Rockall, AIMS65, and Glasgow Blatchford) and post-endoscopy scores (full Rockall and PNED) for their ability to predict predefined clinical endpoints: a composite endpoint (transfusion, endoscopic treatment, interventional radiology, surgery, or 30 day mortality), endoscopic treatment, 30 day mortality, rebleeding, and length of hospital stay. Optimum score thresholds to identify low risk and high risk patients were determined.  The Glasgow Blatchford score was best (area under the receiver operating characteristic curve (AUROC) 0.86) at predicting intervention or death compared with the full Rockall score (0.70), PNED score (0.69), admission Rockall score (0.66, and AIMS65 score (0.68) (all P<0.001). A Glasgow Blatchford score of ≤1 was the optimum threshold to predict survival without intervention (sensitivity 98.6%, specificity 34.6%). The Glasgow Blatchford score was better at predicting endoscopic treatment (AUROC 0.75) than the AIMS65 (0.62) and admission Rockall scores (0.61) (both P<0.001). A Glasgow Blatchford score of ≥7 was the optimum threshold to predict endoscopic treatment (sensitivity 80%, specificity 57%). The PNED (AUROC 0.77) and AIMS65 scores (0.77) were best at predicting mortality, with both superior to admission Rockall score (0.72) and Glasgow Blatchford score (0.64; P<0.001). Score thresholds of ≥4 for PNED, ≥2 for AIMS65, ≥4 for admission Rockall, and ≥5 for full Rockall were optimal at predicting death, with sensitivities of 65.8-78.6% and specificities of 65.0-65.3%. No score was helpful at predicting rebleeding or length

  1. A two-plane internally irrigated root observation system for forest nursery stock.

    Treesearch

    Paul S. Johnson; Charles W. Putnam; William G. Mares

    1981-01-01

    A root observation chamber designed for forest nursery stock is described. The chamber consists of lower root observation section and a detachable upper "planter" section, both constructed of plexiglass and wood; the lower section is internally irrigated by a porous irrigation tube and the upper section by a "leader tube."

  2. Validation of the Beurer BM 44 upper arm blood pressure monitor for home measurement, according to the European Society of Hypertension International Protocol 2002.

    PubMed

    Lüders, Stephan; Krüger, Ralf; Zemmrich, Claudia; Forstner, Klaus; Sturm, Claus-Dieter; Bramlage, Peter

    2012-12-01

    The present study aimed to validate the automated upper arm blood pressure (BP) measuring device BM 44 for home BP monitoring according to the 2002 Protocol of the European Society of Hypertension. The most important new feature of the new device was an integrated 'WHO indicator', which categorizes the patient's individual result within the WHO recommendations for target BP by a coloured scale. Systolic and diastolic BPs were measured sequentially in 35 adult participants (16 men, 19 women) using a standard mercury y-tubed reference sphygmomanometer (two observers) and the BM 44 device (one supervisor). Ninety-nine pairs of comparisons were obtained from 15 participants in phase 1 and a further 18 participants in phase 2 of the validation study. The BM 44 device passed phase 1 of the validation study successfully with a number of absolute differences between device and observers of 5, 10 and 15 mmHg for at least 28 out of 25, 35 out of 35 and 40 out of 40 measurements, respectively. The device also achieved the targets for phases 2.1 and 2.2, with 23 and 26 participants having had at least two of three device-observers differences within 5 mmHg for systolic and diastolic BP, respectively. The Beurer BM 44 upper arm BP monitor has passed the International Protocol requirements, and hence can be recommended for home use in adults. © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins.

  3. Compression force on the upper jaw during neonatal intubation: mannequin study.

    PubMed

    Doreswamy, Srinivasa Murthy; Almannaei, Khaled; Fusch, Chris; Shivananda, Sandesh

    2015-03-01

    Neonatal intubation is a technically challenging procedure, and pressure-related injuries to surrounding structures have been reported. The primary objective of this study was to determine the pressure exerted on the upper jaw during tracheal intubation using a neonatal mannequin. Multidisciplinary care providers working at a neonatal intensive care unit were requested to intubate a neonatal mannequin using the standard laryngoscope and 3.0-mm (internal diameter) endotracheal tube. Compression force exerted was measured by using pressure-sensitive film taped on the upper jaw before every intubation attempt. Pressure, area under pressure and time taken to intubate were compared between the different types of health-care professionals. Thirty care providers intubated the mannequin three times each. Pressure impressions were observed on the developer film after every intubation attempt (n = 90). The mean pressure exerted during intubation across all health-care providers was 568 kPa (SD 78). The mean area placed under pressure was 142 mm(2) (SD 45), and the mean time taken for intubation was 14.7 s (SD 4.3). There was no difference in pressure exerted on the upper jaw between frequent and less frequent intubators. It was found that pressure greater than 400 kPa was inadvertently applied on the upper jaw during neonatal intubation, far exceeding the 250 kPa shown to cause tissue injury in animal models. The upper jaw is exposed to a significant compression force during intubation. Although such exposure is brief, it has the potential to cause tissue injury. Contact of the laryngoscope blade with the upper jaw occurred in all intubation attempts with the currently used design of laryngoscope. © 2014 The Authors. Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  4. Upper GI Bleeding in Children

    MedlinePlus

    Upper GI Bleeding in Children What is upper GI Bleeding? Irritation and ulcers of the lining of the esophagus, stomach or duodenum can result in upper GI bleeding. When this occurs the child may vomit ...

  5. Upper Limb Outcome Measures Used in Stroke Rehabilitation Studies: A Systematic Literature Review

    PubMed Central

    Santisteban, Leire; Térémetz, Maxime; Bleton, Jean-Pierre; Baron, Jean-Claude; Maier, Marc A.; Lindberg, Påvel G.

    2016-01-01

    Background Establishing which upper limb outcome measures are most commonly used in stroke studies may help in improving consensus among scientists and clinicians. Objective In this study we aimed to identify the most commonly used upper limb outcome measures in intervention studies after stroke and to describe domains covered according to ICF, how measures are combined, and how their use varies geographically and over time. Methods Pubmed, CinHAL, and PeDRO databases were searched for upper limb intervention studies in stroke according to PRISMA guidelines and477 studies were included. Results In studies 48different outcome measures were found. Only 15 of these outcome measures were used in more than 5% of the studies. The Fugl-Meyer Test (FMT)was the most commonly used measure (in 36% of studies). Commonly used measures covered ICF domains of body function and activity to varying extents. Most studies (72%) combined multiple outcome measures: the FMT was often combined with the Motor Activity Log (MAL), the Wolf Motor Function Test and the Action Research Arm Test, but infrequently combined with the Motor Assessment Scale or the Nine Hole Peg Test. Key components of manual dexterity such as selective finger movements were rarely measured. Frequency of use increased over a twelve-year period for the FMT and for assessments of kinematics, whereas other measures, such as the MAL and the Jebsen Taylor Hand Test showed decreased use over time. Use varied largely between countries showing low international consensus. Conclusions The results showed a large diversity of outcome measures used across studies. However, a growing number of studies used the FMT, a neurological test with good psychometric properties. For thorough assessment the FMT needs to be combined with functional measures. These findings illustrate the need for strategies to build international consensus on appropriate outcome measures for upper limb function after stroke. PMID:27152853

  6. Is Endoscopic Therapy Safe for Upper Gastrointestinal Bleeding in Anticoagulated Patients With Supratherapeutic International Normalized Ratios?

    PubMed

    Shim, Choong Nam; Chung, Hyun Soo; Park, Jun Chul; Shin, Sung Kwan; Lee, Sang Kil; Lee, Yong Chan; Kim, Ha Yan; Kim, Dong Wook; Lee, Hyuk

    2016-01-01

    The management of upper gastrointestinal bleeding (UGIB) in anticoagulated patients with supratherapeutic international normalized ratios (INRs) presents a challenge. The purpose of the study was to evaluate the safety of endoscopic therapy for UGIB in anticoagulated patients with supratherapeutic INR in terms of rebleeding and therapeutic outcomes. One hundred ninety-two anticoagulated patients who underwent endoscopic treatment for UGIB were enrolled in the study. Patients were divided into 2 groups based on the occurrence of rebleeding within 30 days of the initial therapeutic endoscopy: no-rebleeding group (n = 168) and rebleeding group (n = 24). The overall rebleeding rate was 12.5%. Bleeding from gastric cancer and bleeding at the duodenum were significantly related to rebleeding in a univariate analysis. Multivariate analysis determined that presenting symptoms other than melena (hematemesis, hematochezia, or others) (odds ratio, 3.93; 95% confidence interval, 1.44-10.76) and bleeding from gastric cancer (odds ratio, 6.10; 95% confidence interval, 1.27-29.25) were significant factors predictive of rebleeding. Supratherapeutic INR at the time of endoscopic therapy was not significantly associated with rebleeding in either univariate or multivariate analysis. Significant differences in bleeding-related mortality, additional intervention to control bleeding, length of hospital stay, and transfusion requirements were revealed between the rebleeding and no-rebleeding groups. There were no significant differences in therapeutic outcomes between patients with INR within the therapeutic range and those with supratherapeutic INR. Supratherapeutic INR at the time of endoscopic therapy did not change rebleeding and therapeutic outcomes. Thus, we should consider endoscopic therapy for UGIB in anticoagulated patients, irrespective of INR at the time of endoscopic therapy.

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

    PubMed Central

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

    2017-01-01

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

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

    PubMed

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

    2017-01-01

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

  9. Evolutionary trends of stature in upper Paleolithic and Mesolithic Europe.

    PubMed

    Formicola, V; Giannecchini, M

    1999-03-01

    Long bone lengths of all available European Upper Paleolithic (41 males, 25 females) and Mesolithic (171 males, 118 females) remains have been transformed into stature estimates by means of new regression equations derived from Early Holocene skeletal samples using "Fully's anatomical stature" and the major axis regression technique (Formicola & Franceschi, 1996). Statistical analysis of the data, with reference both to time and space parameters, indicates that: (1) Early Upper Paleolithic samples (pre-Glacial Maximum) are very tall; (2) Late Upper Paleolithic groups (post-Glacial Maximum) from Western Europe, compared to their ancestors, show a marked decrease in height; (3) a further, although not significant, reduction of stature affects Western Mesolithics; (4) no regional differences have been observed during both phases of the Upper Paleolithic; (5) a high level of homogeneity has also been found in the Mesolithic, both in Western and Eastern Europe; (6) the internal homogeneity found during the Mesolithic in Western and Eastern Europe is associated with marked inter-regional variability, with populations of the latter region showing systematically significantly greater stature than their Western contemporaries. Evaluation of possible causes for the great stature of the Early Upper Paleolithic samples points to high nutritional standards as the most important factor. Results obtained on later groups clearly indicate that the Last Glacial Maximum, rather than the Mesolithic transition, is the critical phase in the negative trend affecting Western European populations. While changes in the quality of the diet, and in particular decreased protein intake, provide a likely explanation for that trend, variations in levels of gene flow probably also played a role. Reasons for the West-East Mesolithic dichotomy remain unclear and lack of information for the Late Upper Paleolithic of Eastern Europe prevents insight into the remote origins of this phenomenon. Analysis

  10. Predictive Value of Upper Limb Muscles and Grasp Patterns on Functional Outcome in Cervical Spinal Cord Injury.

    PubMed

    Velstra, Inge-Marie; Bolliger, Marc; Krebs, Jörg; Rietman, Johan S; Curt, Armin

    2016-05-01

    To determine which single or combined upper limb muscles as defined by the International Standards for the Neurological Classification of Spinal Cord Injury (ISNCSCI); upper extremity motor score (UEMS) and the Graded Redefined Assessment of Strength, Sensibility, and Prehension (GRASSP), best predict upper limb function and independence in activities of daily living (ADLs) and to assess the predictive value of qualitative grasp movements (QlG) on upper limb function in individuals with acute tetraplegia. As part of a Europe-wide, prospective, longitudinal, multicenter study ISNCSCI, GRASSP, and Spinal Cord Independence Measure (SCIM III) scores were recorded at 1 and 6 months after SCI. For prediction of upper limb function and ADLs, a logistic regression model and unbiased recursive partitioning conditional inference tree (URP-CTREE) were used. Results: Logistic regression and URP-CTREE revealed that a combination of ISNCSCI and GRASSP muscles (to a maximum of 4) demonstrated the best prediction (specificity and sensitivity ranged from 81.8% to 96.0%) of upper limb function and identified homogenous outcome cohorts at 6 months. The URP-CTREE model with the QlG predictors for upper limb function showed similar results. Prediction of upper limb function can be achieved through a combination of defined, specific upper limb muscles assessed in the ISNCSCI and GRASSP. A combination of a limited number of proximal and distal muscles along with an assessment of grasping movements can be applied for clinical decision making for rehabilitation interventions and clinical trials. © The Author(s) 2015.

  11. Use of Social Media and an Online Survey to Discuss Complex Reconstructive Surgery: A Case of Upper Lip Reconstruction with 402 Responses from International Microsurgeons.

    PubMed

    Kwon, Soo-Ha; Lee, Che-Hsiung; Hsu, Angela Ting-Wei; Shafarenko, Mark; Omar, Usama Farghaly; Tzou, Chieh-Han John; Roka-Palkovits, Julia; Beltrán P, Aldo G; Liakos, Dimitri; Chang, Tommy Nai-Jen

    2018-02-02

    The best reconstructive strategy for upper lip defects is still in debate. The purpose of this study was to analyze the decisions made by international microsurgeons, who were participated through online questionnaire, distributed by email and social media network. A case of a two-thirds upper lip oncologic defect was presented via an online questionnaire and 402 microsurgeons replied their treatment options. The data were then analyzed according to the geographic area, microsurgical fellowship, seniority, and subspecialty. All the data were analyzed using SPSS 22. A total of 27.7% of microsurgeons chose a free flap, while 72.3% chose a local/pedicle flap as their preferred method for reconstruction. The most common choice of free and local/pedicle flaps was radial forearm (73.6%) and Abbé (36.2%), respectively. The microsurgeons in Europe preferred local/pedicle flaps than free flap when compared with Middle/South America, Asia-Pacific, Africa and South Asia/Middle East (11.6% versus 50%, 43.4%, 29.3% and 27.3%, respectively, multivariant p  < 0.05). The microsurgeons with microsurgical fellowships preferred to use free flaps (32.9% versus 17.5%, multivariant p  = 0.021). There was no difference for the seniority and specialty of the microsurgeons. The online questionnaire is valuable and feasible for obtaining experts' opinions. This study provides a current global overview of surgical preferences for this common complicated clinical scenario. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  12. What Preconceptions and Attitudes about Engineering Are Prevalent Amongst Upper Secondary School Pupils? An International Study

    ERIC Educational Resources Information Center

    Koycu, Ümit; de Vries, Marc J.

    2016-01-01

    In the Netherlands, as well as in many other countries, there is an increasing interest in implementing education about engineering as a part of general education at the upper secondary school level. In order to know what pupils at that level think about engineering, a study has been done to investigate their attitude towards and their concept of…

  13. Biomechanical Analysis of the Closed Kinetic Chain Upper-Extremity Stability Test.

    PubMed

    Tucci, Helga T; Felicio, Lilian R; McQuade, Kevin J; Bevilaqua-Grossi, Debora; Camarini, Paula Maria Ferreira; Oliveira, Anamaria S

    2017-01-01

    The closed kinetic chain upper-extremity stability (CKCUES) test is a functional test for the upper extremity performed in the push-up position, where individuals support their body weight on 1 hand placed on the ground and swing the opposite hand until touching the hand on the ground, then switch hands and repeat the process as fast as possible for 15 s. To study scapular kinematic and kinetic measures during the CKCUES test for 3 different distances between hands. Experimental. Laboratory. 30 healthy individuals (15 male, 15 female). Participants performed 3 repetitions of the test at 3 distance conditions: original (36 in), interacromial, and 150% interacromial distance between hands. Participants completed a questionnaire on pain intensity and perceived exertion before and after the procedures. Scapular internal/external rotation, upward/downward rotation, and posterior/anterior tilting kinematics and kinetic data on maximum force and time to maximum force were measured bilaterally in all participants. Percentage of body weight on upper extremities was calculated. Data analyses were based on the total numbers of hand touches performed for each distance condition, and scapular kinematics and kinetic values were averaged over the 3 trials. Scapular kinematics, maximum force, and time to maximum force were compared for the 3 distance conditions within each gender. Significance level was set at α = .05. Scapular internal rotation, posterior tilting, and upward rotation were significantly greater in the dominant side for both genders. Scapular upward rotation was significantly greater in original distance than interacromial distance in swing phase. Time to maximum force in women was significantly greater in the dominant side. CKCUES test kinematic and kinetic measures were not different among 3 conditions based on distance between hands. However, the test might not be suitable for initial or mild-level rehabilitation due to its challenging requirements.

  14. [Surgical strategy for upper cervical vertebrae instability through the anterior approach].

    PubMed

    Huang, Wei-bing; Cai, Xian-hua; Chen, Zhuang-hong; Huang, Ji-feng; Liu, Xi-ming; Wei, Shi-jun

    2013-07-01

    To explore the choice and effect of internal fixation in treating upper cervical vertebrae instability through anterior approach. From March 2000 to September 2010,83 patients with upper cervical vertebrae instability were treated with internal fixation through anterior approach. There were 59 males and 24 females with a mean age of 42 years old (ranged, 20 to 68). Among these patients, 36 patients were treated with odontoid screw fixation, 16 patients with C1,2 transarticular screw fixation, 23 patients with C2,3 steel plate fixation, 5 patients with odontoid screw and transarticular screw fixation,2 patients with odontoid screw and C2.3 steel plate fixation, 1 patient with C1,2 transarticular screw and C2,3 steel plate fixation. One patient with completely cervical vertebrae cord injury died of pulmonary infection after C1,2 transarticular screw fixation. Other patients were followed up from 8 to 36 months with an average of 15 months. Upper cervical vertebrae stability were restored without vertebral artery and spinal cord injury. Thirty-six patients were treated with odontoid screw fixation and 5 patients were treated with screw combined with transarticular screw fixation obtained bone union in the dentations without bone graft. Among the 16 patients treated with C1,2 transarticular screw fixation, 13 patients obtained bone union after bone graft; 1 patient died of pulmonary infection after surgery; 1 patient with comminuted odontoid fracture of type II C and atlantoaxial anterior dislocation did not obtain bone union after bone graft,but the fibrous healing was strong enough to maintain the atlantoaixal joint stability; 1 patient with obsolete atlantoaxial anterior dislocation were re-treated with Brooks stainless steel wire fixation and bone graft through posterior approach, and finally obtained bone union. It could obtain satisfactory effects depending on the difference of cervical vertebrae instability to choose the correctly surgical method.

  15. Multi-model attribution of upper-ocean temperature changes using an isothermal approach.

    PubMed

    Weller, Evan; Min, Seung-Ki; Palmer, Matthew D; Lee, Donghyun; Yim, Bo Young; Yeh, Sang-Wook

    2016-06-01

    Both air-sea heat exchanges and changes in ocean advection have contributed to observed upper-ocean warming most evident in the late-twentieth century. However, it is predominantly via changes in air-sea heat fluxes that human-induced climate forcings, such as increasing greenhouse gases, and other natural factors such as volcanic aerosols, have influenced global ocean heat content. The present study builds on previous work using two different indicators of upper-ocean temperature changes for the detection of both anthropogenic and natural external climate forcings. Using simulations from phase 5 of the Coupled Model Intercomparison Project, we compare mean temperatures above a fixed isotherm with the more widely adopted approach of using a fixed depth. We present the first multi-model ensemble detection and attribution analysis using the fixed isotherm approach to robustly detect both anthropogenic and natural external influences on upper-ocean temperatures. Although contributions from multidecadal natural variability cannot be fully removed, both the large multi-model ensemble size and properties of the isotherm analysis reduce internal variability of the ocean, resulting in better observation-model comparison of temperature changes since the 1950s. We further show that the high temporal resolution afforded by the isotherm analysis is required to detect natural external influences such as volcanic cooling events in the upper-ocean because the radiative effect of volcanic forcings is short-lived.

  16. Multi-model attribution of upper-ocean temperature changes using an isothermal approach

    NASA Astrophysics Data System (ADS)

    Weller, Evan; Min, Seung-Ki; Palmer, Matthew D.; Lee, Donghyun; Yim, Bo Young; Yeh, Sang-Wook

    2016-06-01

    Both air-sea heat exchanges and changes in ocean advection have contributed to observed upper-ocean warming most evident in the late-twentieth century. However, it is predominantly via changes in air-sea heat fluxes that human-induced climate forcings, such as increasing greenhouse gases, and other natural factors such as volcanic aerosols, have influenced global ocean heat content. The present study builds on previous work using two different indicators of upper-ocean temperature changes for the detection of both anthropogenic and natural external climate forcings. Using simulations from phase 5 of the Coupled Model Intercomparison Project, we compare mean temperatures above a fixed isotherm with the more widely adopted approach of using a fixed depth. We present the first multi-model ensemble detection and attribution analysis using the fixed isotherm approach to robustly detect both anthropogenic and natural external influences on upper-ocean temperatures. Although contributions from multidecadal natural variability cannot be fully removed, both the large multi-model ensemble size and properties of the isotherm analysis reduce internal variability of the ocean, resulting in better observation-model comparison of temperature changes since the 1950s. We further show that the high temporal resolution afforded by the isotherm analysis is required to detect natural external influences such as volcanic cooling events in the upper-ocean because the radiative effect of volcanic forcings is short-lived.

  17. Acoustic explorations of the upper ocean boundary layer

    NASA Astrophysics Data System (ADS)

    Vagle, Svein

    2005-04-01

    The upper ocean boundary layer is an important but difficult to probe part of the ocean. A better understanding of small scale processes at the air-sea interface, including the vertical transfer of gases, heat, mass and momentum, are crucial to improving our understanding of the coupling between atmosphere and ocean. Also, this part of the ocean contains a significant part of the total biomass at all trophic levels and is therefore of great interest to researchers in a range of different fields. Innovative measurement plays a critical role in developing our understanding of the processes involved in the boundary layer, and the availability of low-cost, compact, digital signal processors and sonar technology in self-contained and cabled configurations has led to a number of exciting developments. This talk summarizes some recent explorations of this dynamic boundary layer using both active and passive acoustics. The resonant behavior of upper ocean bubbles combined with single and multi-frequency broad band active and passive devices are now giving us invaluable information on air-sea gas transfer, estimation of biological production, marine mammal behavior, wind speed and precipitation, surface and internal waves, turbulence, and acoustic communication in the surf zone.

  18. Validation of the iHealth BP5 wireless upper arm blood pressure monitor for self-measurement according to the European Society of Hypertension International Protocol revision 2010.

    PubMed

    Shang, Fujun; Zhu, Yizheng; Zhu, Zhenlai; Liu, Lei; Wan, Yi

    2013-10-01

    The aim of this study was to validate the iHealth BP5 wireless upper arm blood pressure (BP) monitor according to the European Society of Hypertension International Protocol (ESH-IP) revision 2010. The ESH-IP revision 2010 for validation of BP measuring devices in adults was followed precisely. A total of 99 pairs of test device and reference BP measurements (three pairs for each of the 33 participants) were obtained in the study. The device produced 71, 89, and 97 measurements within 5, 10, and 15 mmHg for systolic blood pressure (SBP) and 73, 90, and 99 mmHg for diastolic blood pressure (DBP), respectively. The mean ± SD device-observer difference was -1.21 ± 5.87 mmHg for SBP and -1.04 ± 5.28 mmHg for DBP. The number of participants with two or three device-observer differences within 5 mmHg was 25 for SBP and 28 for DBP. In addition, three participants had no device-observer difference within 5 mmHg for SBP and none of the participants had the same for DBP. According to the validation results on the basis of the ESH-IP revision 2010, the iHealth BP5 wireless upper arm BP monitor can be recommended for self/home measurement in an adult population.

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

    PubMed

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

    2012-04-01

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

  20. The Math Essential Skills Screener--Upper Elementary Version (MESS-U): Studies of Reliability and Validity

    ERIC Educational Resources Information Center

    Erford, Bradley T.; Biddison, Amanda R.

    2006-01-01

    The Math Essential Skills Screener--Upper Elementary Version (MESS-U) is part of a series of screening tests designed to help identify students ages 9-11 who are at risk for mathematics failure. Internal consistency, test-retest reliability, item analysis, decision efficiency, convergent validity and factorial validity of the MESS-U were studied…

  1. Upper gastrointestinal bleeding.

    PubMed

    Feinman, Marcie; Haut, Elliott R

    2014-02-01

    Upper gastrointestinal (GI) bleeding remains a commonly encountered diagnosis for acute care surgeons. Initial stabilization and resuscitation of patients is imperative. Stable patients can have initiation of medical therapy and localization of the bleeding, whereas persistently unstable patients require emergent endoscopic or operative intervention. Minimally invasive techniques have surpassed surgery as the treatment of choice for most upper GI bleeding. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. A survey of overuse problems in patients with acquired or congenital upper limb deficiency.

    PubMed

    Burger, Helena; Vidmar, Gaj

    2016-08-01

    Little is known about secondary impairments and overuse problems in patient with acquired or congenital upper limb deficiency. Our aim was to estimate the frequency of overuse problems in persons after unilateral upper limb deficiency and identify the factors relevant for development of these problems. Cross-sectional study conducted at the University Rehabilitation Institute in Ljubljana. In total, 65 persons after unilateral upper limb deficiency who had visited our subspecialist outpatient clinic during the 2011-2013 period (excluding those with other possible medical causes of overuse-type problems) were interviewed about the frequency, duration and severity of neck, elbow and shoulder pain and the presence of carpal tunnel syndrome and filled in the Orthotics and Prosthetics User Survey-Upper Extremity Functional Status questionnaire. The most frequent problem was carpal tunnel syndrome, followed by shoulder pain, neck pain and elbow pain. No statistically significant association of deficiency level, cause of deficiency, time since deficiency, extent of daily prosthesis use or type of prosthesis with frequency or severity of pain or number of problems was found. The presence of carpal tunnel syndrome decreased from wearing no prosthesis through aesthetic and body-powered to myoelectric prosthesis (p = 0.014). Factors contributing to overuse problems after upper limb deficiency are not straightforward, so a large multicentric study is warranted. Persons with acquired or congenital upper limb deficiency are under a heightened risk of developing overuse problems but the contributing factors are not clear, so regular individual follow-up is required. © The International Society for Prosthetics and Orthotics 2015.

  3. Social impact of the tangaye (upper volta) photovoltaic demostrtion

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

    Roberts, A.F.

    1983-06-01

    The Tangaye (Upper Volta) Solar Energy Demonstration was implemented in early 1979 by the US Agency for International Development and the NASA Lewis Research Center. It is the only longitudinal field study of a developing country's renewable energy project, and continues to provide its services of water-pumping and grain-grinding to Tangaye villagers. The demonstration has two research foci: the reliability of a photovoltaic (PV) power system in harsh environmental conditions, and the appropriateness of PV technology from a social perspective as villagers mobilize to manage the system and integrate its services into their lives.

  4. Structural Design and Analysis of the Upper Pressure Shell Section of a Composite Crew Module

    NASA Technical Reports Server (NTRS)

    Sleight, David W.; Paddock, David; Jeans, Jim W.; Hudeck, John D.

    2008-01-01

    This paper presents the results of the structural design and analysis of the upper pressure shell section of a carbon composite demonstration structure for the Composite Crew Module (CCM) Project. The project is managed by the NASA Engineering and Safety Center with participants from eight NASA Centers, the Air Force Research Laboratory, and multiple aerospace contractors including ATK/Swales, Northrop Grumman, Lockheed Martin, Collier Research Corporation, Genesis Engineering, and Janicki Industries. The paper discusses details of the upper pressure shell section design of the CCM and presents the structural analysis results using the HyperSizer structural sizing software and the MSC Nastran finite element analysis software. The HyperSizer results showed that the controlling load case driving most of the sizing in the upper pressure shell section was the internal pressure load case. The regions around the cutouts were controlled by internal pressure and the main parachute load cases. The global finite element analysis results showed that the majority of the elements of the CCM had a positive margin of safety with the exception of a few hot spots around the cutouts. These hot spots are currently being investigated with a more detailed analysis. Local finite element models of the Low Impact Docking System (LIDS) interface ring and the forward bay gussets with greater mesh fidelity were created for local sizing and analysis. The sizing of the LIDS interface ring was driven by the drogue parachute loads, Trans-Lunar Insertion (TLI) loads, and internal pressure. The drogue parachute loads controlled the sizing of the gusset cap on the drogue gusset and TLI loads controlled the sizing of the other five gusset caps. The main parachute loads controlled the sizing of the lower ends of the gusset caps on the main parachute fittings. The results showed that the gusset web/pressure shell and gusset web/gusset cap interfaces bonded using Pi-preform joints had local hot spots

  5. Upper-surface-blowing flow-turning performance

    NASA Technical Reports Server (NTRS)

    Sleeman, W. C., Jr.; Phelps, A. E., III

    1976-01-01

    Jet exhaust flow-turning characteristics were determined for systematic variations in upper-surface blowing exhaust nozzles and trailing-edge flap configuration variables from experimental wind-off (static) flow studies. For conditions with parallel flow exhausting from the nozzle, jet height (as indicated by nozzle exit height) and flap radius were found to be the most important parameters relating to flow turning. Nonparallel flow from the nozzle, as obtained from an internal roof angle and/or side spread angle, had a large favorable effect on flow turning. Comparisons made between static turning results and wind tunnel aerodynamic studies of identical configurations indicated that static flow-turning results can be indicative of wind-on powered lift performance for both good and poor nozzle-flap combinations but, for marginal designs, can lead to overly optimistic assessment of powered lift potential.

  6. Commercial gaming devices for stroke upper limb rehabilitation: a systematic review.

    PubMed

    Thomson, Katie; Pollock, Alex; Bugge, Carol; Brady, Marian

    2014-06-01

    Rehabilitation using commercial gaming devices is a new concept for stroke care. Commercial gaming devices such as Nintendo Wii or Sony PlayStation encourage high repetition of arm movements and are being introduced into some clinical settings. The evidence base for gaming use in rehabilitation is growing rapidly and there is a need to systematically synthesise research. Our review aims to integrate evidence on how gaming is being used, explore patient/therapist experience and synthesise evidence of effectiveness. An integrative systematic review was undertaken searching Cochrane Central Register of Controlled Trials (2013), Medline (2013), Embase (2013) and twelve additional databases. Two review authors independently selected studies based on pre-defined inclusion criteria, extracted data and assessed risk of bias. Nineteen studies including 215 patients met inclusion criteria. Studies were typically small scale feasibility studies using a range of research designs, limiting the ability to reach generalised conclusions. Results have been tabulated (activities of daily living, upper limb function/ movement) and qualitative themes identified. Findings suggest that most patients enjoy using commercial gaming and can tolerate 180 mins per week without significant adverse effects. A trend towards improvement was noted for upper limb function/ movement. Few studies recorded outcomes related to activities of daily living or focused on understanding patients' experiences of this intervention. Commercial gaming can provide high intensity upper limb practice however there is insufficient high quality evidence to reach generalisable conclusions about risks or benefits on activities of daily living or upper limb function/movement. © 2014 The Authors. International Journal of Stroke © 2014 World Stroke Organization.

  7. Effect of Upper Limb Deformities on Gross Motor and Upper Limb Functions in Children with Spastic Cerebral Palsy

    ERIC Educational Resources Information Center

    Park, Eun Sook; Sim, Eun Geol; Rha, Dong-wook

    2011-01-01

    The aims of this study were to investigate the nature and extent of upper limb deformities via the use of various classifications, and to analyze the relationship between upper limb deformities and gross motor or upper limb functionality levels. Upper extremity data were collected from 234 children with spastic cerebral palsy (CP) who were…

  8. Domestic and International Service Learning Experiences: A Comparative Study of Pre-Service Teacher Outcomes

    ERIC Educational Resources Information Center

    Miller, Kari Knutson; Gonzalez, Amber M.

    2010-01-01

    This paper examines pre-service teacher outcomes associated with service learning in domestic and international settings. Participants included upper-division, undergraduate-level pre-service teachers who participated in service learning experiences in either local, domestic settings (Orange County, CA) or international settings (Shanghai and…

  9. Seismic Structure of the Antarctic Upper Mantle and Transition Zone Unearthed by Full Waveform Adjoint Tomography

    NASA Astrophysics Data System (ADS)

    Lloyd, A. J.; Wiens, D.; Zhu, H.; Tromp, J.; Nyblade, A.; Anandakrishnan, S.; Aster, R. C.; Huerta, A. D.; Winberry, J. P.; Wilson, T. J.; Dalziel, I. W. D.; Hansen, S. E.; Shore, P.

    2017-12-01

    The upper mantle and transition zone beneath Antarctica and the surrounding ocean are among the poorest seismically imaged regions of the Earth's interior. Over the last 1.5 decades researchers have deployed several large temporary broadband seismic arrays focusing on major tectonic features in the Antarctic. The broader international community has also facilitated further instrumentation of the continent, often operating stations in additional regions. As of 2016, waveforms are available from almost 300 unique station locations. Using these stations along with 26 southern mid-latitude seismic stations we have imaged the seismic structure of the upper mantle and transition zone using full waveform adjoint techniques. The full waveform adjoint inversion assimilates phase observations from 3-component seismograms containing P, S, Rayleigh, and Love waves, including reflections and overtones, from 270 earthquakes (5.5 ≤ Mw ≤ 7.0) that occurred between 2001-2003 and 2007-2016. We present the major results of the full waveform adjoint inversion following 20 iterations, resulting in a continental-scale seismic model (ANT_20) with regional-scale resolution. Within East Antarctica, ANT_20 reveals internal seismic heterogeneity and differences in lithospheric thickness. For example, fast seismic velocities extending to 200-300 km depth are imaged beneath both Wilkes Land and the Gamburtsev Subglacial Mountains, whereas fast velocities only extend to 100-200 km depth beneath the Lambert Graben and Enderby Land. Furthermore, fast velocities are not found beneath portions of Dronning Maud Land, suggesting old cratonic lithosphere may be absent. Beneath West Antarctica slow upper mantle seismic velocities are imaged extending from the Balleny Island southward along the Transantarctic Mountains front, and broaden beneath the southern and northern portion of the mountain range. In addition, slow upper mantle velocities are imaged beneath the West Antarctic coast extending

  10. Gendered Patterns in International Research Collaborations in Academia

    ERIC Educational Resources Information Center

    Uhly, K. M.; Visser, L. M.; Zippel, K. S.

    2017-01-01

    Although women's representation in higher education nears parity with men at the undergraduate level, this representation diminishes as one ascends the academic ranks. Because gender gaps in the "elite" activity of international research collaborations might contribute to the underrepresentation of women in the upper ranks, we ask if…

  11. Assessment of the upper motor neuron in amyotrophic lateral sclerosis.

    PubMed

    Huynh, William; Simon, Neil G; Grosskreutz, Julian; Turner, Martin R; Vucic, Steve; Kiernan, Matthew C

    2016-07-01

    Clinical signs of upper motor neuron (UMN) involvement are an important component in supporting the diagnosis of amyotrophic lateral sclerosis (ALS), but are often not easily appreciated in a limb that is concurrently affected by muscle wasting and lower motor neuron degeneration, particularly in the early symptomatic stages of ALS. Whilst recent criteria have been proposed to facilitate improved detection of lower motor neuron impairment through electrophysiological features that have improved diagnostic sensitivity, assessment of upper motor neuron involvement remains essentially clinical. As a result, there is often a significant diagnostic delay that in turn may impact institution of disease-modifying therapy and access to other optimal patient management. Biomarkers of pathological UMN involvement are also required to ensure patients with suspected ALS have timely access to appropriate therapeutic trials. The present review provides an analysis of current and recently developed assessment techniques, including novel imaging and electrophysiological approaches used to study corticomotoneuronal pathology in ALS. Copyright © 2016 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

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

    PubMed

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

    2016-11-01

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

  13. Multivariate prediction of upper limb prosthesis acceptance or rejection.

    PubMed

    Biddiss, Elaine A; Chau, Tom T

    2008-07-01

    To develop a model for prediction of upper limb prosthesis use or rejection. A questionnaire exploring factors in prosthesis acceptance was distributed internationally to individuals with upper limb absence through community-based support groups and rehabilitation hospitals. A total of 191 participants (59 prosthesis rejecters and 132 prosthesis wearers) were included in this study. A logistic regression model, a C5.0 decision tree, and a radial basis function neural network were developed and compared in terms of sensitivity (prediction of prosthesis rejecters), specificity (prediction of prosthesis wearers), and overall cross-validation accuracy. The logistic regression and neural network provided comparable overall accuracies of approximately 84 +/- 3%, specificity of 93%, and sensitivity of 61%. Fitting time-frame emerged as the predominant predictor. Individuals fitted within two years of birth (congenital) or six months of amputation (acquired) were 16 times more likely to continue prosthesis use. To increase rates of prosthesis acceptance, clinical directives should focus on timely, client-centred fitting strategies and the development of improved prostheses and healthcare for individuals with high-level or bilateral limb absence. Multivariate analyses are useful in determining the relative importance of the many factors involved in prosthesis acceptance and rejection.

  14. The Upper Mississippi River System—Topobathy

    USGS Publications Warehouse

    Stone, Jayme M.; Hanson, Jenny L.; Sattler, Stephanie R.

    2017-03-23

    The Upper Mississippi River System (UMRS), the navigable part of the Upper Mississippi and Illinois Rivers, is a diverse ecosystem that contains river channels, tributaries, shallow-water wetlands, backwater lakes, and flood-plain forests. Approximately 10,000 years of geologic and hydrographic history exist within the UMRS. Because it maintains crucial wildlife and fish habitats, the dynamic ecosystems of the Upper Mississippi River Basin and its tributaries are contingent on the adjacent flood plains and water-level fluctuations of the Mississippi River. Separate data for flood-plain elevation (lidar) and riverbed elevation (bathymetry) were collected on the UMRS by the U.S. Army Corps of Engineers’ (USACE) Upper Mississippi River Restoration (UMRR) Program. Using the two elevation datasets, the U.S. Geological Survey (USGS) Upper Midwest Environmental Sciences Center (UMESC) developed a systemic topobathy dataset.

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

    NASA Technical Reports Server (NTRS)

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

    1990-01-01

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

  16. Upper gastrointestinal bleeding in patients with CKD.

    PubMed

    Liang, Chih-Chia; Wang, Su-Ming; Kuo, Huey-Liang; Chang, Chiz-Tzung; Liu, Jiung-Hsiun; Lin, Hsin-Hung; Wang, I-Kuan; Yang, Ya-Fei; Lu, Yueh-Ju; Chou, Che-Yi; Huang, Chiu-Ching

    2014-08-07

    Patients with CKD receiving maintenance dialysis are at risk for upper gastrointestinal bleeding. However, the risk of upper gastrointestinal bleeding in patients with early CKD who are not receiving dialysis is unknown. The hypothesis was that their risk of upper gastrointestinal bleeding is negatively linked to renal function. To test this hypothesis, the association between eGFR and risk of upper gastrointestinal bleeding in patients with stages 3-5 CKD who were not receiving dialysis was analyzed. Patients with stages 3-5 CKD in the CKD program from 2003 to 2009 were enrolled and prospectively followed until December of 2012 to monitor the development of upper gastrointestinal bleeding. The risk of upper gastrointestinal bleeding was analyzed using competing-risks regression with time-varying covariates. In total, 2968 patients with stages 3-5 CKD who were not receiving dialysis were followed for a median of 1.9 years. The incidence of upper gastrointestinal bleeding per 100 patient-years was 3.7 (95% confidence interval, 3.5 to 3.9) in patients with stage 3 CKD, 5.0 (95% confidence interval, 4.8 to 5.3) in patients with stage 4 CKD, and 13.9 (95% confidence interval, 13.1 to 14.8) in patients with stage 5 CKD. Higher eGFR was associated with a lower risk of upper gastrointestinal bleeding (P=0.03), with a subdistribution hazard ratio of 0.93 (95% confidence interval, 0.87 to 0.99) for every 5 ml/min per 1.73 m(2) higher eGFR. A history of upper gastrointestinal bleeding (P<0.001) and lower serum albumin (P=0.004) were independently associated with higher upper gastrointestinal bleeding risk. In patients with CKD who are not receiving dialysis, lower renal function is associated with higher risk for upper gastrointestinal bleeding. The risk is higher in patients with previous upper gastrointestinal bleeding history and low serum albumin. Copyright © 2014 by the American Society of Nephrology.

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

    PubMed

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

    2016-01-01

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

  18. Internal Gravity Waves in the Magnetized Solar Atmosphere. I. Magnetic Field Effects

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

    Vigeesh, G.; Steiner, O.; Jackiewicz, J., E-mail: vigeesh@leibniz-kis.de

    Observations of the solar atmosphere show that internal gravity waves are generated by overshooting convection, but are suppressed at locations of magnetic flux, which is thought to be the result of mode conversion into magnetoacoustic waves. Here, we present a study of the acoustic-gravity wave spectrum emerging from a realistic, self-consistent simulation of solar (magneto)convection. A magnetic field free, hydrodynamic simulation and a magnetohydrodynamic (MHD) simulation with an initial, vertical, homogeneous field of 50 G flux density were carried out and compared with each other to highlight the effect of magnetic fields on the internal gravity wave propagation in themore » Sun’s atmosphere. We find that the internal gravity waves are absent or partially reflected back into the lower layers in the presence of magnetic fields and argue that the suppression is due to the coupling of internal gravity waves to slow magnetoacoustic waves still within the high- β region of the upper photosphere. The conversion to Alfvén waves is highly unlikely in our model because there is no strongly inclined magnetic field present. We argue that the suppression of internal waves observed within magnetic flux concentrations may also be due to nonlinear breaking of internal waves due to vortex flows that are ubiquitously present in the upper photosphere and the chromosphere.« less

  19. Congenital Median Upper Lip Fistula

    PubMed Central

    al Aithan, Bandar

    2012-01-01

    Congenital median upper lip fistula (MULF) is an extremely rare condition resulting from abnormal fusion of embryologic structures. We present a new case of congenital medial upper lip fistula located in the midline of the philtrum of a 6 year old girl. PMID:22953305

  20. NASA Ares I Crew Launch Vehicle Upper Stage Overview

    NASA Technical Reports Server (NTRS)

    Davis, Daniel J.

    2008-01-01

    By incorporating rigorous engineering practices, innovative manufacturing processes and test techniques, a unique multi-center government/contractor partnership, and a clean-sheet design developed around the primary requirements for the International Space Station (ISS) and Lunar missions, the Upper Stage Element of NASA's Crew Launch Vehicle (CLV), the "Ares I," is a vital part of the Constellation Program's transportation system. Constellation's exploration missions will include Ares I and Ares V launch vehicles required to place crew and cargo in low-Earth orbit (LEO), crew and cargo transportation systems required for human space travel, and transportation systems and scientific equipment required for human exploration of the Moon and Mars. Early Ares I configurations will support ISS re-supply missions. A self-supporting cylindrical structure, the Ares I Upper Stage will be approximately 84' long and 18' in diameter. The Upper Stage Element is being designed for increased supportability and increased reliability to meet human-rating requirements imposed by NASA standards. The design also incorporates state-of-the-art materials, hardware, design, and integrated logistics planning, thus facilitating a supportable, reliable, and operable system. With NASA retiring the Space Shuttle fleet in 2010, the success of the Ares I Project is essential to America's continued leadership in space. The first Ares I test flight, called Ares 1-X, is scheduled for 2009. Subsequent test flights will continue thereafter, with the first crewed flight of the Crew Exploration Vehicle (CEV), "Orion," planned for no later than 2015. Crew transportation to the ISS will follow within the same decade, and the first Lunar excursion is scheduled for the 2020 timeframe.

  1. NASA Ares I Crew Launch Vehicle Upper Stage Overview

    NASA Technical Reports Server (NTRS)

    McArthur, J. Craig

    2008-01-01

    By incorporating rigorous engineering practices, innovative manufacturing processes and test techniques, a unique multi-center government/contractor partnership, and a clean-sheet design developed around the primary requirements for the International Space Station (ISS) and Lunar missions, the Upper Stage Element of NASA's Crew Launch Vehicle (CLV), the "Ares I," is a vital part of the Constellation Program's transportation system. Constellation's exploration missions will include Ares I and Ares V launch vehicles required to place crew and cargo in low-Earth orbit (LEO), crew and cargo transportation systems required for human space travel, and transportation systems and scientific equipment required for human exploration of the Moon and Mars. Early Ares I configurations will support ISS re-supply missions. A self-supporting cylindrical structure, the Ares I Upper Stage will be approximately 84' long and 18' in diameter. The Upper Stage Element is being designed for increased supportability and increased reliability to meet human-rating requirements imposed by NASA standards. The design also incorporates state-of-the-art materials, hardware, design, and integrated logistics planning, thus facilitating a supportable, reliable, and operable system. With NASA retiring the Space Shuttle fleet in 2010, the success of the Ares I Project is essential to America's continued leadership in space. The first Ares I test flight, called Ares I-X, is scheduled for 2009. Subsequent test flights will continue thereafter, with the first crewed flight of the Crew Exploration Vehicle (CEV), "Orion," planned for no later than 2015. Crew transportation to the ISS will follow within the same decade, and the first Lunar excursion is scheduled for the 2020 timeframe.

  2. A Wake-Up Call for U.S. Educators: The Third International Mathematics and Science Study.

    ERIC Educational Resources Information Center

    Cochrane, Douglas

    1999-01-01

    This issue of "Policy Forum" compares the mathematics and science achievement of students midway through elementary school, midway through lower secondary school, and at the end of upper secondary school. The Third International Mathematics and Science Study (TIMSS), conducted in 1995-96, is the largest international education study ever…

  3. Salvage topical therapy for upper tract urothelial carcinoma.

    PubMed

    Balasubramanian, Adithya; Metcalfe, Michael J; Wagenheim, Gavin; Xiao, Lianchun; Papadopoulos, John; Navai, Neema; Davis, John W; Karam, Jose A; Kamat, Ashish M; Wood, Christopher G; Dinney, Colin P; Matin, Surena F

    2018-05-26

    Topical therapy (TT) for upper tract urothelial carcinoma (UTUC) has been explored as a kidney sparing approach to treat carcinoma in situ (CIS) and as adjuvant for endoscopically treated Ta/T1 tumors. In bladder cancer, data support use of salvage TT for repeat induction. We investigate the outcomes of salvage TT for UTUC in patients ineligible for or refusing nephroureterectomy. A single-center retrospective review on patients receiving salvage TT via percutaneous nephrostomy tube or cystoscopically placed ureteral catheters was performed. Primary outcome was response to therapy based on International Bladder Cancer Group criteria. 51 patients with 58 renal units (RUs) received TT. Of these, 17 patients with 18 RUs received the second-line TT, with a median follow-up of 36.5 months (IQR 24.5-67 months). 44% (8/18) received salvage TT for refractory disease and 56% (10/18) as reinduction. 5 RUs with CIS were unresponsive to initial TT and went on to receive salvage TT, of which 20% (1/5) responded. 13 RUs recurred or relapsed following initial TT and received salvage TT for papillary tumors, with 62% (8/13) responding. Our data provide preliminary clinical rationale for the second-line TT for refractory and recurrent, endoscopically managed papillary UTUC in patients ineligible for or refusing nephroureterectomy. However, refractory upper tract CIS appears to have poor response to salvage TT.

  4. [Evaluation of upper urinary tract function in patients undergoing autoplastic surgery for hydronphrosis of the intrarenal pelvis].

    PubMed

    Kurbanaliev, R M; Usupbaev, A Ch; Kolesnichenko, I V; Sadyrbekov, N Zh; Sultanov, B M

    2018-05-01

    To investigate the functional state of the upper urinary tract in patients undergoing autoplastic surgery for a hydronophrosis of the intrarenal pelvis. The study comprised 78 patients with the intrarenal pelvis and impaired urinary outflow due to stricture of the ureteropelvic junction and vascular conflict (interatrial and arteriovenous narrowing), who underwent pyeloplasty using autologous tunica vaginalis. All patients underwent an incision of ureteropelvic stricture and resection of the parietal layer of the tunica vaginalis which was used to repair the obstruction site and internal stenting of the upper urinary tract. The patients were examined at baseline and during follow-up ranging from 3 months to 3 years. At three months after surgery, there was a decrease in the size of the renal pelvis and calyces with an improvement of all parameters of uro- and hemodynamics. At three years after surgery, the structural and functional parameters of the upper urinary tract were completely restored. Obstructive uropathy, resulting from the intrarenal pelvis, leads to persistently impaired urinary outflow from the upper urinary tract. Surgical intervention is the only curative treatment able to restore the urinary flow. In men with the intrarenal pelvis, the autoplastic surgery of the ureteropelvic junction obstruction using a parietal layer of the tunica vaginalis is an effective surgical modality improving renal pelvis capacity and contributing to the recovery of urinary outflow from the upper urinary tract.

  5. Static internal performance of a two-dimensional convergent nozzle with thrust-vectoring capability up to 60 deg

    NASA Technical Reports Server (NTRS)

    Leavitt, L. D.

    1985-01-01

    An investigation was conducted at wind-off conditions in the static-test facility of the Langley 16-Foot Transonic Tunnel to determine the internal performance characteristics of a two-dimensional convergent nozzle with a thrust-vectoring capability up to 60 deg. Vectoring was accomplished by a downward rotation of a hinged upper convergent flap and a corresponding rotation of a center-pivoted lower convergent flap. The effects of geometric thrust-vector angle and upper-rotating-flap geometry on internal nozzle performance characteristics were investigated. Nozzle pressure ratio was varied from 1.0 (jet off) to approximately 5.0.

  6. Progressive upper limb prosthetics.

    PubMed

    Lake, Chris; Dodson, Robert

    2006-02-01

    The field of upper extremity prosthetics is a constantly changing arena as researchers and prosthetists strive to bridge the gap between prosthetic reality and upper limb physiology. With the further development of implantable neurologic sensing devices and targeted muscle innervation (discussed elsewhere in this issue), the challenge of limited input to control vast outputs promises to become a historical footnote in the future annals of upper limb prosthetics. Soon multidextrous terminal devices, such as that found in the iLimb system(Touch EMAS, Inc., Edinburgh, UK), will be a clinical reality (Fig. 22). Successful prosthetic care depends on good communication and cooperation among the surgeon, the amputee, the rehabilitation team, and the scientists harnessing the power of technology to solve real-life challenges. If the progress to date is any indication, amputees of the future will find their dreams limited only by their imagination.

  7. Upper Mantle Structure Beneath the Whitmore Mountains, West Antarctic Rift System, and Marie Byrd Land from Body-Wave Tomography

    NASA Astrophysics Data System (ADS)

    Nyblade, A.; Lloyd, A. J.; Anandakrishnan, S.; Wiens, D. A.; Aster, R. C.; Huerta, A. D.; Wilson, T. J.; Shore, P.; Zhao, D.

    2011-12-01

    As part of the International Polar Year in Antarctica, 37 seismic stations have been installed across West Antarctica as part of the Polar Earth Observing Network (POLENET). 23 stations form a sparse backbone network of which 21 are co-located on rock sites with a network of continuously recording GPS stations. The remaining 14 stations, in conjunction with 2 backbone stations, form a seismic transect extending from the Ellsworth Mountains across the West Antarctic Rift System (WARS) and into Marie Byrd Land. Here we present preliminary P and S wave velocity models of the upper mantle from regional body wave tomography using P and S travel times from teleseismic events recorded by the seismic transect during the first year (2009-2010) of deployment. Preliminary P wave velocity models consisting of ~3,000 ray paths from 266 events indicate that the upper mantle beneath the Whitmore Mountains is seismically faster than the upper mantle beneath Marie Byrd Land and the WARS. Furthermore, we observe two substantial upper mantle low velocity zones located beneath Marie Byrd Land and near the southern boundary of the WARS.

  8. The Tropical Upper Troposphere and Lower Stratosphere in the GEOS-2 GCM

    NASA Technical Reports Server (NTRS)

    Pawson, S.; Takacs, L.; Molod, A.; Nebuda, S.; Chen, M.; Rood, R.; Read, W. L.; Fiorino, M.

    1999-01-01

    The structure of the tropical upper troposphere and lower stratosphere in the GEOS-2 General Circulation Model (GCM) is discussed. The emphasis of this study is on the reality of monthly-mean temperature and water vapor distributions in the model, compared to reasonable observational estimates. It is shown that although the zonal-mean temperature is in good agreement with observations, the GCM supports an excessive zonal asymmetry near the tropopause compared to the ECMWF Reanalyses. In reality there is a QBO-related variability in the zonally averaged lower stratospheric temperature which is not captured by the model. The observed upper tropospheric temperature and humidity fields show variations related to those in the sea surface temperature, which are not incorporated in the GCM; nevertheless, there is some interannual variability in the GCM, indicating a component arising from internal processes. The model is too moist in the middle troposphere (500 hPa) but too dry in the upper troposphere, suggesting that there is too little vertical transport or too much drying in the GCM. Transport into the stratosphere shows a pronounced annual cycle, with drier air entering the tropical stratosphere when the tropopause is coldest in northern winter; while the alternating dry and moist air masses can be traced ascending through the tropical lower stratosphere, the progression of the anomalies is too rapid.

  9. Preparation of IHY-2007 in Indonesia: Local Observational Facilities, International Collaborations, and the Use of International Data

    NASA Astrophysics Data System (ADS)

    Djamaluddin, T.

    2006-11-01

    t_djamal@hotmail.com Since 1980, the National Institute of Aeronautics and Space (LAPAN) has been carrying out integrated observations of solar activities, geomagnetic disturbance, and ionospheric parameters, as well as other solar-terrestrial relationship research. International collaboration, especially with Japan in the field of solar physics, geomagnetism and equatorial atmosphere and with Australia in the field of ionosphere and upper atmosphere, help us in increasing national capacity building. The international data available on the Internet also helps us in comparing our local data with the global one or in fulfilling our needs of data due to lack of facilities, ground based or space based data. Some results will be reviewed. Preparation for IHY-2007 will also be discussed.

  10. Identifying Emergency Department Patients at Low Risk for a Variceal Source of Upper Gastrointestinal Hemorrhage.

    PubMed

    Klein, Lauren R; Money, Joel; Maharaj, Kaveesh; Robinson, Aaron; Lai, Tarissa; Driver, Brian E

    2017-11-01

    Assessing the likelihood of a variceal versus nonvariceal source of upper gastrointestinal bleeding (UGIB) guides therapy, but can be difficult to determine on clinical grounds. The objective of this study was to determine if there are easily ascertainable clinical and laboratory findings that can identify a patient as low risk for a variceal source of hemorrhage. This was a retrospective cohort study of adult ED patients with UGIB between January 2008 and December 2014 who had upper endoscopy performed during hospitalization. Clinical and laboratory data were abstracted from the medical record. The source of the UGIB was defined as variceal or nonvariceal based on endoscopic reports. Binary recursive partitioning was utilized to create a clinical decision rule. The rule was internally validated and test characteristics were calculated with 1,000 bootstrap replications. A total of 719 patients were identified; mean age was 55 years and 61% were male. There were 71 (10%) patients with a variceal UGIB identified on endoscopy. Binary recursive partitioning yielded a two-step decision rule (platelet count > 200 × 10 9 /L and an international normalized ratio [INR] < 1.3), which identified patients who were low risk for a variceal source of hemorrhage. For the bootstrapped samples, the rule performed with 97% sensitivity (95% confidence interval [CI] = 91%-100%) and 49% specificity (95% CI = 44%-53%). Although this derivation study must be externally validated before widespread use, patients presenting to the ED with an acute UGIB with platelet count of >200 × 10 9 /L and an INR of <1.3 may be at very low risk for a variceal source of their upper gastrointestinal hemorrhage. © 2017 by the Society for Academic Emergency Medicine.

  11. Mental health in adolescence and subsequent receipt of medical benefits in young adulthood: The mediating role of upper secondary school completion.

    PubMed

    Sagatun, Åse; Wentzel-Larsen, Tore; Heyerdahl, Sonja; Lien, Lars

    2016-06-01

    Mental health problems in adolescence are associated with impaired function in young adulthood. Our aim was to assess how a hypothetical reduction in mental health problems in adolescence was related to medical benefits in young adulthood and to examine the mediating role of completion of upper secondary school. We used a population-based sample of more than 10,000 10th-grade adolescents with self-reported data on internalizing and externalizing mental health problems. The sample was linked to the Norwegian national registers of education and medical benefits. The mediation analysis was based on a causal inference framework. During a three-year period in young adulthood, 6.4% of men and 5.9% of women received medical benefits. A two-point hypothetical reduction in externalizing problems was related to a lower probability of receiving medical benefits of 1.5 (95% confidence interval (CI) 1.0-2.1) percentage points in young men and 1.8 (95% CI 1.3-2.3) percentage points in young women. The proportion mediated by the completion of upper secondary school was 52% (95% CI 36-76) among boys and 42% (95% CI 29-60) among girls. The corresponding reduction in the probability of receiving medical benefits was 1.8 percentage points for internalizing problems in both sexes (95% CI boys 1.2-2.4 and girls 1.4-2.2). The proportion mediated was lower for internalizing problems and was only significant among girls (19%). CONCLUSIONS INTERVENTION AND PREVENTION STRATEGIES TARGETING INTERNALIZING AND EXTERNALIZING PROBLEMS IN ADOLESCENTS MAY HAVE THE POTENTIAL TO REDUCE THE RECEIPT OF MEDICAL BENEFITS IN YOUNG ADULTHOOD THE COMPLETION OF UPPER SECONDARY SCHOOL SEEMS TO BE A MECHANISM FOR THIS ASSOCIATION, ESPECIALLY FOR EXTERNALIZING PROBLEMS. © 2016 the Nordic Societies of Public Health.

  12. Arnica Ointment 10% Does Not Improve Upper Blepharoplasty Outcome: A Randomized, Placebo-Controlled Trial.

    PubMed

    van Exsel, Denise C E; Pool, Shariselle M W; van Uchelen, Jeroen H; Edens, Mireille A; van der Lei, Berend; Melenhorst, Wynand B W H

    2016-07-01

    It has been suggested that arnica can reduce postoperative edema and ecchymosis associated with cosmetic surgical procedures and improve outcome. Despite a high incidence of arnica use among upper blepharoplasty patients, evidence to support its treatment effect is lacking. The authors performed a randomized, double-blind, placebo-controlled trial to investigate the efficacy of arnica ointment after upper blepharoplasty. One hundred thirty-six bilateral upper blepharoplasty patients were randomized between arnica ointment 10% and placebo ointment. In both study arms, one periorbital area was designated as the treatment side (either arnica or placebo ointment), and the contralateral side served as an untreated (no ointment) internal control. As the primary endpoint, the overall periorbital appearance as based on light photography and judged by a medical and nonmedical panel, was assessed after 3 days, 7 days, and 6 weeks. Secondary endpoints were swelling, ecchymosis, erythema, pain, and patient satisfaction with recovery and outcome. There was no significant difference between arnica and placebo in overall judgment of periorbital appearance 3 days, 7 days, and 6 weeks after surgery. Furthermore, swelling, ecchymosis, erythema, pain, and patient satisfaction with recovery and outcome did not differ between arnica and placebo. Postoperative outcome in untreated eyelids was not different from eyelids treated with either arnica or placebo on any of the studied outcome measures. The authors' study demonstrates that topical arnica ointment after upper blepharoplasty does not improve postoperative outcome. Therapeutic, II.

  13. The incidence of upper extremity injuries in endoscopy nurses working in the United States.

    PubMed

    Drysdale, Susan A

    2013-01-01

    Numerous studies have addressed musculoskeletal disorders in the international working population. The literature indicates that injuries exist at astounding rates with significant economic impact. Attempts have been made by government, private industry, and special interest groups to address the issues related to the occurrence and prevention of musculoskeletal injuries. Because of the limited research on the gastrointestinal (GI) endoscopy nursing sector, this descriptive, correlational study explored the incidence of upper extremity injuries in GI endoscopy nurses and technicians in the United States. A total of 215 subjects were included in the study. Findings show that upper extremity injuries exist among nurses working in GI endoscopy. Twenty-two percent of respondents missed work for upper extremity injuries. The findings also show that the severity of disability is related to the type of work done, type of assistive aids available at work, and whether or not ergonomic or physiotherapy assessments were provided at the place of employment. In reference to rate of injury and the availability of ergonomics and physiotherapy assessments, those who had ergonomic assessments available to them had scores on the Disabilities of the Arm, Shoulder, and Hand (DASH) inventory (indicating upper extremity disability) that were significantly lower (DASH score, 9.96) than those who did not have the assessments available (DASH score, 14.66). The results suggest that there are a significant number of subjects who are disabled to varying degrees and the majority of these are employed in full-time jobs.

  14. Upper lid crease approach for margin rotation in trachomatous cicatricial entropion without external sutures.

    PubMed

    Cruz, Antonio Augusto Velasco E; Akaishi, Patricia M S; Al-Dufaileej, Mohammed; Galindo-Ferreiro, Alicia

    2015-01-01

    To describe the use of a lid crease incision for upper eyelid margin rotation in cicatricial entropion combining internal traction on the anterior lamella, tarsotomy, and tarsal overlap without external sutures. Surgical description: The main steps of the procedure consisted of exposure of the entire tarsal plate up to the eyelashes followed by tarsotomy through the conjunctiva. A double-armed 6.0 polyglactin suture was then passed through the distal tarsal fragment to the marginal section of the orbicularis oculi muscle. As the sutures were tied, the distal tarsus advanced over the marginal section, and traction was exerted on the marginal strip of the orbicularis muscle. There were no bolsters or external knots. The pretarsal skin-muscle flap was closed with a 6.0 plain gut suture. We used this procedure at a tertiary hospital in Saudi Arabia from 2013 to 2014. Sixty upper lids of 40 patients (23 women and 17 men) were operated on, with an age range of 44-99 years [mean ± standard deviation (SD) = 70.9 ± 13.01 years]. Bilateral surgery was performed on 21 patients. Follow-up ranged from 1 to 12 months (mean 3.0 ± 2.71 months). Forty percent of the patients (24 lids) had more than 3 months' follow-up. The postoperative lid margin position was good in all cases. Trichiasis (two lashes) was observed in only one patient with unilateral entropion on the medial aspect of the operated lid. The upper lid margin can be effectively rotated through a lid crease incision with internal sutures. The technique combines the main mechanisms of the Wies and Trabut approaches and avoids the use of bolsters or external sutures, which require a second consultation to be removed. Some other lid problems, such as ptosis, retraction, or dermatochalasis, can be concomitantly addressed during the procedure.

  15. Upper gastrointestinal bleeding - state of the art.

    PubMed

    Szura, Mirosław; Pasternak, Artur

    2014-01-01

    Upper gastrointestinal (GI) bleeding is a condition requiring immediate medical intervention, with high associated mortality exceeding 10%. The most common cause of upper GI bleeding is peptic ulcer disease, which largely corresponds to the intake of NSAIDs and Helicobacter pylori infection. Endoscopy is the essential tool for the diagnosis and treatment of active upper GI hemorrhage. Endoscopic therapy together with proton pump inhibitors and eradication of Helicobacter pylori significantly reduces rebleeding rates, mortality and number of emergency surgical interventions. This paper presents contemporary data on the diagnosis and treatment of upper gastrointestinal bleeding.

  16. Classical test theory and Rasch analysis validation of the Upper Limb Functional Index in subjects with upper limb musculoskeletal disorders.

    PubMed

    Bravini, Elisabetta; Franchignoni, Franco; Giordano, Andrea; Sartorio, Francesco; Ferriero, Giorgio; Vercelli, Stefano; Foti, Calogero

    2015-01-01

    To perform a comprehensive analysis of the psychometric properties and dimensionality of the Upper Limb Functional Index (ULFI) using both classical test theory and Rasch analysis (RA). Prospective, single-group observational design. Freestanding rehabilitation center. Convenience sample of Italian-speaking subjects with upper limb musculoskeletal disorders (N=174). Not applicable. The Italian version of the ULFI. Data were analyzed using parallel analysis, exploratory factor analysis, and RA for evaluating dimensionality, functioning of rating scale categories, item fit, hierarchy of item difficulties, and reliability indices. Parallel analysis revealed 2 factors explaining 32.5% and 10.7% of the response variance. RA confirmed the failure of the unidimensionality assumption, and 6 items out of the 25 misfitted the Rasch model. When the analysis was rerun excluding the misfitting items, the scale showed acceptable fit values, loading meaningfully to a single factor. Item separation reliability and person separation reliability were .98 and .89, respectively. Cronbach alpha was .92. RA revealed weakness of the scale concerning dimensionality and internal construct validity. However, a set of 19 ULFI items defined through the statistical process demonstrated a unidimensional structure, good psychometric properties, and clinical meaningfulness. These findings represent a useful starting point for further analyses of the tool (based on modern psychometric approaches and confirmatory factor analysis) in larger samples, including different patient populations and nationalities. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  17. Turbulent convection driven by internal radiative heating of melt ponds on sea ice

    NASA Astrophysics Data System (ADS)

    Wells, Andrew; Langton, Tom; Rees Jones, David; Moon, Woosok

    2016-11-01

    The melting of Arctic sea ice is strongly influenced by heat transfer through melt ponds which form on the ice surface. Melt ponds are internally heated by the absorption of incoming radiation and cooled by surface heat fluxes, resulting in vigorous buoyancy-driven convection in the pond interior. Motivated by this setting, we conduct two-dimensional direct-numerical simulations of the turbulent convective flow of a Boussinesq fluid between two horizontal boundaries, with internal heating predicted from a two-stream radiation model. A linearised thermal boundary condition describes heat exchange with the overlying atmosphere, whilst the lower boundary is isothermal. Vertically asymmetric convective flow modifies the upper surface temperature, and hence controls the partitioning of the incoming heat flux between emission at the upper and lower boundaries. We determine how the downward heat flux into the ice varies with a Rayleigh number based on the internal heating rate, the flux ratio of background surface cooling compared to internal heating, and a Biot number characterising the sensitivity of surface fluxes to surface temperature. Thus we elucidate the physical controls on heat transfer through Arctic melt ponds which determine the fate of sea ice in the summer.

  18. Upper limb load as a function of repetitive task parameters: part 1--a model of upper limb load.

    PubMed

    Roman-Liu, Danuta

    2005-01-01

    The aim of the study was to develop a theoretical indicator of upper limb musculoskeletal load based on repetitive task parameters. As such the dimensionless parameter, Integrated Cycle Load (ICL) was accepted. It expresses upper limb load which occurs during 1 cycle. The indicator is based on a model of a repetitive task, which consists of a model of the upper limb, a model of basic types of upper limb forces and a model of parameters of a repetitive task such as length of the cycle, length of periods of the cycle and external force exerted during each of the periods of the cycle. Calculations of the ICL parameter were performed for 12 different variants of external load characterised by different values of repetitive task parameters. A comparison of ICL, which expresses external load with a physiological indicator of upper limb load, is presented in Part 2 of the paper.

  19. The Upper Atmosphere Research Satellite (UARS) mission

    NASA Technical Reports Server (NTRS)

    Reber, Carl A.; Trevathan, Charles E.; Mcneal, Robert J.; Luther, Michael R.

    1993-01-01

    The Upper Atmosphere Research Satellite (UARS) is a NASA program aimed at improving our knowledge of the physical and chemical processes controlling the stratosphere, mesosphere, and lower thermosphere, emphasizing those levels that are known to be particularly susceptible to change by human activities. The spacecraft was launched by the Space Shuttle Discovery on September 12, 1991 into a near-circular orbit at 585 km altitude and 57 deg inclination. Measurements include vertical profiles of temperature, many trace gases, and horizontal wind velocities, as well as solar energy inputs. Many of the limb-scanning instruments can measure to as high as 80 deg latitude, providing near-global coverage. The mission is supported by a large international correlative measurement program, yielding data both for validation of the UARS measurements and for complementary scientific studies. A dedicated data system provides rapid processing to geophysical quantities and makes these data available to UARS scientists.

  20. International energy outlook 1996

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

    NONE

    1996-05-01

    This International Energy Outlook presents historical data from 1970 to 1993 and EIA`s projections of energy consumption and carbon emissions through 2015 for 6 country groups. Prospects for individual fuels are discussed. Summary tables of the IEO96 world energy consumption, oil production, and carbon emissions projections are provided in Appendix A. The reference case projections of total foreign energy consumption and of natural gas, coal, and renewable energy were prepared using EIA`s World Energy Projection System (WEPS) model. Reference case projections of foreign oil production and consumption were prepared using the International Energy Module of the National Energy Modeling Systemmore » (NEMS). Nuclear consumption projections were derived from the International Nuclear Model, PC Version (PC-INM). Alternatively, nuclear capacity projections were developed using two methods: the lower reference case projections were based on analysts` knowledge of the nuclear programs in different countries; the upper reference case was generated by the World Integrated Nuclear Evaluation System (WINES)--a demand-driven model. In addition, the NEMS Coal Export Submodule (CES) was used to derive flows in international coal trade. As noted above, foreign projections of electricity demand are now projected as part of the WEPS. 64 figs., 62 tabs.« less

  1. Upper bounds of deformation in the Upper Rhine Graben from GPS data - First results from GURN (GNSS Upper Rhine Graben Network)

    NASA Astrophysics Data System (ADS)

    Masson, Frederic; Knoepfler, Andreas; Mayer, Michael; Ulrich, Patrice; Heck, Bernhard

    2010-05-01

    In September 2008, the Institut de Physique du Globe de Strasbourg (Ecole et Observatoire des Sciences de la Terre, EOST) and the Geodetic Institute (GIK) of Karlsruhe University (TH) established a transnational cooperation called GURN (GNSS Upper Rhine Graben Network). Within the GURN initiative these institutions are cooperating in order to establish a highly precise and highly sensitive network of permanently operating GNSS sites for the detection of crustal movements in the Upper Rhine Graben region. At the beginning, the network consisted of the permanently operating GNSS sites of SAPOS®-Baden-Württemberg, different data providers in France (e.g. EOST, Teria, RGP) and some further sites (e.g. IGS). In July 2009, the network was extended to the South when swisstopo (Switzerland) and to the North when SAPOS®-Rheinland-Pfalz joined GURN. Therefore, actually the GNSS network consists of approx. 80 permanently operating reference sites. The presentation will discuss the actual status of GURN, main research goals, and will present first results concerning the data quality as well as time series of a first reprocessing of all available data since 2002 using GAMIT/GLOBK (EOST working group) and the Bernese GPS Software (GIK working group). Based on these time series, the velocity as well as strain fields will be calculated in the future. The GURN initiative is also aiming for the estimation of the upper bounds of deformation in the Upper Rhine Graben region.

  2. Detailed study of upper mantle anisotropy in the upper mantle of eastern North America

    NASA Astrophysics Data System (ADS)

    Chen, X.; Levin, V. L.; Li, Y.

    2016-12-01

    notion of layered anisotropy in the upper mantle of the North American continent. We find localized changes in splitting parameters at the Grenville Front. The Appalachian Front, or the internal divisions of the Appalachian Orogen do not have obvious changes in splitting parameters associated with them.

  3. Effect of Virtual Reality-based Bilateral Upper Extremity Training on Upper Extremity Function after Stroke: A Randomized Controlled Clinical Trial.

    PubMed

    Lee, Suhyun; Kim, Yumi; Lee, Byoung-Hee

    2016-12-01

    In the present study, we aimed to investigate the effect of virtual reality-based bilateral upper extremity training (VRBT) on paretic upper limb function and muscle strength in patients with stroke. Eighteen stroke survivors were assigned to either the VRBT group (n = 10) or the bilateral upper limb training group (BT, n = 8). Patients in the VRBT group performed bilateral upper extremity exercises in a virtual reality environment, whereas those in the BT group performed conventional bilateral upper extremity exercises. All training was conducted for 30 minutes day -1 , 3 days a week, for a period of 6 weeks. Patients were assessed for upper extremity function and hand strength. Compared with the BT group, the VRBT group exhibited significant improvements in upper extremity function and muscle strength (p < 0.05) after the 6-week training programme. The Box and Block test results revealed that upper extremity function and elbow flexion in hand strength were significantly improved in terms of group, time and interaction effect of group by time. Furthermore, the VRBT group demonstrated significant improvements in upper extremity function, as measured by the Jebsen Hand Function Test and Grooved Pegboard test, and in the hand strength test, as measured by elbow extension, grip, palmar pinch, lateral pinch and tip pinch, in both time and the interaction effect of group by time. These results suggest that VRBT is a feasible and beneficial means of improving upper extremity function and muscle strength in individuals following stroke. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  4. Assessment of upper airway mechanics during sleep.

    PubMed

    Farré, Ramon; Montserrat, Josep M; Navajas, Daniel

    2008-11-30

    Obstructive sleep apnea, which is the most prevalent sleep breathing disorder, is characterized by recurrent episodes of upper airway collapse and reopening. However, the mechanical properties of the upper airway are not directly measured in routine polysomnography because only qualitative sensors (thermistors for flow and thoraco-abdominal bands for pressure) are used. This review focuses on two techniques that quantify upper airway obstruction during sleep. A Starling model of collapsible conduit allows us to interpret the mechanics of the upper airway by means of two parameters: the critical pressure (Pcrit) and the upstream resistance (Rup). A simple technique to measure Pcrit and Rup involves the application of different levels of continuous positive airway pressure (CPAP) during sleep. The forced oscillation technique is another non-invasive procedure for quantifying upper airway impedance during the breathing cycle in sleep studies. The latest developments in these two methods allow them to be easily applied on a routine basis in order to more fully characterize upper airway mechanics in patients with sleep breathing disorders.

  5. Biomedical research on the International Space Station postural and manipulation problems of the human upper limb in weightlessness

    NASA Astrophysics Data System (ADS)

    Neri, Gianluca; Zolesi, Valfredo

    2000-01-01

    Accumulated evidence, based on information gathered on space flight missions and ground based models involving both humans and animals, clearly suggests that exposure to states of microgravity conditions for varying duration induces certain physiological changes; they involve cardiovascular deconditioning, balance disorders, bone weakening, muscle hypertrophy, disturbed sleep patterns and depressed immune responses. The effects of the microgravity on the astronauts' movement and attitude have been studied during different space missions, increasing the knowledge of the human physiology in weightlessness. The purpose of the research addressed in the present paper is to understand and to assess the performances of the upper limb, especially during grasp. Objects of the research are the physiological changes related to the long-term duration spaceflight environment. Specifically, the changes concerning the upper limb are investigated, with particular regard to the performances of the hand in zero-g environments. This research presents also effects on the Earth, improving the studies on a number of pathological states, on the health care and the rehabilitation. In this perspective, a set of experiments are proposed, aimed at the evaluation of the effects of the zero-g environments on neurophysiology of grasping movements, fatigue assessment, precision grip. .

  6. Upper bounds on superpartner masses from upper bounds on the Higgs boson mass.

    PubMed

    Cabrera, M E; Casas, J A; Delgado, A

    2012-01-13

    The LHC is putting bounds on the Higgs boson mass. In this Letter we use those bounds to constrain the minimal supersymmetric standard model (MSSM) parameter space using the fact that, in supersymmetry, the Higgs mass is a function of the masses of sparticles, and therefore an upper bound on the Higgs mass translates into an upper bound for the masses for superpartners. We show that, although current bounds do not constrain the MSSM parameter space from above, once the Higgs mass bound improves big regions of this parameter space will be excluded, putting upper bounds on supersymmetry (SUSY) masses. On the other hand, for the case of split-SUSY we show that, for moderate or large tanβ, the present bounds on the Higgs mass imply that the common mass for scalars cannot be greater than 10(11)  GeV. We show how these bounds will evolve as LHC continues to improve the limits on the Higgs mass.

  7. Driving ability following upper limb amputation.

    PubMed

    Burger, Helena; Marincek, Crt

    2013-10-01

    In the existing literature, there is scarce information about subjects with upper limb amputation and driving. The aim of this study was to find out how frequently subjects following upper limb amputation have problems when driving; most frequently proposed adaptations and, when possible, factors that influence driving ability. Retrospective clinical study. Medical records were reviewed of all subjects following upper limb amputation who had been amputated in the last 5 years and those with congenital upper limb deficiency who in the last 5 years turned 17. Out of 37 subjects, 7 did not attend the clinic for assessment of driving abilities. They were significantly older at the time of the amputation (p < 0.001). To the remaining 30 who attended driving assessment, zero to four car adaptations (two on average) were proposed. There were no correlations between the number of suggested car adaptations and the age at the time of the amputation, amputation level, education and severity of phantom limb pain. Type of prosthesis also did not influence the number of car adaptations. Most people following upper limb amputation need at least one car adaptation for safe driving.

  8. "Heavy Fog in the Channel--Continent Cut Off": Reform of Upper-Secondary Education from the Perspective of English Exceptionalism

    ERIC Educational Resources Information Center

    Hodgson, Ann; Spours, Ken

    2014-01-01

    Recent international studies in upper-secondary education (USE) have highlighted the importance and complexities of this phase as it becomes a more universal experience. Here the authors examine recent trends in USE to provide a context for discussion of the English system, which has been moving from a "linked" to a more…

  9. Innovative Methods in Science Education in Japan--Strategic Methods on Smooth Transition from Upper Secondary School to the University

    ERIC Educational Resources Information Center

    Shinohara, Fumihiko

    2006-01-01

    This paper presents a brief introduction of the science education in Japan with an overview of the educational contents and standards laid by the Japanese Ministry of Education, Culture, Sports, Science and Technology (MEXT). It highlights the results of the International Education Association (IEA) on science education in Japan at upper secondary…

  10. Study of internal gravity waves in the meteor zone

    NASA Technical Reports Server (NTRS)

    Gavrilov, N. M.

    1987-01-01

    An important component of the dynamical regime of the atmosphere at heights near 100 km are internal gravity waves (IGW) with periods from about 5 min to about 17.5 hrs which propagate from the lower atmospheric layers and are generated in the uppermost region of the atmosphere. As IGW propagate upwards, their amplitudes increase and they have a considerable effect on upper atmospheric processes: (1) they provide heat flux divergences comparable with solar heating; (2) they influence the gaseous composition and produce wave variations of the concentrations of gaseous components and emissions of the upper atmosphere; and (3) they cause considerable acceleration of the mean stream. It was concluded that the periods, wavelengths, amplitudes and velocities of IGW propagation in the meteor zone are now measured quite reliably. However, for estimating the influence of IGW on the thermal regime and the circulation of the upper atmosphere these parameters are not as important as the values of wave fluxes of energy, heat, moment and mass.

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

    PubMed

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

    2013-06-01

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

  12. The oral health of upper income Americans.

    PubMed

    Bailit, Howard; Lim, Sungwoo; Ismail, Amid

    2016-06-01

    Limited information is available on the oral health status of upper income Americans (>400 percent of the FPL). They constitute 33 percent of the population and account for 53 percent of dental expenditures. Using 1999-2004 NHANES data, we examined differences in the mean number and percentage of decayed and filled permanent surfaces and missing teeth among age and family income groups. For upper income Americans, across age groups, the mean number of untreated decayed surfaces and missing teeth ranged from 0.2 to 0.5 and 2.6 to 3.3, respectively. The mean number of restored surfaces was low in children but extensive in adults. Income disparities increased with increasing age. Overall, upper income Americans have good oral health. Relatively few have untreated decayed surfaces or missing teeth. The reasons for the large number of restored surfaces in upper income adults require further research. Most upper income Americans are in good oral health, especially the 12-18 year cohort. As this group ages, the oral health of upper income adults is expected to improve. © 2015 American Association of Public Health Dentistry.

  13. Comparison of forearm and upper arm blood pressures.

    PubMed

    Singer, A J; Kahn, S R; Thode, H C; Hollander, J E

    1999-01-01

    In the prehospital setting it is not always feasible to obtain blood pressure (BP) readings from the upper arm. This study was performed to compare BPs obtained from subjects' forearms and upper arms in order to assess the utility of forearm BP as a surrogate for standard BP. The authors performed a prospective, cross-sectional, convenience study in a sample of ambulatory university ED patients, where each subject had sequential determinations of left upper arm and forearm BPs with an automated monitor at ED triage. The order of measurement was determined by the day of the week. Demographic and clinical data were also recorded. The main outcome measure was the correlation between upper arm and forearm systolic and diastolic BPs. Pearson's correlation coefficient and Student's t-test were used to analyze the data. 151 patients were enrolled. The mean age was 35.3+/-15.7 years; 40% were female and 78% were white. The mean forearm and upper arm systolic BPs were 129.8+/-20.7 mm Hg and 126.2+/-17.6 mm Hg (p = 0.002). The mean forearm and upper arm diastolic BPs were 80.7+/-14.5 mm Hg and 76.8+/-13.4 mm Hg (p<0.001). The correlations between forearm and upper arm systolic and diastolic BPs were 0.75 (p<0.001) and 0.72 (p<0.001). The differences between forearm and upper arm systolic and diastolic BPs were within 20 mm Hg in 86% and 94% of patients, respectively. Forearm BP is a fairly good predictor of standard upper arm BP in most patients. Forearm BP may be used when measurement of upper arm BP is not feasible.

  14. CRYOGENIC UPPER STAGE SYSTEM SAFETY

    NASA Technical Reports Server (NTRS)

    Smith, R. Kenneth; French, James V.; LaRue, Peter F.; Taylor, James L.; Pollard, Kathy (Technical Monitor)

    2005-01-01

    NASA s Exploration Initiative will require development of many new systems or systems of systems. One specific example is that safe, affordable, and reliable upper stage systems to place cargo and crew in stable low earth orbit are urgently required. In this paper, we examine the failure history of previous upper stages with liquid oxygen (LOX)/liquid hydrogen (LH2) propulsion systems. Launch data from 1964 until midyear 2005 are analyzed and presented. This data analysis covers upper stage systems from the Ariane, Centaur, H-IIA, Saturn, and Atlas in addition to other vehicles. Upper stage propulsion system elements have the highest impact on reliability. This paper discusses failure occurrence in all aspects of the operational phases (Le., initial burn, coast, restarts, and trends in failure rates over time). In an effort to understand the likelihood of future failures in flight, we present timelines of engine system failures relevant to initial flight histories. Some evidence suggests that propulsion system failures as a result of design problems occur shortly after initial development of the propulsion system; whereas failures because of manufacturing or assembly processing errors may occur during any phase of the system builds process, This paper also explores the detectability of historical failures. Observations from this review are used to ascertain the potential for increased upper stage reliability given investments in integrated system health management. Based on a clear understanding of the failure and success history of previous efforts by multiple space hardware development groups, the paper will investigate potential improvements that can be realized through application of system safety principles.

  15. The effect of the action observation physical training on the upper extremity function in children with cerebral palsy

    PubMed Central

    Kim, Jin-young; Kim, Jong-man; Ko, Eun-young

    2014-01-01

    The purpose this study was to investigate the effect of action observation physical training (AOPT) on the functioning of the upper extremities in children with cerebral palsy (CP), using an evaluation framework based on that of the International Classification of Functioning, Disability and Health (ICF). The subjects were divided into an AOPT group and a physical training (PT) group. AOPT group practiced repeatedly the actions they observed on video clips, in which normal child performed an action with their upper extremities. PT group performed the same actions as the AOPT group did after observing landscape photographs. The subjects participated in twelve 30-min sessions, 3 days a week, for 4 weeks. Evaluation of upper extremity function using the following: the power of grasp and Modified Ashworth Scale for body functions and structures, a Box and Block test, an ABILHAND-Kids questionnaire, and the WeeFIM scale for activity and participation. Measurements were performed before and after the training, and 2 weeks after the end of training. The results of this study showed that, in comparison with the PT group, the functioning of the upper extremities in the AOPT group was significantly improved in body functions and activity and participation according to the ICF framework. This study demonstrates that AOPT has a positive influence on the functioning of the upper extremities in children with CP. It is suggested that this alternative approach for functioning of the upper extremities could be an effective method for rehabilitation in children with CP. PMID:25061598

  16. Stakeholder views on flood risk management in Hungary's Upper Tisza Basin.

    PubMed

    Vari, Anna; Linnerooth-Bayer, Joanne; Ferencz, Zoltan

    2003-06-01

    With escalating costs of flood mitigation and relief, a challenge for the Hungarian government is to develop a flood mitigation and insurance/relief system that is viewed as efficient and fair by the many stakeholders involved. To aid policymakers in this task, this article reports on a recent study to elicit stakeholder views on flood risk management in the Upper Tisza Basin, including views on appropriate means of reducing losses and for transferring the residual losses from the direct victims to taxpayers or an insurance pool. This study is part of a project to develop an integrated approach to flood risk management coordinated by the International Institute of Applied Systems Analysis (IIASA) in collaboration with Swedish and Hungarian researchers. The discussion begins by describing the background of flood risk management problems in the Upper Tisza Basin. The results of interviews carried out with selected key stakeholders and the results of a public survey eliciting views on flood risk management are reported. The final section draws conclusions on incorporating stakeholder views into a flood risk management model, which will be used to illustrate policy paths at an upcoming stakeholder workshop. The conclusions are also of direct interest to Hungarian policymakers.

  17. CFD Analysis of Upper Plenum Flow for a Sodium-Cooled Small Modular Reactor

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

    Kraus, A.; Hu, R.

    2015-01-01

    Upper plenum flow behavior is important for many operational and safety issues in sodium fast reactors. The Prototype Gen-IV Sodium Fast Reactor (PGSFR), a pool-type, 150 MWe output power design, was used as a reference case for a detailed characterization of upper plenum flow for normal operating conditions. Computational Fluid Dynamics (CFD) simulation was utilized with detailed geometric modeling of major structures. Core outlet conditions based on prior system-level calculations were mapped to approximate the outlet temperatures and flow rates for each core assembly. Core outlet flow was found to largely bypass the Upper Internal Structures (UIS). Flow curves overmore » the shield and circulates within the pool before exiting the plenum. Cross-flows and temperatures were evaluated near the core outlet, leading to a proposed height for the core outlet thermocouples to ensure accurate assembly-specific temperature readings. A passive scalar was used to evaluate fluid residence time from core outlet to IHX inlet, which can be used to assess the applicability of various methods for monitoring fuel failure. Additionally, the gas entrainment likelihood was assessed based on the CFD simulation results. Based on the evaluation of velocity gradients and turbulent kinetic energies and the available gas entrainment criteria in the literature, it was concluded that significant gas entrainment is unlikely for the current PGSFR design.« less

  18. Ultrasonographic findings of Kimura's disease presenting in the upper extremities.

    PubMed

    Shin, Gi Won; Lee, Sun Joo; Choo, Hye Jung; Park, Young Mi; Jeong, Hae Woong; Lee, Sung-Moon; Suh, Jin-Suck; Jung, Soo-Jin

    2014-12-01

    To describe ultrasound findings of Kimura's disease arising in the upper extremities. Five patients with Kimura's disease confirmed by surgical resection were retrospectively reviewed by two musculoskeletal radiologists and a pathologist. All six lesions involved the epitrochlear area and appeared as partially (n = 5) or poorly (n = 1) marginated subcutaneous masses with the presence of curvilinear hyperechoic bands intermingled within the hypoechoic components by US. Moderate (n = 4) to severe (n = 2) vascular signals were observed in some proportion of the hyperechoic bands by color Doppler US. The associated findings were the increased echogenicity of surrounding subcutaneous fat (n = 6) and adjacent lymphadenopathy (n = 4). Microscopic examination showed proliferation of lymphoid follicles with prominent germinal centers and intervening fibrosis. In this study, Kimura's disease arising in the upper extremities showed a partially defined hypoechoic subcutaneous mass with internal hyperechoic bands and moderate-to-severe vascularities, increased echogenicity of the surrounding subcutaneous fat and adjacent lymphadenopathy on US. Thus, when these US features are observed in the typical epitrochlear region of an Asian individual, especially if accompanied by peripheral eosinophilia, Kimura's disease should be considered as a possible diagnosis.

  19. Upper ocean moored current and density profiler applied to winter conditions near Bermuda

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

    Eriksen, C.C.; Dahlen, J.M.; Shillingford, J.T. Jr.

    1982-09-20

    A new moored instrument which makes repeated high vertical resolution profiles of current, temperature, and salinity in the upper ocean over extended periods was used to observe midwinter conditions near Bermuda. The operation and performance of the instrument, called the profiling current meter (PCM), in the surface wave environment of winter storms is reported here. The PCM profiles along the upper portion of a slightly subsurface mooring by adjusting its buoyancy under computer control. This design decouples the instrument from vertical motions of the mooring induced by surface waves, so that its electromagnetic current sensor operates in a favorable mean-to-fluctuatingmore » flow regime. Current, temperature, and electrical conductivity are (vector) averaged into contiguous preselected bins several meters wide over the possible profile range of 20- to 250-m depth. The PCM is capable of collecting 1000--4000 profiles in a 6- to 12-month period, depending on depth range and ambient currents. A variety of baroclinic motions are evident in the Bermuda observations. Upper ocean manifestations of both Kelvin and superinertial island-trapped waves dominate longshore currents. Vertical coherence of onshore current and temperature suggest that internal wave vertical wave number energy distribution is independent of frequency but modified by island bathymetry. Kinetic energy in shear integrated over a 115.6-m-thick layer in the upper ocean is limited to values less than or equal to the potential energy required to mix the existing stratification. Mixing events occur when kinetic energy associated with shear drives the bulk Richardson number (defined by the ratio of energy integrals over the range profiles) to unity, where it remains while shear and stratification disappear together.« less

  20. External Versus Two Different Internal Foci of Attention in Long-Distance Throwing.

    PubMed

    Oki, Yuta; Kokubu, Masahiro; Nakagomi, Shiro

    2018-02-01

    The present study examined the influence of attentional focus on performance during a long-distance throwing task. Twelve participants executed three maximum-effort, long-distance baseball throwing attempts in three focus conditions: internal focus on wrist flexion (wrist internal focus), internal focus on the separation between pelvis and upper torso orientations (torso internal focus), and external focus on the ball path (external focus). Compared with the external focus and torso internal focus conditions, performance was poorer in the wrist internal focus condition. Performances were not different in the torso internal and external focus conditions. In addition, attentional focus affected the release angle of the ball but not its initial velocity. Our results reveal that the body part targeted for internal focus of attention and the forcefulness of the motor activity can be as important to motor performance as whether the attention is internal or external.

  1. Cervical Vascular and Upper Airway Asymmetry in Velo-Cardio-Facial Syndrome: Correlation of Nasopharyngoscopy with MRA

    PubMed Central

    Oppenheimer, Avi G.; Fulmer, Susan; Shifteh, Keivan; Chang, Ja-Kwei; Brook, Allan; Shanske, Alan L.; Shprintzen, Robert J.

    2010-01-01

    Purpose Velo-cardio-facial syndrome (VCFS), the most common genetic syndrome causing cleft palate, is associated with internal carotid and vertebral artery anomalies, as well as upper airway asymmetry. Medially displaced internal carotid arteries, often immediately submucosal, present a risk of vascular injury during pharyngeal flap surgery for velopharyngeal insufficiency (VPI). We evaluate the frequency and spectrum of cervical vascular anomalies in a large cohort of VCFS patients correlating MRA with nasopharyngolaryngoscopy in detecting at-risk carotid arteries. Furthermore, we assess the relationship with respect to laterality between cervical vascular patterns and the asymmetric abnormalities of these subjects' upper airways. Methods Cervical MRAs of 86 subjects with VCFS and 50 control subjects were independently reviewed by three neuroradiologists. The course of the internal carotid and vertebral arteries were identified within the pharyngeal soft tissues. Medial deviation, level of bifurcation, dominance, anomalous origin, and vessel tortuosity were recorded. Nasopharyngoscopy examinations were available for retrospective review in 43 patients and were assessed for palatal and posterior pharyngeal wall symmetry, true vocal cord motion and size, and for the presence or absence of carotid pulsations. The endoscopic findings were compared with MRA results. Results Of the 86 subjects, 80 (93%) had one or more vascular anomalies. 42 subjects (49%) were found to have medial deviation of at least one internal carotid artery. In 24 subjects (28%) the anomalous internal carotid artery were directly submucosal; four of these were bilateral (5% of the total sample, 17% of those with a submucosal internal carotid). Other carotid anomalies included low carotid bifurcation (44 subjects or 51%), anomalous origin of the right common carotid (32 cases, or 37%), and two cases of internal carotid agenesis/hypoplasia. Vertebral artery anomalies included vessel tortuosity (34

  2. Urinary Infections in Patients with Catheters in the Upper Urinary Tract: Microbiological Study.

    PubMed

    Lara-Isla, Alba; Medina-Polo, José; Alonso-Isa, Manuel; Benítez-Sala, Raúl; Sopeña-Sutil, Raquel; Justo-Quintas, Juan; Gil-Moradillo, Javier; González-Padilla, Daniel A; García-Rojo, Esther; Passas-Martínez, Juan Bautista; Tejido-Sánchez, Ángel

    2017-01-01

    Infections related to catheters in the upper urinary tract (CUUT) are associated with specific characteristics. A prospective observational study was carried out from 2012 to 2015 to evaluate infections in patients with CUUT. A total of 209 infections were included (99 with double-J, 81 with nephrostomy, and 29 with internal/external nephroureteral stents). Among nephrostomy tube carriers, the most frequently isolated microorganisms were Pseudomonas and Enterococcus. In those with an internal/external nephroureteral stent, Klebsiella was the most common, and 57.1% were extended-spectrum beta-lactamase-producing Klebsiella. In double-J carriers, Escherichia coli and Enterococcus were the most common microorganisms. Multiple-drug resistance (MDR) microorganisms were isolated in 28.6, 47.1, and 58.3% of patients with double-J, nephrostomy, and internal-external nephroureteral stents. A percutaneous CUUT (p = 0.005) and immunosuppression (p = 0.034) were risk factors for MDR microorganisms. Non-E. coli bacteria are commonly isolated in patients with CUUT. MDR microorganisms are frequent, mainly in percutaneous approach or immunosuppression. © 2017 S. Karger AG, Basel.

  3. Upper extremity function in stroke subjects: relationships between the international classification of functioning, disability, and health domains.

    PubMed

    Faria-Fortini, Iza; Michaelsen, Stella Maris; Cassiano, Janine Gomes; Teixeira-Salmela, Luci Fuscaldi

    2011-01-01

    Upper limb (UL) impairments are the most common disabling deficits after stroke and have complex relationships with activity and participation domains. However, relatively few studies have applied the ICF model to identify the contributions of specific UL impairments, such as muscular weakness, pain, and sensory loss, as predictors of activity and participation. The purposes of this predictive study were to evaluate the relationships between UL variables related to body functions/structures, activity, and participation domains and to determine which would best explain activity and participation with 55 subjects with chronic stroke. Body functions/structures were assessed by measures of grip, pinch, and UL strength, finger tactile sensations, shoulder pain, and cognition (MMSE); activity domain by measures of observed performance (BBT, NHPT, and TEMPA); and participation by measures of quality of life (SSQOL). Upper-limb and grip strength were related to all activity measures (0.52

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

    PubMed Central

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

    2013-01-01

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

  5. The Upper Atmosphere; Threshold of Space.

    ERIC Educational Resources Information Center

    Bird, John

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

  6. The IRIS-GUS Shuttle Borne Upper Stage System

    NASA Technical Reports Server (NTRS)

    Tooley, Craig; Houghton, Martin; Bussolino, Luigi; Connors, Paul; Broudeur, Steve (Technical Monitor)

    2002-01-01

    This paper describes the Italian Research Interim Stage - Gyroscopic Upper Stage (IRIS-GUS) upper stage system that will be used to launch NASA's Triana Observatory from the Space Shuttle. Triana is a pathfinder earth science mission being executed on rapid schedule and small budget, therefore the mission's upper stage solution had to be a system that could be fielded quickly at relatively low cost and risk. The building of the IRIS-GUS system wa necessary because NASA lost the capability to launch moderately sized upper stage missions fro the Space Shuttle when the PAM-D system was retired. The IRIS-GUS system restores this capability. The resulting system is a hybrid which mates the existing, flight proven IRIS (Italian Research Interim Stage) airborne support equipment to a new upper stage, the Gyroscopic Upper Stage (GUS) built by the GSFC for Triana. Although a new system, the GUS exploits flight proven hardware and design approaches in most subsystems, in some cases implementing proven design approaches with state-of-the-art electronics. This paper describes the IRIS-GUS upper stage system elements, performance capabilities, and payload interfaces.

  7. Reliability of the Quality of Upper Extremity Skills Test for Children with Cerebral Palsy Aged 2 to 12 Years

    ERIC Educational Resources Information Center

    Thorley, Megan; Lannin, Natasha; Cusick, Anne; Novak, Iona; Boyd, Roslyn

    2012-01-01

    Aim: To investigate reliability of the Quality of Upper Extremity Skills Test (QUEST) scores for children with cerebral palsy (CP) aged 2-12 years. Method: Thirty-one QUESTs from 24 children with CP were rated once by two raters and twice by one rater. Internal consistency of total scores, inter- and intra-rater reliability findings for total,…

  8. "Mugging Up" versus "Exposure": International Schools and Social Mobility in Hyderabad, India

    ERIC Educational Resources Information Center

    Gilbertson, Amanda

    2014-01-01

    Drawing on 12 months of fieldwork in Hyderabad, India, this paper describes the emergence of "international" schools that are only accessible to upper-middle class and elite families and provide forms of cultural capital increasingly important for middle-class employment--"communication skills", "open-mindedness" and…

  9. Internal Wave-Convection-Mean Flow Interactions

    NASA Astrophysics Data System (ADS)

    Lecoanet, D.; Couston, L. A.; Favier, B.; Le Bars, M.

    2017-12-01

    We present a series of simulations of Boussinesq fluid with a nonlinear equation of state which in thermal equilibrium is convective in the bottom part of the domain, but stably stratified in the upper part of the domain. The stably stratified region supports internal gravity waves, which are excited by the convection. The convection can significantly affected by the stably stratified region. Furthermore, the waves in the stable region can interact nonlinearly to drive coherent mean flows which exhibit regular oscillations, similar to the QBO in the Earth's atmosphere. We will describe the dependence of the mean flow oscillations on the properties of the convection which generate the internal waves. This provides a novel framework for understanding mean flow oscillations in the Earth's atmosphere, as well as the atmospheres of giant planets.

  10. Pressure-volume behavior of the upper airway.

    PubMed

    Fouke, J M; Teeter, J P; Strohl, K P

    1986-09-01

    The study was performed to investigate the relationship between force generation and upper airway expansion during respiratory efforts by upper airway muscles. In 11 anesthetized dogs we isolated the upper airway (nasal, oral, pharyngeal, and laryngeal regions) by transecting the cervical trachea and sealing the nasal and oral openings. During spontaneous respiratory efforts the pressure within the sealed upper airway, used as an index of dilating force, decreased during inspiration. On alternate breaths the upper airway was opened to a pneumotachograph, and an increase in volume occurred, also during inspiration. Progressive hyperoxic hypercapnia produced by rebreathing increased the magnitude of change in pressure and volume. At any level of drive, peak pressure or volume occurred at the same point during inspiration. At any level of drive, volume and pressure changes increased with end-expiratory occlusion of the trachea. The force-volume relationship determined from measurements during rebreathing was compared with pressure-volume curves performed by passive inflation of the airway while the animal was apneic. The relationship during apnea was 1.06 +/- 0.55 (SD) ml/cmH2O, while the force-volume relationship from rebreathing trials was -1.09 +/- 0.45 ml/cmH2O. We conclude that there is a correspondence between force production and volume expansion in the upper airway during active respiratory efforts.

  11. Upper cervical and upper thoracic thrust manipulation versus nonthrust mobilization in patients with mechanical neck pain: a multicenter randomized clinical trial.

    PubMed

    Dunning, James R; Cleland, Joshua A; Waldrop, Mark A; Arnot, Cathy F; Young, Ian A; Turner, Michael; Sigurdsson, Gisli

    2012-01-01

    Randomized clinical trial. To compare the short-term effects of upper cervical and upper thoracic high-velocity low-amplitude (HVLA) thrust manipulation to nonthrust mobilization in patients with neck pain. Although upper cervical and upper thoracic HVLA thrust manipulation and nonthrust mobilization are common interventions for the management of neck pain, no studies have directly compared the effects of both upper cervical and upper thoracic HVLA thrust manipulation to nonthrust mobilization in patients with neck pain. Patients completed the Neck Disability Index, the numeric pain rating scale, the flexion-rotation test for measurement of C1-2 passive rotation range of motion, and the craniocervical flexion test for measurement of deep cervical flexor motor performance. Following the baseline evaluation, patients were randomized to receive either HVLA thrust manipulation or nonthrust mobilization to the upper cervical (C1-2) and upper thoracic (T1-2) spines. Patients were reexamined 48-hours after the initial examination and again completed the outcome measures. The effects of treatment on disability, pain, C1-2 passive rotation range of motion, and motor performance of the deep cervical flexors were examined with a 2-by-2 mixed-model analysis of variance (ANOVA). One hundred seven patients satisfied the eligibility criteria, agreed to participate, and were randomized into the HVLA thrust manipulation (n = 56) and nonthrust mobilization (n = 51) groups. The 2-by-2 ANOVA demonstrated that patients with mechanical neck pain who received the combination of upper cervical and upper thoracic HVLA thrust manipulation experienced significantly (P<.001) greater reductions in disability (50.5%) and pain (58.5%) than those of the nonthrust mobilization group (12.8% and 12.6%, respectively) following treatment. In addition, the HVLA thrust manipulation group had significantly (P<.001) greater improvement in both passive C1-2 rotation range of motion and motor performance of

  12. Upper flow regime sheets, lenses and scour fills: Extending the range of architectural elements for fluvial sediment bodies

    NASA Astrophysics Data System (ADS)

    Fielding, Christopher R.

    2006-08-01

    Fluvial strata dominated internally by sedimentary structures of interpreted upper flow regime origin are moderately common in the rock record, yet their abundance is not appreciated and many examples may go unnoticed. A spectrum of sedimentary structures is recognised, all of which occur over a wide range of scale: 1. cross-bedding with humpback, sigmoidal and ultimately low-angle cross-sectional foreset geometries (interpreted as recording the transition from dune to upper plane bed bedform stability field), 2. planar/flat lamination with parting lineation, characteristic of the upper plane bed phase, 3. flat and low-angle lamination with minor convex-upward elements, characteristic of the transition from upper plane bed to antidune stability fields, 4. convex-upward bedforms, down- and up-palaeocurrent-dipping, low-angle cross-bedding and symmetrical drapes, interpreted as the product of antidunes, and 5. backsets terminating updip against an upstream-dipping erosion surface, interpreted as recording chute and pool conditions. In some fluvial successions, the entirety or substantial portions of channel sandstone bodies may be made up of such structures. These Upper Flow Regime Sheets, Lenses and Scour Fills (UFR) are defined herein as an extension of Miall's [Miall, A.D., 1985. Architectural-element analysis: a new method of facies analysis applied to fluvial deposits. Earth Sci. Rev. 22: 261-308.] Laminated Sand Sheets architectural element. Given the conditions that favour preservation of upper flow regime structures (rapid changes in flow strength), it is suggested that the presence of UFR elements in ancient fluvial successions may indicate sediment accumulation under the influence of a strongly seasonal palaeoclimate that involves a pronounced seasonal peak in precipitation and runoff.

  13. Ares I Crew Launch Vehicle Upper Stage Element Overview

    NASA Technical Reports Server (NTRS)

    McArthur, J. Craig

    2008-01-01

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

  14. The NASA program on upper atmospheric research

    NASA Technical Reports Server (NTRS)

    1976-01-01

    The purpose of the NASA Upper Atmospheric Research Program is to develop a better understanding of the physical and chemical processes that occur in the earth's upper atmosphere with emphasis on the stratosphere.

  15. Temperature variability caused by internal tides in the coral reef ecosystem of Hanauma bay, Hawai'i

    NASA Astrophysics Data System (ADS)

    Smith, Katharine A.; Rocheleau, Greg; Merrifield, Mark A.; Jaramillo, Sergio; Pawlak, Geno

    2016-03-01

    Hanauma Bay Nature Preserve is a shallow bay (<30 m depth) on the island of O'ahu, Hawai'i, offshore of which tidal flow over deep ridge topography (500-1000 m depth) is known to generate semidiurnal frequency internal tides. A field experiment was conducted during March to June 2009 to determine whether the deep internal tides propagate shoreward to influence variability in temperature and currents in the bay environment. Temperature observations in the bay exhibit a diurnal cycle that is strongest near the surface (upper 10 m) and is associated with solar heating. In early summer (May-June), as the upper mixed layer warms and a shallow seasonal thermocline develops, temperature fluctuations in deeper bay waters (>15 m depth) become dominated by large semidiurnal variations (up to 2.7 °C) that are attributed to the internal tide. These temperature drops caused by the internal tide occur consistently twice a day under summer stratification at depths as shallow as 15 m, while smaller temperature drops (up to 1.8 °C) occur occasionally at 5 m. Although semidiurnal band temperatures vary seasonally, semidiurnal band currents exhibit similar magnitudes in spring and summer. This suggests that the weak temperature fluctuations in spring are due to the bay residing entirely in the upper mixed layer at this time of year, while internal tide energy continues to influence currents. Observations made along a cross-shore/vertical transect at the center of the bay with an autonomous underwater vehicle highlight the structure of cold intrusions that fill a large portion of the bay as well as the relationship between temperature, salinity, chlorophyll, and backscatter. Near-bottom, advective heat flux estimates at the mouth of the bay indicate that the internal tide tends to advect cold water into the bay primarily on the northeast side of the bay entrance, with cold water outflow on the opposite side. The observations highlight the role of the internal tide along with

  16. Microsurgical refinements with the use of internal mammary (IM) perforators as recipient vessels in transverse upper gracilis (TUG) autologous breast reconstruction

    PubMed Central

    Libondi, Guido; Ramakrishnan, Venkat

    2017-01-01

    Background The transverse upper gracilis (TUG) flap is the senior authors’ second choice for autologous breast reconstruction when the DIEP flap is not available. It provides durable, pliable tissue with well hidden scars. The main criticism of this flap is the limited volume, donor site complications, short pedicle and vessel mismatch depending on which recipient vessels are used. We described methods of reducing vessel mismatch, complications of venous coupler and refinements to help give a more superior aesthetic outcome. Methods We describe several maneuvers to help reduce vessel mismatch with the use of the internal mammary (IM) perforator vessels with a modification of the Harashina fish-mouth technique or the use of a vessel bifurcation to increase vessel diameter. We also describe the optimum method of perforator preparation and potential methods to prevent palpable venous couplers. The author’s describe their case series of 14 TUG flaps to reconstruct 13 breasts in 12 patients. Results Eight unilateral, 2 partial breast reconstruction, 1 bilateral and 1 bilateral TUG flap for a unilateral reconstruction was carried out. All flaps survived with one partial flap necrosis, one donor site seroma and two cases of palpable/tender venous couplers. The mean reconstructed breast was 320 grams. Conclusions The TUG flap is a reconstructive challenge, but with correct planning a good aesthetic outcome is possible. The IM perforator is our first choice recipient vessel in TUG breast reconstructions. With meticulous preparation and by overcoming vessel mismatch the use of this recipient vessel is a reliable option. PMID:28861378

  17. Upper airway obstruction in Norwich Terriers: 16 cases.

    PubMed

    Johnson, L R; Mayhew, P D; Steffey, M A; Hunt, G B; Carr, A H; McKiernan, B C

    2013-01-01

    Norwich Terriers have grown increasingly popular as show animals and pets, and awareness of respiratory problems within the breed is growing. To describe components of obstructive upper airway syndrome in a nonbrachycephalic terrier breed. Sixteen Norwich Terriers; 12 with and 4 without clinical signs of respiratory disease. Prospective case series. Physical and laryngoscopic examinations were performed by 1 investigator in all dogs. Medical and surgical interventions were summarized and results of follow-up examination or owner reports were recorded. The study population was comprised of 9 females (6 intact) and 7 males (5 intact). Median age was 3.0 years (range, 0.5-11 years). Of 12 dogs presented for a respiratory complaint, physical examination was normal in 4 dogs. Laryngoscopic examination was abnormal in 11/12 dogs with redundant supra-arytenoid folds, laryngeal collapse, everted laryngeal saccules, and a narrowed laryngeal opening in most. Of 4 dogs lacking clinical signs, all had normal physical examination; however, 3/4 dogs had similar appearance of the larynx to dogs with clinical signs. Response to surgical intervention was minimal to moderate in all dogs. Norwich Terriers suffer from an upper airway obstructive syndrome that differs from that encountered in brachycephalic breeds. Affected dogs are difficult to identify without laryngoscopic examination because of the lack of clinical signs and abnormalities in physical examination findings, despite severe airway obstruction. Care is warranted when anesthetizing Norwich Terriers because of the small size of the laryngeal opening. Copyright © 2013 by the American College of Veterinary Internal Medicine.

  18. Live Imaging of Cellular Internalization of Single Colloidal Particle by Combined Label-Free and Fluorescence Total Internal Reflection Microscopy.

    PubMed

    Byrne, Gerard D; Vllasaliu, Driton; Falcone, Franco H; Somekh, Michael G; Stolnik, Snjezana

    2015-11-02

    In this work we utilize the combination of label-free total internal reflection microscopy and total internal reflectance fluorescence (TIRM/TIRF) microscopy to achieve a simultaneous, live imaging of single, label-free colloidal particle endocytosis by individual cells. The TIRM arm of the microscope enables label free imaging of the colloid and cell membrane features, while the TIRF arm images the dynamics of fluorescent-labeled clathrin (protein involved in endocytosis via clathrin pathway), expressed in transfected 3T3 fibroblasts cells. Using a model polymeric colloid and cells with a fluorescently tagged clathrin endocytosis pathway, we demonstrate that wide field TIRM/TIRF coimaging enables live visualization of the process of colloidal particle interaction with the labeled cell structure, which is valuable for discerning the membrane events and route of colloid internalization by the cell. We further show that 500 nm in diameter model polystyrene colloid associates with clathrin, prior to and during its cellular internalization. This association is not apparent with larger, 1 μm in diameter colloids, indicating an upper particle size limit for clathrin-mediated endocytosis.

  19. Restrictive and Expansive Policy Learning--Challenges and Strategies for Knowledge Exchange in Upper Secondary Education across the Four Countries of the UK

    ERIC Educational Resources Information Center

    Hodgson, Ann; Spours, Ken

    2016-01-01

    This article examines the challenges and possibilities for UK policy learning in relation to upper secondary education (USE) across England, Scotland, Wales and Northern Ireland (NI) within current national and global policy contexts. Drawing on a range of international literature, the article explores the concepts of "restrictive" and…

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

    PubMed

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

    2016-01-01

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

  1. Extensive upper respiratory tract sarcoidosis

    PubMed Central

    Soares, Mafalda Trindade; Sousa, Carolina; Garanito, Luísa; Freire, Filipe

    2016-01-01

    Sarcoidosis is a chronic granulomatous disease of unknown aetiology. It can affect any part of the organism, although the lung is the most frequently affected organ. Upper airway involvement is rare, particularly if isolated. Sarcoidosis is a diagnosis of exclusion, established by histological evidence of non-caseating granulomas and the absence of other granulomatous diseases. The authors report a case of a man with sarcoidosis manifesting as a chronic inflammatory stenotic condition of the upper respiratory tract and trachea. PMID:27090537

  2. Upper Extremity Amputations and Prosthetics

    PubMed Central

    Ovadia, Steven A.; Askari, Morad

    2015-01-01

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

  3. Permeability of continental crust influenced by internal and external forcing

    USGS Publications Warehouse

    Rojstaczer, S.A.; Ingebritsen, S.E.; Hayba, D.O.

    2008-01-01

    The permeability of continental crust is so highly variable that it is often considered to defy systematic characterization. However, despite this variability, some order has been gleaned from globally compiled data. What accounts for the apparent coherence of mean permeability in the continental crust (and permeability-depth relations) on a very large scale? Here we argue that large-scale crustal permeability adjusts to accommodate rates of internal and external forcing. In the deeper crust, internal forcing - fluxes induced by metamorphism, magmatism, and mantle degassing - is dominant, whereas in the shallow crust, external forcing - the vigor of the hydrologic cycle - is a primary control. Crustal petrologists have long recognized the likelihood of a causal relation between fluid flux and permeability in the deep, ductile crust, where fluid pressures are typically near-lithostatic. It is less obvious that such a relation should pertain in the relatively cool, brittle upper crust, where near-hydrostatic fluid pressures are the norm. We use first-order calculations and numerical modeling to explore the hypothesis that upper-crustal permeability is influenced by the magnitude of external fluid sources, much as lower-crustal permeability is influenced by the magnitude of internal fluid sources. We compare model-generated permeability structures with various observations of crustal permeability. ?? 2008 The Authors Journal compilation ?? 2008 Blackwell Publishing Ltd.

  4. 44. DETAIL VIEW OF CONTROL PANEL IN UPPER WEST WALL ...

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

    44. DETAIL VIEW OF CONTROL PANEL IN UPPER WEST WALL CONTROL STATION, LOOKING EAST. UPPER INTERMEDIATE WALL AND UPPER EAST WALL CONTROL STATIONS IN BACKGROUND - Upper Mississippi River 9-Foot Channel Project, Lock & Dam 27, Granite City, Madison County, IL

  5. Present state of knowledge of the upper atmosphere 1988: An assessment report

    NASA Astrophysics Data System (ADS)

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

    1988-06-01

    This document was issued in response to the Clean Air Act Amendments of 1977, Public Law 95-95, mandating that NASA and other key agencies submit biennial reports to Congress and EPA. NASA is to report on the state of our knowledge of the upper atmosphere, particularly the stratosphere. This is the sixth ozone assessment report submitted to Congress and the concerned regulatory agencies. Part 1 contains an outline of the NASA Upper Atmosphere Research Program and summaries of the research efforts supported during the last two years. An assessment is presented of the state of knowledge as of March 15, 1988 when the Ozone Trends Panel, organized by NASA and co-sponsored by the World Meteorological Organization, NOAA, FAA and the United Nations Environment Program released an executive summary of its findings from a critical in-depth study involving over 100 scientists from 12 countries. Chapter summaries of the International Ozone Trends Panel Report form the major part of this report. Two other sections are Model Predictions of Future Ozone Change and Chemical Kinetics and Photochemical Data for Use in Stratospheric Modeling. Each of these sections and the report in its entirety were peer reviewed.

  6. Present state of knowledge of the upper atmosphere 1988: An assessment report

    NASA Technical Reports Server (NTRS)

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

    1988-01-01

    This document was issued in response to the Clean Air Act Amendments of 1977, Public Law 95-95, mandating that NASA and other key agencies submit biennial reports to Congress and EPA. NASA is to report on the state of our knowledge of the upper atmosphere, particularly the stratosphere. This is the sixth ozone assessment report submitted to Congress and the concerned regulatory agencies. Part 1 contains an outline of the NASA Upper Atmosphere Research Program and summaries of the research efforts supported during the last two years. An assessment is presented of the state of knowledge as of March 15, 1988 when the Ozone Trends Panel, organized by NASA and co-sponsored by the World Meteorological Organization, NOAA, FAA and the United Nations Environment Program released an executive summary of its findings from a critical in-depth study involving over 100 scientists from 12 countries. Chapter summaries of the International Ozone Trends Panel Report form the major part of this report. Two other sections are Model Predictions of Future Ozone Change and Chemical Kinetics and Photochemical Data for Use in Stratospheric Modeling. Each of these sections and the report in its entirety were peer reviewed.

  7. SAS and SPSS macros to calculate standardized Cronbach's alpha using the upper bound of the phi coefficient for dichotomous items.

    PubMed

    Sun, Wei; Chou, Chih-Ping; Stacy, Alan W; Ma, Huiyan; Unger, Jennifer; Gallaher, Peggy

    2007-02-01

    Cronbach's a is widely used in social science research to estimate the internal consistency of reliability of a measurement scale. However, when items are not strictly parallel, the Cronbach's a coefficient provides a lower-bound estimate of true reliability, and this estimate may be further biased downward when items are dichotomous. The estimation of standardized Cronbach's a for a scale with dichotomous items can be improved by using the upper bound of coefficient phi. SAS and SPSS macros have been developed in this article to obtain standardized Cronbach's a via this method. The simulation analysis showed that Cronbach's a from upper-bound phi might be appropriate for estimating the real reliability when standardized Cronbach's a is problematic.

  8. Nuclear and Particle Physics Simulations: The Consortium of Upper-Level Physics Software

    NASA Astrophysics Data System (ADS)

    Bigelow, Roberta; Moloney, Michael J.; Philpott, John; Rothberg, Joseph

    1995-06-01

    The Consortium for Upper Level Physics Software (CUPS) has developed a comprehensive series of Nine Book/Software packages that Wiley will publish in FY `95 and `96. CUPS is an international group of 27 physicists, all with extensive backgrounds in the research, teaching, and development of instructional software. The project is being supported by the National Science Foundation (PHY-9014548), and it has received other support from the IBM Corp., Apple Computer Corp., and George Mason University. The Simulations being developed are: Astrophysics, Classical Mechanics, Electricity & Magnetism, Modern Physics, Nuclear and Particle Physics, Quantum Mechanics, Solid State, Thermal and Statistical, and Wave and Optics.

  9. The precipitation of energetic heavy ions into the upper atmosphere of Jupiter

    NASA Technical Reports Server (NTRS)

    Horanyi, M.; Cravens, T. E.; Waite, J. H., Jr.

    1987-01-01

    Evidence for auroral particle precipitation at Jupiter was provided by the ultraviolet spectrometers onboard the Voyagers 1 and 2 spacecraft and by the International Ultraviolet Explorer (IUE). Magnetospheric measurements made by instruments onboard the Voyager spacecraft show that energetic sulfur and oxygen ions are precipitating into the upper atmosphere of Jupiter. A theoretical model has been constructed describing the interaction of precipitating oxygen with the Jovian atmosphere. The auroral energy is deposited in the atmosphere by means of ionization, excitation, and dissociation and heating of the atmospheric gas. Energetic ion and electron precipitation are shown to have similar effects on the atmosphere and ionosphere of Jupiter.

  10. Internal Interdecadal Variability in CMIP5 Control Simulations

    NASA Astrophysics Data System (ADS)

    Cheung, A. H.; Mann, M. E.; Frankcombe, L. M.; England, M. H.; Steinman, B. A.; Miller, S. K.

    2015-12-01

    Here we make use of control simulations from the CMIP5 models to quantify the amplitude of the interdecadal internal variability component in Atlantic, Pacific, and Northern Hemisphere mean surface temperature. We compare against estimates derived from observations using a semi-empirical approach wherein the forced component as estimated using CMIP5 historical simulations is removed to yield an estimate of the residual, internal variability. While the observational estimates are largely consistent with those derived from the control simulations for both basins and the Northern Hemisphere, they lie in the upper range of the model distributions, suggesting the possibility of differences between the amplitudes of observed and modeled variability. We comment on some possible reasons for the disparity.

  11. Upper gastrointestinal alterations in kidney transplant candidates.

    PubMed

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

    2018-05-14

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

  12. Risk Assessment Challenges in the Ares I Upper Stage

    NASA Technical Reports Server (NTRS)

    Stott, James E.; Ring, Robert W.; Elrada, Hassan A.; Hark, Frank

    2007-01-01

    NASA Marshall Space Flight Center (MSFC) is currently at work developing hardware and systems for the Ares I rocket that will send future astronauts into orbit. Built on cutting-edge launch technologies, evolved powerful Apollo and Space Shuttle propulsion elements, and decades of NASA spaceflight experience, Ares I is the essential core of a safe, reliable, cost-effective space transportation system -- one that will carry crewed missions back to the moon, on to Mars and out into the solar system. Ares I is an in-line, two-stage rocket configuration topped by the Orion crew vehicle and its launch abort system. In addition to the vehicle's primary mission -carrying crews of four to six astronauts to Earth orbit --Ares I may also use its 25-ton payload capacity to deliver resources and supplies to the International Space Station, or to "park" payloads in orbit for retrieval by other spacecraft bound for the moon or other destinations. Crew transportation to the International Space Station is planned to begin no later than 2014. The first lunar excursion is scheduled for the 2020 timeframe. This paper presents the challenges in designing the Ares I upper stage for reliability and safety while minimizing weight and maximizing performance.

  13. Physical examination of upper extremity compressive neuropathies.

    PubMed

    Popinchalk, Samuel P; Schaffer, Alyssa A

    2012-10-01

    A thorough history and physical examination are vital to the assessment of upper extremity compressive neuropathies. This article summarizes relevant anatomy and physical examination findings associated with upper extremity compressive neuropathies. Copyright © 2012 Elsevier Inc. All rights reserved.

  14. Upper Gastrointestinal Stent Insertion in Malignant and Benign Disorders

    PubMed Central

    Kang, Hyoun Woo

    2015-01-01

    Upper gastrointestinal (GI) stents are increasingly being used to manage upper GI obstructions. Initially developed for palliative treatment of esophageal cancer, upper GI stents now play an emerging role in benign strictures of the upper GI tract. Because recurrent obstruction and stent-related complications are common, new modifications of stents have been implemented. Self-expandable metal stents (SEMS) have replaced older plastic stents. In addition, newly designed SEMS have been developed to prevent complications. This review provides an overview of the various types, indications, methods, complications, and clinical outcomes of upper GI stents in a number of malignant and benign disorders dividing the esophagus and gastroduodenum. PMID:26064817

  15. Study on the adverse effects of hydropower development on international shipping

    NASA Astrophysics Data System (ADS)

    Wang, Changhong

    2017-04-01

    The Lancang - Mekong river is an important international waterway to Southeast Asia and South Asia, which has important strategic significance for promoting regional economic cooperation and safeguarding national economic and security interests. On the Mekong River, the main aim is to develop hydropower resources utilization and shipping. River Hydropower Stations are in Laos and designed by foreign enterprises according to the construction of BOT. In this study, on the basis of a lot of research work and extensive collection of relevant information, and, through in-depth analysis of research, it reveals that the upper Mekong River hydropower development have many adverse effects on international shipping, put forward related suggestions for the healthy and sustainable development of international shipping.

  16. Mechanical Properties of the Upper Airway

    PubMed Central

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

    2013-01-01

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

  17. Sequences of upper and lower extremity motions in javelin throwing.

    PubMed

    Liu, Hui; Leigh, Steve; Yu, Bing

    2010-11-01

    Javelin throwing is technically demanding. Sequences of upper and lower extremity motions are important for javelin throwing performance. The purpose of this study was to determine the general sequences of upper and lower extremity motions of elite male and female javelin throwers. Three-dimensional kinematic data were collected for 32 female and 30 male elite javelin throwers during competitions. Shoulder, elbow, wrist, hip, knee, ankle, lower trunk, and upper trunk joint and segment angles were reduced for the best trial of each participant. Beginning times of 6 upper extremity and 10 lower extremity joint and segment angular motions were identified. Sequences of the upper and lower extremity motions were determined through statistical analyses. Upper and lower extremity motions of the male and female elite javelin throwers followed specific sequences (P ≤ 0.050). Upper extremity motions of the male and female elite javelin throwers did not follow a proximal-to-distal sequence as suggested in the literature. Male and female elite javelin throwers apparently employed different sequences for upper and lower extremity motions (P < 0.001). Further studies are needed to determine the effects of sequences of upper and lower extremity motions on javelin throwing performance.

  18. Infectious mononucleosis presenting as upper airway obstruction.

    PubMed

    Jain, Vivek; Singhi, Sunit; Desai, Ravi V

    2003-01-01

    Upper airway obstruction though a common complication of infectious mononucleosis is rarely considered in differential diagnosis of stridor. We report a three-year-old child who had upper airway obstruction due to infectious mononucleosis, managed conservatively with oxygen, intravenous fluids and steroids.

  19. Psychosocial Risk Factors for Upper Respiratory Infection: Personality Predictors of URI (Upper Respiratory Illness) during Basic Training

    DTIC Science & Technology

    1988-08-05

    boils, (t) encephalitis, (u) hepatitis (jaundice), (v) dysentery, (w) infectious mononucleosis , (x) warts, (y) whooping cough, and (z) bron- chitis...may provide information regarding general susceptibility to infectious disease. A risk profile for upper respiratory infections, therefore, may help...develop methods for predicting and controlling the influence of infectious diseases in general, and upper respiratory infections in particular, in Navy

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

    du Breuil, Anne L.; Close, Jeremy

    2016-01-01

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

  2. Health professionals identify components of the International Classification of Functioning, Disability and Health (ICF) in questionnaires for the upper limb

    PubMed Central

    Philbois, Stella V.; Martins, Jaqueline; Souza, Cesário S.; Sampaio, Rosana F.; Oliveira, Anamaria S.

    2016-01-01

    BACKGROUND: Several Brazilian studies have addressed the International Classification of Functioning, Disability and Health (ICF), but few have analyzed the knowledge of the health professionals with regards to the ICF. OBJECTIVE: To verify whether the classification of the items in the Brazilian-Portuguese versions of The Shoulder Pain and Disability Index (SPADI) and The Disabilities Arm, Shoulder and Hand (DASH) questionnaires, obtained from health professionals who worked with patients having upper limb injuries, could be related to ICF components as defined by others studies. METHOD: There were 4 participants for the group "professionals with high familiarity of the ICF (PHF)" and 19 for the group of "professionals with some or no familiarity of the ICF (PSNF)". The participants judged whether the items on the two questionnaires belonged to the ICF body function, body structure or activity-participation component, and marked a confidence level for each trial using a numerical scale ranging from zero to 10. The items were classified by the discriminant content validity method using the Student'st-test and the Hochberg correction. The ratings were compared to the literature by the percentage of agreement and Kappa coefficient. RESULTS: The percentage of agreement of the rating from the PSNF and the PHF groups with the literature was equal to or greater than 77%. For the DASH, the agreement of the PSNF and PHF groups with the literature were, respectively, moderate (Kappa=0.46 to 0.48) and substantial (Kappa=0.62 to 0.70). CONCLUSIONS: Health professionals were able to correlate the three components of the ICF for most items on the 2 questionnaires, demonstrating some ease of understanding the ICF components. However, the relation of concept of pain with body function component is not clear for professional and deserves a more attentive approach. PMID:26786076

  3. Evaluation of pediatric upper extremity peripheral nerve injuries.

    PubMed

    Ho, Emily S

    2015-01-01

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

  4. Morel-Lavallee Lesion in the Upper Extremity.

    PubMed

    Cochran, Grant K; Hanna, Kathryn H

    2017-01-01

    Background: The Morel-Lavallee lesion (MLL) is a closed internal degloving injury that results from shearing of the skin and subcutaneous tissue from the underlying fascia. Disruption of the perforating blood vessels and lymphatics results in a lesion filled with serosanguinous fluid and necrotized fat. MLLs are most commonly described in association with pelvic and lower extremity trauma, and there are limited reports of these lesions in other locations. Methods: This case report describes a 58-year-old male referred from his primary care physician with a soft tissue mass in the upper arm. Careful history discovered prior trauma with extensive bruising and MRI revealed a large encapsulated mass consistent with MLL. Results: An open debridement with excision of pseudocapsule was performed. Meticulous closure over a drain was performed and the patient healed without complication or recurrence. Intra-operative cultures were negative and pathology was consistent with MLL. Conclusion: MLL should always be considered in the setting of previous trauma regardless the location. In the chronic setting an open approach with excision of pseudocapsule can have an acceptable result.

  5. 33 CFR 117.1103 - Upper Mississippi River.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Upper Mississippi River. 117.1103 Section 117.1103 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES DRAWBRIDGE OPERATION REGULATIONS Specific Requirements Wisconsin § 117.1103 Upper Mississippi River. See...

  6. 33 CFR 117.1103 - Upper Mississippi River.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 1 2014-07-01 2014-07-01 false Upper Mississippi River. 117.1103 Section 117.1103 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES DRAWBRIDGE OPERATION REGULATIONS Specific Requirements Wisconsin § 117.1103 Upper Mississippi River. See...

  7. 33 CFR 117.1103 - Upper Mississippi River.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Upper Mississippi River. 117.1103 Section 117.1103 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES DRAWBRIDGE OPERATION REGULATIONS Specific Requirements Wisconsin § 117.1103 Upper Mississippi River. See...

  8. 33 CFR 117.1103 - Upper Mississippi River.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Upper Mississippi River. 117.1103 Section 117.1103 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES DRAWBRIDGE OPERATION REGULATIONS Specific Requirements Wisconsin § 117.1103 Upper Mississippi River. See...

  9. 33 CFR 117.1103 - Upper Mississippi River.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false Upper Mississippi River. 117.1103 Section 117.1103 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES DRAWBRIDGE OPERATION REGULATIONS Specific Requirements Wisconsin § 117.1103 Upper Mississippi River. See...

  10. Guidelines for internal optics optimization of the ITER EC H and CD upper launcher

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

    Moro, A.; Bruschi, A.; Figini, L.

    2014-02-12

    The importance of localized injection of Electron Cyclotron waves to control Magneto-HydroDynamic instability is well assessed in tokamak physics and the set of four Electron Cyclotron (EC) Upper Launchers (UL) in ITER is mainly designed for this purpose. Each of the 4 ULs uses quasi-optical mirrors (shaping and planes, fixed and steerable) to redirect and focus 8 beams (in two rows, with power close to 1 MW per beam coming from the EC transmission lines) in the plasma region where the instability appears. Small beam dimensions and maximum beam superposition guarantee the necessary localization of the driven current. To achievemore » the goal of MHD stabilization with minimum EC power to preserve the energy confinement in the outer half of the plasma cross section, optimization of the quasi-optical design is required and a guideline of a strategy is presented. As a result of this process and following the guidelines indicated, modifications of the design (new mirrors positions, rotation axes and/or focal properties) will be proposed for the next step of an iterative process, including the mandatory compatibility check with the mechanical constraints.« less

  11. Double-crested cormorants along the upper Mississippi River

    USGS Publications Warehouse

    Kirsch, E.M.

    1995-01-01

    The Upper Mississippi River is an important habitat corridor for migratory birds and other wildlife, and it supports an important commercial and sport fishery. A study was initiated by the U.S. Fish and Wildlife Service in 1991 to describe Double-crested cormorant (Phalacrocorax auritus) distribution and abundance on the Upper Mississippi River throughout the year to better understand the possible impacts of cormorants on fish resources and populations of other piscivorous birds. Double-crested Cormorants were common breeders and abundant during migration on the Upper Mississippi River during the 1940s. Numbers of cormorants declined in the 1960s and 1970s along the Upper Mississippi River as they did in other parts of the United States. In 1992, 418 cormorant pairs were estimated to have nested in four colonies on the Upper Mississippi River, and less than 7,000 cormorants were estimated to have migrated along the river during the fall and spring of 1991 and 1992. Recent public concern for fish resources has grown with a perceived growth of the local cormorant population. Migrating cormorants collected on the Upper Mississippi River took Gizzard Shad (Dorosoma cepedianum) primarily, but chicks were fed a wide variety of fish species.

  12. Involvement of upper torso stress amplification, tissue compression and distortion in the pathogenesis of keloids.

    PubMed

    Bux, Shamin; Madaree, Anil

    2012-03-01

    Keloids are benign tumours composed of fibrous tissue produced during excessive tissue repair triggered by minor injury, trauma or surgical incision. Although it is recognized that keloids have a propensity to form in the upper torso of the body, the predisposing factors responsible for this have not been investigated. It is crucial that the aetiopathoical factors implicated in keloid formation be established to provide guidelines for well-informed more successful treatment. We compared keloid-prone and keloid-protected skin, identified pertinent morphological differences and explored how inherent structural characteristics and intrinsic factors may promote keloid formation. It was determined that keloid prone areas were covered with high tension skin that had low stretch and a low elastic modulus when compared with skin in keloid protected areas where the skin was lax with a high elastic modulus and low pre-stress level. Factors contributing to elevated internal stress in keloid susceptible skin were the protrusion of hard connective tissue such as bony prominences or cartilage into the dermis of skin as well as inherent skin characteristics such as the bundled arrangement of collagen in the reticular dermis, the existent high tension, the low elastic modulus, low stretch ability, contractile forces exerted by wound healing fibroblastic cells and external forces. Stress promotes keloid formation by causing dermal distortion and compression which subsequently stimulate proliferation and enhanced protein synthesis in wound healing fibroblastic cells. The strain caused by stress also compresses and occludes microvessels causing ischaemic effects and reperfusion injury which stimulate growth when blood rich in growth factors returns to the tissue. The growth promoting effects of increased internal stress, primarily, and growth factors released by reperfusing blood, manifest in keloid formation. Other inherent skin characteristics promoting keloid growth during the

  13. 33 CFR 117.671 - Upper Mississippi River.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 1 2014-07-01 2014-07-01 false Upper Mississippi River. 117.671 Section 117.671 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES DRAWBRIDGE OPERATION REGULATIONS Specific Requirements Minnesota § 117.671 Upper Mississippi River. (a) The...

  14. 33 CFR 117.671 - Upper Mississippi River.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false Upper Mississippi River. 117.671 Section 117.671 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES DRAWBRIDGE OPERATION REGULATIONS Specific Requirements Minnesota § 117.671 Upper Mississippi River. (a) The...

  15. 33 CFR 117.671 - Upper Mississippi River.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Upper Mississippi River. 117.671 Section 117.671 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES DRAWBRIDGE OPERATION REGULATIONS Specific Requirements Minnesota § 117.671 Upper Mississippi River. (a) The...

  16. The upper atmosphere of Uranus

    NASA Technical Reports Server (NTRS)

    Strobel, Darrell F.; Yelle, Roger V.; Shemansky, Donald E.; Atreya, Sushil K.

    1991-01-01

    Voyager measurements of the upper atmosphere of Uranus are analyzed and developed. The upper atmosphere of Uranus is predominantly H2, with at most 10 percent He by volume, and the dominant constituent of the exosphere is H. The thermosphere is warm, with an asymptotic isothermal temperature of about 800 K. Atomic hydrogen at this temperature forms an extensive thermal corona and creates gas drag that severely limits the lifetime of small ring particles. The upper atmosphere emits copious amounts of UV radiation from pressures greater than 0.01 microbar. The depth of this emission level imposes a powerful constraint on permissible emission mechanisms. Electron excitation from a thin layer near the exobase appears to violate this constraint. Solar fluorescence is consistent with the observed trend in solar zenith-angle variation of the emissions and is absent from the night side of the planet. On Uranus, it accounts for the observed Lyman beta to H2 bands intensity ratio and an important fraction of the observed intensity (about 55 percent).

  17. Upper Oceanic Energy Response to Tropical Cyclone Passage

    DTIC Science & Technology

    2013-04-15

    insolation, and the upper ocean stratification . The importance of the upper ocean energy content to TCs, particularly their intensification, has been...similar to those of Shay and Brewster (2010), who showed that the stable stratification of the east Pacific also makes the 100-m mixed layer depth a poor... The upper oceanic temporal response to tropical cyclone (TC) passage is investigated using a 6-yr daily record of data-driven analyses of two

  18. Prevalence of upper limb disorders among female librarians.

    PubMed

    Pandy, R

    2013-09-01

    Work as a librarian involves exposure to potential risk factors for developing upper limb disorders. The prevalence of upper limb symptoms has, however, not previously been assessed in this occupational group. To estimate the 7-day and annual prevalence of self-reported neck and upper limb symptoms in librarians and to examine associations with specific tasks and ergonomic risk factors. A cross-sectional study using components of the standardized Nordic questionnaire. The study population consisted of librarians employed by a large local authority, and data collection was by means of a self-administered questionnaire. from studies on keyboard workers and on the general population were used as comparators. The 7-day prevalence of self-reported neck and upper limb pain in female librarians was 42% (95% confidence interval (CI) 33.7-50.5) and the annual prevalence was 65% (95% CI 56.6-72.8). The prevalence of reported wrist and hand pain increased with increased working involving a wide thumb-index span (P < 0.05) with a significant linear trend in prevalence with increasing exposure (P < 0.01). There was a strong association between reporting hand and/or wrist pain and awareness of work-related upper limb disorder (P < 0.05). The annual prevalence of self-reported upper limb symptoms among female librarians was high, but there was insufficient evidence to confirm whether the prevalence was higher than in the general population or among keyboard workers. Working with a wide thumb-index span was associated with reporting upper limb symptoms.

  19. ON COMPUTING UPPER LIMITS TO SOURCE INTENSITIES

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

    Kashyap, Vinay L.; Siemiginowska, Aneta; Van Dyk, David A.

    2010-08-10

    A common problem in astrophysics is determining how bright a source could be and still not be detected in an observation. Despite the simplicity with which the problem can be stated, the solution involves complicated statistical issues that require careful analysis. In contrast to the more familiar confidence bound, this concept has never been formally analyzed, leading to a great variety of often ad hoc solutions. Here we formulate and describe the problem in a self-consistent manner. Detection significance is usually defined by the acceptable proportion of false positives (background fluctuations that are claimed as detections, or Type I error),more » and we invoke the complementary concept of false negatives (real sources that go undetected, or Type II error), based on the statistical power of a test, to compute an upper limit to the detectable source intensity. To determine the minimum intensity that a source must have for it to be detected, we first define a detection threshold and then compute the probabilities of detecting sources of various intensities at the given threshold. The intensity that corresponds to the specified Type II error probability defines that minimum intensity and is identified as the upper limit. Thus, an upper limit is a characteristic of the detection procedure rather than the strength of any particular source. It should not be confused with confidence intervals or other estimates of source intensity. This is particularly important given the large number of catalogs that are being generated from increasingly sensitive surveys. We discuss, with examples, the differences between these upper limits and confidence bounds. Both measures are useful quantities that should be reported in order to extract the most science from catalogs, though they answer different statistical questions: an upper bound describes an inference range on the source intensity, while an upper limit calibrates the detection process. We provide a recipe for computing

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

    PubMed

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

    2018-01-15

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

  1. Risk factors for upper extremity venous thrombosis associated with peripherally inserted central venous catheters.

    PubMed

    Marnejon, Thomas; Angelo, Debra; Abu Abdou, Ahmed; Gemmel, David

    2012-01-01

    To identify clinically important risk factors associated with upper extremity venous thrombosis following peripherally inserted central venous catheters (PICC). A retrospective case control study of 400 consecutive patients with and without upper extremity venous thrombosis post-PICC insertion was performed. Patient data included demographics, body mass index (BMI), ethnicity, site of insertion, size and lumen of catheter, internal length, infusate, and co-morbidities, such as diabetes mellitus, congestive heart failure, and renal failure. Additional risk factors analyzed were active cancer, any history of cancer, recent trauma, smoking, a history of prior deep vein thrombosis, and recent surgery, defined as surgery within three months prior to PICC insertion. The prevalence of trauma, renal failure, and infusion with antibiotics and total parenteral nutrition (TPN) was higher among patients exhibiting upper extremity venous thrombosis (UEVT), when compared to controls. Patients developing UEVT were also more likely to have PICC line placement in a basilic vein and less likely to have brachial vein placement (P<.001). Left-sided PICC line sites also posed a greater risk (P=.026). The rate of standard DVT prophylaxis with low molecular weight heparin and unfractionated heparin and the use of warfarin was similar in both groups. Average length of hospital stay was almost double among patients developing UEVT, 19.5 days, when compared to patients undergoing PICC line insertion without thrombosis, 10.8 days (t=6.98, P<.001). In multivariate analysis, trauma, renal failure, left-sided catheters, basilic placement, TPN, and infusion with antibiotics, specifically vancomycin, were significant risk factors for UEVT associated with PICC insertion. Prophylaxis with low molecular weight heparin, unfractionated heparin or use of warfarin did not prevent the development of venous thrombosis in patients with PICCs. Length of hospital stay and cost are markedly increased in

  2. Association between selective serotonin reuptake inhibitors and upper gastrointestinal bleeding: population based case-control study

    PubMed Central

    de Abajo, Francisco José; Rodríguez, Luis Alberto García; Montero, Dolores

    1999-01-01

    Objective To examine the association between selective serotonin reuptake inhibitors and risk of upper gastrointestinal bleeding. Design Population based case-control study. Setting General practices included in the UK general practice research database. Subjects 1651 incident cases of upper gastrointestinal bleeding and 248 cases of ulcer perforation among patients aged 40 to 79 years between April 1993 and September 1997, and 10 000 controls matched for age, sex, and year that the case was identified. Interventions Review of computer profiles for all potential cases, and an internal validation study to confirm the accuracy of the diagnosis on the basis of the computerised information. Main outcome measures Current use of selective serotonin reuptake inhibitors or other antidepressants within 30 days before the index date. Results Current exposure to selective serotonin reuptake inhibitors was identified in 3.1% (52 of 1651) of patients with upper gastrointestinal bleeding but only 1.0% (95 of 10 000) of controls, giving an adjusted rate ratio of 3.0 (95% confidence interval 2.1 to 4.4). This effect measure was not modified by sex, age, dose, or treatment duration. A crude incidence of 1 case per 8000 prescriptions was estimated. A small association was found with non-selective serotonin reuptake inhibitors (relative risk 1.4, 1.1 to 1.9) but not with antidepressants lacking this inhibitory effect. None of the groups of antidepressants was associated with ulcer perforation. The concurrent use of selective serotonin reuptake inhibitors with non-steroidal anti-inflammatory drugs increased the risk of upper gastrointestinal bleeding beyond the sum of their independent effects (15.6, 6.6 to 36.6). A smaller interaction was also found between selective serotonin reuptake inhibitors and low dose aspirin (7.2, 3.1 to 17.1). Conclusions Selective serotonin reuptake inhibitors increase the risk of upper gastrointestinal bleeding. The absolute effect is, however

  3. A School for All or a School for the Labour Market? Analyzing the Goal Formulation of the 1991 Swedish Upper Secondary Education Reform

    ERIC Educational Resources Information Center

    Erikson, Josefina

    2017-01-01

    The 1991, Swedish upper secondary school reform presents internationally an unusual case of the far-reaching integration of academic and vocational programmes. It has often been claimed that late tracking, such as characterizes this reform, helps to reduce inequalities between different social classes. This article addresses the question of how…

  4. Predictors of Upper-Extremity Physical Function in Older Adults.

    PubMed

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

    2016-10-01

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

  5. Radiative Heating of the ISCCP Upper Level Cloud Regimes and its Impact on the Large-scale Tropical Circulation

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

    Li, Wei; Schumacher, Courtney; McFarlane, Sally A.

    2013-01-31

    Radiative heating profiles of the International Satellite Cloud Climatology Project (ISCCP) cloud regimes (or weather states) were estimated by matching ISCCP observations with radiative properties derived from cloud radar and lidar measurements from the Department of Energy (DOE) Atmospheric Radiation Measurement (ARM) sites at Manus, Papua New Guinea, and Darwin, Australia. Focus was placed on the ISCCP cloud regimes containing the majority of upper level clouds in the tropics, i.e., mesoscale convective systems (MCSs), deep cumulonimbus with cirrus, mixed shallow and deep convection, and thin cirrus. At upper levels, these regimes have average maximum cloud occurrences ranging from 30% tomore » 55% near 12 km with variations depending on the location and cloud regime. The resulting radiative heating profiles have maxima of approximately 1 K/day near 12 km, with equal heating contributions from the longwave and shortwave components. Upper level minima occur near 15 km, with the MCS regime showing the strongest cooling of 0.2 K/day and the thin cirrus showing no cooling. The gradient of upper level heating ranges from 0.2 to 0.4 K/(day∙km), with the most convectively active regimes (i.e., MCSs and deep cumulonimbus with cirrus) having the largest gradient. When the above heating profiles were applied to the 25-year ISCCP data set, the tropics-wide average profile has a radiative heating maximum of 0.45Kday-1 near 250 hPa. Column-integrated radiative heating of upper level cloud accounts for about 20% of the latent heating estimated by the Tropical Rainfall Measuring Mission (TRMM) Precipitation Radar (PR). The ISCCP radiative heating of tropical upper level cloud only slightly modifies the response of an idealized primitive equation model forced with the tropics-wide TRMM PR latent heating, which suggests that the impact of upper level cloud is more important to large-scale tropical circulation variations because of convective feedbacks rather than direct

  6. Upper High School Students' Understanding of Electromagnetism

    ERIC Educational Resources Information Center

    Saglam, Murat; Millar, Robin

    2006-01-01

    Although electromagnetism is an important component of upper secondary school physics syllabuses in many countries, there has been relatively little research on students' understanding of the topic. A written test consisting of 16 diagnostic questions was developed and used to survey the understanding of electromagnetism of upper secondary school…

  7. Upper respiratory tract (image)

    MedlinePlus

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

  8. Laboratory test variables useful for distinguishing upper from lower gastrointestinal bleeding.

    PubMed

    Tomizawa, Minoru; Shinozaki, Fuminobu; Hasegawa, Rumiko; Shirai, Yoshinori; Motoyoshi, Yasufumi; Sugiyama, Takao; Yamamoto, Shigenori; Ishige, Naoki

    2015-05-28

    To distinguish upper from lower gastrointestinal (GI) bleeding. Patient records between April 2011 and March 2014 were analyzed retrospectively (3296 upper endoscopy, and 1520 colonoscopy). Seventy-six patients had upper GI bleeding (Upper group) and 65 had lower GI bleeding (Lower group). Variables were compared between the groups using one-way analysis of variance. Logistic regression was performed to identify variables significantly associated with the diagnosis of upper vs lower GI bleeding. Receiver-operator characteristic (ROC) analysis was performed to determine the threshold value that could distinguish upper from lower GI bleeding. Hemoglobin (P = 0.023), total protein (P = 0.0002), and lactate dehydrogenase (P = 0.009) were significantly lower in the Upper group than in the Lower group. Blood urea nitrogen (BUN) was higher in the Upper group than in the Lower group (P = 0.0065). Logistic regression analysis revealed that BUN was most strongly associated with the diagnosis of upper vs lower GI bleeding. ROC analysis revealed a threshold BUN value of 21.0 mg/dL, with a specificity of 93.0%. The threshold BUN value for distinguishing upper from lower GI bleeding was 21.0 mg/dL.

  9. Laboratory test variables useful for distinguishing upper from lower gastrointestinal bleeding

    PubMed Central

    Tomizawa, Minoru; Shinozaki, Fuminobu; Hasegawa, Rumiko; Shirai, Yoshinori; Motoyoshi, Yasufumi; Sugiyama, Takao; Yamamoto, Shigenori; Ishige, Naoki

    2015-01-01

    AIM: To distinguish upper from lower gastrointestinal (GI) bleeding. METHODS: Patient records between April 2011 and March 2014 were analyzed retrospectively (3296 upper endoscopy, and 1520 colonoscopy). Seventy-six patients had upper GI bleeding (Upper group) and 65 had lower GI bleeding (Lower group). Variables were compared between the groups using one-way analysis of variance. Logistic regression was performed to identify variables significantly associated with the diagnosis of upper vs lower GI bleeding. Receiver-operator characteristic (ROC) analysis was performed to determine the threshold value that could distinguish upper from lower GI bleeding. RESULTS: Hemoglobin (P = 0.023), total protein (P = 0.0002), and lactate dehydrogenase (P = 0.009) were significantly lower in the Upper group than in the Lower group. Blood urea nitrogen (BUN) was higher in the Upper group than in the Lower group (P = 0.0065). Logistic regression analysis revealed that BUN was most strongly associated with the diagnosis of upper vs lower GI bleeding. ROC analysis revealed a threshold BUN value of 21.0 mg/dL, with a specificity of 93.0%. CONCLUSION: The threshold BUN value for distinguishing upper from lower GI bleeding was 21.0 mg/dL. PMID:26034359

  10. Upper Rio Grande Simulation Model (URGSIM)

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

    Roach, Jesse; & Tidwell, Vincent

    2010-08-05

    URGSIM estimates the location of surface water and groundwater resources in the upper Rio Grande Basin between the Colorado-New Mexico state line, and Caballo Reservoir from 1975 - 2045. It is a mass balance hydrology model of the Upper Rio Grande surface water, groundwater, and water demand systems which runs at a monthly timestep from 1975-1999 in calibration mode, 2000-2004 in validation mode, and 2005-2045 in scenario analysis mode.

  11. Survey of upper extremity injuries among martial arts participants.

    PubMed

    Diesselhorst, Matthew M; Rayan, Ghazi M; Pasque, Charles B; Peyton Holder, R

    2013-01-01

    To survey participants at various experience levels of different martial arts (MA) about upper extremity injuries sustained during training and fighting. A 21-s question survey was designed and utilised. The survey was divided into four groups (Demographics, Injury Description, Injury Mechanism, and Miscellaneous information) to gain knowledge about upper extremity injuries sustained during martial arts participation. Chi-square testing was utilised to assess for significant associations. Males comprised 81% of respondents. Involvement in multiple forms of MA was the most prevalent (38%). The hand/wrist was the most common area injured (53%), followed by the shoulder/upper arm (27%) and the forearm/elbow (19%). Joint sprains/muscle strains were the most frequent injuries reported overall (47%), followed by abrasions/bruises (26%). Dislocations of the upper extremity were reported by 47% of participants while fractures occurred in 39%. Surgeries were required for 30% of participants. Females were less likely to require surgery and more likely to have shoulder and elbow injuries. Males were more likely to have hand injuries. Participants of Karate and Tae Kwon Do were more likely to have injuries to their hands, while participants of multiple forms were more likely to sustain injuries to their shoulders/upper arms and more likely to develop chronic upper extremity symptoms. With advanced level of training the likelihood of developing chronic upper extremity symptoms increases, and multiple surgeries were required. Hand protection was associated with a lower risk of hand injuries. Martial arts can be associated with substantial upper extremity injuries that may require surgery and extended time away from participation. Injuries may result in chronic upper extremity symptoms. Hand protection is important for reducing injuries to the hand and wrist.

  12. Lung and Upper Aerodigestive Cancer | Division of Cancer Prevention

    Cancer.gov

    [[{"fid":"180","view_mode":"default","fields":{"format":"default","field_file_image_alt_text[und][0][value]":"Lung and Upper Aerodigestive Cancer Research Group Homepage Logo","field_file_image_title_text[und][0][value]":"Lung and Upper Aerodigestive Cancer Research Group Homepage Logo","field_folder[und]":"15"},"type":"media","attributes":{"alt":"Lung and Upper Aerodigestive

  13. The upper limit of vulnerability of the heart

    NASA Astrophysics Data System (ADS)

    Mazeh, Nachaat

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

  14. Upper stimulation threshold for retinal ganglion cell activation.

    PubMed

    Meng, Kevin; Fellner, Andreas; Rattay, Frank; Ghezzi, Diego; Meffin, Hamish; Ibbotson, Michael R; Kameneva, Tatiana

    2018-08-01

    The existence of an upper threshold in electrically stimulated retinal ganglion cells (RGCs) is of interest because of its relevance to the development of visual prosthetic devices, which are designed to restore partial sight to blind patients. The upper threshold is defined as the stimulation level above which no action potentials (direct spikes) can be elicited in electrically stimulated retina. We collected and analyzed in vitro recordings from rat RGCs in response to extracellular biphasic (anodic-cathodic) pulse stimulation of varying amplitudes and pulse durations. Such responses were also simulated using a multicompartment model. We identified the individual cell variability in response to stimulation and the phenomenon known as upper threshold in all but one of the recorded cells (n  =  20/21). We found that the latencies of spike responses relative to stimulus amplitude had a characteristic U-shape. In silico, we showed that the upper threshold phenomenon was observed only in the soma. For all tested biphasic pulse durations, electrode positions, and pulse amplitudes above lower threshold, a propagating action potential was observed in the distal axon. For amplitudes above the somatic upper threshold, the axonal action potential back-propagated in the direction of the soma, but the soma's low level of hyperpolarization prevented action potential generation in the soma itself. An upper threshold observed in the soma does not prevent spike conductance in the axon.

  15. Upper Animas Mining District

    EPA Pesticide Factsheets

    Web page provides narrative of What's New?, Site Description, Site Risk, Cleanup Progress, Community Involvement, Next Steps, Site Documents, FAQ, Contacts and LInks for the Upper Animas Mining District site in San Juan County, Colorado.

  16. Collaborative Tools in Upper Secondary School--Why?

    ERIC Educational Resources Information Center

    Mathiasen, Helle; Degn, Hans-Peter; Dalsgaard, Christian; Bech, Christian W.; Gregersen, Claus

    2013-01-01

    The paper will discuss potentials of digital media to support student engagement and student production in Danish upper secondary education with a specific focus on group work and collaboration. With the latest school reform, upper secondary education in Denmark has experienced an increased focus on problem-based and self-governed work of…

  17. Appropriate management of special situations in Crohn's disease (upper gastro-intestinal; extra-intestinal manifestations; drug safety during pregnancy and breastfeeding): Results of a multidisciplinary international expert panel-EPACT II.

    PubMed

    Mottet, Christian; Vader, John-Paul; Felley, Christian; Froehlich, Florian; Gonvers, Jean-Jacques; Juillerat, Pascal; Stockbrügger, Reinhold; Angelucci, Erika; Seibold, Frank; Michetti, Pierre; Pittet, Valérie

    2009-12-01

    High-grade evidence is lacking for most therapeutic decisions in Crohn's disease. Appropriateness criteria were developed for upper gastro-intestinal, extra-intestinal manifestations and drug safety during conception, pregnancy and breastfeeding in patients with Crohn's disease, to assist the physician in clinical decision making. The European Panel on the Appropriateness of Crohn's Disease Therapy (EPACT II), a multidisciplinary international European expert panel, rated clinical scenarios based on evidence from the published literature and panelists' own clinical expertise. Median ratings (on a 9-point scale) were stratified into three categories: appropriate (7-9), uncertain (4-6 with or without disagreement) and inappropriate (1-3). Experts were also asked to rank appropriate medications by priority. Proton pump inhibitors, steroids, azathioprine/6-mercaptopurine and infliximab are appropriate for upper gastro-duodenal Crohn's disease; for stenosis, endoscopic balloon dilation is the first-line therapy, although surgery is also appropriate. Ursodeoxycholic acid is the only appropriate treatment for primary sclerosing cholangitis. Infliximab is appropriate for Pyoderma gangrenosum, ankylosing spondylitis and uveitis, steroids for Pyoderma gangrenosum and ankylosing spondylitis, adalimumab for Pyoderma gangrenosum and ankylosing spondylitis, cyclosporine-A/tacrolimus for Pyoderma gangrenosum. Mesalamine, sulfasalazine, prednisone, azathioprine/6-mercaptopurine, ciprofloxacin, and probiotics, may be administered safely during pregnancy or for patients wishing to conceive, with the exception that male patients considering conception should avoid sulfasalazine. Metronidazol is considered safe in the 2nd and 3rd trimesters whereas infliximab is rated safe in the 1st trimester but uncertain in the 2nd and 3rd trimesters. Methotrexate is always contraindicated at conception, during pregnancy or during breastfeeding, due to its known teratogenicity. Mesalamine

  18. Facts about Upper and Lower Limb Reduction Defects

    MedlinePlus

    ... its normal size or is missing. What We Know About Upper and Lower Limb Reduction Defects How ... and productive lives. What We Still Do Not Know About Upper and Lower Limb Reduction Defects What ...

  19. Dental maturational sequence and dental tissue proportions in the early Upper Paleolithic child from Abrigo do Lagar Velho, Portugal

    PubMed Central

    Bayle, Priscilla; Macchiarelli, Roberto; Trinkaus, Erik; Duarte, Cidália; Mazurier, Arnaud; Zilhão, João

    2010-01-01

    Neandertals differ from recent and terminal Pleistocene human populations in their patterns of dental development, endostructural (internal structure) organization, and relative tissue proportions. Although significant changes in craniofacial and postcranial morphology have been found between the Middle Paleolithic and earlier Upper Paleolithic modern humans of western Eurasia and the terminal Pleistocene and Holocene inhabitants of the same region, most studies of dental maturation and structural morphology have compared Neandertals only to later Holocene humans. To assess whether earlier modern humans contrasted with later modern populations and possibly approached the Neandertal pattern, we used high-resolution microtomography to analyze the remarkably complete mixed dentition of the early Upper Paleolithic (Gravettian) child from Abrigo do Lagar Velho, Portugal, and compared it to a Neandertal sample, the late Upper Paleolithic (Magdalenian) child of La Madeleine, and a worldwide extant human sample. Some aspects of the dental maturational pattern and tooth endostructural organization of Lagar Velho 1 are absent from extant populations and the Magdalenian specimen and are currently documented only among Neandertals. Therefore, a simple Neandertal versus modern human dichotomy is inadequate to accommodate the morphostructural and developmental variation represented by Middle Paleolithic and earlier Upper Paleolithic populations. These data reinforce the complex nature of Neandertal-modern human similarities and differences, and document ongoing human evolution after the global establishment of modern human morphology. PMID:20080622

  20. Upper-Level Waves of Synoptic Scale at Midlatitudes

    NASA Astrophysics Data System (ADS)

    Rivest, Chantal

    1990-01-01

    Upper-level waves of synoptic scale are important dynamical entities at midlatitudes. They often induce surface cyclogenesis (cf. Peterssen and Smebye, 1971), and their life duration is typically longer than time scales for disruption by the ambient shear (Sanders, 1988). The objectives of the present thesis are to explain the maintenance and genesis of upper-level synoptic-scale waves in the midlatitude flow. We develop an analytical model of waves on generalized Eady basic states that have uniform tropospheric and stratospheric potential vorticity, but allow for the decay of density with height. The Eady basic state represents the limiting case of infinite stratospheric stability and constant density. We find that the Eady normal mode characteristics hold in the presence of realistic tropopause and stratosphere. In particular, the basic states studied support at the synoptic scale upper-level normal modes. These modes provide simple models for the dynamics of upper-level synoptic-scale waves, as waves supported by the large latitudinal gradients of potential vorticity at the tropopause. In the presence of infinitesimal positive tropospheric gradients of potential vorticity, the upper-level normal mode solutions no longer exist, as was demonstrated in Green (1960). Disappearance of the normal mode solution when a parameter changes slightly represents a dilemma that we seek to understand. We examine what happens to the upper-level normal modes in the presence of tropospheric gradients of potential vorticity in a series of initial -value experiments. Our results show that the normal modes become slowly decaying quasi-modes. Mathematically the quasi-modes consist of a superposition of singular modes sharply peaked in the phase speed domain, and their decay proceeds as the modes interfere with one another. We repeat these experiments in basic states with a smooth tropopause in the presence of tropospheric and stratospheric gradients, and similar results are obtained

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

    PubMed

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

    2013-10-01

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

  2. 51. View of upper radar scanner switch in radar scanner ...

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

    51. View of upper radar scanner switch in radar scanner building 105 from upper catwalk level showing emanating waveguides from upper switch (upper one-fourth of photograph) and emanating waveguides from lower radar scanner switch in vertical runs. - Clear Air Force Station, Ballistic Missile Early Warning System Site II, One mile west of mile marker 293.5 on Parks Highway, 5 miles southwest of Anderson, Anderson, Denali Borough, AK

  3. How large is the Upper Indus Basin? The pitfalls of auto-delineation using DEMs

    NASA Astrophysics Data System (ADS)

    Khan, Asif; Richards, Keith S.; Parker, Geoffrey T.; McRobie, Allan; Mukhopadhyay, Biswajit

    2014-02-01

    Extraction of watershed areas from Digital Elevation Models (DEMs) is increasingly required in a variety of environmental analyses. It is facilitated by the availability of DEMs based on remotely sensed data, and by Geographical Information System (GIS) software. However, accurate delineation depends on the quality of the DEM and the methodology adopted. This paper considers automated and supervised delineation in a case study of the Upper Indus Basin (UIB), Pakistan, for which published estimates of the basin area show significant disagreement, ranging from 166,000 to 266,000 km2. Automated delineation used ArcGIS Archydro and hydrology tools applied to three good quality DEMs (two from SRTM data with 90m resolution, and one from 30m resolution ASTER data). Automatic delineation defined a basin area of c.440,000 km2 for the UIB, but included a large area of internal drainage in the western Tibetan Plateau. It is shown that discrepancies between different estimates reflect differences in the initial extent of the DEM used for watershed delineation, and the unchecked effect of iterative pit-filling of the DEM (going beyond the filling of erroneous pixels to filling entire closed basins). For the UIB we have identified critical points where spurious addition of catchment area has arisen, and use Google Earth to examine the geomorphology adjacent to these points, and also examine the basin boundary data provided by the HydroSHEDS database. We show that the Pangong Tso watershed and some other areas in the western Tibetan plateau are not part of the UIB, but are areas of internal drainage. Our best estimate of the area of the Upper Indus Basin (at Besham Qila) is 164,867 km2 based on the SRTM DEM, and 164,853 km2 using the ASTER DEM). This matches the catchment area measured by WAPDA SWHP. An important lesson from this investigation is that one should not rely on automated delineation, as iterative pit-filling can produce spurious drainage networks and basins, when

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

    PubMed

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

    2017-03-01

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

  5. Maui Analysis of Upper Atmospheric Injections

    NASA Technical Reports Server (NTRS)

    Dressler, Rainer A.

    2008-01-01

    Maui Analysis of Upper Atmospheric Injections (MAUI) will observe the Space Shuttle engine exhaust plumes from the Maui Space Surveillance Site in Hawaii. The observations will occur when the Space Shuttle fires its engines at night or twilight. A telescope and all-sky imagers will take images and data while the Space Shuttle flies over the Maui site. The images will be analyzed to better understand the interaction between the spacecraft plume and the upper atmosphere of Earth.

  6. An L-Shaped Incision for an Extensive Thoracic Aortic Aneurysm and Coronary Artery Bypass Using the Left Internal Thoracic Artery.

    PubMed

    Abe, Tomonobu; Suenaga, Hiroto; Oshima, Hideki; Araki, Yoshimori; Mutsuga, Masato; Fujimoto, Kazuro; Usui, Akihiko

    2015-04-01

    An L-shaped incision combining an upper half mid-sternotomy and a left antero-lateral thoracotomy at the fourth intercostal space has been proposed by several authors for extensive aneurysms involving the aortic arch and the proximal thoracic descending aorta. This approach usually requires the division of the left internal thoracic artery at its mid position, thus making it unusable for coronary artery bypass. We herein report a modified surgical approach for simultaneous extensive arch and proximal thoracic descending aorta replacement and coronary artery bypass using the left internal thoracic artery combining a left antero-lateral thoracotomy at the sixth intercostal space and upper mid-sternotomy. The visualization of the whole diseased aorta down to the level below the hilum of the left lung was good, and the integrity of the left internal thoracic artery graft was preserved by early heparin administration before sternotomy.

  7. Upper Limit for Regional Sea Level Projections

    NASA Astrophysics Data System (ADS)

    Jevrejeva, Svetlana; Jackson, Luke; Riva, Riccardo; Grinsted, Aslak; Moore, John

    2016-04-01

    With more than 150 million people living within 1 m of high tide future sea level rise is one of the most damaging aspects of warming climate. The latest Intergovernmental Panel on Climate Change report (AR5 IPCC) noted that a 0.5 m rise in mean sea level will result in a dramatic increase the frequency of high water extremes - by an order of magnitude, or more in some regions. Thus the flood threat to the rapidly growing urban populations and associated infrastructure in coastal areas are major concerns for society. Hence, impact assessment, risk management, adaptation strategy and long-term decision making in coastal areas depend on projections of mean sea level and crucially its low probability, high impact, upper range. With probabilistic approach we produce regional sea level projections taking into account large uncertainties associated with Greenland and Antarctica ice sheets contribution. We calculate the upper limit (as 95%) for regional sea level projections by 2100 with RCP8.5 scenario, suggesting that for the most coastlines upper limit will exceed the global upper limit of 1.8 m.

  8. Transfusion strategy for acute upper gastrointestinal bleeding.

    PubMed

    Handel, James; Lang, Eddy

    2015-09-01

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

  9. Upper Eyelid Fractional CO2 Laser Resurfacing With Incisional Blepharoplasty.

    PubMed

    Kotlus, Brett S; Schwarcz, Robert M; Nakra, Tanuj

    2016-01-01

    Laser resurfacing, performed at the same time as blepharoplasty, has most commonly been applied to the lower eyelid skin but can effectively be used on the upper eyelid to reduce rhytidosis and improve skin quality. The authors evaluate the safety and efficacy of this procedure. Fractional CO2 laser resurfacing was performed in conjunction with incisional upper blepharoplasty. The ultrapulsed laser energy was applied to the sub-brow skin, the upper medial canthal skin, and the pretarsal skin in 30 patients. Photos were obtained preoperatively and at 3 months. All patients demonstrated reduction in upper eyelid rhytidosis without any serious complications. Independent rhytidosis grading (0-4) showed a mean improvement of 42%. One patient experienced wound dehiscence that satisfactorily resolved without intervention. Upper eyelid laser resurfacing is effective and can be safely performed at the same time as upper blepharoplasty. This approach reduces or eliminates the need for medial incisions to address medial canthal skin redundancy and rhytidosis and it directly treats upper eyelid wrinkles on residual eyelid and infra-brow skin during blepharoplasty.

  10. 11th International Conference on Atmospheric Electricity

    NASA Technical Reports Server (NTRS)

    Christian, H. J. (Compiler)

    1999-01-01

    This document contains the proceedings from the 11th International Conference on Atmospheric Electricity (ICAE 99), held June 7-11, 1999. This conference was attended by scientists and researchers from around the world. The subjects covered included natural and artificially initiated lightning, lightning in the middle and upper atmosphere (sprites and jets), lightning protection and safety, lightning detection techniques (ground, airborne, and space-based), storm physics, electric fields near and within thunderstorms, storm electrification, atmospheric ions and chemistry, shumann resonances, satellite observations of lightning, global electrical processes, fair weather electricity, and instrumentation.

  11. Application of RFID technology-upper extremity rehabilitation training.

    PubMed

    Chen, Chih-Chen; Chen, Yu-Luen; Chen, Shih-Ching

    2016-01-01

    [Purpose] Upper extremity rehabilitation after an injury is very important. This study proposes radio frequency identification (RFID) technology to improve and enhance the effectiveness of the upper extremity rehabilitation. [Subjects and Methods] People use their upper extremities to conduct daily activities. When recovering from injuries, many patients neglect the importance of rehabilitation, which results in degraded function. This study recorded the training process using the traditional rehabilitation hand gliding cart with a RFID reader, RFID tags in the panel, and a servo host computer. [Results] Clinical evidence, time taken to achieve a full score, counts of missing the specified spots, and Brunnstrom stage of aided recovery, the proximal part of the upper extremity show that the RFID-based upper extremity training significantly and reduce negative impacts of the disability in daily life and activities. [Conclusion] This study combined a hand-gliding cart with an RFID reader, and when patients moved the cart, the movement could be observed via the activated RFID tags. The training data was collected and quantified for a better understanding of the recovery status of the patients. Each of the participating patients made progress as expected.

  12. Work-Related Upper Limb Disorders: A Case Report

    PubMed Central

    Stoyneva, Zlatka Borisova; Dermendjiev, Svetlan; Dermendjiev, Tihomir; Dobrev, Hristo

    2015-01-01

    In this study the complex interrelationship between physical factors, job stress, lifestyle and genetic factors on symptoms of work-related musculoskeletal disorders of the upper limbs is demonstrated by a case report and discussion of the literature. A 58 year old woman with long lasting complaints of the upper limbs with increasing intensity and duration, generalisation, combined with skin thickness, Raynaud’s phenomenon, joint disorders, arterial and pulmonary hypertension, metabolic lipid dysfunctions is presented. Occupational history proves continuous duration of service at a job with occupational physical static load with numerous repetitive monotonous systematic motions of fingers and hands as a weaver of Persian rugs followed by work at an automated loom and variable labour activities. Though the complaints dated since the time she was a manual weaver, the manifestations of generalized joint degenerative changes, system sclerosis with Raynaud’s phenomenon with similar upper extremities signs and symptoms discount upper limbs musculoskeletal disorder as caused only or mainly by occupational risk factors. The main principles and criteria for occupational diagnosis of musculoskeletal upper limb disorders and legislative requirements for their reglamentation are discussed. PMID:27275213

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

    PubMed

    Çağıcı, Can Alper

    2017-11-16

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

  14. Upper intestinal lipids regulate energy and glucose homeostasis.

    PubMed

    Cheung, Grace W C; Kokorovic, Andrea; Lam, Tony K T

    2009-09-01

    Upon the entry of nutrients into the small intestine, nutrient sensing mechanisms are activated to allow the body to adapt appropriately to the incoming nutrients. To date, mounting evidence points to the existence of an upper intestinal lipid-induced gut-brain neuronal axis to regulate energy homeostasis. Moreover, a recent discovery has also revealed an upper intestinal lipid-induced gut-brain-liver neuronal axis involved in the regulation of glucose homeostasis. In this mini-review, we will focus on the mechanisms underlying the activation of these respective neuronal axes by upper intestinal lipids.

  15. [Thin-section computed tomography of the bronchi; 2. Right upper lobe and left upper division].

    PubMed

    Matsuoka, Y; Ookubo, T; Ohtomo, K; Nishikawa, J; Kojima, K; Oyama, K; Yoshikawa, K; Iio, M

    1990-02-01

    Thin (2mm) section contiguous computed tomographic (CT) scans were obtained through the bronchi of the right upper lobe and the left upper division in 30 patients. All segmental bronchi were identified. The right subsegmental bronchi were identified in 100%, and the left subsegmental bronchi in 97%. The type of the orifice of the right bronchus was trifurcated (53%), the extension of B1 was apicoanterior (50%), and the size of B2b was equal to B3a (63%). The extension of the left B3 was subapicoanterior (38%), and the size of B1+2c was equal to B3a (62%).

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

    USGS Publications Warehouse

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

    2013-01-01

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

  17. Upper Gastrointestinal (GI) Series

    MedlinePlus

    ... abdomen or ask you to change position several times to evenly coat your upper GI tract with the barium. If you are having a double-contrast study, you will swallow gas-forming crystals that mix with the barium coating your stomach. ...

  18. Upper third molar internal structural organization and semicircular canal morphology in Plio-Pleistocene South African cercopithecoids.

    PubMed

    Beaudet, Amélie; Dumoncel, Jean; Thackeray, John Francis; Bruxelles, Laurent; Duployer, Benjamin; Tenailleau, Christophe; Bam, Lunga; Hoffman, Jakobus; de Beer, Frikkie; Braga, José

    2016-06-01

    Despite the abundance of cercopithecoids in the fossil record, especially in South Africa, and the recent development of morphometric approaches, uncertainties regarding the taxonomic identification of isolated cranio-dental specimens remain. Because cercopithecoids, nearly always found in stratigraphic association with hominin remains in Plio-Pleistocene deposits, are considered as sensitive ecological and chronological biomarkers, a significant effort should be made to clarify their palaeobiodiversity by assessing additional reliable morphological diagnostic criteria. Here we test the relevance of both molar crown internal structure and bony labyrinth morphology for discrimination of fossil cercopithecoid species. We use microtomographic-based 3D virtual imaging and quantitative analyses to investigate tooth endostructural organization and inner ear shape in 29 craniodental specimens from the South African sites of Kromdraai, Makapansgat, Sterkfontein and Swartkrans and provide the first detailed description of the internal structural condition characterizing this Plio-Pleistocene primate assemblage. Our preliminary results show that enamel-dentine junction morphology could be informative for discriminating highly autapomorphic taxa such as Theropithecus, while semicircular canal shape is tentatively proposed as an efficient criterion for diagnosing Dinopithecus ingens. Further research in virtual paleoprimatology may contribute to the identification of unassigned isolated fossil remains and shed new light on the internal craniodental morphology of extinct primate taxa. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Low Cost, Upper Stage-Class Propulsion

    NASA Technical Reports Server (NTRS)

    Vickers, John

    2015-01-01

    The low cost, upper stage-class propulsion (LCUSP) element will develop a high strength copper alloy additive manufacturing (AM) process as well as critical components for an upper stage-class propulsion system that will be demonstrated with testing. As manufacturing technologies have matured, it now appears possible to build all the major components and subsystems of an upper stage-class rocket engine for substantially less money and much faster than traditionally done. However, several enabling technologies must be developed before that can happen. This activity will address these technologies and demonstrate the concept by designing, manufacturing, and testing the critical components of a rocket engine. The processes developed and materials' property data will be transitioned to industry upon completion of the activity. Technologies to enable the concept are AM copper alloy process development, AM post-processing finishing to minimize surface roughness, AM material deposition on existing copper alloy substrate, and materials characterization.

  20. Closed-kinetic chain upper-body training improves throwing performance of NCAA Division I softball players.

    PubMed

    Prokopy, Max P; Ingersoll, Christopher D; Nordenschild, Edwin; Katch, Frank I; Gaesser, Glenn A; Weltman, Arthur

    2008-11-01

    Closed-kinetic chain resistance training (CKCRT) of the lower body is superior to open-kinetic chain resistance training (OKCRT) to improve performance parameters (e.g., vertical jump), but the effects of upper-body CKCRT on throwing performance remain unknown. This study compared shoulder strength, power, and throwing velocity changes in athletes training the upper body exclusively with either CKCRT (using a system of ropes and slings) or OKCRT. Fourteen female National Collegiate Athletic Association Division I softball player volunteers were blocked and randomly placed into two groups: CKCRT and OKCRT. Blocking ensured the same number of veteran players and rookies in each training group. Training occurred three times weekly for 12 weeks during the team's supervised off-season program. Olympic, lower-body, core training, and upper-body intensity and volume in OKCRT and CKCRT were equalized between groups. Criterion variables pre- and posttraining included throwing velocity, bench press one-repetition maximum (1RM), dynamic single-leg balance, and isokinetic peak torque and power (PWR) (at 180 degrees x s(-1)) for shoulder flexion, extension, internal rotation, and external rotation (ER). The CKCRT group significantly improved throwing velocity by 2.0 mph (3.4%, p < 0.05), and the OKCRT group improved 0.3 mph (0.5%, NS). A significant interaction was observed (p < 0.05). The CKCRT group improved its 1RM bench press to the same degree (1.9 kg) as the OKCRT group (p < 0.05 within each group). The CKCRT group improved all measures of shoulder strength and power, whereas OKCRT conferred little change in shoulder torque and power scores. Although throwing is an open-chain movement, adaptations from CKCRT may confer benefits to subsequent performance. Strength coaches can incorporate upper-body CKCRT without sacrificing gains in maximal strength or performance criteria associated with an athletic open-chain movement such as throwing.

  1. Ares I-X Upper Stage Simulator Compartment Pressure Comparisons During Ascent

    NASA Technical Reports Server (NTRS)

    Downs. William J.; Kirchner, Robert D.; McLachlan, Blair G.; Hand, Lawrence A.; Nelson, Stuart L.

    2011-01-01

    Predictions of internal compartment pressures are necessary in the design of interstage regions, systems tunnels, and protuberance covers of launch vehicles to assess potential burst and crush loading of the structure. History has proven that unexpected differential pressure loads can lead to catastrophic failure. Pressures measured in the Upper Stage Simulator (USS) compartment of Ares I-X during flight were compared to post-flight analytical predictions using the CHCHVENT chamber-to-chamber venting analysis computer program. The measured pressures were enveloped by the analytical predictions for most of the first minute of flight but were outside of the predictions thereafter. This paper summarizes the venting system for the USS, discusses the probable reasons for the discrepancies between the measured and predicted pressures, and provides recommendations for future flight vehicles.

  2. Model of Semidiurnal Pseudo Tide in the High-Latitude Upper Mesosphere

    NASA Technical Reports Server (NTRS)

    Talaat, E. R.; Mayr, H. G.

    2011-01-01

    We present numerical results for the m = 1 meridional winds of semi diurnal oscillations in the high-latitude upper mesosphere, which are generated in the Numerical Spectral Model (NSM) without solar excitations of the tides. Identified with heuristic computer runs, the pseudo tides attain amplitudes that are, at times, as large as the non-migrating tides produced with standard solar forcing. Under the influence of parameterized gravity waves, the nonlinear NSM generates internal oscillations like the quasi-biennial oscillation, that are produced with periods favored by the dynamical properties of the system. The Coriolis force would favor at polar latitudes the excitation of the 12-hour periodicity. This oscillation may help explain the large non-migrating semidiurnal tides that are observed in the region with ground-based and satellite measurements.

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

    PubMed

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

    2016-08-01

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

  4. A comparison of upper limb amputees and patients with upper limb injuries using the Disability of the Arm, Shoulder and Hand (DASH).

    PubMed

    Davidson, Judith

    To use the Disability of the Arm Shoulder and Hand (DASH) scale to measure the disability of patients with upper limb amputation(s) and to compare these to other upper limb injuries. All 274 patients over the age of 18 years presenting to Prince Henry Hospital in Sydney over a 4-year time frame were given the DASH assessment tool and asked to complete it under supervision of the Occupational Therapist. Patients with brachial plexus injuries, Complex Regional Pain Syndrome and bilateral upper limb amputations demonstrated significantly higher levels of disability to patients with unilateral upper limb amputations. Partial hand amputees reported a higher level of disability than major unilateral upper limb amputees. For the 48 patients who completed pre- and post-treatment assessments, there was a significant improvement in their health status. Further research is required to understand the factors that affect a patient's perceptions of their disability. Perhaps the definitive nature of an amputation and the immediate involvement of highly skilled health professionals serve to assist patients to accept their injury and therefore minimizes the level of disability.

  5. Diffusion-weighted MR imaging of upper abdominal organs at different time points: Apparent diffusion coefficient normalization using a reference organ.

    PubMed

    Song, Ji Soo; Kwak, Hyo Sung; Byon, Jung Hee; Jin, Gong Yong

    2017-05-01

    To compare the apparent diffusion coefficient (ADC) of upper abdominal organs acquired at different time points, and to investigate the usefulness of normalization. We retrospectively evaluated 58 patients who underwent three rounds of magnetic resonance (MR) imaging including diffusion-weighted imaging of the upper abdomen. MR examinations were performed using three different 3.0 Tesla (T) and one 1.5T systems, with variable b value combinations and respiratory motion compensation techniques. The ADC values of the upper abdominal organs from three different time points were analyzed, using the ADC values of the paraspinal muscle (ADC psm ) and spleen (ADC spleen ) for normalization. Intraclass correlation coefficients (ICC) and comparison of dependent ICCs were used for statistical analysis. The ICCs of the original ADC and ADC psm showed fair to substantial agreement, while ADC spleen showed substantial to almost perfect agreement. The ICC of ADC spleen of all anatomical regions showed less variability compared with that of the original ADC (P < 0.005). Normalized ADC using the spleen as a reference organ significantly decreased variability in measurement of the upper abdominal organs in different MR systems at different time points and could be regarded as an imaging biomarker for future multicenter, longitudinal studies. 5 J. MAGN. RESON. IMAGING 2017;45:1494-1501. © 2016 International Society for Magnetic Resonance in Medicine.

  6. Airflow structures and nano-particle deposition in a human upper airway model

    NASA Astrophysics Data System (ADS)

    Zhang, Z.; Kleinstreuer, C.

    2004-07-01

    Considering a human upper airway model, or equivalently complex internal flow conduits, the transport and deposition of nano-particles in the 1-150 nm diameter range are simulated and analyzed for cyclic and steady flow conditions. Specifically, using a commercial finite-volume software with user-supplied programs as a solver, the Euler-Euler approach for the fluid-particle dynamics is employed with a low-Reynolds-number k- ω model for laminar-to-turbulent airflow and the mass transfer equation for dispersion of nano-particles or vapors. Presently, the upper respiratory system consists of two connected segments of a simplified human cast replica, i.e., the oral airways from the mouth to the trachea (Generation G0) and an upper tracheobronchial tree model of G0-G3. Experimentally validated computational fluid-particle dynamics results show the following: (i) transient effects in the oral airways appear most prominently during the decelerating phase of the inspiratory cycle; (ii) selecting matching flow rates, total deposition fractions of nano-size particles for cyclic inspiratory flow are not significantly different from those for steady flow; (iii) turbulent fluctuations which occur after the throat can persist downstream to at least Generation G3 at medium and high inspiratory flow rates (i.e., Qin⩾30 l/min) due to the enhancement of flow instabilities just upstream of the flow dividers; however, the effects of turbulent fluctuations on nano-particle deposition are quite minor in the human upper airways; (iv) deposition of nano-particles occurs to a relatively greater extent around the carinal ridges when compared to the straight tubular segments in the bronchial airways; (v) deposition distributions of nano-particles vary with airway segment, particle size, and inhalation flow rate, where the local deposition is more uniformly distributed for large-size particles (say, dp=100 nm) than for small-size particles (say, dp=1 nm); (vi) dilute 1 nm particle

  7. Validation of the Omron M3 Intellisense (HEM-7051-E) upper arm blood pressure monitor, for self-measurement, according to the European Society of Hypertension International Protocol revision 2010 in a stage 3-5 chronic kidney disease population.

    PubMed

    Akpolat, Tekin; Erdem, Emre; Aydogdu, Türkan

    2012-01-01

    Encouragement of home blood pressure (BP) monitoring has a great potential to improve hypertension control rates. The purpose of this study was to test validation of the Omron M3 Intellisense (HEM-7051-E) upper arm BP measuring monitor for self-measurement according to the European Society of Hypertension International Protocol revision 2010 (ESH-IP2) in stage 3-5 chronic kidney disease (CKD) patients. 66 patients having CKD stage 3-5 were included in the study. Nine consecutive measurements were made according to the ESH-IP2 protocol. The Omron M3 Intellisense device fulfills the validation criteria of the ESH-IP2 for stage 3-5 CKD patients. Although arterial stiffness can affect accurate BP measurement, there are limited data regarding the use of automated oscillometric devices in CKD. To our knowledge, this is the first study investigating validation of an oscillometric device in stage 3-5 predialysis CKD patients. This study validates the Omron M3 Intellisense upper arm device for stage 3-5 CKD patients. New validation studies investigating other oscillometric sphygmomanometers for CKD patients and involvement of nephrologists in these studies have great potential to increase patient care in CKD. Copyright © 2011 S. Karger AG, Basel.

  8. UPPER BOUND RISK ESTIMATES FOR MIXTURES OF CARCINOGENS

    EPA Science Inventory

    The excess cancer risk that might result from exposure to a mixture of chemical carcinogens usually is estimated with data from experiments conducted on individual chemicals. An upper bound on the total excess risk is estimated commonly by summing individual upper bound risk esti...

  9. Ubiquitous human upper-limb motion estimation using wearable sensors.

    PubMed

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

    2011-07-01

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

  10. Landscape ecology of the Upper Mississippi River System: Lessons learned, challenges and opportunities

    USGS Publications Warehouse

    DeJager, Nathan R.

    2016-03-22

    The Upper Mississippi River System (UMRS) is a mosaic of river channels, backwater lakes, floodplain forests, and emergent marshes. This complex mosaic supports diverse aquatic and terrestrial plant communities, over 150 fish species; 40 freshwater mussel species; 50 amphibian and reptile species; and over 360 bird species, many of which use the UMRS as a critical migratory route. The river and floodplain are also hotspots for biogeochemical activity as the river-floodplain collects and processes nutrients derived from the UMR basin. These features qualify the UMRS as a Ramsar wetland of international significance.Two centuries of land-use change, including construction for navigation and conversion of large areas to agriculture, has altered the broad-scale structure of the river and changed local environmental conditions in many areas. Such changes have affected rates of nutrient processing and transport, as well as the abundance of various fish, mussel, plant, and bird species. However, the magnitude and spatial scale of these effects are not well quantified, especially in regards to the best methods and locations for restoring various aspects of the river ecosystem.The U.S. Congress declared the navigable portions of the Upper Mississippi River System (UMRS) a “nationally significant ecosystem and nationally significant commercial navigation system” in the Water Resources Development Act of 1986 (Public Law 99-662) and launched the Upper Mississippi River Restoration (UMRR) Program, the first comprehensive program for ecosystem restoration, monitoring, and research on a large river system. This fact sheet focuses on landscape ecological studies conducted by the U.S. Geological Survey to support decision making by the UMRR with respect to ecosystem restoration.

  11. Upper limb robot-assisted therapy in cerebral palsy: a single-blind randomized controlled trial.

    PubMed

    Gilliaux, Maxime; Renders, Anne; Dispa, Delphine; Holvoet, Dominique; Sapin, Julien; Dehez, Bruno; Detrembleur, Christine; Lejeune, Thierry M; Stoquart, Gaëtan

    2015-02-01

    Several pilot studies have evoked interest in robot-assisted therapy (RAT) in children with cerebral palsy (CP). To assess the effectiveness of RAT in children with CP through a single-blind randomized controlled trial. Sixteen children with CP were randomized into 2 groups. Eight children performed 5 conventional therapy sessions per week over 8 weeks (control group). Eight children completed 3 conventional therapy sessions and 2 robot-assisted sessions per week over 8 weeks (robotic group). For both groups, each therapy session lasted 45 minutes. Throughout each RAT session, the patient attempted to reach several targets consecutively with the REAPlan. The REAPlan is a distal effector robot that allows for displacements of the upper limb in the horizontal plane. A blinded assessment was performed before and after the intervention with respect to the International Classification of Functioning framework: body structure and function (upper limb kinematics, Box and Block test, Quality of Upper Extremity Skills Test, strength, and spasticity), activities (Abilhand-Kids, Pediatric Evaluation of Disability Inventory), and participation (Life Habits). During each RAT session, patients performed 744 movements on average with the REAPlan. Among the variables assessed, the smoothness of movement (P < .01) and manual dexterity assessed by the Box and Block test (P = .04) improved significantly more in the robotic group than in the control group. This single-blind randomized controlled trial provides the first evidence that RAT is effective in children with CP. Future studies should investigate the long-term effects of this therapy. © The Author(s) 2014.

  12. Upper Girdle Imaging in Facioscapulohumeral Muscular Dystrophy

    PubMed Central

    Tasca, Giorgio; Monforte, Mauro; Iannaccone, Elisabetta; Laschena, Francesco; Ottaviani, Pierfrancesco; Leoncini, Emanuele; Boccia, Stefania; Galluzzi, Giuliana; Pelliccioni, Marco; Masciullo, Marcella; Frusciante, Roberto; Mercuri, Eugenio; Ricci, Enzo

    2014-01-01

    Background In Facioscapulohumeral muscular dystrophy (FSHD), the upper girdle is early involved and often difficult to assess only relying on physical examination. Our aim was to evaluate the pattern and degree of involvement of upper girdle muscles in FSHD compared with other muscle diseases with scapular girdle impairment. Methods We propose an MRI protocol evaluating neck and upper girdle muscles. One hundred-eight consecutive symptomatic FSHD patients and 45 patients affected by muscular dystrophies and myopathies with prominent upper girdle involvement underwent this protocol. Acquired scans were retrospectively analyzed. Results The trapezius (100% of the patients) and serratus anterior (85% of the patients) were the most and earliest affected muscles in FSHD, followed by the latissimus dorsi and pectoralis major, whilst spinati and subscapularis (involved in less than 4% of the patients) were consistently spared even in late disease stages. Asymmetry and hyperintensities on short-tau inversion recovery (STIR) sequences were common features, and STIR hyperintensities could also be found in muscles not showing signs of fatty replacement. The overall involvement appears to be disease-specific in FSHD as it significantly differed from that encountered in the other myopathies. Conclusions The detailed knowledge of single muscle involvement provides useful information for correctly evaluating patients' motor function and to set a baseline for natural history studies. Upper girdle imaging can also be used as an additional tool helpful in supporting the diagnosis of FSHD in unclear situations, and may contribute with hints on the currently largely unknown molecular pathogenesis of this disease. PMID:24932477

  13. An energy/emissions/economic analysis resource for north Moravia, upper Silesia, and Kisuca

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

    Walder, V.

    1995-12-31

    The United States Agency for International Development (USAID) is sponsoring the Technology Transfer Network (TTN) which is centered in Ostrava, Czech Republic. The primary objective of the TTN is to provide a resource for municipalities, industries, and companies interested in reducing air pollution, improving energy efficiency, and implementing projects in North Moravia, Upper Silesia, and Kisuca. The TTN is providing a communications network (newsletters, mailings, and other media), seminars, workshops, software, access to past and ongoing studies, and a database of U.S. vendors supporting the region. Seminars and major communication material of the TTN will be provided in Czech/Slovak, Polish,more » and English as appropriate.« less

  14. International Space Station (ISS)

    NASA Image and Video Library

    2002-10-10

    Launched October 7, 2002 aboard the Space Shuttle Orbiter Atlantis, the STS-112 mission lasted 11 days and performed three sessions of Extra Vehicular Activity (EVA). Its primary mission was to install the Starboard (S1) Integrated Truss Structure and Equipment Translation Aid (CETA) Cart to the International Space Station (ISS). The S1 truss provides structural support for the orbiting research facility's radiator panels, which use ammonia to cool the Station's complex power system. The S1 truss, attached to the S0 (S Zero) truss installed by the previous STS-110 mission, flows 637 pounds of anhydrous ammonia through three heat rejection radiators. The truss is 45-feet long, 15-feet wide, 10-feet tall, and weighs approximately 32,000 pounds. The CETA is the first of two human-powered carts that will ride along the International Space Station's railway providing a mobile work platform for future extravehicular activities by astronauts. This is a view of the newly installed S1 Truss as photographed during the mission's first scheduled EVA. The Station's Canadarm2 is in the foreground. Visible are astronauts Piers J. Sellers (lower left) and David A. Wolf (upper right), both STS-112 mission specialists.

  15. Exposure assessment of upper limb repetitive movements: a consensus document developed by the Technical Committee on Musculoskeletal Disorders of International Ergonomics Association (IEA) endorsed by International Commission on Occupational Health (ICOH).

    PubMed

    Colombini, D; Occhipinti, E; Delleman, N; Fallentin, N; Kilbom, A; Grieco, A

    2001-01-01

    This consensus document intends to supply a set of definitions, criteria and procedures useful to describe and, wherever possible, to assess the work conditions that can represent a physical overload for the upper limbs. The document is aimed at all the operators, i.e. occupational doctors but mainly technicians, who are, involved in risk exposure assessment and management. The document intends to provide methods and procedures easily applicable in the field, possibly not requiring sophisticated instrumentation and when possible based on observation procedures. The proposed methods shall be based as far as possible on knowledge and data from scientific literature: should they be contradictory or deficient, reference will be made to standards or pre-standards issued by national and international agencies and bodies, with the experience of researchers involved and common sense. In this regard, it is to be emphasized that the potential users increasingly demand an easily applicable method for description and assessment of work with repetitive movements. The group intends to give a response even if there are still uncertainties from a strictly scientific standpoint: however the group commits itself to perform subsequent validations especially of as yet unconsolidated issues. This document focuses specifically on identification of risk factors and describes some of the methods that have been developed for evaluating them. There is a rapidly developing body of literature on job analysis and not yet agreement on a single best way to analyze jobs. Professional judgement is required to select the appropriate methods. Analysis and design of jobs should to be integrated into an ongoing ergonomics program that includes management commitment, training, health surveillance, and medical case management. In summing up this report, space must be given to the check lists that are so often seen in the medical press, although this is not the occasion to propose a detailed analytical

  16. An integrated model-driven method for in-treatment upper airway motion tracking using cine MRI in head and neck radiation therapy.

    PubMed

    Li, Hua; Chen, Hsin-Chen; Dolly, Steven; Li, Harold; Fischer-Valuck, Benjamin; Victoria, James; Dempsey, James; Ruan, Su; Anastasio, Mark; Mazur, Thomas; Gach, Michael; Kashani, Rojano; Green, Olga; Rodriguez, Vivian; Gay, Hiram; Thorstad, Wade; Mutic, Sasa

    2016-08-01

    For the first time, MRI-guided radiation therapy systems can acquire cine images to dynamically monitor in-treatment internal organ motion. However, the complex head and neck (H&N) structures and low-contrast/resolution of on-board cine MRI images make automatic motion tracking a very challenging task. In this study, the authors proposed an integrated model-driven method to automatically track the in-treatment motion of the H&N upper airway, a complex and highly deformable region wherein internal motion often occurs in an either voluntary or involuntary manner, from cine MRI images for the analysis of H&N motion patterns. Considering the complex H&N structures and ensuring automatic and robust upper airway motion tracking, the authors firstly built a set of linked statistical shapes (including face, face-jaw, and face-jaw-palate) using principal component analysis from clinically approved contours delineated on a set of training data. The linked statistical shapes integrate explicit landmarks and implicit shape representation. Then, a hierarchical model-fitting algorithm was developed to align the linked shapes on the first image frame of a to-be-tracked cine sequence and to localize the upper airway region. Finally, a multifeature level set contour propagation scheme was performed to identify the upper airway shape change, frame-by-frame, on the entire image sequence. The multifeature fitting energy, including the information of intensity variations, edge saliency, curve geometry, and temporal shape continuity, was minimized to capture the details of moving airway boundaries. Sagittal cine MR image sequences acquired from three H&N cancer patients were utilized to demonstrate the performance of the proposed motion tracking method. The tracking accuracy was validated by comparing the results to the average of two manual delineations in 50 randomly selected cine image frames from each patient. The resulting average dice similarity coefficient (93.28%  ±  1

  17. Improved Mars Upper Atmosphere Climatology

    NASA Technical Reports Server (NTRS)

    Bougher, S. W.

    2004-01-01

    The detailed characterization of the Mars upper atmosphere is important for future Mars aerobraking activities. Solar cycle, seasonal, and dust trends (climate) as well as planetary wave activity (weather) are crucial to quantify in order to improve our ability to reasonably depict the state of the Mars upper atmosphere over time. To date, our best information is found in the Mars Global Surveyor (MGS) Accelerometer (ACC) database collected during Phase 1 (Ls = 184 - 300; F10.7 = 70 - 90) and Phase 2 (Ls = 30 - 90; F10.7 = 90 - 150) of aerobraking. This database (100 - 170 km) consists of thermospheric densities, temperatures, and scale heights, providing our best constraints for exercising the coupled Mars General Circulation Model (MGCM) and the Mars Thermospheric General Circulation Model (MTGCM). The Planetary Data System (PDS) contains level 0 and 2 MGS Accelerometer data, corresponding to atmospheric densities along the orbit track. Level 3 products (densities, temperatures, and scale heights at constant altitudes) are also available in the PDS. These datasets provide the primary model constraints for the new MGCM-MTGCM simulations summarized in this report. Our strategy for improving the characterization of the Mars upper atmospheres using these models has been three-fold : (a) to conduct data-model comparisons using the latest MGS data covering limited climatic and weather conditions at Mars, (b) to upgrade the 15-micron cooling and near-IR heating rates in the MGCM and MTGCM codes for ad- dressing climatic variations (solar cycle and seasonal) important in linking the lower and upper atmospheres (including migrating tides), and (c) to exercise the detailed coupled MGCM and MTGCM codes to capture and diagnose the planetary wave (migrating plus non-migrating tidal) features throughout the Mars year. Products from this new suite of MGCM-MTGCM coupled simulations are being used to improve our predictions of the structure of the Mars upper atmosphere for the

  18. Upper jurassic dinosaur egg from utah.

    PubMed

    Hirsch, K F; Stadtman, K L; Miller, W E; Madsen, J H

    1989-03-31

    The Upper Jurassic egg described here is the first known egg from the 100-million-year gap in the fossil record between Lower Jurassic (South Africa) and upper Lower Cretaceous (Utah). The discovery of the egg, which was found mixed in with thousands of dinosaur bones rather than in a nest, the pathological multilayering of the eggshell as found in modern and fossil reptilians, and the pliable condition of the eggshell at the time of burial indicate an oviducal retention of the egg at the time of burial.

  19. STS upper stage operations

    NASA Technical Reports Server (NTRS)

    Kitchens, M. D.; Schnyer, A. D.

    1977-01-01

    Several design/development and operational approaches for STS upper stages are being pursued to realize maximum operational and economic benefits upon the introduction of the STS in the 1980s. The paper focuses special attention on safety operations, launch site operations and on-orbit operations.

  20. PRELIMINARY SURVEY OF ENTOMOPATHOGENIC NEMATODES IN UPPER NORTHERN THAILAND.

    PubMed

    Vitta, Apichat; Fukruksa, Chamaiporn; Yimthin, Thatcha; Deelue, Kitsakorn; Sarai, Chutima; Polseela, Raxsina; Thanwisai, Aunchalee

    2017-01-01

    Entomopathogenic nematodes (EPNs) of the genera Steinernema and Heterorhabditis are used as biocontrol agents for insect pests. Survey of indigenous EPNs provides not only the diversity aspects but also the contribution in pest management in local areas. The objective of this study was to survey EPNs in upper northern Thailand. Nine hundred seventy soil samples were obtained from 194 sites in upper northern region of Thailand; of these 60 (6.2%) had EPNs in 2 genera: Steinernema (32 isolates) and Heterorhabditis (28 isolates). Most EPNs were isolated from loam with a soil temperature of 24-38°C, a pH of 1.5-7.0 and a soil moisture content of 0.5-6.8%. Molecular identification based on sequencing of a partial region of an internal transcribed spacer was performed for Heterorhabditis and the 28S rDNA for Steinernema. A BLASTN search of known sequence EPNs revealed 24 isolates of S. websteri and one isolate of S. scarabaei were identified; closely related to S. websteri (accession no. JF503100) and S. scarabaei (accession no. AY172023). The Heterorhabditis species identified were: H. indica (11 isolates), H. gerrardi (2 isolates) and Heterorhabditis sp (8 isolates). Phylogenetic analysis revealed 11 isolates of Heterorhabditis were related to H. indica; 2 isolates were related to Heterorhabditis gerrardi and 8 isolates were closely related to Heterorhabditis sp SGmg3. The study results show the genetic diversity of EPNs and describe a new observation of S. scarabaei and H. gerrardi in Thailand. This finding is new and provides important information for further study on using native EPNs in biological control.

  1. 7 CFR 1030.2 - Upper Midwest marketing area.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 9 2014-01-01 2013-01-01 true Upper Midwest marketing area. 1030.2 Section 1030.2 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; MILK), DEPARTMENT OF AGRICULTURE MILK IN THE UPPER MIDWEST MARKETING AREA Order...

  2. 7 CFR 1030.2 - Upper Midwest marketing area.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 9 2013-01-01 2013-01-01 false Upper Midwest marketing area. 1030.2 Section 1030.2 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; MILK), DEPARTMENT OF AGRICULTURE MILK IN THE UPPER MIDWEST MARKETING AREA Order...

  3. 7 CFR 1030.2 - Upper Midwest marketing area.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Upper Midwest marketing area. 1030.2 Section 1030.2 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Milk), DEPARTMENT OF AGRICULTURE MILK IN THE UPPER MIDWEST MARKETING AREA Order...

  4. 7 CFR 1030.2 - Upper Midwest marketing area.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 9 2011-01-01 2011-01-01 false Upper Midwest marketing area. 1030.2 Section 1030.2 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Milk), DEPARTMENT OF AGRICULTURE MILK IN THE UPPER MIDWEST MARKETING AREA Order...

  5. 7 CFR 1030.2 - Upper Midwest marketing area.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 9 2012-01-01 2012-01-01 false Upper Midwest marketing area. 1030.2 Section 1030.2 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Milk), DEPARTMENT OF AGRICULTURE MILK IN THE UPPER MIDWEST MARKETING AREA Order...

  6. Upper entropy axioms and lower entropy axioms

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

    Guo, Jin-Li, E-mail: phd5816@163.com; Suo, Qi

    2015-04-15

    The paper suggests the concepts of an upper entropy and a lower entropy. We propose a new axiomatic definition, namely, upper entropy axioms, inspired by axioms of metric spaces, and also formulate lower entropy axioms. We also develop weak upper entropy axioms and weak lower entropy axioms. Their conditions are weaker than those of Shannon–Khinchin axioms and Tsallis axioms, while these conditions are stronger than those of the axiomatics based on the first three Shannon–Khinchin axioms. The subadditivity and strong subadditivity of entropy are obtained in the new axiomatics. Tsallis statistics is a special case of satisfying our axioms. Moreover,more » different forms of information measures, such as Shannon entropy, Daroczy entropy, Tsallis entropy and other entropies, can be unified under the same axiomatics.« less

  7. Hypnosis and upper digestive function and disease

    PubMed Central

    Chiarioni, Giuseppe; Palsson, Olafur S; Whitehead, William E

    2008-01-01

    Hypnosis is a therapeutic technique that primarily involves attentive receptive concentration. Even though a small number of health professionals are trained in hypnosis and lingering myths and misconceptions associated with this method have hampered its widespread use to treat medical conditions, hypnotherapy has gained relevance as an effective treatment for irritable bowel syndrome not responsive to standard care. More recently, a few studies have addressed the potential influence of hypnosis on upper digestive function and disease. This paper reviews the efficacy of hypnosis in the modulation of upper digestive motor and secretory function. The present evidence of the effectiveness of hypnotherapy as a treatment for functional and organic diseases of the upper bowel is also summarized, coupled with a discussion of potential mechanisms of its therapeutic action. PMID:19009639

  8. Comparison of upper arm and forearm blood pressure.

    PubMed

    Domiano, Kathy L; Hinck, Susan M; Savinske, Debra L; Hope, Kathryn L

    2008-11-01

    The upper arm is the primary site used to obtain a blood pressure measurement (BPM); however, when it is not possible to use the upper arm, the forearm is a commonly used alternate site. This study determines if there is a significant difference between upper arm and forearm BPMs among adults and examines the relationship of participant characteristics to the BPM difference. A convenience sample was recruited from a low-income, independent-living, 104-apartment complex in the Midwest. Of the 106 participants, 64% were female and 89% were White. Ages ranged from 20 to 85 years (M = 50.7). The investigators calculated the BMIs (range = 18 to 42, M = 29.3, SD = 5.4) for the 89% (n = 94) of participants who reported their weight. The forearm tended to have higher BPMs than the upper arm (M difference = 4.0 mm Hg systolic, 2.3 mm Hg diastolic). However, site differences were greatest for men, obese adults, and middle aged (36 to 65) adults.

  9. Upper lip changes and gingival exposure on smiling: vertical dimension analysis.

    PubMed

    Miron, Hagai; Calderon, Shlomo; Allon, Dror

    2012-01-01

    Our objectives were to evaluate and quantify upper lip soft-tissue changes in the vertical dimensions both at rest and at maximum smile, and to examine the correlation between upper labial vestibular attachment height and maxillary gingival exposure on smiling. Seventy-two volunteers (36 men, 36 women) aged 20 to 40 (mean, 30.49 years) were recruited for this study. For each subject, 9 measurements of upper lip position and maxillary incisor crown height at rest and in maximum smile were recorded. A statistically significant sexual dimorphism was apparent in most of the measured variables. Relaxed external upper lip length was 3.1 mm shorter in the women than in the men. The mean maxillary central incisor display at rest was 1.78 mm greater in the women than in the men. A high smile line was 2.5 times more prevalent in the women. The upper lip was shortened by 30% in subjects with a high smile line compared with 23% in subjects with a low smile line. The following findings were observed in subjects with a high smile pattern: (1) short upper lip length, (2) low smiling/resting upper lip length ratio, (3) inferior attachment of the upper labial vestibule, and (4) prominent upper lip vermilion. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  10. Tracking an upper limit of the "Carnian Crisis" and/or Carnian stage in the Western Carpathians (Slovakia)

    NASA Astrophysics Data System (ADS)

    Kohút, Milan; Hofmann, Mandy; Havrila, Milan; Linnemann, Ulf; Havrila, Jakub

    2018-01-01

    The Late Triassic timescale, especially the Carnian-Norian boundary, is poorly constrained mainly due to a paucity of high-precision radio-isotopic ages that can be related accurately to contradictions between the biostratigraphic and magnetostratigraphic correlations. LA ICP-MS dating of detrital zircons from five samples of the Lunz Formation—the Upper Triassic siliciclastic sediments from the Western Carpathians (Slovakia)—provided a wide spectrum of ages that vary from Late Archaean (ca. 2582 Ma) to Triassic (ca. 216 Ma). These marine delta sediments represent a typical product of the "Carnian Crisis"—a major climate change and biotic turnover that occurred during the Carnian stage in the Tethys Ocean within the carbonate shelf and intrashelf basins in the Northern Calcareous Alps and the Western Carpathians. The supply of clastic material in the studied Lunz Formation was derived from several sources, especially: (i) from the recycled Variscan orogen; (ii) from the remote East European Platform; and (iii) from the contemporaneous Triassic volcanic sources. Syn-sedimentary volcanic zircons with a concordia age of 221.2 ± 1.6 Ma (calculated from 12 single analyses) represent the maximum age of deposition of the Lunz Formation, and demonstrate that the upper limit of the "Carnian Crisis" and/or the Carnian stage in the Alpine-Carpathians realm is younger than the current age of the Carnian-Norian boundary at ca. 227 Ma listed on the International Chronostratigraphic Chart (International Commission on Stratigraphy 2016/12 Edition).

  11. Reliability and validity of the upper-extremity Motor Activity Log-14 for measuring real-world arm use.

    PubMed

    Uswatte, Gitendra; Taub, Edward; Morris, David; Vignolo, Mary; McCulloch, Karen

    2005-11-01

    In research on Constraint-Induced Movement (CI) therapy, a structured interview, the Motor Activity Log (MAL), is used to assess how stroke survivors use their more-impaired arm outside the laboratory. This article examines the psychometrics of the 14-item version of this instrument in 2 chronic stroke samples with mild-to-moderate upper-extremity hemiparesis. Participants (n=41) in the first study completed MALs before and after CI therapy or a placebo control procedure. In addition, caregivers independently completed a MAL on the participants. Participants (n=27) in the second study completed MALs and wore accelerometers that monitored their arm movements for 3 days outside the laboratory before and after an automated form of CI therapy. Validity of the participant MAL Quality of Movement (QOM) scale was supported. Correlations between pretreatment-to-posttreatment change scores on the participant QOM scale and caregiver MAL QOM scale, caregiver MAL amount of use (AOU) scale, and accelerometer recordings were 0.70, 0.73, and 0.91 (P<0.01), respectively. Internal consistency (alpha>0.81), test-retest reliability (r>0.91), stability, and responsiveness (ratio>3) of the participant QOM scale were also supported. The participant AOU and caregiver QOM and AOU scales were internally consistent, stable, and sensitive, but were not reliable. The participant MAL QOM scale can be used exclusively to reliably and validly measure real-world, upper-extremity rehabilitation outcome and functional status in chronic stroke patients with mild-to-moderate hemiparesis.

  12. Oxygen dependence of upper thermal limits in fishes.

    PubMed

    Ern, Rasmus; Norin, Tommy; Gamperl, A Kurt; Esbaugh, Andrew J

    2016-11-01

    Temperature-induced limitations on the capacity of the cardiorespiratory system to transport oxygen from the environment to the tissues, manifested as a reduced aerobic scope (maximum minus standard metabolic rate), have been proposed as the principal determinant of the upper thermal limits of fishes and other water-breathing ectotherms. Consequently, the upper thermal niche boundaries of these animals are expected to be highly sensitive to aquatic hypoxia and other environmental stressors that constrain their cardiorespiratory performance. However, the generality of this dogma has recently been questioned, as some species have been shown to maintain aerobic scope at thermal extremes. Here, we experimentally tested whether reduced oxygen availability due to aquatic hypoxia would decrease the upper thermal limits (i.e. the critical thermal maximum, CT max ) of the estuarine red drum (Sciaenops ocellatus) and the marine lumpfish (Cyclopterus lumpus). In both species, CT max was independent of oxygen availability over a wide range of oxygen levels despite substantial (>72%) reductions in aerobic scope. These data show that the upper thermal limits of water-breathing ectotherms are not always linked to the capacity for oxygen transport. Consequently, we propose a novel metric for classifying the oxygen dependence of thermal tolerance; the oxygen limit for thermal tolerance (P CT max ), which is the water oxygen tension (Pw O 2 ) where an organism's CT max starts to decline. We suggest that this metric can be used for assessing the oxygen sensitivity of upper thermal limits in water-breathing ectotherms, and the susceptibility of their upper thermal niche boundaries to environmental hypoxia. © 2016. Published by The Company of Biologists Ltd.

  13. Intensified Training Period Increases Salivary IgA Responses But Does Not Affect the Severity of Upper Respiratory Tract Infection Symptoms in Prepuberal Rhythmic Gymnasts.

    PubMed

    Antualpa, Kizzy; Aoki, Marcelo Saldanha; Moreira, Alexandre

    2018-05-01

    This study examined the effect of a 4-week intensified training (IT) period, followed by a 2-week tapering period (TP), on salivary immunoglobulin A (SIgA), salivary cortisol, and the severity of upper respiratory tract infection symptoms in 23 rhythmic gymnasts [12.1 (2.6) y; 143.9 (13.7) cm; 37.2 (9.4) kg]. Saliva sampling was conducted at pre- and post-IT, and post-TP (analyzed using enzyme-linked immunosorbent assay). The Wisconsin Upper Respiratory Symptom Survey (WURSS-21) questionnaire was completed daily to analyze the severity of upper respiratory tract infection symptoms. The session rating of the perceived exertion was used to determine the internal training load and the acute:chronic workload ratio. A higher SIgA concentration [SIgA abs (μg/mL); F = 7.6; P = .001] for post-IT [234 (104)] versus pre-IT [173 (91)], and post-TP [182 (70)], and a higher SIgA secretion rate [SIgA rate (μg/min); F = 3.4; P = .04] for post-IT [69 (28)] versus pre-IT [55 (27)], and post-TP [58 (22)] were observed. No significant change was observed for cortisol (F = 0.81; P = .45) or for the severity of upper respiratory tract infection symptoms (χ 2  = 2.81; P = .24). Internal training load was higher during IT (vs TP; effect size = 2.37). The acute:chronic workload for the IT weeks varied from 1.2 (0.3) to 1.4 (0.3). These results suggest that a 4-week IT may temporarily augment the oral mucosal immunity, and an acute:chronic workload of 1.2-1.4 seems to be a safe approach to periodized training loads in youth rhythmic gymnasts.

  14. Taming Liquid Hydrogen: The Centaur Upper Stage Rocket, 1958-2002

    NASA Technical Reports Server (NTRS)

    Dawson, Virginia P.; Bowles, Mark D.

    2004-01-01

    During its maiden voyage in May 1962, a Centaur upper stage rocket, mated to an Atlas booster, exploded 54 seconds after launch, engulfing the rocket in a huge fireball. Investigation revealed that Centaur's light, stainless-steel tank had split open, spilling its liquid-hydrogen fuel down its sides, where the flame of the rocket exhaust immediately ignited it. Coming less than a year after President Kennedy had made landing human beings on the Moon a national priority, the loss of Centaur was regarded as a serious setback for the National Aeronautics and Space Administration (NASA). During the failure investigation, Homer Newell, Director of Space Sciences, ruefully declared: "Taming liquid hydrogen to the point where expensive operational space missions can be committed to it has turned out to be more difficult than anyone supposed at the outset." After this failure, Centaur critics, led by Wernher von Braun, mounted a campaign to cancel the program. In addition to the unknowns associated with liquid hydrogen, he objected to the unusual design of Centaur. Like the Atlas rocket, Centaur depended on pressure to keep its paper-thin, stainless-steel shell from collapsing. It was literally inflated with its propellants like a football or balloon and needed no internal structure to give it added strength and stability. The so-called "pressure-stabilized structure" of Centaur, coupled with the light weight of its high- energy cryogenic propellants, made Centaur lighter and more powerful than upper stages that used conventional fuel. But, the critics argued, it would never become the reliable rocket that the United States needed.

  15. Validation of the YuWell YE690A upper-arm blood pressure monitor, for clinic use and self-measurement, according to the European Society of Hypertension International Protocol revision 2010.

    PubMed

    Chen, Qi; Lei, Lei; Li, Yan; Wang, Ji-Guang

    2017-10-01

    The present study aimed to evaluate the accuracy of the automated oscillometric upper-arm blood pressure monitor YuWell YE690A for blood pressure measurement according to the International Protocol of the European Society of Hypertension revision 2010. Systolic and diastolic blood pressures were measured sequentially in 33 adult Chinese (12 women, 44.2 years of mean age) using a mercury sphygmomanometer (two observers) and the YE690A device (one supervisor). A total of 99 pairs of comparisons were obtained from 33 participants for judgments in two parts with three grading phases. All the blood pressure requirements were fulfilled. The YuWell YE690A device achieved the targets in part 1 of the validation study. The number of absolute differences between device and observers within 5, 10, and 15 mmHg was 79/99, 96/99, and 97/99, respectively, for systolic blood pressure and 72/99, 95/99, and 98/99, respectively, for diastolic blood pressure. The device also fulfilled the criteria in part 2 of the validation study. Thirty-one and 25 participants for systolic and diastolic blood pressure, respectively, had at least two of the three device-observer differences within 5 mmHg (required ≥24). No participant for systolic and two participants for diastolic blood pressure had all the three device-observer comparisons greater than 5 mmHg. The YuWell blood pressure monitor YE690A has passed the requirements of the International Protocol revision 2010 and hence can be recommended for blood pressure measurement in adults.

  16. Microbial Isolates from the Upper Atmosphere Support Panspermia Hypothesis

    NASA Astrophysics Data System (ADS)

    Yang, Yinjie; Yokobori, Shin-Ichi; Yamagishi, Akihiko

    Terrestrial microbes may be transported into the upper atmosphere via various means. Due to the environmental similarity of the upper atmosphere to outer space, knowledge of microbes in the upper atmosphere would be valuable for assessing the chances and limits of microbial transfer from the earth to extraterrestrial bodies (i.e., Panspermia of terrestrial microbes). We collected air dust samples in the upper troposphere and the stratosphere over Japan by using aircrafts or balloons. Microbial isolates from the samples were endospore-forming species (Bacillus, Paenibacillus, Streptomyces) and non-spore-forming Deinococci. Besides the evidence of microbial presence in the upper atmosphere, we show the possible presence of terrestrial microbes in space by extrapolated height-dependent distribution of microbes. High resistance to radiation and desiccation was common for our upper-atmospheric isolates and likely the most important feature enabled their survival in the environment of elevated radiation and desiccation. In this regard, Panspermia of viable Deinococci and endospores would be more likely than other terrestrial microbes. Specifically, the Deinococcus isolates exhibited extreme resistance to radiation (several times higher than bacterial endospores), the principle threat for microbial survival during interplanetary transfer. Based on detailed characterization of the Deinococcus isolates, we proposed two new species Deinococcus aerius sp. nov. and Deinococcus aetherius sp. nov., which are now candidate microbes for exposure experiment in space.

  17. Three-dimensional changes in nose and upper lip volume after orthognathic surgery.

    PubMed

    van Loon, B; van Heerbeek, N; Bierenbroodspot, F; Verhamme, L; Xi, T; de Koning, M J J; Ingels, K J A O; Bergé, S J; Maal, T J J

    2015-01-01

    Orthognathic surgery aims to improve both the function and facial appearance of the patient. Translation of the maxillomandibular complex for correction of malocclusion is always followed by changes to the covering soft tissues, especially the nose and lips. The purpose of this study was to evaluate the changes in the nasal region and upper lip due to orthognathic surgery using combined cone beam computed tomography (CBCT) and three-dimensional (3D) stereophotogrammetry datasets. Patients who underwent a Le Fort I osteotomy, with or without a bilateral sagittal split osteotomy, were included in this study. Pre- and postoperative documentation consisted of 3D stereophotogrammetry and CBCT scans. 3D measurements were performed on the combined datasets and analyzed. Anterior translation and clockwise pitching of the maxilla led to a significant volume increase in the lip. Cranial translation of the maxilla led to an increase in the alar width. The combination of CBCT DICOM data and 3D stereophotogrammetry proved to be useful in the 3D analysis of the maxillary hard tissue changes, as well as changes in the soft tissues. Measurements could be acquired and compared to investigate the influence of maxillary movement on the soft tissues of the nose and the upper lip. Copyright © 2014 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  18. Effects of general relativity on glitch amplitudes and pulsar mass upper bounds

    NASA Astrophysics Data System (ADS)

    Antonelli, M.; Montoli, A.; Pizzochero, P. M.

    2018-04-01

    Pinning of vortex lines in the inner crust of a spinning neutron star may be the mechanism that enhances the differential rotation of the internal neutron superfluid, making it possible to freeze some amount of angular momentum which eventually can be released, thus causing a pulsar glitch. We investigate the general relativistic corrections to pulsar glitch amplitudes in the slow-rotation approximation, consistently with the stratified structure of the star. We thus provide a relativistic generalization of a previous Newtonian model that was recently used to estimate upper bounds on the masses of glitching pulsars. We find that the effect of general relativity on the glitch amplitudes obtained by emptying the whole angular momentum reservoir is less than 30 per cent. Moreover, we show that the Newtonian upper bounds on the masses of large glitchers obtained from observations of their maximum recorded event differ by less than a few percent from those calculated within the relativistic framework. This work can also serve as a basis to construct more sophisticated models of angular momentum reservoir in a relativistic context: in particular, we present two alternative scenarios for macroscopically rigid and slack pinned vortex lines, and we generalize the Feynman-Onsager relation to the case when both entrainment coupling between the fluids and a strong axisymmetric gravitational field are present.

  19. Extratropical Influence of Upper Tropospheric Water Vapor on Greenhouse Warming

    NASA Technical Reports Server (NTRS)

    Hu, H.; Liu, W.

    1998-01-01

    The purpose of this paper is to re-examine the impact of upper tropospheric water vapor on greenhouse warming in midlatitudes by analyzing the recent observations of the upper tropospheric water vapor from the Microwave Limb Sounder (MLS) on the Upper Atmosphere Research Satellite (UARS), in conjuction with other space-based measurement and model simulation products.

  20. Reliability, Validity, and Responsiveness of the QuickDASH in Patients With Upper Limb Amputation.

    PubMed

    Resnik, Linda; Borgia, Matthew

    2015-09-01

    To examine the internal consistency, test-retest reliability, validity, and responsiveness of the shortened version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire in persons with upper limb amputation. Cross-sectional and longitudinal. Three sites participating in the U.S. Department of Veterans Affairs Home Study of the DEKA Arm. A convenience sample of upper limb amputees (N=44). Training with a multifunction upper limb prosthesis. Multiple outcome measures including the QuickDASH were administered twice within 1 week, and for a subset of 20 persons, after completion of in-laboratory training with the DEKA Arm. Scale alphas and intraclass correlation coefficient type 3,1 (ICC3,1) were used to examine reliability. Minimum detectable change (MDC) scores were calculated. Analyses of variance, comparing QuickDASH scores by the amount of prosthetic use and amputation level, were used for known-group validity analyses with alpha set at .05. Pairwise correlations between QuickDASH and other measures were used to examine concurrent validity. Responsiveness was measured by effect size (ES) and standardized response mean (SRM). QuickDASH alpha was .83, and ICC was .87 (95% confidence interval, .77-.93). MDC at the 95% confidence level (MDC95%) was 17.4. Full- or part-time prosthesis users had better QuickDASH scores compared with nonprosthesis users (P=.021), as did those with more distal amputations at both baseline (P=.042) and with the DEKA Arm (P=.024). The QuickDASH was correlated with concurrent measures of activity limitation as expected. The ES and SRM after training with the DEKA Arm were 0.6. This study provides evidence of reliability and validity of the QuickDASH in persons with upper limb amputation. Results provide preliminary evidence of responsiveness to prosthetic device type/training. Further research with a larger sample is needed to confirm results. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by

  1. Characterization of the 2012-044C BRIZ-M Upper Stage Breakup

    NASA Astrophysics Data System (ADS)

    Matney, M. J.; Hamilton, J.; Horstman, M.; Papanyan, V.

    2013-08-01

    On 6 August 2012, Russia launched two commercial satellites aboard a Proton rocket, and attempted to place them in geosynchronous orbit using a Briz-M upper stage (2012-044C, SSN 38746). Unfortunately, the upper stage failed early in its burn and was left stranded in an elliptical orbit with a perigee in low Earth orbit (LEO). Because the stage failed with much of its fuel on board, it was deemed a significant breakup risk. These fears were confirmed when it broke up 16 October, creating a large cloud of debris with perigees below that of the International Space Station. The debris cloud was tracked by the U.S. Space Surveillance Network (SSN), which can reliably detect and track objects down to about 10 cm in size. Because of the unusual geometry of the breakup, there was an opportunity for the NASA Orbital Debris Program Office to use specialized radar assets to characterize the extent of the debris cloud in sizes smaller than the standard debris tracked by the SSN. This paper describes the observation campaign to measure the small particle distributions of this cloud and presents the results of the data analysis. We shall compare the data to the modelled size distribution, number, and shape of the cloud, and what implications this may have for future breakup debris models. We shall conclude the paper with a discussion about how this measurement process can be improved for future breakups.

  2. Characterization of the 2012-044C Briz-M Upper Stage Breakup

    NASA Technical Reports Server (NTRS)

    Matney, M. J.; Hamilton, J.; Horstman, M.; Papanyan, V.

    2013-01-01

    On 6 August, 2012, Russia launched two commercial satellites aboard a Proton rocket, and attempted to place them in geosynchronous orbit using a Briz-M upper stage (2012-044C, SSN 38746). Unfortunately, the upper stage failed early in its burn and was left stranded in an elliptical orbit with a perigee in low Earth orbit (LEO). Because the stage failed with much of its fuel on board, it was deemed a significant breakup risk. These fears were confirmed when it broke up 16 October, creating a large cloud of debris with perigees below that of the International Space Station. The debris cloud was tracked by the US Space Surveillance Network (SSN), which can reliably detect and track objects down to about 10 cm in size. Because of the unusual geometry of the breakup, there was an opportunity for NASA Orbital Debris Program Office to use specialized radar assets to characterize the extent of the debris cloud in sizes smaller than the standard debris tracked by the SSN. This paper will describe the observation campaign to measure the small particle distributions of this cloud, and presents the results of the analysis of the data. We shall compare the data to the modelled size distribution, number, and shape of the cloud, and what implications this may have for future breakup debris models. We shall conclude the paper with a discussion how this measurement process can be improved for future breakups.

  3. Water level response to hydropower development in the upper Mekong River.

    PubMed

    Li, Shaojuan; He, Daming

    2008-05-01

    Environmental changes and their transboundary influences on the Mekong watercourse system have been an international research focus in recent years, but the opinions and results related to the impacts of upper Mekong River dams are quite different. In this paper, based on the records of water levels from 1960 to 2003 at three mainstream sites in the upper Mekong River, a quantitative examination has been undertaken into characteristics of the mainstream water-level process at multiple timescales and its response to cascade development. The major results are: i) Annual mean, wet period mean, and the mean water levels during the period between March and April (PBMA period) exhibit a significant increasing trend at Jiuzhou and Yunjinghong sites, which are influenced by large-scale factors such as climate change and solar activity. ii) The interdecadal and interannual variations of annual mean, annual maximum, and wet period mean water levels at three sites show similar features during the dam construction period. iii) The interdecadal variations of PBMA period water level show a gradual increase at Gajiu and Yunjinghong sites but a falling trend at Jiuzhou; these trends confirm that there is some regulation on the flow in the dry season caused by the two existing dams. iv) The downstream effects of the present dams on water levels are very limited at the annual mean and wet season mean levels, not apparent at the monthly and yearly timescales, and relatively significant at daily and hourly timescales.

  4. Characterization of the 2012-044c Briz-M Upper Stage Breakup

    NASA Technical Reports Server (NTRS)

    Matney, M. J.; Hamilton, Joseph; Papanyan, Valen

    2013-01-01

    On 6 August, 2012, Russia launched two commercial satellites aboard a Proton rocket, and attempted to place them in geosynchronous orbit using a Briz-M upper stage (2012-044C, SSN 38746). Unfortunately, the upper stage failed early in its burn and was left stranded in an elliptical orbit with a perigee in low Earth orbit (LEO). Because the stage failed with much of its fuel on board, it was deemed a significant breakup risk. These fears were confirmed when it broke up 16 October, creating a large cloud of debris with perigees below that of the International Space Station. The debris cloud was tracked by the US Space Surveillance Network (SSN), which can reliably detect and track objects down to about 10 cm in size. Because of the unusual geometry of the breakup, there was an opportunity for NASA Orbital Debris Program Office to request radar assets to characterize the extent of the debris cloud in sizes smaller than the standard debris tracked by the SSN. This paper will describe the observation campaign to measure the small particle distributions of this cloud, and presents the results of the analysis of the data. We shall compare the data to the modelled size distribution, number, and shape of the cloud, and what implications this may have for future breakup debris models. We shall conclude the paper with a discussion how this measurement process can be improved for future breakups.

  5. Characterization of Upper Eyelid Tarsus and Lid Wiper Dimensions.

    PubMed

    Navascues-Cornago, Maria; Maldonado-Codina, Carole; Gupta, Ruchi; Morgan, Philip B

    2016-09-01

    To measure various dimensions of the upper tarsal plate and the area of upper lid wiper staining. The repeatability of the method of measurement was investigated. Thirty-five healthy non-contact lens wearers were enrolled. The following parameters were measured from digital images of the upper eyelid captured with a slitlamp camera: length, height, and total area of the tarsal plate and area of lid wiper staining (lissamine green). Measurements were performed in a randomized and masked fashion on two separate occasions by the same investigator using ImageJ (National Institutes of Health). Coefficients of repeatability (COR) were calculated. The dimensions (mean±SD) of the tarsal plate were 20.6±1.9 mm length, 7.9±0.8 mm height, and 103.3±18.8 mm total area. The area of lid wiper staining was 2.7±2.0 mm. No association was found between tarsal dimensions and lid wiper staining (all P>0.05). Image analysis COR values were 0.6 mm tarsal length, 0.1 mm tarsal height, 1.2 mm tarsal area, and 0.4 mm lid wiper staining. There was no significant difference between repeated measurements for any parameter (all P>0.05). Limits of agreement were narrow for all parameters, indicating good agreement between repeated measurements. This work has demonstrated that there is a wide range in the dimensions of the upper tarsal plate in an urban UK population. No association was found between the upper tarsal dimensions and lid wiper staining. ImageJ was shown to be a repeatable method to measure the dimensions of the upper tarsal plate and upper lid wiper staining.

  6. Chronic pain associated with upper-limb loss.

    PubMed

    Hanley, Marisol A; Ehde, Dawn M; Jensen, Mark; Czerniecki, Joseph; Smith, Douglas G; Robinson, Lawrence R

    2009-09-01

    To describe the prevalence, intensity, and functional impact of the following types of pain associated with upper-limb loss: phantom limb, residual limb, back, neck, and nonamputated-limb pain. Cross-sectional survey; 104 respondents with upper-limb loss at least 6 months postamputation completed measures of pain intensity, interference, disability, and health-related quality-of-life. Nearly all (90%) of the respondents reported pain, with 76% reporting more than one pain type. Phantom-limb pain and residual-limb pain were the most prevalent (79% and 71%, respectively), followed by back (52%), neck (43%), and nonamputated-limb pain (33%). Although nonamputated-limb pain was least prevalent, it was reported to cause the highest levels of interference and pain-related disability days. Self-reported quality-of-life was significantly lower for individuals with each type of pain compared with those without any pain. Age, time since amputation, and cause of amputation were not associated with pain. In addition to pain in the phantom and residual limb, back, neck, and nonamputated-limb pain are also common after upper-limb loss. All of these pain types are associated with significant disability and activity interference for some individuals, suggesting that assessment of multiple pain types in persons with upper-limb amputation may be important.

  7. Assessing Upper-Level Winds on Day-of-Launch

    NASA Technical Reports Server (NTRS)

    Bauman, William H., III; Wheeler, Mark M.

    2012-01-01

    On the day-or-launch. the 45th Weather Squadron Launch Weather Officers (LWOS) monitor the upper-level winds for their launch customers to include NASA's Launch Services Program (LSP). During launch operations, the payload launch team sometimes asks the LWO if they expect the upper level winds to change during the countdown but the LWOs did not have the capability to quickly retrieve or display the upper-level observations and compare them to the numerical weather prediction model point forecasts. The LWOs requested the Applied Meteorology Unit (AMU) develop a capability in the form of a graphical user interface (GUI) that would allow them to plot upper-level wind speed and direction observations from the Kennedy Space Center Doppler Radar Wind Profilers and Cape Canaveral Air Force Station rawinsondes and then overlay model point forecast profiles on the observation profiles to assess the performance of these models and graphically display them to the launch team. The AMU developed an Excel-based capability for the LWOs to assess the model forecast upper-level winds and compare them to observations. They did so by creating a GUI in Excel that allows the LWOs to first initialize the models by comparing the O-hour model forecasts to the observations and then to display model forecasts in 3-hour intervals from the current time through 12 hours.

  8. Extensional deformation of the Guadalquivir Basin: rate of WSW-ward tectonic displacement from Upper Tortonian sedimentary rocks

    NASA Astrophysics Data System (ADS)

    Roldán, Francisco J.; Azañón, Jose Miguel; Rodríguez-Fernández, Jose; María Mateos, Rosa

    2016-04-01

    The Guadalquivir Basin (Upper Tortonian-Quaternary sedimentary infilling) has been considered the foreland basin of the Betic Orogen built up during its collision with the Sudiberian margin. The basin is currently restricted to its westernmost sector, in the Cadiz Gulf, because the Neogene-Quaternary uplift of the Betic Cordillera has produced the emersion of their central and eastern parts. The upper Tortonian chronostratigraphic unit is the oldest one and it was indistinctly deposited on the South Iberian paleomargin and the External units from the Betic Cordillera. However, these rocks are undeformed on the Sudiberian paleomargin while they are deeply affected by brittle deformation on the External Betic Zone. Outcrops of Upper Tortonian sedimentary rocks on External Betic Zone are severely fragmented showing allocthonous characters with regard to those located on the Sudiberian paleomargin. This post- Upper Tortonian deformation is not well known in the External Zones of the Cordillera where the most prominent feature is the ubiquity of a highly deformed tecto-sedimentary unit outcropping at the basement of the Guadalquivir sedimentary infilling. This tecto-sedimentary unit belongs to the Mass Wasting Extensional Complex (Rodríguez-Fernández, 2014) formed during the collision and westward migration of the Internal Zone of the Betic Cordillera (15-8,5 Ma). In the present work, we show an ensemble of tectonic, geophysical and cartographic data in order to characterize the post-Upper Tortonian deformation. For this, seismic reflection profiles have been interpreted with the help of hidrocarbon boreholes to define the thickness of the Upper Tortonian sedimentary sequence. All these data provide an estimation of the geometrical and kinematic characteristics of the extensional faults, direction of movement and rate of displacement of these rocks during Messinian/Pliocene times. References Rodríguez-Fernández, J., Roldan, F. J., J.M. Azañón y Garcia-Cortes, A

  9. The Relative Importance of Random Error and Observation Frequency in Detecting Trends in Upper Tropospheric Water Vapor

    NASA Technical Reports Server (NTRS)

    Whiteman, David N.; Vermeesch, Kevin C.; Oman, Luke D.; Weatherhead, Elizabeth C.

    2011-01-01

    Recent published work assessed the amount of time to detect trends in atmospheric water vapor over the coming century. We address the same question and conclude that under the most optimistic scenarios and assuming perfect data (i.e., observations with no measurement uncertainty) the time to detect trends will be at least 12 years at approximately 200 hPa in the upper troposphere. Our times to detect trends are therefore shorter than those recently reported and this difference is affected by data sources used, method of processing the data, geographic location and pressure level in the atmosphere where the analyses were performed. We then consider the question of how instrumental uncertainty plays into the assessment of time to detect trends. We conclude that due to the high natural variability in atmospheric water vapor, the amount of time to detect trends in the upper troposphere is relatively insensitive to instrumental random uncertainty and that it is much more important to increase the frequency of measurement than to decrease the random error in the measurement. This is put in the context of international networks such as the Global Climate Observing System (GCOS) Reference Upper-Air Network (GRUAN) and the Network for the Detection of Atmospheric Composition Change (NDACC) that are tasked with developing time series of climate quality water vapor data.

  10. The relative importance of random error and observation frequency in detecting trends in upper tropospheric water vapor

    NASA Astrophysics Data System (ADS)

    Whiteman, David N.; Vermeesch, Kevin C.; Oman, Luke D.; Weatherhead, Elizabeth C.

    2011-11-01

    Recent published work assessed the amount of time to detect trends in atmospheric water vapor over the coming century. We address the same question and conclude that under the most optimistic scenarios and assuming perfect data (i.e., observations with no measurement uncertainty) the time to detect trends will be at least 12 years at approximately 200 hPa in the upper troposphere. Our times to detect trends are therefore shorter than those recently reported and this difference is affected by data sources used, method of processing the data, geographic location and pressure level in the atmosphere where the analyses were performed. We then consider the question of how instrumental uncertainty plays into the assessment of time to detect trends. We conclude that due to the high natural variability in atmospheric water vapor, the amount of time to detect trends in the upper troposphere is relatively insensitive to instrumental random uncertainty and that it is much more important to increase the frequency of measurement than to decrease the random error in the measurement. This is put in the context of international networks such as the Global Climate Observing System (GCOS) Reference Upper-Air Network (GRUAN) and the Network for the Detection of Atmospheric Composition Change (NDACC) that are tasked with developing time series of climate quality water vapor data.

  11. Differences in displacement of the proximal and distal ends of mid-upper thoracic esophageal squamous cell carcinoma.

    PubMed

    Qiu, Guoqin; Wen, Dengshun; DU, Xianghui; Sheng, Liming; Zhou, Xia; Ji, Yongling; Bao, Wuan; Zhang, Danhong; Cheng, Lei

    2016-07-01

    In the present study, clips were used as markers to evaluate displacement differences between proximal and distal ends of esophageal tumors and to test whether their internal target volume (ITV) margins should be determined separately. A total of 23 patients with mid-upper thoracic esophageal squamous-cell carcinoma, a tumor length of ≤8 cm and an esophageal lumen suitable for endoscopic ultrasonography were recruited for the present study. Clips were implanted endoscopically at the proximal and distal ends of the esophageal tumor (upper and lower clips). In a further exploratory study on 16 of the patients, a third clip was placed at the distal esophagus 2 cm above the gastro-esophageal junction (GEJ) (cardiac clip). The clips were contoured for all 10 phases of the four-dimensional computed tomography and the maximum displacements of the clip centroids among different breathing phases in left-right (LR), superior-inferior (SI) and anterior-posterior (AP) directions were marked as x, y and z, respectively. The ITV margins that covered 95% of the LR, SI and AP motion were 2.89, 5.00 and 2.36 mm, respectively. Axial displacement (y) was greater than radial displacement (x, z; P<0.05). It was also revealed that LR(x), SI(y) and AP(z) displacement of cardiac clips was greater than that of upper or lower clips (P<0.05). Differences in the axial and radial displacement of the upper and lower clips indicated that axial and radial ITV margins should be determined separately. However, further study is required on patients in whom the distal tumor end is located in proximity to the GEJ.

  12. Pedicled fat flap to increase lateral fullness in upper blepharoplasty.

    PubMed

    Sozer, Sadri O; Agullo, Francisco J; Palladino, Humberto; Payne, Phileemon E; Banerji, Soumo

    2010-03-01

    The eyelid of a young person can be distinguished by the lateral fullness of the upper eyelid. With aging, lateral fullness decreases. Volume restoration in the periorbital area has been previously addressed by fat draping and grafting. More recently, techniques for regaining lateral fullness of the upper eyelid have focused on fat grafting, although effective graft take, reabsorption, and irregularities have been a concern. To address these issues, the concept of pedicled fat draping in the upper eyelid was explored. In a retrospective study from June 2006 to August 2008, 31 patients underwent upper blepharoplasty with augmentation of the lateral fullness with a pedicled fat flap from the central fat pad. The fat from the central compartment was elevated, dissected, and then transposed to the lateral upper eyelid below the orbicularis muscle. All patients were women ranging in age from 43 to 68 years. Pre- and postoperative picture comparison demonstrated a more youthful appearance with increased lateral fullness of the upper eyelids. There were no cases of fat necrosis encountered. Increased volume remained stable over an average of one-year follow-up. No complications were recorded. Transposing a pedicled fat pad from the central compartment laterally has proven to be an effective technique for achieving predictable upper lateral eyelid fullness and thus achieving a long-lasting, more youthful appearance.

  13. Sulfadiazine-Induced Obstructive Nephropathy Presenting with Upper Urinary Tract Extravasation.

    PubMed

    Kabha, Maharan; Dekalo, Snir; Barnes, Sophie; Mintz, Ishay; Matzkin, Haim; Sofer, Mario

    2016-01-01

    Background: Obstructive nephropathy is an uncommon side effect of sulfadiazine, which is used for the treatment of toxoplasmosis. We present a case of acute renal colic and urine extravasation of a patient shortly after she was started on this medication. Case Presentation: A 31-year-old female presented with acute renal colic 2 weeks after starting treatment with sulfadiazine and pyrimethamine for ocular toxoplasmosis. Results: A noncontrast computed tomography revealed left hydronephrosis and fluid located around the kidney and in the left gutter. There were no urinary stones. Administration of intravenous contrast revealed significant urine extravasation at the level of the ureteropelvic junction. Intravenous contrast injection confirmed that the extravasation consisted of urine leakage at the ureteropelvic junction. Her clinical condition improved with the insertion of an internal stent, which was left in place for 4 weeks. A retrograde pyelography performed at the time of the internal stent removal ruled out persistent extravasation and filling defects in the left upper urinary tract. Considering the clinical circumstances and the imaging results, it appears that this is a first reported case of sulfadiazine-induced obstructive uropathy associated with urine extravasation. Conclusion: Although rare, obstructive uropathy related to sulfadiazine medication should be promptly suspected, diagnosed, and treated. Patients should be instructed to substantially increase their liquid intake while on that medication.

  14. Emplacement model of obsidian-rhyolite magma deduced from complete internal section of the Akaishiyama lava, Shirataki, northern Hokkaido, Japan

    NASA Astrophysics Data System (ADS)

    Wada, K.; Sano, K.

    2016-12-01

    Simultaneously explosive and effusive eruptions of silicic magmas has shed light on the vesiculation and outgassing history of ascending magmas in the conduit and emplacement model of obsidian-rhyolite lavas (Castro et al., 2014; Shipper et al, 2013). As well as the knowledge of newly erupted products such as 2008-2009 Chaitén and 2011-2012 Cordón Caule eruptions, field and micro-textural evidences of well-exposed internal structure of obsidian-rhyolite lava leads to reveal eruption processes of silicic magmas. The Shirataki monogenetic volcano field, 2.2 million year age, northern Hokkaido, Japan, contains many outcrops of obsidian and vesiculated rhyolite zones (SiO2=76.7-77.4 wt.%). Among their outcrops, Akaishiyama lava shows good exposures of internal sections from the top to the bottom along the Kyukasawa valley with thickness of about 190 meters, showing the symmetrical structure comprising a upper clastic zone (UCZ; 5m thick), an upper dense obsidian zone (UDO; 15m), an upper banded obsidian zone (UBO; 70-80m), a central rhyolite zone (CR; 65m), a lower banded obsidian zone (LBO; 15m), a lower dense obsidian zone (LDO; 20m), and a lower clastic zone (LCZ; 3m). The upper banded obsidian zone is characterized by existence of spherulite concentration layers with tuffisite veins and rhyolite enclaves. Spherulites consisting of albite, cristobalaite and obsidian glass, are clustered in the dense obsidian. Tuffisite veins show brecciated obsidians in tuffaceous matrix, showing an outgassing path during the emplacement of obsidian lava. Perpendicular dip of spherulite parallel rows indicates the banded zone itself was the domain of vent area. From the observation of these occurrences in the internal section and rock texture, we show the qualitative formation model of Shirataki obsidian-rhyolite lava.

  15. Nasopharyngeal polymicrobial colonization during health, viral upper respiratory infection and upper respiratory bacterial infection.

    PubMed

    Xu, Qingfu; Wischmeyer, Jareth; Gonzalez, Eduardo; Pichichero, Michael E

    2017-07-01

    We sought to understand how polymicrobial colonization varies during health, viral upper respiratory infection (URI) and acute upper respiratory bacterial infection to understand differences in infection-prone vs. non-prone patients. Nasopharyngeal (NP) samples were collected from 74 acute otitis media (AOM) infection-prone and 754 non-prone children during 2094 healthy visits, 673 viral URI visits and 631 AOM visits. Three otopathogens Streptococcus pneumoniae (Spn), Nontypeable Haemophilus influenzae (NTHi), and Moraxella catarrhalis (Mcat) were identified by culture. NP colonization rates of multiple otopathogens during health were significantly lower than during viral URI, and during URI they were lower than at onset of upper respiratory bacterial infection in both AOM infection-prone and non-prone children. AOM infection-prone children had higher polymicrobial colonization rates than non-prone children during health, viral URI and AOM. Polymicrobial colonization rates of AOM infection-prone children during health were equivalent to that of non-prone children during viral URI, and during viral URI were equivalent to that of non-prone during AOM infection. Spn colonization was positively associated with NTHi and Mcat colonization during health, but negatively during AOM infection. The infection-prone patients more frequently have multiple potential bacterial pathogens in the NP than the non-prone patients. Polymicrobial interaction in the NP differs during health and at onset of infection. Copyright © 2017 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  16. Less common upper limb mononeuropathies.

    PubMed

    Williams, Faren H; Kumiga, Bryan

    2013-05-01

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

  17. Upper extremity sensorimotor control among collegiate football players.

    PubMed

    Laudner, Kevin G

    2012-03-01

    Injuries stemming from shoulder instability are very common among athletes participating in contact sports, such as football. Previous research has shown that increased laxity negatively affects the function of the sensorimotor system potentially leading to a pathological cycle of shoulder dysfunction. Currently, there are no data detailing such effects among football players. Therefore, the purpose of this study was to examine the differences in upper extremity sensorimotor control among football players compared with that of a control group. Forty-five collegiate football players and 70 male control subjects with no previous experience in contact sports participated. All the subjects had no recent history of upper extremity injury. Each subject performed three 30-second upper extremity balance trials on each arm. The balance trials were conducted in a single-arm push-up position with the test arm in the center of a force platform and the subjects' feet on a labile device. The trials were averaged, and the differences in radial area deviation between groups were analyzed using separate 1-way analyses of variance (p < 0.05). The football players showed significantly more radial area deviation of the dominant (0.41 ± 1.23 cm2, p = 0.02) and nondominant arms (0.47 ± 1.63 cm2, p = 0.03) when compared with the control group. These results suggest that football players may have decreased sensorimotor control of the upper extremity compared with individuals with no contact sport experience. The decreased upper extremity sensorimotor control among the football players may be because of the frequent impacts accumulated during football participation. Football players may benefit from exercises that target the sensorimotor system. These findings may also be beneficial in the evaluation and treatment of various upper extremity injuries among football players.

  18. Wenckebach upper rate response in single chamber pacemaker.

    PubMed

    Barold, S S

    2000-07-01

    The Medtronic Minix pacemaker during normal function in the VVT mode was found to exhibit a Wenckenbach upper rate response similar to that of dual chamber devices. This behavior occurred only when the upper rate interval was longer than the pacemaker refractory period. In a single chamber device this response may simulate pacemaker malfunction.

  19. Teaching Comparative Local History: Upper Mississippi River Towns.

    ERIC Educational Resources Information Center

    Crozier, William L.

    Intended to engage students in a comparative look at local history in two upper Mississippi river towns (Winona, Minnesota and Dubuque, Iowa), this paper describes the computer-assisted component of an upper-level American Studies course. With emphasis on the 19th century, students examine the transition made by the United States from a…

  20. Relationship Between Physical Qualities and Minutes Played in International Women's Rugby Sevens.

    PubMed

    Goodale, Tyler L; Gabbett, Tim J; Stellingwerff, Trent; Tsai, Ming-Chang; Sheppard, Jeremy M

    2016-05-01

    To investigate the physical qualities that differentiate playing minutes in international-level women's rugby sevens players. Twenty-four national-level female rugby sevens players underwent measurements of anthropometry, acceleration, speed, lower- and upper-body strength, lower-body power, and aerobic fitness. Playing minutes in international competition were used to differentiate players into 2 groups, a high- or low-playing-minutes group. Playing minutes were related to team selection, which was determined by the coaching staff. Playing minutes were therefore used to differentiate performance levels. Players in the high-playing-minutes group (≥70 min) were older (mean ± SD 24.3 ± 3.1 vs 21.2 ± 4.3 y, P = .05, effect size [ES] = 0.77 ± 0.66, 90% confidence limit) and had greater experience in a national-training-center environment (2.4 ± 0.8 vs 1.7 ± 0.9 y, P = .03, ES = 0.83 ± 0.65), faster 1600-m time (374.5 ± 20.4 vs 393.5 ± 29.8 s, P = .09, ES = -0.70 ± 0.68), and greater 1-repetition-maximum upper-body strength (bench press 68.4 ± 6.3 vs 62.2 ± 8.1 kg, P = .07, ES = 0.80 ± 0.70, and neutral-grip pull-up 84.0 ± 8.2 vs 79.1 ± 5.4 kg, P = .12, ES = 0.68 ± 0.72) than athletes who played fewer minutes. Age (rs = .59 ± ~.28), training experience (rs = .57 ± ~.29), bench press (r = .44 ± ~.36), and 1600-m time (r = -.43 ± ~.34) were significantly associated with playing minutes. Neutral-grip pull-up and bench press contributed significantly to a discriminant analysis. The average squared canonical correlation was .46. The discriminant analysis predicted 7 of 9 and 6 of 10 high- and low-playing-minutes athletes, respectively. Age, training experience, upper-body strength, and aerobic fitness differentiated athlete playing minutes in international women's rugby sevens.

  1. A short overview of upper limb rehabilitation devices

    NASA Astrophysics Data System (ADS)

    Macovei, S.; Doroftei, I.

    2016-08-01

    As some studies show, the number of people over 65 years old increases constantly, leading to the need of solution to provide services regarding patient mobility. Diseases, accidents and neurologic problems affect hundreds of people every day, causing pain and lost of motor functions. The ability of using the upper limb is indispensable for a human being in everyday activities, making easy tasks like drinking a glass of water a real challenge. We can agree that physiotherapy promotes recovery, but not at an optimal level, due to limited financial and human resources. Hence, the need of robot-assisted rehabilitation emerges. A robot for upper-limb exercises should have a design that can accurately control interaction forces and progressively adapt assistance to the patients’ abilities and also to record the patient's motion and evolution. In this paper a short overview of upper limb rehabilitation devices is presented. Our goal is to find the shortcomings of the current developed devices in terms of utility, ease of use and costs, for future development of a mechatronic system for upper limb rehabilitation.

  2. Endoscopic Management of Upper Urinary Tract Urothelial Carcinoma.

    PubMed

    Samson, Patrick; Smith, Arthur D; Hoenig, David; Okeke, Zeph

    2018-05-01

    Endoscopic management of upper tract urothelial carcinoma has become more popular over the last few decades as there has been an impetus for renal preservation in these patients. While radical nephroureterectomy has been the gold standard in treatment of this disease, ureteroscopic and percutaneous management has become a viable option for select patients. The literature on endoscopic management of upper urinary tract tumors was explored. Different management methods are discussed, both from published literature and experience of the authors of this chapter. We review the indications, details of the procedure, and troubleshooting methods in the endoscopic management of upper tract urothelial carcinoma. Imperative indications as well as controversial indications are discussed. The role and efficacy of adjuvant intrarenal topical agents are examined as well as the protocol for administering these agents. Follow-up protocols are also reviewed. In select patients, endoscopic management with ureteroscopy and/or percutaneous resection of upper tract urothelial tumors is appropriate and can preserve renal function while obtaining comparable oncologic control compared with radical surgery.

  3. Trends in Acute Nonvariceal Upper Gastrointestinal Bleeding in Dialysis Patients

    PubMed Central

    Yang, Ju-Yeh; Lee, Tsung-Chun; Montez-Rath, Maria E.; Paik, Jane; Chertow, Glenn M.; Desai, Manisha

    2012-01-01

    Impaired kidney function is a risk factor for upper gastrointestinal (GI) bleeding, an event associated with poor outcomes. The burden of upper GI bleeding and its effect on patients with ESRD are not well described. Using data from the US Renal Data System, we quantified the rates of occurrence of and associated 30-day mortality from acute, nonvariceal upper GI bleeding in patients undergoing dialysis; we used medical claims and previously validated algorithms where available. Overall, 948,345 patients contributed 2,296,323 patient-years for study. The occurrence rates for upper GI bleeding were 57 and 328 episodes per 1000 person-years according to stringent and lenient definitions of acute, nonvariceal upper GI bleeding, respectively. Unadjusted occurrence rates remained flat (stringent) or increased (lenient) from 1997 to 2008; after adjustment for sociodemographic characteristics and comorbid conditions, however, we found a significant decline for both definitions (linear approximation, 2.7% and 1.5% per year, respectively; P<0.001). In more recent years, patients had higher hematocrit levels before upper GI bleeding episodes and were more likely to receive blood transfusions during an episode. Overall 30-day mortality was 11.8%, which declined significantly over time (relative declines of 2.3% or 2.8% per year for the stringent and lenient definitions, respectively). In summary, despite declining trends worldwide, crude rates of acute, nonvariceal upper GI bleeding among patients undergoing dialysis have not decreased in the past 10 years. Although 30-day mortality related to upper GI bleeding declined, perhaps reflecting improvements in medical care, the burden on the ESRD population remains substantial. PMID:22266666

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

    PubMed

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

    2015-11-01

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

  5. Guidelines for the diagnosis and treatment of acute non-variceal upper gastrointestinal bleeding (2015, Nanchang, China).

    PubMed

    Bai, Yu; Li, Zhao Shen

    2016-02-01

    Acute non-variceal upper gastrointestinal bleeding (ANVUGIB) is one of the most common medical emergencies in China and worldwide. In 2009, we published the "Guidelines for the diagnosis and treatment of acute non-variceal upper gastrointestinal bleeding" for the patients in China; however, during the past years numerous studies on the diagnosis and treatment of ANVUGIB have been conducted, and the management of ANVUGIB needs to be updated. The guidelines were updated after the databases including PubMed, Embase and CNKI were searched to retrieve the clinical trials on the management of ANVUGIB. The clinical trials were evaluated for high-quality evidence, and the advances in definitions, diagnosis, etiology, severity evaluation, treatment and prognosis of ANVUGIB were carefully reviewed, the recommendations were then proposed. After several rounds of discussions and revisions among the national experts of digestive endoscopy, gastroenterology, radiology and intensive care, the 2015 version of "Guidelines for the diagnosis and treatment of acute non-variceal upper gastrointestinal bleeding" was successfully developed by the Chinese Journal of Internal Medicine, National Medical Journal of China, Chinese Journal of Digestion and Chinese Journal of Digestive Endoscopy. It shall be noted that although much progress has been made, the clinical management of ANVUGIB still needs further improvement and refinement, and high-quality randomized trials are required in the future. © 2016 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

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

    PubMed

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

    2014-03-01

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

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

    PubMed Central

    Kubin, Leszek

    2017-01-01

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

  8. Temporal Decrease in Upper Atmospheric Chlorine

    NASA Technical Reports Server (NTRS)

    Froidevaux, L.; Livesey, N. J.; Read, W. G.; Salawitch, R. J.; Waters, J. W.; Drouin, B.; MacKenzie, I. A.; Pumphrey, H. C.; Bernath, P.; Boone, C.; hide

    2006-01-01

    We report a steady decrease in the upper stratospheric and lower mesospheric abundances of hydrogen chloride (HCl) from August 2004 through January 2006, as measured by the Microwave Limb Sounder (MLS) aboard the Aura satellite. For 60(deg)S to 60(deg)N zonal means, the average yearly change in the 0.7 to 0.1 hPa (approx.50 to 65 km) region is -27 +/- 3 pptv/year, or -0.78 +/- 0.08 percent/year. This is consistent with surface abundance decrease rates (about 6 to 7 years earlier) in chlorine source gases. The MLS data confirm that international agreements to reduce global emissions of ozone-depleting industrial gases are leading to global decreases in the total gaseous chlorine burden. Tracking stratospheric HCl variations on a seasonal basis is now possible with MLS data. Inferred stratospheric total chlorine (CITOT) has a value of 3.60 ppbv at the beginning of 2006, with a (2-sigma) accuracy estimate of 7%; the stratospheric chlorine loading has decreased by about 43 pptv in the 18-month period studied here. We discuss the MLS HCl measurements in the context of other satellite-based HCl data, as well as expectations from surface chlorine data. A mean age of air of approx. 5.5 years and an age spectrum width of 2 years or less provide a fairly good fit to the ensemble of measurements.

  9. Isolated primary lymphedema tarda of the upper limb.

    PubMed

    Shariati, Farzaneh; Ravari, Hasan; Kazemzadeh, Gholamhossein; Sadeghi, Ramin

    2013-03-01

    Primary lymphedema tarda is considered as a congenital disease with late presentation. Primary lymphedema tarda usually affects lower limbs, and primary lymphedema tarda of the upper limbs usually accompanies lower limb lymphedema. In the current case report, we present an 80-year-old male patient with isolated left upper limb swelling that lymphoscintigraphy imaging proved to be lymphedema.

  10. Upper Ocean Evolution Across the Beaufort Sea Marginal Ice Zone from Autonomous Gliders

    NASA Astrophysics Data System (ADS)

    Lee, Craig; Rainville, Luc; Perry, Mary Jane

    2016-04-01

    The observed reduction of Arctic summertime sea ice extent and expansion of the marginal ice zone (MIZ) have profound impacts on the balance of processes controlling sea ice evolution, including the introduction of several positive feedback mechanisms that may act to accelerate melting. Examples of such feedbacks include increased upper ocean warming though absorption of solar radiation, elevated internal wave energy and mixing that may entrain heat stored in subsurface watermasses (e.g., the relatively warm Pacific Summer (PSW) and Atlantic (AW) waters), and elevated surface wave energy that acts to deform and fracture sea ice. Spatial and temporal variability in ice properties and open water fraction impact these processes. To investigate how upper ocean structure varies with changing ice cover, and how the balance of processes shift as a function of ice fraction and distance from open water, four long-endurance autonomous Seagliders occupied sections that extended from open water, through the marginal ice zone, deep into the pack during summer 2014 in the Beaufort Sea. Sections reveal strong fronts where cold, ice-covered waters meet waters that have been exposed to solar warming, and O(10 km) scale eddies near the ice edge. In the pack, Pacific Summer Water and a deep chlorophyll maximum form distinct layers at roughly 60 m and 80 m, respectively, which become increasingly diffuse as they progress through the MIZ and into open water. The isopynal layer between 1023 and 1024 kgm-3, just above the PSW, consistently thickens near the ice edge, likely due to mixing or energetic vertical exchange associated with strong lateral gradients in this region. This presentation will discuss the upper ocean variability, its relationship to sea ice extent, and evolution over the summer to the start of freeze up.

  11. Upper Ocean Evolution Across the Beaufort Sea Marginal Ice Zone from Autonomous Gliders

    NASA Astrophysics Data System (ADS)

    Lee, C.; Rainville, L.; Perry, M. J.

    2016-02-01

    The observed reduction of Arctic summertime sea ice extent and expansion of the marginal ice zone (MIZ) have profound impacts on the balance of processes controlling sea ice evolution, including the introduction of several positive feedback mechanisms that may act to accelerate melting. Examples of such feedbacks include increased upper ocean warming though absorption of solar radiation, elevated internal wave energy and mixing that may entrain heat stored in subsurface watermasses (e.g., the relatively warm Pacific Summer (PSW) and Atlantic (AW) waters), and elevated surface wave energy that acts to deform and fracture sea ice. Spatial and temporal variability in ice properties and open water fraction impact these processes. To investigate how upper ocean structure varies with changing ice cover, and how the balance of processes shift as a function of ice fraction and distance from open water, four long-endurance autonomous Seagliders occupied sections that extended from open water, through the marginal ice zone, deep into the pack during summer 2014 in the Beaufort Sea. Sections reveal strong fronts where cold, ice-covered waters meet waters that have been exposed to solar warming, and O(10 km) scale eddies near the ice edge. In the pack, Pacific Summer Water and a deep chlorophyll maximum form distinct layers at roughly 60 m and 80 m, respectively, which become increasingly diffuse as they progress through the MIZ and into open water. The isopynal layer between 1023 and 1024 kg m-3, just above the PSW, consistently thickens near the ice edge, likely due to mixing or energetic vertical exchange associated with strong lateral gradients in this region. This presentation will discuss the upper ocean variability, its relationship to sea ice extent, and evolution over the summer to the start of freeze up.

  12. Vaginal orgasm is more prevalent among women with a prominent tubercle of the upper lip.

    PubMed

    Brody, Stuart; Costa, Rui Miguel

    2011-10-01

    Recent studies have uncovered multiple markers of vaginal orgasm history (unblocked pelvic movement during walking, less use of immature psychological defense mechanisms, greater urethrovaginal space). Other markers (perhaps of prenatal origin) even without obvious mechanistic roles in vaginal orgasm might exist, and a clinical observation led to the novel hypothesis that a prominent tubercle of the upper lip is such a marker. To examine the hypothesis that a prominent tubercle of the upper lip is associated specifically with greater likelihood of experiencing vaginal orgasm (orgasm elicited by penile-vaginal intercourse [PVI] without concurrent masturbation). Women (N = 258, predominantly Scottish) completed an online survey reporting their frequencies of various sexual activities and corresponding orgasms, age, and the prominence of the tubercle of their upper lip. Social desirability response bias was also assessed. Multivariate associations of lip tubercle prominence with vaginal orgasm (ever and past month consistency) and with orgasm by other means. RESULTS.: A prominent and sharply raised lip tubercle was associated with greater odds (odds ratio = 12.3) of ever having a vaginal orgasm, and also with greater past month vaginal orgasm consistency (an effect driven by the women who never had a vaginal orgasm), than less prominent lip tubercle categories. Lip tubercle was not associated with social desirability responding, or with orgasm triggered by masturbation during PVI, solitary or partner clitoral or vaginal masturbation, vibrator, or cunnilingus. The results are discussed in light of the unique nature of vaginal orgasm and the possibility of prenatal developmental influences. © 2011 International Society for Sexual Medicine.

  13. Upper Ocean Evolution Across the Beaufort Sea Marginal Ice Zone

    NASA Astrophysics Data System (ADS)

    Lee, C.; Rainville, L.; Gobat, J. I.; Perry, M. J.; Freitag, L. E.; Webster, S.

    2016-12-01

    The observed reduction of Arctic summertime sea ice extent and expansion of the marginal ice zone (MIZ) have profound impacts on the balance of processes controlling sea ice evolution, including the introduction of several positive feedback mechanisms that may act to accelerate melting. Examples of such feedbacks include increased upper ocean warming though absorption of solar radiation, elevated internal wave energy and mixing that may entrain heat stored in subsurface watermasses (e.g., the relatively warm Pacific Summer and Atlantic waters), and elevated surface wave energy that acts to deform and fracture sea ice. Spatial and temporal variability in ice properties and open water fraction impact these processes. To investigate how upper ocean structure varies with changing ice cover, how the balance of processes shift as a function of ice fraction and distance from open water, and how these processes impact sea ice evolution, a network of autonomous platforms sampled the atmosphere-ice-ocean system in the Beaufort, beginning in spring, well before the start of melt, and ending with the autumn freeze-up. Four long-endurance autonomous Seagliders occupied sections that extended from open water, through the marginal ice zone, deep into the pack during summer 2014 in the Beaufort Sea. Gliders penetrated up to 200 km into the ice pack, under complete ice cover for up to 10 consecutive days. Sections reveal strong fronts where cold, ice-covered waters meet waters that have been exposed to solar warming, and O(10 km) scale eddies near the ice edge. In the pack, Pacific Summer Water and a deep chlorophyll maximum form distinct layers at roughly 60 m and 80 m, respectively, which become increasingly diffuse late in the season as they progress through the MIZ and into open water. Stratification just above the Pacific Summer Water rapidly weakens near the ice edge and temperature variance increases, likely due to mixing or energetic vertical exchange associated with strong

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

    PubMed

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

    2015-12-01

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

  15. Sensitivity analysis of seismic waveforms to upper-mantle discontinuities using the adjoint method

    NASA Astrophysics Data System (ADS)

    Koroni, Maria; Bozdağ, Ebru; Paulssen, Hanneke; Trampert, Jeannot

    2017-09-01

    Using spectral-element simulations of wave propagation, we investigated the sensitivity of seismic waveforms, recorded on transverse components, to upper-mantle discontinuities in 1-D and 3-D background models. These sensitivity kernels, or Fréchet derivatives, illustrate the spatial sensitivity to model parameters, of which those for shear wave speed and the surface topography of internal boundaries are discussed in this paper. We focus on the boundaries at 400 and 670 km depth of the mantle transition zone. SS precursors have frequently been used to infer the topography of upper-mantle discontinuities. These seismic phases are underside reflections off these boundaries and are usually analysed in the distance range of 110°-160°. This distance range is chosen to minimize the interference from other waves. We show sensitivity kernels for consecutive time windows at three characteristic epicentral distances within the 110°-160° range. The sensitivity kernels are computed with the adjoint method using synthetic data. From our simulations we can draw three main conclusions: (i) The exact Fréchet derivatives show that in all time windows, and also in those centred on the SS precursors, there is interference from other waves. This explains the difficulty reported in the literature to correct for 3-D shear wave speed perturbations, even if the 3-D structure is perfectly known. (ii) All studies attempting to map the topography of the 400 and 670 km discontinuities to date assume that the traveltimes of SS precursors can be linearly decomposed into a 3-D elastic structure and a topography part. We recently showed that such a linear decomposition is not possible for SS precursors, and the sensitivity kernels presented in this paper explain why. (iii) In agreement with previous work, we show that other parts of the seismograms have greater sensitivity to upper-mantle discontinuities than SS precursors, especially multiply bouncing S waves exploiting the S

  16. The GCOS Reference Upper-Air Network (GRUAN)

    NASA Astrophysics Data System (ADS)

    Vömel, H.; Berger, F. H.; Immler, F. J.; Seidel, D.; Thorne, P.

    2009-04-01

    While the global upper-air observing network has provided useful observations for operational weather forecasting for decades, its measurements lack the accuracy and long-term continuity needed for understanding climate change. Consequently, the scientific community faces uncertainty on such key issues as the trends of temperature in the upper troposphere and stratosphere or the variability and trends of stratospheric water vapour. To address these shortcomings, and to ensure that future climate records will be more useful than the records to date, the Global Climate Observing System (GCOS) program initiated the GCOS Reference Upper Air Network (GRUAN). GRUAN will be a network of about 30-40 observatories with a representative sampling of geographic regions and surface types. These stations will provide upper-air reference observations of the essential climate variables, i.e. temperature, geopotential, humidity, wind, radiation and cloud properties using specialized radiosondes and complementary remote sensing profiling instrumentation. Long-term stability, quality assurance / quality control, and a detailed assessment of measurement uncertainties will be the key aspects of GRUAN observations. The network will not be globally complete but will serve to constrain and adjust data from more spatially comprehensive global observing systems including satellites and the current radiosonde networks. This paper outlines the scientific rationale for GRUAN, its role in the Global Earth Observation System of Systems, network requirements and likely instrumentation, management structure, current status and future plans.

  17. Elastic band causing exfoliation of the upper permanent central incisors.

    PubMed

    Alves, Monica Ghislaine Oliveira; Kitakawa, Dárcio; Becker, Joao Batista Macedo; Brandão, Adriana Aigotti Haberbeck; Cabral, Luiz Antonio Guimarães; Almeida, Janete Dias

    2015-01-01

    Objective. This study reports a case in which elastic band use culminated in the loss of the incisors. Case Report. An 11-year-old white girl was seen complaining of pain, with purulent discharge and severe tooth mobility. The bone destruction detected radiographically in the region, despite its single location and absence in posterior quadrants of the maxilla and/or mandible, was similar to that observed in Langerhans cell disease. To our surprise, an elastic band involving the midportion of the roots of the two upper central incisors was found during biopsy. The debris was removed and a metal wire was placed in permanent maxillary right and left incisors. The patient was followed up, but no improvement in tooth mobility was observed. Bone loss increased, and internal resorption and root exposure occurred, which culminated in the extraction of permanent maxillary right and left incisors. Conclusion. The present case highlights the fact that professionals sometimes are confronted by anamnestic reports never seen before.

  18. The upper pennsylvanian pittsburgh coal bed: Resources and mine models

    USGS Publications Warehouse

    Watson, W.D.; Ruppert, L.F.; Tewalt, S.J.; Bragg, L.J.

    2001-01-01

    The U.S. Geological Survey recently completed a digital coal resource assessment model of the Upper Pennsylvanian Pittsburgh coal bed, which indicates that after subtracting minedout coal, 16 billion short tons (14 billion tonnes) remain of the original 34 billion short tons (31 billion tonnes) of coal. When technical, environmental, and social restrictions are applied to the remaining Pittsburgh coal model, only 12 billion short tons (11 billion tonnes) are available for mining. Our assessment models estimate that up to 0.61 billion short tons (0.55 billion tonnes), 2.7 billion short tons (2.4 billion tonnes), and 8.5 billion short tons (7.7 billion tonnes) could be available for surface mining, continuous mining, and longwall mining, respectively. This analysis is an example of a second-generation regional coal availability study designed to model recoverability characteristics for all the major coal beds in the United States. ?? 2001 International Association for Mathematical Geology.

  19. Aeronomy of the Venus Upper Atmosphere

    NASA Astrophysics Data System (ADS)

    Gérard, J.-C.; Bougher, S. W.; López-Valverde, M. A.; Pätzold, M.; Drossart, P.; Piccioni, G.

    2017-11-01

    We present aeronomical observations collected using remote sensing instruments on board Venus Express, complemented with ground-based observations and numerical modeling. They are mostly based on VIRTIS and SPICAV measurements of airglow obtained in the nadir mode and at the limb above 90 km. They complement our understanding of the behavior of Venus' upper atmosphere that was largely based on Pioneer Venus observations mostly performed over thirty years earlier. Following a summary of recent spectral data from the EUV to the infrared, we examine how these observations have improved our knowledge of the composition, thermal structure, dynamics and transport of the Venus upper atmosphere. We then synthesize progress in three-dimensional modeling of the upper atmosphere which is largely based on global mapping and observations of time variations of the nitric oxide and O2 nightglow emissions. Processes controlling the escape flux of atoms to space are described. Results based on the VeRA radio propagation experiment are summarized and compared to ionospheric measurements collected during earlier space missions. Finally, we point out some unsolved and open questions generated by these recent datasets and model comparisons.

  20. Formation and sustainment of internal transport barriers in the International Thermonuclear Experimental Reactor with the baseline heating mixa)

    NASA Astrophysics Data System (ADS)

    Poli, Francesca M.; Kessel, Charles E.

    2013-05-01

    Plasmas with internal transport barriers (ITBs) are a potential and attractive route to steady-state operation in ITER. These plasmas exhibit radially localized regions of improved confinement with steep pressure gradients in the plasma core, which drive large bootstrap current and generate hollow current profiles and negative magnetic shear. This work examines the formation and sustainment of ITBs in ITER with electron cyclotron heating and current drive. The time-dependent transport simulations indicate that, with a trade-off of the power delivered to the equatorial and to the upper launcher, the sustainment of steady-state ITBs can be demonstrated in ITER with the baseline heating configuration.

  1. Upper Respiratory Tract Diseases in Athletes in Different Sports Disciplines.

    PubMed

    Gałązka-Franta, Anna; Jura-Szołtys, Edyta; Smółka, Wojciech; Gawlik, Radosław

    2016-12-01

    Upper respiratory tract diseases in athletes are a very common medical problem. Training conditions in different sports disciplines increase the risk of upper respiratory disease. Epidemiological evidence suggests that heavy acute or chronic exercise is related to an increased incidence of upper respiratory tract infections in athletes. Regular physical exercise at high intensity may lead to transient immunosuppression due to high prevalence of allergic diseases in athletes. Regardless of the cause they can exclude athletes from the training program and significantly impair their performance. In the present work, the most common upper respiratory tract diseases in athletes taking into account the disciplines in which they most often occur were presented. The focus was laid on symptoms, diagnostic methods and pharmacotherapy. Moreover, preventive procedures which can help reduce the occurrence of upper respiratory tract disease in athletes were presented. Management according to anti-doping rules, criteria for return to training and competition as an important issues of athlete's health were discussed.

  2. Upper atmosphere pollution measurements (GASP)

    NASA Technical Reports Server (NTRS)

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

    1975-01-01

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

  3. Upper South Platte Watershed Protection and Restoration Project

    Treesearch

    Steve Culver; Cindy Dean; Fred Patten; Jim Thinnes

    2001-01-01

    The Upper South Platte Basin is a critical watershed in Colorado. Nearly 80 percent of the water used by the 1.5 million Denver metropolitan residents comes from or is transmitted through this river drainage. The Colorado Unified Watershed Assessment identified the Upper South Platte River as a Category 1 watershed in need of restoration. Most of the river basin is...

  4. Diagnosis and management of upper gastrointestinal bleeding in children.

    PubMed

    Owensby, Susan; Taylor, Kellee; Wilkins, Thad

    2015-01-01

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

  5. An integrated model-driven method for in-treatment upper airway motion tracking using cine MRI in head and neck radiation therapy

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

    Li, Hua, E-mail: huli@radonc.wustl.edu; Chen, Hsin

    Purpose: For the first time, MRI-guided radiation therapy systems can acquire cine images to dynamically monitor in-treatment internal organ motion. However, the complex head and neck (H&N) structures and low-contrast/resolution of on-board cine MRI images make automatic motion tracking a very challenging task. In this study, the authors proposed an integrated model-driven method to automatically track the in-treatment motion of the H&N upper airway, a complex and highly deformable region wherein internal motion often occurs in an either voluntary or involuntary manner, from cine MRI images for the analysis of H&N motion patterns. Methods: Considering the complex H&N structures andmore » ensuring automatic and robust upper airway motion tracking, the authors firstly built a set of linked statistical shapes (including face, face-jaw, and face-jaw-palate) using principal component analysis from clinically approved contours delineated on a set of training data. The linked statistical shapes integrate explicit landmarks and implicit shape representation. Then, a hierarchical model-fitting algorithm was developed to align the linked shapes on the first image frame of a to-be-tracked cine sequence and to localize the upper airway region. Finally, a multifeature level set contour propagation scheme was performed to identify the upper airway shape change, frame-by-frame, on the entire image sequence. The multifeature fitting energy, including the information of intensity variations, edge saliency, curve geometry, and temporal shape continuity, was minimized to capture the details of moving airway boundaries. Sagittal cine MR image sequences acquired from three H&N cancer patients were utilized to demonstrate the performance of the proposed motion tracking method. Results: The tracking accuracy was validated by comparing the results to the average of two manual delineations in 50 randomly selected cine image frames from each patient. The resulting average dice similarity

  6. Anatomic Optical Coherence Tomography of Upper Airways

    NASA Astrophysics Data System (ADS)

    Chin Loy, Anthony; Jing, Joseph; Zhang, Jun; Wang, Yong; Elghobashi, Said; Chen, Zhongping; Wong, Brian J. F.

    The upper airway is a complex and intricate system responsible for respiration, phonation, and deglutition. Obstruction of the upper airways afflicts an estimated 12-18 million Americans. Pharyngeal size and shape are important factors in the pathogenesis of airway obstructions. In addition, nocturnal loss in pharyngeal muscular tone combined with high pharyngeal resistance can lead to collapse of the airway and periodic partial or complete upper airway obstruction. Anatomical optical coherence tomography (OCT) has the potential to provide high-speed three-dimensional tomographic images of the airway lumen without the use of ionizing radiation. In this chapter we describe the methods behind endoscopic OCT imaging and processing to generate full three dimensional anatomical models of the human airway which can be used in conjunction with numerical simulation methods to assess areas of airway obstruction. Combining this structural information with flow dynamic simulations, we can better estimate the site and causes of airway obstruction and better select and design surgery for patients with obstructive sleep apnea.

  7. Detachment experiments in new DIII-D upper divertor

    NASA Astrophysics Data System (ADS)

    Moser, A. L.; Leonard, A. W.; Groebner, R. J.; Guo, H.; Wang, H.; Watkins, J. G.; McLean, A. G.; Fenstermacher, M. E.; Shafer, M. W.; Briesemeister, A. R.; Hinson, E. T.

    2017-10-01

    Installation of the Small Angle Slot (SAS) in the upper divertor of DIII-D enables new studies of the effect of target and baffle geometry on divertor detachment. This structure provides a more-closed upper divertor as well as the SAS divertor itself. Initial SAS experiment results indicate that divertor detachment occurs at a lower line-averaged density than in the more-open, lower single null divertor configurations on DIII-D. In contrast, the increased divertor closure of the new installation did not reduce the upstream density required for detachment beyond that achieved with the previous upper divertor structure. Particle pumping in the upper divertor structure is found to produce a 10 % reduction in the pedestal density required for detachment compared to the case with no pumping. Comparisons focus on both the onset of detachment (measured by in-target Langmuir probes) as a function of upstream density, as well as the effect of the new divertor configurations on pedestal density profiles. Work supported by US DOE under DE-FC02-04ER54698, DE-AC05-00OR22725, DE-AC04-94AL85000, DE-AC52-07NA27344, and DE-SC00013911.

  8. Scientific explanations in Greek upper secondary physics textbooks

    NASA Astrophysics Data System (ADS)

    Velentzas, Athanasios; Halkia, Krystallia

    2018-01-01

    In this study, an analysis of the structure of scientific explanations included in physics textbooks of upper secondary schools in Greece was completed. In scientific explanations for specific phenomena found in the sample textbooks, the explanandum is a logical consequence of the explanans, which in all cases include at least one scientific law (and/or principle, model or rule) previously presented, as well as statements concerning a specific case or specific conditions. The same structure is also followed in most of the cases in which the textbook authors explain regularities (i.e. laws, rules) as consequences of one or more general law or principle of physics. Finally, a number of the physics laws and principles presented in textbooks are not deduced as consequences from other, more general laws, but they are formulated axiomatically or inductively derived and the authors argue for their validity. Since, as it was found, the scientific explanations presented in the textbooks used in the study have similar structures to the explanations in internationally known textbooks, the findings of the present work may be of interest not only to science educators in Greece, but also to the community of science educators in other countries.

  9. Upper mantle electrical conductivity for seven subcontinental regions of the Earth

    USGS Publications Warehouse

    Campbell, W.H.; Schiffmacher, E.R.

    1988-01-01

    Spherical harmonic analysis coefficients of the external and internal parts of the quiet-day geomagnetic field variations (Sq) separated for the 7 continental regions of the observatories have been used to determine conductivity profiles to depths of about 600 km by the Schmucker equivalent substitute conductor method. The profiles give evidence of increases in conductivity between about 150 and 350 km depth, then a general increase in conductivity thereafter. For South America we found a high conductivity at shallow depths. The European profile showed a highly conducting layer near 125 km. At the greater depths, Europe, Australia and South America had the lowest values of conductivity. North America and east Asia had intermediate values whereas the African and central Asian profiles both showed the conductivities rising rapidly beyond 450 km depth. The regional differences indicate that there may be considerable lateral heterogeneity of electrical conductivity in the Earth's upper mantle. -Authors

  10. A Subject-Specific Acoustic Model of the Upper Airway for Snoring Sounds Generation

    PubMed Central

    Saha, Shumit; Bradley, T. Douglas; Taheri, Mahsa; Moussavi, Zahra; Yadollahi, Azadeh

    2016-01-01

    Monitoring variations in the upper airway narrowing during sleep is invasive and expensive. Since snoring sounds are generated by air turbulence and vibrations of the upper airway due to its narrowing; snoring sounds may be used as a non-invasive technique to assess upper airway narrowing. Our goal was to develop a subject-specific acoustic model of the upper airway to investigate the impacts of upper airway anatomy, e.g. length, wall thickness and cross-sectional area, on snoring sounds features. To have a subject-specific model for snoring generation, we used measurements of the upper airway length, cross-sectional area and wall thickness from every individual to develop the model. To validate the proposed model, in 20 male individuals, intensity and resonant frequencies of modeled snoring sounds were compared with those measured from recorded snoring sounds during sleep. Based on both modeled and measured results, we found the only factor that may positively and significantly contribute to snoring intensity was narrowing in the upper airway. Furthermore, measured resonant frequencies of snoring were inversely correlated with the upper airway length, which is a risk factor for upper airway collapsibility. These results encourage the use of snoring sounds analysis to assess the upper airway anatomy during sleep. PMID:27210576

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

    PubMed

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

    2012-08-15

    Work-related upper limb and neck musculoskeletal disorders (MSDs) are one of the most common occupational disorders around the world. Although ergonomic design and training are likely to reduce the risk of workers developing work-related upper limb and neck MSDs, the evidence is unclear. To assess the effects of workplace ergonomic design or training interventions, or both, for the prevention of work-related upper limb and neck MSDs in adults. We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, AMED, Web of Science (Science Citation Index), SPORTDiscus, Cochrane Occupational Safety and Health Review Group Database and Cochrane Bone, Joint and Muscle Trauma Group Specialised Register to July 2010, and Physiotherapy Evidence Database, US Centers for Disease Control and Prevention, the National Institute for Occupational Safety and Health database, and International Occupational Safety and Health Information Centre database to November 2010. We included randomised controlled trials (RCTs) of ergonomic workplace interventions for preventing work-related upper limb and neck MSDs. We included only studies with a baseline prevalence of MSDs of the upper limb or neck, or both, of less than 25%. Two review authors independently extracted data and assessed risk of bias. We included studies with relevant data that we judged to be sufficiently homogeneous regarding the intervention and outcome in the meta-analysis. We assessed the overall quality of the evidence for each comparison using the GRADE approach. We included 13 RCTs (2397 workers). Eleven studies were conducted in an office environment and two in a healthcare setting. We judged one study to have a low risk of bias. The 13 studies evaluated effectiveness of ergonomic equipment, supplementary breaks or reduced work hours, ergonomic training, a combination of ergonomic training and equipment, and patient lifting interventions for preventing work-related MSDs of the upper

  12. Ultrasound investigation of fetal human upper respiratory anatomy.

    PubMed

    Wolfson, V P; Laitman, J T

    1990-07-01

    Although the human upper respiratory-upper digestive tract is an area of vital importance, relatively little is known about either the structural or functional changes that occur in the region during the fetal period. While investigations in our laboratory have begun to chart these changes through the use of postmortem materials, in vivo studies have been rarely attempted. This study combines ultrasonography with new applications of video editing to examine aspects of prenatal upper respiratory development. Structures of the fetal upper respiratory-digestive tract and their movements were studied through the use of ultrasonography and detailed frame-by-frame analysis. Twenty-five living fetuses, aged 18-36 weeks gestation, were studied in utero during routine diagnostic ultrasound examination. These real-time linear array sonograms were videotaped during each study. Videotapes were next analyzed for anatomical structures and movement patterns, played back through the ultrasound machine in normal speed, and then examined with a frame-by-frame video editor (FFVE) to identify structures and movements. Still images were photographed directly from the video monitor using a 35 mm camera. Results show that upper respiratory and digestive structures, as well as their movements, could be seen clearly during normal speed and repeat frame-by-frame analysis. Major structures that could be identified in the majority of subjects included trachea in 20 of 25 fetuses (80%); larynx, 76%; pharynx, 76%. Smaller structures were more variable, but were nevertheless observed on both sagittal and coronal section: piriform sinuses, 76%; thyroid cartilage, 36%; cricoid cartilage, 32%; and epiglottis, 16%. Movements of structures could also be seen and were those typically observed in connection with swallowing: fluttering tongue movements, changes in pharyngeal shape, and passage of a bolus via the piriform sinuses to esophagus. Fetal swallows had minimal laryngeal motion. This study

  13. Upper mantle structure at Walvis Ridge from Pn tomography

    NASA Astrophysics Data System (ADS)

    Ryberg, Trond; Braeuer, Benjamin; Weber, Michael

    2017-10-01

    Passive continental margins offer the unique opportunity to study the processes involved in continental extension and break-up. Within the LISPWAL (LIthospheric Structure of the Namibian continental Passive margin at the intersection with the Walvis Ridge from amphibious seismic investigations) project, combined on- and offshore seismic experiments were designed to characterize the Southern African passive margin at the Walvis Ridge in northern Namibia. In addition to extensive analysis of the crustal structures, we carried out seismic investigations targeting the velocity structure of the upper mantle in the landfall region of the Walvis Ridge with the Namibian coast. Upper mantle Pn travel time tomography from controlled source, amphibious seismic data was used to investigate the sub-Moho upper mantle seismic velocity. We succeeded in imaging upper mantle structures potentially associated with continental break-up and/or the Tristan da Cunha hotspot track. We found mostly coast-parallel sub-Moho velocity anomalies, interpreted as structures which were created during Gondwana break-up.

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

    PubMed

    Khamaysi, Iyad; Gralnek, Ian M

    2013-10-01

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

  15. [The importance of upper limb diseases in occupational medicine].

    PubMed

    Riva, Matteo Marco; Santini, Marisa; Mosconi, Giovanni

    2013-01-01

    In this work the authors analyse the results of the clinical evaluation of patients affected by suspected work related musculo-skeletal disorders (WMSDs), observed throughout 2008-2009 in the specific ambulatory of Occupational Medicine Division of Ospedali Riuaniti di Bergamo. The aim is to illustrate the epidemiological relevance of upper limb (UL) WMSDs. We observed 430 patients (mean age 46,9 years, DS 9,3; mean working seniority 29 years, DS 10,4), investigating 600 disorders in diferent musculoskeletal segments. Most of the patients (66%) got to the division for a clinical consultation requested by general practitioners, 29,8% by occupational physicians, 4,2% by national insurance for occupational injuries and diseases (INAIL). Most of the patients (38,4%) were employed in construction industry. Among the 600 disorders investigated, 34,5% was at lumbar spine, 74,5% was at upper limb. The clinical diagnosis was already clear at the first consultation for 81,6% of subjects with low back pain and for 56,5% of patients with upper limb disorders; for the others was necessary to prescribe some instrumental exams or specialistic (neurologic, physiatric, orthopaedic) medical examination. We concluded for a diagnosis of WMSDs in 48,3% of the 600 cases: the percentage is 50,2% if we consider only disorders at lumbar spine and 52,5% among disorders at upper limb. The most frequent reason of refusing occupational aetiology, in the cases of low back pain, was the concomitant presence of other diseases at the segment; on the contrary, for the cases of upper limb disorders, was the lack of correlation between type of disease and professional exposure. All physicians demonstrate a high attention about upper limb disorders, topical subject of great epidemiological interest. General practitioners and occupational physicians have to take more advantage of diagnostic support and clinical evaluations offered by Occupational Medicine Divisions an Universities about WMSDs. In

  16. Plans: Poop Deck, Boat Deck, Housetop, Bridge Deck, Upper Bridge ...

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

    Plans: Poop Deck, Boat Deck, Housetop, Bridge Deck, Upper Bridge Deck, Navigating Bridge, Forecastle Deck, Upper Deck, Second Deck and Hold - Saugatuck, James River Reserve Fleet, Newport News, Newport News, VA

  17. Axial and radial water transport and internal water storage in tropical forest canopy trees.

    Treesearch

    Shelley A. James; Frederick C. Meinzer; Guillermo Goldstein; David Woodruff; Timothy Jones; Teresa Restom; Monica Mejia; Michael Clearwater; Paula Campanello

    2003-01-01

    Heat and stable isotope tracers were used to study axial and radial water transport in relation to sapwood anatomical characteristics and internal water storage in four canopy tree species of a seasonally dry tropical forest in Panama. Anatomical characteristics of the wood and radial profiles of sap flow were measured at the base, upper trunk, and crown of a single...

  18. Validation of the Medipro MediCare 100f upper arm blood pressure monitor, for self-measurement, according to the European Society of Hypertension International Protocol revision 2010.

    PubMed

    Yi, Jun; Wan, Yi; Pan, Feng; Yu, Xiaorong; Zhao, Huadong; Shang, Fujun; Xu, Yongyong

    2011-08-01

    The validation of sphygmomanometer is important in accurate blood pressure measurement. This study presents the validation results by the Medipro MediCare 100f upper arm blood pressure monitor according to the European Society of Hypertension International Protocol (ESH-IP) revision 2010. The ESH-IP revision 2010 for the validation of blood pressure measuring devices in adults was followed precisely. A total of 99 couples of test device and reference blood pressure measurements were obtained during the study (three pairs for each of the 33 participants). The device produced 73, 93, and 98 measurements within 5, 10, and 15 mmHg for systolic blood pressure (SBP) and 79, 93, and 96 for diastolic blood pressure (DBP), respectively. The mean standard deviation device-observer difference was 1.4 ± 5.2 mmHg for SBP and 0.02±5.8 mmHg for DBP. The number of participants with two or three of the device-observer differences within 5 mmHg was 24 for SBP and 30 for DBP, whereas there was no participant with none of the device-observer differences within 5 mmHg. According to the results of the validation study based on the ESH-IP revision 2010, the Medipro MediCare 100f can be recommended for self-measurement in an adult population.

  19. Implications of prosthesis funding structures on the use of prostheses: experiences of individuals with upper limb absence.

    PubMed

    Biddiss, Elaine; McKeever, Patricia; Lindsay, Sally; Chau, Tom

    2011-06-01

    While sparsely researched, funding structures may play an important role in use of and satisfaction with prostheses and related health services. The objectives of this study were to (1) quantify the direct costs of prosthesis wear, (2) explore variations in funding distribution, and (3) describe the role of affordability in prosthesis selection and wear. An anonymous, online cross-sectional descriptive survey was administered. Analyses were conducted of qualitative and quantitative data extracted from an international sample of 242 individuals with upper limb absence. Access to prosthesis funding was variable and fluctuated with age, level of limb absence and country of care. Of individuals who gave details on prosthetic costs, 63% (n = 69) were fully reimbursed for their prosthetic expenses, while 37% (n = 40) were financially disadvantaged by the cost of components (mean [SD] US$9,574 [$9,986]) and their ongoing maintenance (US$1,936 [$3,179]). Of the 71 non-wearers in this study, 48% considered cost an influential factor in their decision not to adopt prosthesis use. Prosthesis funding is neither homogeneous nor transparent and can be influential in both the selection and use of a prosthetic device. Inequitable access to prosthesis funding is evident in industrialized nations and may lead to prosthesis abandonment and/or diminished quality of life for individuals with upper limb absences. Increased efforts are required to ensure equitable access to upper limb prosthetics and related services in line with individuals' needs.

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

    PubMed

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

    2017-09-19

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

  1. Galileo spacecraft integration - International cooperation on a planetary mission in the Shuttle era

    NASA Technical Reports Server (NTRS)

    Spehalski, R. J.

    1983-01-01

    The Galileo mission is designed to greatly expand scientific knowledge of Jupiter and its system. The retropropulsion module (RPM) as a major functional element of the Galileo spacecraft is described. The major mission and spacecraft requirements on the RPM are presented. Complexities of the integration process due to the international interface are identified. Challenges associated with integration with new launch vehicles, the Shuttle and upper stage, and their relationships to the RPM are discussed. The results of the integration process involving mission and propulsion performance, reliability, mechanical and thermal interfaces, and safety are described. Finally, considerations and recommendations for future missions involving international cooperation are given.

  2. Phosphorus retention and internal loading in the Bay of Quinte, Lake Ontario, using diagenetic modelling.

    PubMed

    Doan, Phuong T K; Watson, Sue B; Markovic, Stefan; Liang, Anqi; Guo, Jay; Mugalingam, Shan; Stokes, Jonathan; Morley, Andrew; Zhang, Weitao; Arhonditsis, George B; Dittrich, Maria

    2018-04-24

    Internal phosphorus (P) loading significantly contributes to hysteresis in ecosystem response to nutrient remediation, but the dynamics of sediment P transformations are often poorly characterized. Here, we applied a reaction-transport diagenetic model to investigate sediment P dynamics in the Bay of Quinte, a polymictic, spatially complex embayment of Lake Ontario, (Canada). We quantified spatial and temporal variability of sediment P binding forms and estimated P diffusive fluxes and sediment P retention in different parts of the bay. Our model supports the notion that diagenetic recycling of redox sensitive and organic bound P forms drive sediment P release. In the recent years, summer sediment P diffusive fluxes varied in the range of 3.2-3.6 mg P m -2  d -1 in the upper bay compared to 1.5 mg P m -2  d -1 in the middle-lower bay. Meanwhile sediment P retention ranged between 71% and 75% in the upper and middle-lower bay, respectively. The reconstruction of temporal trends of internal P loading in the past century, suggests that against the backdrop of reduced external P inputs, sediment P exerts growing control over the lake nutrient budget. Higher sediment P diffusive fluxes since mid-20th century with particular increase in the past 20 years in the shallower upper basins, emphasize limited sediment P retention potential and suggest prolonged ecosystem recovery, highlighting the importance of ongoing P control measures. Copyright © 2018 Elsevier B.V. All rights reserved.

  3. Upper stage alternatives for the shuttle era

    NASA Technical Reports Server (NTRS)

    1981-01-01

    The status and general characteristics of Space Shuttle upper stages now in use or in development, as well as new vehicle possibilities are examined. Upper stage requirements for both civil and Department of Defense missions, categorized generally into near-term (early and mid-1980's), mid-term (late 1980's to mid-1990's), and far-term (late 1990's and beyond) are discussed. Finally, the technical, schedule and cost impact of alternative ways in which these requirements could be met are examined, and a number of conclusions and recommendations are reached.

  4. GCOS reference upper air network (GRUAN): Steps towards assuring future climate records

    NASA Astrophysics Data System (ADS)

    Thorne, P. W.; Vömel, H.; Bodeker, G.; Sommer, M.; Apituley, A.; Berger, F.; Bojinski, S.; Braathen, G.; Calpini, B.; Demoz, B.; Diamond, H. J.; Dykema, J.; Fassò, A.; Fujiwara, M.; Gardiner, T.; Hurst, D.; Leblanc, T.; Madonna, F.; Merlone, A.; Mikalsen, A.; Miller, C. D.; Reale, T.; Rannat, K.; Richter, C.; Seidel, D. J.; Shiotani, M.; Sisterson, D.; Tan, D. G. H.; Vose, R. S.; Voyles, J.; Wang, J.; Whiteman, D. N.; Williams, S.

    2013-09-01

    The observational climate record is a cornerstone of our scientific understanding of climate changes and their potential causes. Existing observing networks have been designed largely in support of operational weather forecasting and continue to be run in this mode. Coverage and timeliness are often higher priorities than absolute traceability and accuracy. Changes in instrumentation used in the observing system, as well as in operating procedures, are frequent, rarely adequately documented and their impacts poorly quantified. For monitoring changes in upper-air climate, which is achieved through in-situ soundings and more recently satellites and ground-based remote sensing, the net result has been trend uncertainties as large as, or larger than, the expected emergent signals of climate change. This is more than simply academic with the tropospheric temperature trends issue having been the subject of intense debate, two international assessment reports and several US congressional hearings. For more than a decade the international climate science community has been calling for the instigation of a network of reference quality measurements to reduce uncertainty in our climate monitoring capabilities. This paper provides a brief history of GRUAN developments to date and outlines future plans. Such reference networks can only be achieved and maintained with strong continuing input from the global metrological community.

  5. Black breast cancer survivors experience greater upper extremity disability.

    PubMed

    Dean, Lorraine T; DeMichele, Angela; LeBlanc, Mously; Stephens-Shields, Alisa; Li, Susan Q; Colameco, Chris; Coursey, Morgan; Mao, Jun J

    2015-11-01

    Over one-third of breast cancer survivors experience upper extremity disability. Black women present with factors associated with greater upper extremity disability, including: increased body mass index (BMI), more advanced disease stage at diagnosis, and varying treatment type compared with Whites. No prior research has evaluated the relationship between race and upper extremity disability using validated tools and controlling for these factors. Data were drawn from a survey study among 610 women with stage I-III hormone receptor positive breast cancer. The disabilities of the arm, shoulder and hand (QuickDASH) is an 11-item self-administered questionnaire that has been validated for breast cancer survivors to assess global upper extremity function over the past 7 days. Linear regression and mediation analysis estimated the relationships between race, BMI and QuickDASH score, adjusting for demographics and treatment types. Black women (n = 98) had 7.3 points higher average QuickDASH scores than White (n = 512) women (p < 0.001). After adjusting for BMI, age, education, cancer treatment, months since diagnosis, and aromatase inhibitor status, Black women had an average 4-point (95 % confidence interval 0.18-8.01) higher QuickDASH score (p = 0.04) than White women. Mediation analysis suggested that BMI attenuated the association between race and disability by 40 %. Even several years post-treatment, Black breast cancer survivors had greater upper extremity disability, which was partially mediated by higher BMIs. Close monitoring of high BMI Black women may be an important step in reducing disparities in cancer survivorship. More research is needed on the relationship between race, BMI, and upper extremity disability.

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

    NASA Technical Reports Server (NTRS)

    1991-01-01

    A general overview of NASA's Upper Atmosphere Research Satellite (UARS) program is presented in a broad based informational publication. The UARS will be responsible for carrying out the first systematic, comprehensive study of the stratosphere and will furnish important new data on the mesosphere and thermosphere. The UARS mission objectives are to provide an increased understanding of energy input into the upper atmosphere; global photochemistry of the upper atmosphere; dynamics of the upper atmosphere; coupling among these processes; and coupling between the upper and lower atmosphere. These mission objectives are briefly described along with the UARS on-board instrumentation and related data management systems.

  7. Validation study in four health-care databases: upper gastrointestinal bleeding misclassification affects precision but not magnitude of drug-related upper gastrointestinal bleeding risk.

    PubMed

    Valkhoff, Vera E; Coloma, Preciosa M; Masclee, Gwen M C; Gini, Rosa; Innocenti, Francesco; Lapi, Francesco; Molokhia, Mariam; Mosseveld, Mees; Nielsson, Malene Schou; Schuemie, Martijn; Thiessard, Frantz; van der Lei, Johan; Sturkenboom, Miriam C J M; Trifirò, Gianluca

    2014-08-01

    To evaluate the accuracy of disease codes and free text in identifying upper gastrointestinal bleeding (UGIB) from electronic health-care records (EHRs). We conducted a validation study in four European electronic health-care record (EHR) databases such as Integrated Primary Care Information (IPCI), Health Search/CSD Patient Database (HSD), ARS, and Aarhus, in which we identified UGIB cases using free text or disease codes: (1) International Classification of Disease (ICD)-9 (HSD, ARS); (2) ICD-10 (Aarhus); and (3) International Classification of Primary Care (ICPC) (IPCI). From each database, we randomly selected and manually reviewed 200 cases to calculate positive predictive values (PPVs). We employed different case definitions to assess the effect of outcome misclassification on estimation of risk of drug-related UGIB. PPV was 22% [95% confidence interval (CI): 16, 28] and 21% (95% CI: 16, 28) in IPCI for free text and ICPC codes, respectively. PPV was 91% (95% CI: 86, 95) for ICD-9 codes and 47% (95% CI: 35, 59) for free text in HSD. PPV for ICD-9 codes in ARS was 72% (95% CI: 65, 78) and 77% (95% CI: 69, 83) for ICD-10 codes (Aarhus). More specific definitions did not have significant impact on risk estimation of drug-related UGIB, except for wider CIs. ICD-9-CM and ICD-10 disease codes have good PPV in identifying UGIB from EHR; less granular terminology (ICPC) may require additional strategies. Use of more specific UGIB definitions affects precision, but not magnitude, of risk estimates. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. 19. DETAIL VIEW OF UPPER EAST WALL CONTROL STATION, SHOWING ...

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

    19. DETAIL VIEW OF UPPER EAST WALL CONTROL STATION, SHOWING EMERGENCY BULKHEAD STIFFLEG DERRICK TO RIGHT, LOOKING WEST - Upper Mississippi River 9-Foot Channel Project, Lock & Dam 27, Granite City, Madison County, IL

  9. Endoscopic Treatment of Upper Tract Urothelial Carcinoma.

    PubMed

    Verges, Daniel P; Lallas, Costas D; Hubosky, Scott G; Bagley, Demetrius H

    2017-04-01

    This study aims to make the reader be aware of recent trends regarding the endoscopic management of upper tract urothelial carcinoma (UTUC) via review of the urologic literature over the past 5 years. Given the rare incidence of this disease, and the lack of level 1 evidence, systematic reviews and meta-analyses were also evaluated. Studies of importance are also considered and outlined in the annotated reference section. The PubMed database was queried using the following medical subject headings (MeSH terms): "carcinoma, transitional cell," "ureter," "ureteral neoplasms," "kidney pelvis," "endoscopy," "laser therapy," "ureteroscopy," "urologic surgical procedures," and "ureteroscopes." MeSH terms were linked together in varying combinations and limited to human studies in English. Given the relatively rare nature of upper tract urothelial carcinoma (UTUC), level 1 evidence regarding the efficacy of endoscopic treatment does not exist, even after 30+ years of experience. Rather, the literature available mostly is in the form of single institutional retrospective series consisting of relatively small numbers of patients with short to intermediate follow-up. Only within the last 3 years have published series with larger numbers of patients and mean follow-up over 5 years been made available. Even with these more robust experiences, comparisons among series are difficult given variable treatment and follow-up approaches. Most endoscopically managed UTUC will locally recur, especially with longer follow-up. Renal preservation rate is high, however, approaching 80% with follow-up well over 3 years. Patients with high-grade disease often fare poorly regardless of treatment modality. As such, endoscopic management for high-grade urothelial carcinoma should only be used in exceptional circumstances (i.e., in those patients medically unfit for NU or those with solitary kidneys wishing to avoid the morbidity of dialysis). No level 1 evidence exists for the routine use

  10. Identification and classification of upper limb motions using PCA.

    PubMed

    Veer, Karan; Vig, Renu

    2018-03-28

    This paper describes the utility of principal component analysis (PCA) in classifying upper limb signals. PCA is a powerful tool for analyzing data of high dimension. Here, two different input strategies were explored. The first method uses upper arm dual-position-based myoelectric signal acquisition and the other solely uses PCA for classifying surface electromyogram (SEMG) signals. SEMG data from the biceps and the triceps brachii muscles and four independent muscle activities of the upper arm were measured in seven subjects (total dataset=56). The datasets used for the analysis are rotated by class-specific principal component matrices to decorrelate the measured data prior to feature extraction.

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

    PubMed

    Smith, David J

    2013-10-01

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

  12. Spacesuit Soft Upper Torso Sizing Systems

    NASA Technical Reports Server (NTRS)

    Graziosi, David; Splawn, Keith

    2011-01-01

    The passive sizing system consists of a series of low-profile pulleys attached to the front and back of the shoulder bearings on a spacesuit soft upper torso (SUT), textile cord or stainless steel cable, and a modified commercial ratchet mechanism. The cord/cable is routed through the pulleys and attached to the ratchet mechanism mounted on the front of the spacesuit within reach of the suited subject. Upon actuating the ratchet mechanism, the shoulder bearing breadth is changed, providing variable upper torso sizing. The active system consists of a series of pressurizable nastic cells embedded into the fabric layers of a spacesuit SUT. These cells are integrated to the front and back of the SUT and are connected to an air source with a variable regulator. When inflated, the nastic cells provide a change in the overall shoulder bearing breadth of the spacesuit and thus, torso sizing. The research focused on the development of a high-performance sizing and actuation system. This technology has application as a suit-sizing mechanism to allow easier suit entry and more accurate suit fit with fewer torso sizes than the existing EMU (Extravehicular Mobility Unit) suit system. This advanced SUT will support NASA s Advanced EMU Evolutionary Concept of a two-sizes-fit-all upper torso for replacement of the current EMU hard upper torso (HUT). Both the passive and nastic sizing system approaches provide astronauts with real-time upper torso sizing, which translates into a more comfortable suit, providing enhanced fit resulting in improved crewmember performance during extravehicular activity. These systems will also benefit NASA by reducing flight logistics as well as overall suit system cost. The nastic sizing system approach provides additional structural redundancy over existing SUT designs by embedding additional coated fabric and uncoated fabric layers. Two sizing systems were selected to build into a prototype SUT: one active and one passive. From manned testing, it

  13. 31. DETAIL VIEW OF UPPER INTERMEDIATE WALL CONTROL STATION, SHOWING ...

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

    31. DETAIL VIEW OF UPPER INTERMEDIATE WALL CONTROL STATION, SHOWING RECESSES FOR AUXILIARY LOCK LIFT GATE LEAVES, LOOKING EAST - Upper Mississippi River 9-Foot Channel Project, Lock & Dam 27, Granite City, Madison County, IL

  14. 32. DETAIL VIEW OF UPPER INTERMEDIATE WALL CONTROL STATION, SHOWING ...

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

    32. DETAIL VIEW OF UPPER INTERMEDIATE WALL CONTROL STATION, SHOWING RECESSES FOR AUXILIARY LOCK LIFT GATE LEAVES, LOOKING NORTHEAST - Upper Mississippi River 9-Foot Channel Project, Lock & Dam 27, Granite City, Madison County, IL

  15. Accuracy and precision of flash glucose monitoring sensors inserted into the abdomen and upper thigh compared with the upper arm.

    PubMed

    Charleer, Sara; Mathieu, Chantal; Nobels, Frank; Gillard, Pieter

    2018-06-01

    Nowadays, most Belgian patients with type 1 diabetes use flash glucose monitoring (FreeStyle Libre [FSL]; Abbott Diabetes Care, Alameda, California) to check their glucose values, but some patients find the sensor on the upper arm too visible. The aim of the present study was to compare the accuracy and precision of FSL sensors when placed on different sites. A total of 23 adults with type 1 diabetes used three FSL sensors simultaneously for 14 days on the upper arm, abdomen and upper thigh. FSL measurements were compared with capillary blood glucose (BG) measurements obtained with a built-in FSL BG meter. The aggregated mean absolute relative difference was 11.8 ± 12.0%, 18.5 ± 18.4% and 12.3 ± 13.8% for the arm, abdomen (P = .002 vs arm) and thigh (P = .5 vs arm), respectively. Results of Clarke error grid analysis for the arm and thigh were similar (zone A: 84.9% vs 84.5%; P = .6), while less accuracy was seen for the abdomen (zone A: 69.4%; P = .01). Apart from the first day, the accuracy of FSL sensors on the arm and thigh was more stable across the 14-day wear duration than accuracy of sensors on the abdomen, which deteriorated mainly during week 2 (P < .0005). The aggregated precision absolute relative difference was markedly lower for the arm/thigh (10.9 ± 11.9%) compared with the arm/abdomen (20.9 ± 22.8%; P = .002). Our results indicate that the accuracy and precision of FSL sensors placed on the upper thigh are similar to the upper arm, whereas the abdomen performed unacceptably poorly. © 2018 John Wiley & Sons Ltd.

  16. The upper bounds of reduced axial and shear moduli in cross-ply laminates with matrix cracks

    NASA Technical Reports Server (NTRS)

    Lee, Jong-Won; Allen, D. H.; Harris, C. E.

    1991-01-01

    The present study proposes a mathematical model utilizing the internal state variable concept for predicting the upper bounds of the reduced axial and shear stiffnesses in cross-ply laminates with matrix cracks. The displacement components at the matrix crack surfaces are explicitly expressed in terms of the observable axial and shear strains and the undamaged material properties. The reduced axial and shear stiffnesses are predicted for glass/epoxy and graphite/epoxy laminates. Comparison of the model with other theoretical and experimental studies is also presented to confirm direct applicability of the model to angle-ply laminates with matrix cracks subjected to general in-plane loading.

  17. Technology improves upper extremity rehabilitation.

    PubMed

    Kowalczewski, Jan; Prochazka, Arthur

    2011-01-01

    Stroke survivors with hemiparesis and spinal cord injury (SCI) survivors with tetraplegia find it difficult or impossible to perform many activities of daily life. There is growing evidence that intensive exercise therapy, especially when supplemented with functional electrical stimulation (FES), can improve upper extremity function, but delivering the treatment can be costly, particularly after recipients leave rehabilitation facilities. Recently, there has been a growing level of interest among researchers and healthcare policymakers to deliver upper extremity treatments to people in their homes using in-home teletherapy (IHT). The few studies that have been carried out so far have encountered a variety of logistical and technical problems, not least the difficulty of conducting properly controlled and blinded protocols that satisfy the requirements of high-level evidence-based research. In most cases, the equipment and communications technology were not designed for individuals with upper extremity disability. It is clear that exercise therapy combined with interventions such as FES, supervised over the Internet, will soon be adopted worldwide in one form or another. Therefore it is timely that researchers, clinicians, and healthcare planners interested in assessing IHT be aware of the pros and cons of the new technology and the factors involved in designing appropriate studies of it. It is crucial to understand the technical barriers, the role of telesupervisors, the motor improvements that participants can reasonably expect and the process of optimizing IHT-exercise therapy protocols to maximize the benefits of the emerging technology. Copyright © 2011 Elsevier B.V. All rights reserved.

  18. Reliability and Validity of the Musculoskeletal Tumor Society Scoring System for the Upper Extremity in Japanese Patients.

    PubMed

    Uehara, Kosuke; Ogura, Koichi; Akiyama, Toru; Shinoda, Yusuke; Iwata, Shintaro; Kobayashi, Eisuke; Tanzawa, Yoshikazu; Yonemoto, Tsukasa; Kawano, Hirotaka; Kawai, Akira

    2017-09-01

    The Musculoskeletal Tumor Society (MSTS) scoring system developed in 1993 is a widely used disease-specific evaluation tool for assessment of physical function in patients with musculoskeletal tumors; however, only a few studies have confirmed its reliability and validity. The aim of this study was to validate the MSTS scoring system for the upper extremity (MSTS-UE) in Japanese patients with musculoskeletal tumors for use by others in research. Does the MSTS-UE have: (1) sufficient reliability and internal consistency; (2) adequate construct validity; and (3) reasonable criterion validity in comparison to the Toronto Extremity Salvage Score (TESS) or SF-36? Reliability was performed using test-retest analysis, and internal consistency was evaluated with Cronbach's alpha coefficient. Construct validity was evaluated using a scree plot to confirm the construct number and the Akaike information criterion network. Criterion validity was evaluated by comparing the MSTS-UE with the TESS and SF-36. The test-retest reliability with intraclass correlation coefficient (0.95; 95% CI, 0.91-0.97) was excellent, and internal consistency with Cronbach's α (0.7; 95% CI, 0.53-0.81) was acceptable. There were no ceiling and floor effects. The Akaike Information Criterion network showed that lifting ability, pain, and dexterity played central roles among the components. The MSTS-UE showed substantial correlation with the TESS scoring scale (r = 0.75; p < 0.001) and fair correlation with the SF-36 physical component summary (r = 0.37; p = 0.007). Although the MSTS-UE showed slight correlation with the SF-36 mental component summary, the emotional acceptance component of the MSTS-UE showed fair correlation (r = 0.29; p = 0.039). We can conclude that the MSTS is not an adequate measure of general health-related quality of life; however, this system was designed mainly to be a simple measure of function in a single extremity. To evaluate the mental state of patients with

  19. Upper Body Muscular Endurance Among Children 2-5 Years.

    ERIC Educational Resources Information Center

    Gabbard, Carl P.; And Others

    The upper body muscular endurance of males and females 2-5 years of age was assessed, and relationships relative to sex, age, endurance and selected anthropometric measures were investigated. None of the relationships were found to be of practical predicative value; while upper body muscular strength increased with age, no significant differences…

  20. HALOE Algorithm Improvements for Upper Tropospheric Sounding

    NASA Technical Reports Server (NTRS)

    Thompson, Robert Earl; McHugh, Martin J.; Gordley, Larry L.; Hervig, Mark E.; Russell, James M., III; Douglass, Anne (Technical Monitor)

    2001-01-01

    This report details the ongoing efforts by GATS, Inc., in conjunction with Hampton University and University of Wyoming, in NASA's Mission to Planet Earth Upper Atmospheric Research Satellite (UARS) Science Investigator Program entitled 'HALOE Algorithm Improvements for Upper Tropospheric Sounding.' The goal of this effort is to develop and implement major inversion and processing improvements that will extend Halogen Occultation Experiment (HALOE) measurements further into the troposphere. In particular, O3, H2O, and CH4 retrievals may be extended into the middle troposphere, and NO, HCl and possibly HF into the upper troposphere. Key areas of research being carried out to accomplish this include: pointing/tracking analysis; cloud identification and modeling; simultaneous multichannel retrieval capability; forward model improvements; high vertical-resolution gas filter channel retrievals; a refined temperature retrieval; robust error analyses; long-term trend reliability studies; and data validation. The current (first year) effort concentrates on the pointer/tracker correction algorithms, cloud filtering and validation, and multichannel retrieval development. However, these areas are all highly coupled, so progress in one area benefits from and sometimes depends on work in others.

  1. Innovations in prosthetic interfaces for the upper extremity.

    PubMed

    Kung, Theodore A; Bueno, Reuben A; Alkhalefah, Ghadah K; Langhals, Nicholas B; Urbanchek, Melanie G; Cederna, Paul S

    2013-12-01

    Advancements in modern robotic technology have led to the development of highly sophisticated upper extremity prosthetic limbs. High-fidelity volitional control of these devices is dependent on the critical interface between the patient and the mechanical prosthesis. Recent innovations in prosthetic interfaces have focused on several control strategies. Targeted muscle reinnervation is currently the most immediately applicable prosthetic control strategy and is particularly indicated in proximal upper extremity amputations. Investigation into various brain interfaces has allowed acquisition of neuroelectric signals directly or indirectly from the central nervous system for prosthetic control. Peripheral nerve interfaces permit signal transduction from both motor and sensory nerves with a higher degree of selectivity. This article reviews the current developments in each of these interface systems and discusses the potential of these approaches to facilitate motor control and sensory feedback in upper extremity neuroprosthetic devices.

  2. Prevalence of upper airway tumors and cysts among patients who snore.

    PubMed

    Suzuki, Masaaki; Saigusa, Hanako; Chiba, Shintaro; Hoshino, Tadahiko; Okamoto, Makito

    2007-11-01

    Sleep specialists usually do not pay much attention to the upper airway in patients who snore, because they can make the diagnosis of sleep-disordered breathing without performing nasopharyngeal endoscopy if they have the Epworth Sleepiness Scale scores and the results of polysomnography. The purpose of this study was to determine the prevalence of benign and malignant tumors and cysts in the upper airway in patients who snore. A retrospective multicenter trial was performed in 4 sleep laboratories. Adult male and female patients whose chief complaint on their first visit was witnessed snoring were enrolled in this study. All of the patients were evaluated by otolaryngologists using nasopharyngeal endoscopy to detect organic diseases in the upper airway. Among 2,923 patients, 2 patients had malignant tumors, 5 had benign tumors, and 2 had cysts in the upper airway. The prevalence of upper airway benign and malignant tumors and cysts among adult male and female patients was 0.24%. Routine detailed nasopharyngeal endoscopy should be carried out in each institution so as not to overlook organic diseases in the upper airway among patients who snore.

  3. An international registry for primary ciliary dyskinesia.

    PubMed

    Werner, Claudius; Lablans, Martin; Ataian, Maximilian; Raidt, Johanna; Wallmeier, Julia; Große-Onnebrink, Jörg; Kuehni, Claudia E; Haarman, Eric G; Leigh, Margaret W; Quittner, Alexandra L; Lucas, Jane S; Hogg, Claire; Witt, Michal; Priftis, Kostas N; Yiallouros, Panayiotis; Nielsen, Kim G; Santamaria, Francesca; Ückert, Frank; Omran, Heymut

    2016-03-01

    Primary ciliary dyskinesia (PCD) is a rare autosomal recessive disorder leading to chronic upper and lower airway disease. Fundamental data on epidemiology, clinical presentation, course and treatment strategies are lacking in PCD. We have established an international PCD registry to realise an unmet need for an international platform to systematically collect data on incidence, clinical presentation, treatment and disease course.The registry was launched in January 2014. We used internet technology to ensure easy online access using a web browser under www.pcdregistry.eu. Data from 201 patients have been collected so far. The database is comprised of a basic data form including demographic and diagnostic information, and visit forms designed to monitor the disease course.To establish a definite PCD diagnosis, we used strict diagnostic criteria, which required two to three diagnostic methods in addition to classical clinical symptoms. Preliminary analysis of lung function data demonstrated a mean annual decline of percentage predicted forced expiratory volume in 1 s of 0.59% (95% CI 0.98-0.22).Here, we present the development of an international PCD registry as a new promising tool to advance the understanding of this rare disorder, to recruit candidates for research studies and ultimately to improve PCD care. Copyright ©ERS 2016.

  4. Present state of knowledge of the upper atmosphere: An assessment report

    NASA Technical Reports Server (NTRS)

    1984-01-01

    A program of research, technology, and monitoring of the phenomena of the upper atmosphere, to provide for an understanding of and to maintain the chemical and physical integrity of the Earth's upper atmosphere was developed. NASA implemented a long-range upper atmospheric science program aimed at developing an organized, solid body of knowledge of upper atmospheric processes while providing, in the near term, assessments of potential effects of human activities on the atmosphere. The effects of chlorofluorocarbon (CFC) releases on stratospheric ozone were reported. Issues relating the current understanding of ozone predictions and trends and highlights recent and future anticipated developments that will improve our understanding of the system are summarized.

  5. 45. DETAIL VIEW OF AUXILIARY BUILDING AT UPPER END OF ...

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

    45. DETAIL VIEW OF AUXILIARY BUILDING AT UPPER END OF WEST WALL, SHOWING RECESSES FOR AUXILIARY LOCK LIFT GATE LEAVES, LOOKING NORTHWEST - Upper Mississippi River 9-Foot Channel Project, Lock & Dam 27, Granite City, Madison County, IL

  6. Three-dimensional changes to the upper airway after maxillomandibular advancement with counterclockwise rotation: a systematic review and meta-analysis.

    PubMed

    Louro, R S; Calasans-Maia, J A; Mattos, C T; Masterson, D; Calasans-Maia, M D; Maia, L C

    2018-05-01

    The aim of this study was to evaluate the effect of counterclockwise (CCW) rotation and maxillomandibular advancement (MMA) on the upper airway space using three-dimensional images. An electronic search was performed in the PubMed, Cochrane Library, Scopus, Virtual Health Library, Web of Science, and OpenGrey databases (end date July 2016); a hand-search of primary study reference lists was also conducted. The inclusion criteria encompassed computed tomography evaluations of the upper airway spaces of adult patients undergoing orthognathic surgery with CCW rotation and MMA. The articles were evaluated for risk of bias with a tool for before-and-after studies. A meta-analysis was performed with the mean differences using a random-effects model. Heterogeneity was assessed with the Q-test and the I 2 index. The meta-analysis revealed significant (P<0.001) increases in both the total airway volume (effect size of 6832mm 3 and confidence interval of 5554-8109mm 3 ) and the minimum axial area (effect size of 92mm 2 and confidence interval of 70-113mm 2 ). The heterogeneity was low in both comparisons (I 2 =38% and 7%, respectively). The technique of mandibular advancement with CCW rotation produced significant increases in the volumes and areas of the upper airway spaces. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  7. Upper limb motor function in young adults with spina bifida and hydrocephalus

    PubMed Central

    Salman, M. S.; Jewell, D.; Hetherington, R.; Spiegler, B. J.; MacGregor, D. L.; Drake, J. M.; Humphreys, R. P.; Gentili, F.

    2011-01-01

    Objective The objective of the study was to measure upper limb motor function in young adults with spina bifida meningomyelocele (SBM) and typically developing age peers. Method Participants were 26 young adults with SBM, with a Verbal or Performance IQ score of at least 70 on the Wechsler scales, and 27 age- and gender-matched controls. Four upper limb motor function tasks were performed under four different visual and cognitive challenge conditions. Motor independence was assessed by questionnaire. Results Fewer SBM than control participants obtained perfect posture and rebound scores. The SBM group performed less accurately and was more disrupted by cognitive challenge than controls on limb dysmetria tasks. The SBM group was slower than controls on the diadochokinesis task. Adaptive motor independence was related to one upper limb motor task, arm posture, and upper rather than lower spinal lesions were associated with less motor independence. Conclusions Young adults with SBM have significant limitations in upper limb function and are more disrupted by some challenges while performing upper limb motor tasks. Within the group of young adults with SBM, upper spinal lesions compromise motor independence more than lower spinal lesions. PMID:19672605

  8. Effects of Lightning in the Upper Atmosphere

    NASA Astrophysics Data System (ADS)

    Sentman, Davis D.; Pasko, Victor P.; Morrill, Jeff S.

    2010-02-01

    AGU Chapman Conference on Effects of Thunderstorms and Lightning in the Upper Atmosphere; University Park, Pennsylvania, 10-14 May 2009; The serendipitous observation in 1989 of electrical discharge in the high atmosphere induced by thundercloud lightning launched a new field of geophysical investigation. From this single unexpected observation sprang a vigorous and fertile new research field that simultaneously encompasses geophysical disciplines that are normally pursued independently, such as meteorology and lightning, plasma and gas discharge physics, atmospheric chemistry, ionospheric physics, and energetic particle physics. Transient electrical discharge in the upper atmosphere spans the full range of altitudes between the tropopause and the ionosphere and takes a variety of forms that carry the whimsical names red sprites, blue jets, gigantic jets, elves (emissions of light and very low frequency perturbations from electromagnetic pulse sources), and sprite halos, collectively known as transient luminous events (TLEs). To date, TLEs have been observed from ground and airborne or spaceborne platforms above thunderstorm systems worldwide, and radio observations made concomitantly with optical observations have shown that they are produced by the transient far fields of thundercloud lightning. TLEs appear to be large-scale (tens of kilometers in dimension), upper atmospheric versions of conventional gas discharge akin to weakly ionized, collision-dominated systems found in laboratory discharge devices (millimeter-centimeter dimensions), with characteristic energies of a few electron volts. The dominant physical processes have been identified as described by the familiar kinetic theory of the photochemistry of the upper atmosphere, but with electric field-driven electron impact ionization playing the role of photolysis or energetic precipitating particle-induced ionization.

  9. Upper Elk Meadows Research Natural Area: guidebook supplement 43

    Treesearch

    Reid Schuller; Cheshire Mayrsohn

    2013-01-01

    This guidebook describes Upper Elk Meadows Research Natural Area (RNA), a 90-ha (223-ac) area that supports a mixture of coniferous forest and open, shruband herb-dominated wetlands. The major forest plant association present within Upper Elk Meadows RNA is Pacific silver fir/vine maple/coolwort foamflower (Abies amabilis/Acer circinatum-Tiarella trifoliata...

  10. Right Upper Quadrant Pain: Ultrasound First!

    PubMed

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

    2017-10-01

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

  11. Continuing the Original Stanford Sleep Surgery Protocol From Upper Airway Reconstruction to Upper Airway Stimulation: Our First Successful Case.

    PubMed

    Liu, Stanley Yung; Riley, Robert Wayne

    2017-07-01

    In 1993, a surgical protocol for dynamic upper airway reconstruction in patients with obstructive sleep apnea (OSA) was published, and it became commonly known as the Stanford phase 1 and 2 sleep surgery protocol. It served as a platform on which research and clinical studies have continued to perfect the surgical care of patients with OSA. However, relapse is inevitable in a chronic condition such as OSA, and a subset of previously cured surgical patients return with complaints of excessive daytime sleepiness. This report describes a patient who was successfully treated with phase 1 and 2 operations more than a decade previously. He returned at 65 years of age with relapse of moderate OSA, and after workup with polysomnography and drug-induced sleep endoscopy, he underwent upper airway stimulation of the hypoglossal nerve that resulted in a cure of OSA. This case shows why upper airway stimulation is an appropriate option for patients with OSA relapse, after previously successful maxillomandibular advancement. Copyright © 2017. Published by Elsevier Inc.

  12. Space Wire Upper Layer Protocols

    NASA Technical Reports Server (NTRS)

    Rakow, Glenn; Schnurr, Richard; Gilley, Daniel; Parkes, Steve

    2004-01-01

    This viewgraph presentation addresses efforts to provide a streamlined approach for developing SpaceWire Upper layer protocols which allows industry to drive standardized communication solutions for real projects. The presentation proposes a simple packet header that will allow flexibility in implementing a diverse range of protocols.

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

    PubMed

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

    2014-02-01

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

  14. Seismic evidence for widespread serpentinized forearc upper mantle along the Cascadia margin

    USGS Publications Warehouse

    Brocher, T.M.; Parsons, T.; Trehu, A.M.; Snelson, C.M.; Fisher, M.A.

    2003-01-01

    Petrologic models suggest that dehydration and metamorphism of subducting slabs release water that serpentinizes the overlying forearc mantle. To test these models, we use the results of controlled-source seismic surveys and earthquake tomography to map the upper mantle along the Cascadia margin forearc. We find anomalously low upper-mantle velocities and/or weak wide-angle reflections from the top of the upper mantle in a narrow region along the margin, compatible with recent teleseismic studies and indicative of a serpentinized upper mantle. The existence of a hydrated forearc upper-mantle wedge in Cascadia has important geological and geophysical implications. For example, shearing within the upper mantle, inferred from seismic reflectivity and consistent with its serpentinite rheology, may occur during aseismic slow slip events on the megathrust. In addition, progressive dehydration of the hydrated mantle wedge south of the Mendocino triple junction may enhance the effects of a slap gap during the evolution of the California margin.

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

    PubMed

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

    2010-08-01

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

  16. Internal performance characteristics of vectored axisymmetric ejector nozzles

    NASA Technical Reports Server (NTRS)

    Lamb, Milton

    1993-01-01

    A series of vectoring axisymmetric ejector nozzles were designed and experimentally tested for internal performance and pumping characteristics at NASA-Langley Research Center. These ejector nozzles used convergent-divergent nozzles as the primary nozzles. The model geometric variables investigated were primary nozzle throat area, primary nozzle expansion ratio, effective ejector expansion ratio (ratio of shroud exit area to primary nozzle throat area), ratio of minimum ejector area to primary nozzle throat area, ratio of ejector upper slot height to lower slot height (measured on the vertical centerline), and thrust vector angle. The primary nozzle pressure ratio was varied from 2.0 to 10.0 depending upon primary nozzle throat area. The corrected ejector-to-primary nozzle weight-flow ratio was varied from 0 (no secondary flow) to approximately 0.21 (21 percent of primary weight-flow rate) depending on ejector nozzle configuration. In addition to the internal performance and pumping characteristics, static pressures were obtained on the shroud walls.

  17. Studies in upper and lower atmosphere coupling

    NASA Technical Reports Server (NTRS)

    Chiu, Y. T.; Rice, C. J.; Sharp, L. R.

    1979-01-01

    The theoretical and data-analytic work on upper and lower atmosphere coupling performed under a NASA Headquarters contract during the period April 1978 to March 1979 are summarized. As such, this report is primarily devoted to an overview of various studies published and to be published under this contract. Individual study reports are collected as exhibits. Work performed under the subject contract are in the following four areas of upper-lower atmosphere coupling: (1) Magnetosphere-ionosphere electrodynamic coupling in the aurora; (2) Troposphere-thermosphere coupling; (3) Ionosphere-neutral-atmosphere coupling; and (4) Planetary wave dynamics in the middle atmosphere.

  18. [Design and accuracy analysis of upper slicing system of MSCT].

    PubMed

    Jiang, Rongjian

    2013-05-01

    The upper slicing system is the main components of the optical system in MSCT. This paper focuses on the design of upper slicing system and its accuracy analysis to improve the accuracy of imaging. The error of slice thickness and ray center by bearings, screw and control system were analyzed and tested. In fact, the accumulated error measured is less than 1 microm, absolute error measured is less than 10 microm. Improving the accuracy of the upper slicing system contributes to the appropriate treatment methods and success rate of treatment.

  19. 41. VIEW NORTH OF UPPER LEVEL OF CRUSHER ADDITION. DINGS ...

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

    41. VIEW NORTH OF UPPER LEVEL OF CRUSHER ADDITION. DINGS MAGNETIC PULLEY AT CENTER. ALSO SHOWS 100-TON CRUSHED UNOXIDIZED ORE BIN (RIGHT), PULLEY FORM 18 INCH BELT CONVEYOR CRUSHED OXIDIZED ORE BIN FEED AND STEPHENSADAMSON 25 TON/HR BUCKET ELEVATOR (UPPER CENTER). THE UPPER PORTION OF THE SAMPLING ELEVATOR IS ABOVE THE MAGNETIC PULLEY (CENTER LEFT) WITH THE ROUTE OF THE 16 INCH BELT CONVEYOR FINES FEED TO CRUSHED OXIDIZED ORE BIN TO ITS LEFT. - Bald Mountain Gold Mill, Nevada Gulch at head of False Bottom Creek, Lead, Lawrence County, SD

  20. Overjet and overbite analysis during the eruption of the upper permanent incisors.

    PubMed

    Cuoghi, Osmar A; Sella, Rodrigo C; Mamede, Igo; de Macedo, Fernanda A; Miranda-Zamalloa, Yésselin M; de Mendonça, Marcos R

    2009-01-01

    ABSTRACT The purpose of this study was to analyze the overjet and overbite behavior during eruption of the upper permanent incisors. Fourth-eight plaster casts of 16 patients from ages 6-13 years were appraised longitudinally. It was found that the overjet remains constant, starting at the eruption of the upper permanent central incisors until eruption of the upper permanent canine teeth, while the overbite increases after eruption of the upper permanent lateral incisors and remains constant with the eruption of the canine teeth.

  1. Upper limb dysfunction following selective neck dissection: a retrospective questionnaire study.

    PubMed

    Carr, Simon D; Bowyer, Duncan; Cox, Graham

    2009-06-01

    To determine total upper limb function following selective neck dissection over a mean follow-up of 1.6 years. A retrospective questionnaire study in a tertiary head and neck surgical unit. One hundred forty-eight patients who underwent selective neck dissection for head and neck cancer from January 2000 to December 2005 were invited to participate. The main outcome measure was ipsilateral upper limb dysfunction as measured by the Disability of Arm, Shoulder and Hand (DASH) questionnaire. Sixty-five patients responded to the invitation to join the study from 148 invited. Despite accessory nerve conserving surgery for all the selective neck dissections studied, 23% reported no upper limb dysfunction, 54% reported mild upper limb dysfunction, 15% reported moderate, and 8% reported a severe dysfunction. Long-term upper limb dysfunction is common following nerve preserving surgery. The DASH questionnaire is a useful preoperative and postoperative clinical tool for those patients undergoing selective neck dissections. (c) 2009 Wiley Periodicals, Inc.

  2. Optimal parameters for marking upper blepharoplasty incisions: a 10-year experience.

    PubMed

    Halvorson, Eric G; Husni, Nicholas R; Pandya, Sonal N; Seckel, Brooke R

    2006-05-01

    Although a variety of techniques for upper blepharoplasty have been described, few studies illustrate and clinically evaluate a system for marking incisions. Presented is a 10-year experience using a specific method for marking upper blepharoplasty incisions that consistently yielded excellent esthetic results. All upper blepharoplasties performed by the senior author between April, 1994 and April, 2004 were reviewed. Markings were designed to end the medial incision 6 mm from the angular vein, end the lateral incision 12 mm from the palpebral fissure, and to extend the incisions superiorly at 45 degrees. Over 10 years, 476 patients underwent cosmetic upper blepharoplasty. There were 22 (4.6%) revisions. Eighteen (3.8%) were performed in clinic using CO2 laser, and 4 (0.8%) patients required surgical revision. Patient satisfaction was high, and no scars were visible outside the brow. Excellent outcomes can be expected using this simple, reproducible, and widely applicable system for marking upper blepharoplasty incisions.

  3. 4. REAR (NORTH) FACADE OF THE UPPER FALLS GATE HOUSE. ...

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

    4. REAR (NORTH) FACADE OF THE UPPER FALLS GATE HOUSE. - Washington Water Power Spokane River Upper Falls Hydroelectric Development, Gate House, Spokane River, approximately 0.5 mile northeast of intersection of Spokane Falls Boulevard & Post Street, Spokane, Spokane County, WA

  4. Technical evaluation of a total maximum daily load model for Upper Klamath and Agency Lakes, Oregon

    USGS Publications Warehouse

    Wood, Tamara M.; Wherry, Susan A.; Carter, James L.; Kuwabara, James S.; Simon, Nancy S.; Rounds, Stewart A.

    2013-01-01

    We reviewed a mass balance model developed in 2001 that guided establishment of the phosphorus total maximum daily load (TMDL) for Upper Klamath and Agency Lakes, Oregon. The purpose of the review was to evaluate the strengths and weaknesses of the model and to determine whether improvements could be made using information derived from studies since the model was first developed. The new data have contributed to the understanding of processes in the lakes, particularly internal loading of phosphorus from sediment, and include measurements of diffusive fluxes of phosphorus from the bottom sediments, groundwater advection, desorption from iron oxides at high pH in a laboratory setting, and estimates of fluxes of phosphorus bound to iron and aluminum oxides. None of these processes in isolation, however, is large enough to account for the episodically high values of whole-lake internal loading calculated from a mass balance, which can range from 10 to 20 milligrams per square meter per day for short periods. The possible role of benthic invertebrates in lake sediments in the internal loading of phosphorus in the lake has become apparent since the development of the TMDL model. Benthic invertebrates can increase diffusive fluxes several-fold through bioturbation and biodiffusion, and, if the invertebrates are bottom feeders, they can recycle phosphorus to the water column through metabolic excretion. These organisms have high densities (1,822–62,178 individuals per square meter) in Upper Klamath Lake. Conversion of the mean density of tubificid worms (Oligochaeta) and chironomid midges (Diptera), two of the dominant taxa, to an areal flux rate based on laboratory measurements of metabolic excretion of two abundant species suggested that excretion by benthic invertebrates is at least as important as any of the other identified processes for internal loading to the water column. Data from sediment cores collected around Upper Klamath Lake since the development of the

  5. Upper urinary tract carcinoma in Lynch syndrome cases.

    PubMed

    Crockett, David G; Wagner, David G; Holmäng, Sten; Johansson, Sonny L; Lynch, Henry T

    2011-05-01

    Patients with Lynch syndrome are much more likely to have generally rare upper urinary tract urothelial carcinoma but not bladder urothelial carcinoma. While the risk has been quantified, to our knowledge there is no description of how this population of patients with Lynch syndrome and upper urinary tract cancer differs from the general population with upper urinary tract cancer. We obtained retrospective data on a cohort of patients with Lynch syndrome from the Hereditary Cancer Center in Omaha, Nebraska and compared the data to those on a control general population from western Sweden. These data were supplemented by a new survey about exposure to known risk factors. Of the patients with Lynch syndrome 91% had mutations in MSH2 rather than in MSH1 and 79% showed upper tract urothelial carcinoma a mean of 15.85 years after prior Lynch syndrome-type cancer. Median age at diagnosis was 62 years vs 70 in the general population (p <0.0001). Only half of our patients had a significant smoking history and the male-to-female ratio was 0.95. Of patients with Lynch syndrome 51% had urothelial carcinoma in the ureter while it occurred in the renal pelvis in 65% of the general population (p = 0.0013). Similar numbers of high grade tumors were found in the Lynch syndrome and general populations (88% and 74%, respectively, p = 0.1108). Upper urinary tract tumors develop at a younger age and are more likely to be in the ureter with an almost equal gender ratio in patients with Lynch syndrome. It has high grade potential similar to that in the general population. Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  6. Interpretation of massive sandstones in ephemeral fluvial settings: A case study from the Upper Candelária Sequence (Upper Triassic, Paraná Basin, Brazil)

    NASA Astrophysics Data System (ADS)

    Horn, Bruno Ludovico Dihl; Goldberg, Karin; Schultz, Cesar Leandro

    2018-01-01

    Ephemeral rivers display a wide range of upper- and lower-flow regime structures due to great flow-velocity changes during the floods. The development of flow structures in these setting is yet to be understood, especially in the formation of thick, massive sandstones. The Upper Triassic of Southern Gondwana was marked by a climate with great seasonal changes, yet there is no description of river systems with seasonal characteristics in Southern Gondwana. This work aims to characterize a ephemeral alluvial system of the Upper Triassic of the Paraná Basin. The characteristics of the deposits are discussed in terms of depositional processes through comparison with similar deposits from literature, flow characteristics and depositional signatures compared to flume experiments. The alluvial system is divided in four facies associations: (1) channels with wanning fill, characterized by low width/thickness ratio, tabular bodies, scour-and-fill structures with upper- and lower-flow regime bedforms; (2) channels with massive fill, characterized by low w/t ratio, sheet-like bodies, scour-and-fill structures with massive sandstones; (3) proximal sheetfloods, characterized by moderate w/t ratio, sheet-like bodies with upper- and lower-flow regime bedforms and (4) distal sheetfloods, characterized by high w/t ratio, sheet-like bodies with lower-flow regime bedforms. Evidence for the seasonal reactivation of the riverine system includes the scarcity of well-developed macroforms and presence of in-channel mudstones, thick intraformational conglomerates, and the occurrence of well- and poorly-preserved vertebrate bones in the same beds. The predominantly massive sandstones indicate deposition from a hyperconcentrated flow during abrupt changes in flow speed, caused by de-confinement or channel avulsion, whereas turbulent portions of the flow formed the upper- and lower-flow regime bedforms after the deposition of the massive layers. The upper portion of the Candelária Sequence

  7. Upper Neogene stratigraphy and tectonics of Death Valley - A review

    USGS Publications Warehouse

    Knott, J.R.; Sarna-Wojcicki, A. M.; Machette, M.N.; Klinger, R.E.

    2005-01-01

    New tephrochronologic, soil-stratigraphic and radiometric-dating studies over the last 10 years have generated a robust numerical stratigraphy for Upper Neogene sedimentary deposits throughout Death Valley. Critical to this improved stratigraphy are correlated or radiometrically-dated tephra beds and tuffs that range in age from > 3.58 Ma to < 1.1 ka. These tephra beds and tuffs establish relations among the Upper Pliocene to Middle Pleistocene sedimentary deposits at Furnace Creek basin, Nova basin, Ubehebe-Lake Rogers basin, Copper Canyon, Artists Drive, Kit Fox Hills, and Confidence Hills. New geologic formations have been described in the Confidence Hills and at Mormon Point. This new geochronology also establishes maximum and minimum ages for Quaternary alluvial fans and Lake Manly deposits. Facies associated with the tephra beds show that ???3.3 Ma the Furnace Creek basin was a northwest-southeast-trending lake flanked by alluvial fans. This paleolake extended from the Furnace Creek to Ubehebe. Based on the new stratigraphy, the Death Valley fault system can be divided into four main fault zones: the dextral, Quaternary-age Northern Death Valley fault zone; the dextral, pre-Quaternary Furnace Creek fault zone; the oblique-normal Black Mountains fault zone; and the dextral Southern Death Valley fault zone. Post -3.3 Ma geometric, structural, and kinematic changes in the Black Mountains and Towne Pass fault zones led to the break up of Furnace Creek basin and uplift of the Copper Canyon and Nova basins. Internal kinematics of northern Death Valley are interpreted as either rotation of blocks or normal slip along the northeast-southwest-trending Towne Pass and Tin Mountain fault zones within the Eastern California shear zone. ?? 2005 Elsevier B.V. All rights reserved.

  8. Teleseismic array analysis of upper mantle compressional velocity structure. Ph.D. Thesis

    NASA Technical Reports Server (NTRS)

    Walck, M. C.

    1984-01-01

    Relative array analysis of upper mantle lateral velocity variations in southern California, analysis techniques for dense data profiles, the P-wave upper mantle structure beneath an active spreading center: the Gulf of California, and the upper mantle under the Cascade ranges: a comparison with the Gulf of California are presented.

  9. Using CREST to Model Floods for the Upper Missouri Basin

    NASA Astrophysics Data System (ADS)

    Rodriguez, L.; Spelman, D.; Skym, P.; Oguamanam, M.

    2012-12-01

    The Upper Missouri River basin in Montana is prone to frequent floods during the months of May through June. During the summer of 2011, the duration of heavy rain and high snow melt caused floods in the Missouri Watershed to last for several weeks. Although organizations and citizens are aware of the flooding, the severity of any given flood is difficult to predict. Thus, a flood forecasting system would benefit the community by providing advance notice of areas prone to floods. The team addressed these issues by calibrating a fully distributed hydrological model on this region using the University of Oklahoma's Coupled Routing Excess STorage (CREST) 2.0 model. The CREST model contains ten internal parameters that must be optimized through calibration to in-situ data which was done using only remotely sensed data as inputs; these include: rainfall from TRMM, Digital Elevation Model (DEM) from SRTM, and potential evapotranspiration (PET). At a one kilometer spatial and three hour temporal resolutions, CREST was calibrated over a three year period. This calibration was unsuccessful, resulting in a maximum NSCE of just 0.24, due to the heavy impact of snow-pack melt on the hydrology of the Upper Missouri River watershed and the lack of snow melt inputs to the model. Because of this, a modeled snow melt product, which was selected to be the Snow Data Assimilation System (SNODAS), was implemented into the model for the first time. This implementation required substantial data processing prior to input as well as substantial troubleshooting within the CREST model. Additionally, the San Bernard watershed, which is in the absence of snow, was used and calibrated in the model for comparison. The arrangement of these calibrations was performed, and the necessary steps required were documented. However, the actual calibrations were not carried out due to lack of access needed in computational power and time. Significant progress was made in understanding the fundamental steps

  10. Waterhammer Testing and Modeling of the Ares I Upper Stage Reaction Control System

    NASA Technical Reports Server (NTRS)

    Williams, J. Hunter; Holt, Kimberly A.

    2010-01-01

    NASA's Ares I rocket is the agency's first step in completing the goals of the Constellation Program, which plans to deliver a new generation of space explorers into low earth orbit for future missions to the International Space Station, the moon, and other destinations within the solar system. Ares I is a two-stage rocket topped by the Orion crew capsule and its service module. The launch vehicle's First Stage is a single, five-segment reusable solid rocket booster (RSRB), derived from the Space Shuttle Program's four segment RSRB. The vehicle's Upper Stage, being designed at Marshall Space Flight Center (MSFC), is propelled by a single J-2X Main Engine fueled with liquid oxygen and liquid hydrogen. During active Upper Stage flight of the Ares I launch vehicle, the Upper Stage Reaction Control System (US ReCS) will perform attitude control operations for the vehicle. The US ReCS will provide three-axis attitude control capability (roll, pitch, and yaw) for the Upper Stage while the J-2X is not firing and roll control capability while the engine is firing. Because of the requirements imposed upon the system, the design must accommodate rapid pulsing of multiple thrusters simultaneously to maintain attitude control. In support of these design activities and in preparation for Critical Design Review, analytical models of the US ReCS propellant feed system have been developed using the Thermal Hydraulic Library of MSC.EASY5 v.2008, herein referred to as EASY5. EASY5 is a commercially available fluid system modeling package with significant history of modeling space propulsion systems. In Fall 2009, a series of development tests were conducted at MSFC on a cold-flow test article for the US ReCS, herein referred to as System Development Test Article (SDTA). A subset of those tests performed were aimed at examining the effects of waterhammer on a flight-representative system and to ensure that those effects could be quantified with analytical models and incorporated into

  11. Depth to bedrock in the upper San Pedro Valley, Cochise County, southeastern Arizona

    USGS Publications Warehouse

    Gettings, M.E.; Houser, Brenda B.

    2000-01-01

    The thickness, distribution, and character of alluvial sediments that were deposited in the structural subbasins of the upper San Pedro basin in southeastern Arizona during the late Cenozoic provide important constraints on ground-water availability of the area. Two sedimentary units are recognized; the Oligocene and Miocene Pantano(?) Formation and an unnamed upper Miocene through lower Pleistocene unit termed basin fill. The complete Bouguer gravity anomaly map shows that there are three major structural subbasins in the upper San Pedro basin north of the international border with Mexico. The Tombstone subbasin is north of Tombstone, and two more are located north and south of Sierra Vista, respectively. This report concentrates on the two subbasins north and south of Sierra Vista. The northern subbasin (termed the Huachuca City subbasin) extends from east of Huachuca City to northeast of Whetstone, and the southern subbasin (termed the Palominas subbasin) extends southward from a line between Nicksville and Hereford to the border. The locations and shapes of these subbasins, thickness of basin fill, and depth to bedrock were estimated using a procedure involving interpolation of (1) the density functions derived in this study, (2) stratigraphic data from water wells, and (3) a residual gravity anomaly grid obtained by subtracting the gravity effects of the bedrock ranges bordering the basin from the complete Bouguer gravity anomaly. This procedure indicates that the subbasins are shallow and contain significant thicknesses of the Pantano(?) Formation in addition to the overlying younger basin fill. The maximum depth to bedrock is about 1,700 m in the Palominas subbasin and 800m in the Huachuca City subbasin; the basin-fill unit occupies the upper 250-350 m in general with local thickenings exceeding 1,000 m in the Palominas subbasin. An east-west trending buried bedrock high beneath Fort Huachuca, Sierra Vista, and Charleston separates the subbasins. The depth

  12. Short-term use of serotonin reuptake inhibitors and risk of upper gastrointestinal bleeding.

    PubMed

    Wang, Yen-Po; Chen, Yung-Tai; Tsai, Chia-Fen; Li, Szu-Yuan; Luo, Jiing-Chyuan; Wang, Shuu-Jiun; Tang, Chao-Hsiun; Liu, Chia-Jen; Lin, Han-Chieh; Lee, Fa-Yauh; Chang, Full-Young; Lu, Ching-Liang

    2014-01-01

    The association between selective serotonin receptor inhibitors (SSRIs) and risk of upper gastrointestinal bleeding remains controversial. Previous studies have generally evaluated the issue for approximately 3 months, even though the SSRI-mediated inhibition of platelet serotonin concentrations occurs within 7-14 days. The authors explored the risk of upper gastrointestinal bleeding after short-term SSRI exposure by a case-crossover design. The records of psychiatric inpatients with upper gastrointestinal bleeding were retrieved from the Taiwan National Health Insurance Database (1998-2009). Rates of antidepressant use were compared for case and control periods with time windows of 7, 14, and 28 days. The adjusted self-matched odds ratios from a conditional logistic regression model were used to determine the association between SSRI use and upper gastrointestinal bleeding. A total of 5,377 patients with upper gastrointestinal bleeding were enrolled. The adjusted odds ratio for the risk of upper gastrointestinal bleeding after SSRI exposure was 1.67 (95% CI=1.23-2.26) for the 7-day window, 1.84 (95% CI=1.42-2.40) for the 14-day window, and 1.67 (95% CI=1.34-2.08) for the 28-day window. SSRIs with high and intermediate, but not low, affinity for serotonin transporter were associated with upper gastrointestinal bleeding. An elevated risk of upper gastrointestinal bleeding after SSRI exposure was seen in male but not female patients. Short-term SSRI use (7-28 days) is significantly associated with upper gastrointestinal bleeding. Gender differences may exist in the relationship between SSRI use and upper gastrointestinal bleeding. Physicians should carefully monitor signs of upper gastrointestinal bleeding even after short-term exposure to SSRIs, as is done with nonsteroidal anti-inflammatory drugs and aspirin.

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

    NASA Technical Reports Server (NTRS)

    Bienkowski, G. K.

    1983-01-01

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

  14. Internal waves in the Gulf of California - Observations from a spaceborne radar

    NASA Technical Reports Server (NTRS)

    Fu, L.-L.; Holt, B.

    1984-01-01

    Pronounced signatures of internal waves were detected repeatedly in the Gulf of California by the Seasat synthetic aperture radar (SAR). A series of nine images with exactly repeating ground coverage was used to study the temporal variability of the internal wave field in the area. It was found that the number of observed wave groups was highly correlated with the strength of the local tides: the maximum number occurred during spring tides and the minimum number occurred during neap tides, indicating that the internal waves were tidally forced. Most of the wave activity was found to the north of 28 deg N where the tides were the strongest in the Gulf. The application of a simple, nonlinear internal wave model to the observations indicated that the peak-to-peak amplitude of the observed waves was about 50 m with an uncertainty of a factor of 2. The estimated upper bound for the rate of the loss of tidal energy to internal waves was about 5 x 10 to the 15th erg/s, representing only 10 percent of the rate of the dissipation of the dominant M2 tide in the Gulf.

  15. Epidemiology of traumatic upper limb amputations.

    PubMed

    Pomares, G; Coudane, H; Dap, F; Dautel, G

    2018-04-01

    While published data on functional outcomes after upper limb amputations are plentiful, epidemiology data are relatively rare. This led us to performing an epidemiology study of traumatic upper limb amputations at our facility. This retrospective study spanned a 10-year period of cases seen at the SOS Main (Hand emergency center) of the Nancy University Hospital in France. Patients who suffered traumatic amputation of the upper limb were identified and divided into two groups: replantation and surgical amputation. All anatomical amputation levels were retained. Non-traumatic amputations were excluded. Epidemiology data (sex, age, dominant side, injured side) was collected along with the specific anatomical level of the injury, the injury mechanism and whether it was work-related. We also looked at the success rate of microsurgery and whether multi-finger amputations were partial or complete. In parallel, the annual incidence of amputations seen at the SOS Main over this period was calculated. Over the 10-year period, 1715 traumatic upper-limb amputations were identified, which was 3% of all cases seen at the SOS Main. Most of the cases involved middle-aged men. Revascularization was attempted in one-third of cases and microsurgery was successful in 70% of cases. The surgical amputation group consisted of 1132 patients with a mean age of 59 years, while the replantation group consisted of 583 patients with a mean age of 48 years. The primary mechanism of injury was a table saw. This injury, which must be addressed urgently, is not very common in everyday practice. This is contrary to lower limb amputations, which are more common and occur in the context of micro- and macroangiopathy in older patients. The success rate of microsurgery in this cohort must be placed in the context of age, amputation level and mechanism. The functional outcomes are not always as good as the vascular outcomes. This data is invaluable as it fills a gap in our knowledge about amputations

  16. [Tests of hand functionality in upper limb amputation with prosthesis].

    PubMed

    Bazzini, G; Orlandini, D; Moscato, T A; Nicita, D; Panigazzi, M

    2007-01-01

    The need for standardized instruments for clinical measurements has become pressing in the fields of occupational rehabilitation and ergonomics. This is particularly the case for instruments that allow a quantitative evaluation of upper limb function, and especially hand function in patients who have undergone an amputation and then application of an upper limb prosthesis. This study presents a review of the main tests used to evaluate hand function, with a critical analysis of their use in subjects with an upper limb prosthesis. The tests are divided into: tests to evaluate strength, tests to evaluate co-ordination and dexterity, tests of global or overall function, and tests proposed specifically for subjects with an upper limb prosthesis. Of the various tests presented, the authors give their preference to the Bimanual Functional Assessment, Abilhand and/or the ADL Questionnaire, because of the practical usefulness, clinimetric features, simplicity and ease of administration of these tests.

  17. A hybrid joint based controller for an upper extremity exoskeleton

    NASA Astrophysics Data System (ADS)

    Mohd Khairuddin, Ismail; Taha, Zahari; Majeed, Anwar P. P. Abdul; Hakeem Deboucha, Abdel; Azraai Mohd Razman, Mohd; Aziz Jaafar, Abdul; Mohamed, Zulkifli

    2016-02-01

    This paper presents the modelling and control of a two degree of freedom upper extremity exoskeleton. The Euler-Lagrange formulation was used in deriving the dynamic modelling of both the human upper limb as well as the exoskeleton that consists of the upper arm and the forearm. The human model is based on anthropometrical measurements of the upper limb. The proportional-derivative (PD) computed torque control (CTC) architecture is employed in this study to investigate its efficacy performing joint-space control objectives specifically in rehabilitating the elbow and shoulder joints along the sagittal plane. An active force control (AFC) algorithm is also incorporated into the PD-CTC to investigate the effectiveness of this hybrid system in compensating disturbances. It was found that the AFC- PD-CTC performs well against the disturbances introduced into the system whilst achieving acceptable trajectory tracking as compared to the conventional PD-CTC control architecture.

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

    PubMed

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

    2015-01-01

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

  19. Nerve Injuries of the Upper Extremity

    MedlinePlus

    ... Upper Extremity Find a hand surgeon near you. Videos Figures Figure 1 - Nerve with bundles of individual ... or "in." Also, avoid using media types like "video," "article," and "picture." Tip 4: Your results can ...

  20. Probability of Future Observations Exceeding One-Sided, Normal, Upper Tolerance Limits

    DOE PAGES

    Edwards, Timothy S.

    2014-10-29

    Normal tolerance limits are frequently used in dynamic environments specifications of aerospace systems as a method to account for aleatory variability in the environments. Upper tolerance limits, when used in this way, are computed from records of the environment and used to enforce conservatism in the specification by describing upper extreme values the environment may take in the future. Components and systems are designed to withstand these extreme loads to ensure they do not fail under normal use conditions. The degree of conservatism in the upper tolerance limits is controlled by specifying the coverage and confidence level (usually written inmore » “coverage/confidence” form). Moreover, in high-consequence systems it is common to specify tolerance limits at 95% or 99% coverage and confidence at the 50% or 90% level. Despite the ubiquity of upper tolerance limits in the aerospace community, analysts and decision-makers frequently misinterpret their meaning. The misinterpretation extends into the standards that govern much of the acceptance and qualification of commercial and government aerospace systems. As a result, the risk of a future observation of the environment exceeding the upper tolerance limit is sometimes significantly underestimated by decision makers. This note explains the meaning of upper tolerance limits and a related measure, the upper prediction limit. So, the objective of this work is to clarify the probability of exceeding these limits in flight so that decision-makers can better understand the risk associated with exceeding design and test levels during flight and balance the cost of design and development with that of mission failure.« less

  1. Superior Patency of Upper Arm Arteriovenous Fistulae in High Risk Patients

    PubMed Central

    Chiulli, Larissa C; Vasilas, Penny; Dardik, Alan

    2011-01-01

    Background Despite an increased propensity to primary failure in forearm arteriovenous fistulae compared to upper arm fistulae, forearm fistulae remain the preferred primary access type for chronic hemodialysis patients. In a high risk patient population with multiple medical comorbidities associated with requirement for intravenous access we compared the rates of access failure in forearm and upper arm fistulae. Materials and Methods The records of all patients having primary native arteriovenous fistulae placed between 2004 and 2009 at the VA Connecticut Healthcare system were reviewed (n=118). Primary and secondary patency of upper arm and forearm fistulae were evaluated using Kaplan-Meier survival analysis. The effects of medical comorbidities on access patency were analyzed with Cox regression. Results The median time to primary failure of the vascular access was 0.288 years in the forearm group compared to 0.940 years in the upper arm group (p=0.028). Secondary patency was 52% at 4.9 years in upper arm fistulae compared to 52% at 1.1 years in the forearm group (p=0.036). There was no significant effect of patient comorbidities on fistula failure; however, there was a trend toward upper arm surgical site as a protective factor for primary fistula patency (Hazard Ratio=0.573, p=0.076). Conclusions In veterans needing hemodialysis, a high risk population with extensive comorbid factors often requiring intravascular access, upper arm fistulae are not only a viable option for primary vascular access, but are likely to be a superior option to classic forearm fistulae. PMID:21571318

  2. Forearm and upper-arm oscillometric blood pressure comparison in acutely ill adults.

    PubMed

    Schell, Kathleen; Morse, Kate; Waterhouse, Julie K

    2010-04-01

    When patients' upper arms are not accessible and/or when cuffs do not fit large upper arms, the forearm site is often used for blood pressure (BP) measurement. The purpose of this study is to compare forearm and upper-arm BPs in 70 acutely ill adults, admitted to a community hospital's 14-bed ICU. Using Philips oscillometric monitors, three repeated measures of forearm and upper-arm BPs are obtained with head of bed flat and with head of bed elevated at 30 degrees. Arms are resting on the bed. Paired t tests show statistically significant differences in systolic BPs, diastolic BPs, and mean arterial pressures in the supine and head-elevated positions. Bland-Altman analyses indicate that forearm and upper-arm oscillometric BPs are not interchangeable in acutely ill adults.

  3. Imaging of upper extremity stress fractures in the athlete.

    PubMed

    Anderson, Mark W

    2006-07-01

    Although it is much less common than injuries in the lower extremities, an upper extremity stress injury can have a significant impact on an athlete. If an accurate and timely diagnosis is to be made, the clinician must have a high index of suspicion of a stress fracture in any athlete who is involved in a throwing, weightlifting, or upper extremity weight-bearing sport and presents with chronic pain in the upper extremity. Imaging should play an integral role in the work-up of these patients; if initial radiographs are unrevealing, further cross-sectional imaging should be strongly considered. Although a three-phase bone scan is highly sensitive in this regard, MRI has become the study of choice at most centers.

  4. Effect of parallel refraction on magnetospheric upper hybrid waves

    NASA Technical Reports Server (NTRS)

    Engel, J.; Kennel, C. F.

    1984-01-01

    Large amplitude (not less than 10 mV/m) electrostatic plasma waves near the upper hybrid (UH) frequency have been observed from 0 to 50 deg magnetic latitude (MLAT) during satellite plasma-pause crossings. A three-dimensional numerical ray-tracing calculation, based on an electron distribution measured during a GEOS 1 dayside intense upper-hybrid wave event, suggests how UH waves might achieve such large amplitudes away from the geomagnetic equator. Refractive effects largely control the wave amplification and, in particular, the unavoidable refraction due to parallel geomagnetic field gradients restricts growth to levels below those observed. However, a cold electron density gradient parallel to the field can lead to upper hybrid wave growth that can account for the observed emission levels.

  5. Internal and external control of net photosynthesis and stomatal conductance of mature eastern white pine (Pinus strobus)

    Treesearch

    Chris A. Maier; R.O. Teskey

    1992-01-01

    Leaf gas exchange and water relations were monitored in the upper canopy of two 25 m tall eastern white pine (Pinus strobus L.) trees over two consecutive growing seasons (1986 and 1987). Examination of the seasonal and diurnal patterns of net photosynthesis and leaf conductance showed that both internal and external (environmental) factors were...

  6. [Antithrombotic therapy and nonvariceal upper gastrointestinal bleeding].

    PubMed

    Belanová, Veronika; Gřiva, Martin

    2015-12-01

    The incidence of acute upper gastrointestinal bleeding is about 85-108/100,000 inhabitants per year, nonvariceal bleeding accounts for 80-90%. Antiplatelet and anticoagulation treatment are the significant risk factors for upper gastrointestinal bleeding. To evaluate the occurrence of upper gastrointestinal bleeding in the general community of patients in a county hospital. And to compare the role played by antiplatelet and anticoagulation drugs and other risk medication. Retrospective analysis of patients over 18 years of age who underwent endoscopy for acute upper gastrointestinal bleeding or anaemia (haemoglobin<100 g/l) with proved source of blood losses in upper gastrointestinal tract during a hospital stay in 2013 (from January to June). We included 111 patients of average age 69±15 years, men 60%. Nonvariceal bleeding accounted for 90% of the cases. None of the patients with variceal bleeding (10% of patients) took antiplatelet or anticoagulation therapy. There were 100 patients with nonvariceal bleeding of average age 70±15, 61% men. With the symptoms of acute bleeding (hematemesis, melena) presented in 73% of patients. The most frequent cause of bleeding was gastric and duodenal ulcer (54%). 32% of patients with nonvariceal bleeding had antiplatelets, 19% anticoagulants and 10% used nonsteroidal anti-inflammatory drugs, selective serotonin reuptake inhibitors or corticosteroids. 30-days mortality of patients with nonvariceal bleeding was 11%, annual mortality was 23%. There was no significant difference in mortality, blood transfusion requirements or surgical intervention between the patients with antithrombotic agents and without them. 25% of patients (8 patients) using acetylsalicylic acid did not fulfil the indication for this treatment. Among the patients examined by endoscopy for symptomatic nonvariceal bleeding and/or anaemia (haemoglobin<100 g/l) significantly higher portions of patients are taking antiplatelet rather than anticoagulation therapy

  7. Upper atmosphere has cooled steadily for three decades

    NASA Astrophysics Data System (ADS)

    Wendel, JoAnna

    2014-11-01

    Increasing amounts of greenhouse gases released by human activities do not just affect only the lower atmosphere: Scientists project that anthropogenic carbon emissions have caused a cooling trend in the upper atmosphere, between 200 and 400 kilometers, over the past few decades. Cooling in this atmospheric region can affect the operations of satellites and the orbits of space junk. However, data about cooling trends in the upper atmosphere are still incomplete, and better data are needed to confirm this projection.

  8. 1. CONTEXTUAL VIEW OF THE UPPER FALLS GATE HOUSE, FOREBAY ...

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

    1. CONTEXTUAL VIEW OF THE UPPER FALLS GATE HOUSE, FOREBAY IN FOREGROUND, LOOKING NORTH. - Washington Water Power Spokane River Upper Falls Hydroelectric Development, Gate House, Spokane River, approximately 0.5 mile northeast of intersection of Spokane Falls Boulevard & Post Street, Spokane, Spokane County, WA

  9. Design and performance of a horizontal mooring for upper-ocean research

    USGS Publications Warehouse

    Grosenbaugh, Mark; Anderson, Steven; Trask, Richard; Gobat, Jason; Paul, Walter; Butman, Bradford; Weller, Robert

    2002-01-01

    This paper describes the design and performance of a two-dimensional moored array for sampling horizontal variability in the upper ocean. The mooring was deployed in Massachusetts Bay in a water depth of 84 m for the purpose of measuring the horizontal structure of internal waves. The mooring was instrumented with three acoustic current meters (ACMs) spaced along a 170-m horizontal cable that was stretched between two subsurface buoys 20 m below the sea surface. Five 25-m-long vertical instrument strings were suspended from the horizontal cable. A bottom-mounted acoustic Doppler current profiler (ADCP) was deployed nearby to measure the current velocity throughout the water column. Pressure sensors mounted on the subsurface buoys and the vertical instrument strings were used to measure the vertical displacements of the array in response to the currents. Measurements from the ACMs and the ADCP were used to construct time-dependent, two-dimensional current fields. The current fields were used as input to a numerical model that calculated the deformation of the array with respect to the nominal zero-current configuration. Comparison of the calculated vertical offsets of the downstream subsurface buoy and downstream vertical instrument string with the pressure measurements were used to verify the numerical code. These results were then used to estimate total deformation of the array due to the passage of the internal waves. Based on the analysis of the three internal wave events with the highest measured vertical offsets, it is concluded that the geometry of the main structure (horizontal cable and anchor legs) was kept to within ±2.0 m, and the geometry of the vertical instrument strings was kept to within ±4.0 m except for one instance when the current velocity reached 0.88 m s−1.

  10. Seal Analysis for the Ares-I Upper Stage Fuel Tank Manhole Cover

    NASA Technical Reports Server (NTRS)

    Phillips, Dawn R.; Wingate, Robert J.

    2010-01-01

    Techniques for studying the performance of Naflex pressure-assisted seals in the Ares-I Upper Stage liquid hydrogen tank manhole cover seal joint are explored. To assess the feasibility of using the identical seal design for the Upper Stage as was used for the Space Shuttle External Tank manhole covers, a preliminary seal deflection analysis using the ABAQUS commercial finite element software is employed. The ABAQUS analyses are performed using three-dimensional symmetric wedge finite element models. This analysis technique is validated by first modeling a heritage External Tank liquid hydrogen tank manhole cover joint and correlating the results to heritage test data. Once the technique is validated, the Upper Stage configuration is modeled. The Upper Stage analyses are performed at 1.4 times the expected pressure to comply with the Constellation Program factor of safety requirement on joint separation. Results from the analyses performed with the External Tank and Upper Stage models demonstrate the effects of several modeling assumptions on the seal deflection. The analyses for Upper Stage show that the integrity of the seal is successfully maintained.

  11. Depositional environment and organic matter accumulation of Upper Ordovician–Lower Silurian marine shale in the Upper Yangtze Platform, South China

    USGS Publications Warehouse

    Li, Yangfang; Zhang, Tongwei; Ellis, Geoffrey S.; Shao, Deyong

    2017-01-01

    The main controlling factors of organic matter accumulation in the Upper Ordovician Wufeng–Lower Silurian Longmaxi Formations are complex and remain highly controversial. This study investigates the vertical variation of total organic carbon (TOC) content as well as major and trace element concentrations of four Ordovician–Silurian transition sections from the Upper Yangtze Platform of South China to reconstruct the paleoenvironment of these deposits and to improve our understanding of those factors that have influenced organic matter accumulation in these deposits.The residual TOC content of the Wufeng Formation averages 3.2% and ranges from 0.12 to 6.0%. The overlying lower Longmaxi Formation displays higher TOC content (avg. 4.4%), followed upsection by consistent and lower values that average 1.6% in the upper Longmaxi Formation. The concentration and covariation of redox-sensitive trace elements (Mo, U and V) suggest that organic-rich intervals of the Wufeng Formation accumulated under predominantly anoxic conditions. Organic-rich horizons of the lower Longmaxi Formation were deposited under strongly anoxic to euxinic conditions, whereas organic-poor intervals of the upper Longmaxi Formation accumulated under suboxic conditions. Positive correlations between redox proxies and TOC contents suggest that organic matter accumulation was predominantly controlled by preservation. Barium excess (Baxs) values indicate high paleoproductivity throughout the entire depositional sequence, with an increase in the lower Longmaxi Formation. Increased productivity may have been induced by enhanced P recycling, as evidenced by elevated Corg/Ptot ratios. Mo–U covariation and Mo/TOC values reveal that the Wufeng Formation was deposited under extremely restricted conditions, whereas the Longmaxi Formation accumulated under moderately restricted conditions. During the Late Ordovician, the extremely restricted nature of ocean circulation on the Upper Yangtze Platform in

  12. Forearm versus upper arm grafts for vascular access.

    PubMed

    Gage, Shawn M; Lawson, Jeffrey H

    2017-03-06

    Forearm and upper arm arteriovenous grafts perform similarly in terms of patency and complications. Primary patency at 1 year for forearm arteriovenous grafts versus upper arm grafts ranges from 22%-50% versus 22%-42%, and secondary patency at 1 year ranges from 78%-89% versus 52%-67%), respectively. Secondary patency at 2 years, ranges from 30%-64% versus 35%-60% for forearm and upper arteriovenous graft, respectively. Ample pre-operative planning is essential to improved clinical success and the decision to place a graft at one location versus the other should be based solely on previous access history, physical exam, appropriate venous imaging, and other factors that make up the clinical picture. Operative implant strategies and risk of complications are very similar between the two configurations. Postoperative ischemia due to steal syndrome is a potential complication that requires immediate attention. Utilization of the proximal radial or ulnar artery for inflow for the graft can minimize risk of clinically relevant steal syndrome.

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

    PubMed

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

    2009-12-01

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

  14. An objective isobaric/isentropic technique for upper air analysis

    NASA Technical Reports Server (NTRS)

    Mancuso, R. L.; Endlich, R. M.; Ehernberger, L. J.

    1981-01-01

    An objective meteorological analysis technique is presented whereby both horizontal and vertical upper air analyses are performed. The process used to interpolate grid-point values from the upper-air station data is the same as for grid points on both an isobaric surface and a vertical cross-sectional plane. The nearby data surrounding each grid point are used in the interpolation by means of an anisotropic weighting scheme, which is described. The interpolation for a grid-point potential temperature is performed isobarically; whereas wind, mixing-ratio, and pressure height values are interpolated from data that lie on the isentropic surface that passes through the grid point. Two versions (A and B) of the technique are evaluated by qualitatively comparing computer analyses with subjective handdrawn analyses. The objective products of version A generally have fair correspondence with the subjective analyses and with the station data, and depicted the structure of the upper fronts, tropopauses, and jet streams fairly well. The version B objective products correspond more closely to the subjective analyses, and show the same strong gradients across the upper front with only minor smoothing.

  15. The Upper Atmosphere Research Satellite microwave limb sounder instrument

    NASA Astrophysics Data System (ADS)

    Barath, F. T.; Chavez, M. C.; Cofield, R. E.; Flower, D. A.; Frerking, M. A.; Gram, M. B.; Harris, W. M.; Holden, J. R.; Jarnot, R. F.; Kloezeman, W. G.

    1993-06-01

    The microwave limb sounder (MLS) on the Upper Atmosphere Research Satellite (UARS) is the first satellite experiment using limb sounding techniques at microwave frequencies. Primary measurement objectives are stratospheric ClO, O3, H2O, temperature, and pressure. Measurements are of thermal emission: all are performed simultaneously and continuously and are not degraded by ice clouds or volcanic aerosols. The instrument has a 1.6-m mechanically scanning antenna system and contains heterodyne radiometers in spectral bands centred near 63, 183, and 205 GHz. The radiometers operate at ambient temperature and use Schottky-diode mixers with local oscillators derived from phase-locked Gunn oscillators. Frequency tripling by varactor multipliers generates the 183- and 205-GHz local oscillators, and quasi-optical techniques inject these into the mixers. Six 15-channel filter banks spectrally resolve stratospheric thermal emission lines and produce an output spectrum every 2 s. Thermal stability is sufficient for 'total power' measurements which do not require fast chopping. Radiometric calibration, consisting of measurements of cold space and an internal target, is performed every 65-s limb scan. Instrument in-orbit performance has been excellent, and all objectives are being met.

  16. The Upper Atmosphere Research Satellite microwave limb sounder instrument

    NASA Technical Reports Server (NTRS)

    Barath, F. T.; Chavez, M. C.; Cofield, R. E.; Flower, D. A.; Frerking, M. A.; Gram, M. B.; Harris, W. M.; Holden, J. R.; Jarnot, R. F.; Kloezeman, W. G.

    1993-01-01

    The microwave limb sounder (MLS) on the Upper Atmosphere Research Satellite (UARS) is the first satellite experiment using limb sounding techniques at microwave frequencies. Primary measurement objectives are stratospheric ClO, O3, H2O, temperature, and pressure. Measurements are of thermal emission: all are performed simultaneously and continuously and are not degraded by ice clouds or volcanic aerosols. The instrument has a 1.6-m mechanically scanning antenna system and contains heterodyne radiometers in spectral bands centred near 63, 183, and 205 GHz. The radiometers operate at ambient temperature and use Schottky-diode mixers with local oscillators derived from phase-locked Gunn oscillators. Frequency tripling by varactor multipliers generates the 183- and 205-GHz local oscillators, and quasi-optical techniques inject these into the mixers. Six 15-channel filter banks spectrally resolve stratospheric thermal emission lines and produce an output spectrum every 2 s. Thermal stability is sufficient for 'total power' measurements which do not require fast chopping. Radiometric calibration, consisting of measurements of cold space and an internal target, is performed every 65-s limb scan. Instrument in-orbit performance has been excellent, and all objectives are being met.

  17. The neurophysiological effects of dry needling in patients with upper trapezius myofascial trigger points: study protocol of a controlled clinical trial

    PubMed Central

    Abbaszadeh-Amirdehi, Maryam; Ansari, Noureddin Nakhostin; Naghdi, Soofia; Olyaei, Gholamreza; Nourbakhsh, Mohammad Reza

    2013-01-01

    Introduction Dry needling (DN) is an effective method for the treatment of myofascial trigger points (MTrPs). There is no report on the neurophysiological effects of DN in patients with MTrPs. The aim of the present study will be to assess the immediate neurophysiological efficacy of deep DN in patients with upper trapezius MTrPs. Methods and analysis A prospective, controlled clinical trial was designed to include patients with upper trapezius MTrPs and volunteered healthy participants to receive one session of DN. The primary outcome measures are neuromuscular junction response and sympathetic skin response. The secondary outcomes are pain intensity and pressure pain threshold. Data will be collected at baseline and immediately after intervention. Ethics and dissemination This study protocol has been approved by the Research Council, School of Rehabilitation and the Ethics Committee of Tehran University of Medical Sciences. The results of the study will be disseminated in a peer-reviewed journal and presented at international congresses. PMID:23793673

  18. Validation of the BPUMP BF1112 upper-arm blood pressure monitor for home blood pressure monitoring according to the European Society of Hypertension International Protocol revision 2010.

    PubMed

    Chen, Qi; Kang, Yuan-Yuan; Li, Yan; Wang, Ji-Guang

    2017-04-01

    The present study aimed to evaluate the accuracy of the automated oscillometric upper-arm blood pressure (BP) monitor BPUMP BF1112 for home BP monitoring according to the International Protocol of the European Society of Hypertension revision 2010 (ESH-IP2010). Systolic and diastolic BPs were sequentially measured in 33 adult Chinese (13 women, mean age 46.7 years) using a mercury sphygmomanometer (two observers) and the BF1112 device (one supervisor). A total of 99 pairs of comparisons were obtained from 33 participants for judgments in two parts with three grading phases. The BPUMP BF1112 device achieved the targets in part 1 of the validation study. The number of absolute differences between device and observers within 5, 10, and 15 mmHg was 85/99, 96/99, and 97/99, respectively, for systolic BP, and 83/99, 97/99, and 99/99, respectively, for diastolic BP. The device also fulfilled the criteria in part 2 of the validation study. A total of 31 and 30 participants for systolic and diastolic BP, respectively, had at least two of the three device-observer differences within 5 mmHg (required≥24mmHg). No participant for systolic or diastolic BP had all the three device-observer comparisons greater than 5 mmHg. The BPUMP BP monitor BF1112 has passed the requirements of the ESH-IP2010, and hence can be recommended for home use in adults.

  19. Geology of natural gas reservoir: Upper Travis Peak Formation, western flank of Sabine Uplift, east Texas

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

    Fracasso, M.A.

    The Travis Peak Formation (Lower Cretaceous) in the eastern East Texas basin represents a sand-rich, fluvial-deltaic depositional system. This lobate, high-constructive deltaic system prograded radially to the southeast from an Upshur County locus. Regional studies of the Travis Peak established a threefold internal stratigraphic framework: a middle sand-rich fluvial and delta-plain sequence is gradationally overlain and underlain by a marine-influenced delta-fringe zone with a higher mud content. The entire Travis Peak succession thins over the Bethany dome on the western flank of the Sabine uplift. However, the delta-fringe sequences are relatively thicker over the structure because of a disproportionately greatermore » thinning of the middle sandy fluvial-deltaic sequence. Lesser sand deposition over the Bethany dome reflects an active structural control over facies distribution. Gas production in the Bethany field and surrounding area is concentrated in thin zones (5-15 ft) of the upper delta-fringe sequence. This distribution probably reflects the increased abundance of mudstone beds in the upper delta-fringe interval, which may have served as source rocks or barriers to upward gas migration, or as both. The predominant trapping mechanism in this region is stratigraphic sand pinch-out in a structurally updip direction on the flanks of major structures. Studies of core and closely spaced electric logs west of the Bethany dome help define the depositional systems in the upper delta-fringe producing interval. This sequence comprises a complex mosaic of continental and marine facies, and exhibits an overall upward trend of increasing marine influence that spans a gradual transition into transgressive carbonates of the Sligo Formation.« less

  20. Reflections on the present and future of upper limb prostheses.

    PubMed

    Farina, Dario; Amsüss, Sebastian

    2016-01-01

    Despite progress in research and media attention on active upper limb prostheses, presently the most common commercial upper limb prosthetic devices are not fundamentally different from solutions offered almost one century ago. Limited information transfer for both control and sensory-motor integration and challenges in socket technology have been major obstacles. By analysing the present state-of-the-art and academic achievements, we provide our opinion on the future of upper limb prostheses. We believe that surgical procedures for muscle reinnervation and osseointegration will become increasingly clinically relevant; muscle electrical signals will remain the main clinical means for prosthetic control; and chronic electrode implants, first in muscles (control), then in nerves (sensory feedback), will become viable clinical solutions. After decades of suspended clinically relevant progress, it is foreseeable that a new generation of upper limb prostheses will enter the market in the near future based on such advances, thereby offering substantial clinical benefit for patients.

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

    PubMed

    El Zaatari, Sireen; Hublin, Jean-Jacques

    2014-04-01

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

  2. Flood of June 8-9, 2008, Upper Iowa River, Northeast Iowa

    USGS Publications Warehouse

    Fischer, Edward E.; Eash, David A.

    2010-01-01

    Major flooding occurred June 8-9, 2008, in the Upper Iowa River Basin in northeast Iowa following severe thunderstorm activity over the region. About 7 inches of rain were recorded for the 48-hour period ending 4 p.m., June 8, at Decorah, Iowa; more than 7 inches of rain were recorded for the 48-hour period ending 7 a.m., June 8, at Dorchester, Iowa, about 17 miles northeast of Decorah. The maximum peak discharge measured in the Upper Iowa River was 34,100 cubic feet per second at streamgage 05387500 Upper Iowa River at Decorah, Iowa. This discharge is the largest discharge recorded in the Upper Iowa River Basin since streamgaging operations began in the basin in 1914. The flood-probability range of the peak discharge is 0.2 to 1 percent. High-water marks were measured at 15 locations along the Upper Iowa River between State Highway 26 near the mouth at the Mississippi River and U.S. Highway 63 at Chester, Iowa, a distance of 124 river miles. The high-water marks were used to develop a flood profile.

  3. Enhanced left-finger deftness following dominant upper- and lower-limb amputation.

    PubMed

    Swanberg, Kelley M; Clark, Abigail M; Kline, Julia E; Yurkiewicz, Ilana R; Chan, Brenda L; Pasquina, Paul F; Heilman, Kenneth M; Tsao, Jack W

    2011-09-01

    After amputation, the sensorimotor cortex reorganizes, and these alterations might influence motor functions of the remaining extremities. The authors examined how amputation of the dominant or nondominant upper or lower extremity alters deftness in the intact limbs. The participants were 32 unilateral upper- or lower-extremity amputees and 6 controls. Upper-extremity deftness was tested by coin rotation (finger deftness) and pegboard (arm, hand, and finger deftness) tasks. Following right-upper- or right-lower-extremity amputation, the left hand's finger movements were defter than the left-hand fingers of controls. In contrast, with left-upper- or left-lower-extremity amputation, the right hand's finger performance was the same as that of the controls. Although this improvement might be related to increased use (practice), the finding that right-lower-extremity amputation also improved the left hand's finger deftness suggests an alternative mechanism. Perhaps in right-handed persons the left motor cortex inhibits the right side of the body more than the right motor cortex inhibits the left side, and the physiological changes induced by right-sided amputation reduced this inhibition.

  4. Inspiratory and expiratory aerosol deposition in the upper airway.

    PubMed

    Verbanck, S; Kalsi, H S; Biddiscombe, M F; Agnihotri, V; Belkassem, B; Lacor, C; Usmani, O S

    2011-02-01

    Aerosol deposition efficiency (DE) in the extrathoracic airways during mouth breathing is currently documented only for the inspiratory phase of respiration, and there is a need for quantification of expiratory DE. Our aim was to study both inspiratory and expiratory DE in a realistic upper airway geometry. This was done experimentally on a physical upper airway cast by scintigraphy, and numerically by computational fluid dynamic simulations using a Reynolds Averaged Navier?Stokes (RANS) method with a k-? SST turbulence model coupled with a stochastic Lagrangian approach. Experiments and simulations were carried out for particle sizes (3 and 6 μm) and flow rates (30 and 60 L/min) spanning the ranges of Stokes (Stk) and Reynolds (Re) number pertinent to therapeutic and environmental aerosols. We showed that inspiratory total deposition data obtained by scintigraphy fell onto a previously published deposition curve representative of a range of upper airway geometries. We also found that expiratory and inspiratory DE curves were almost identical. Finally, DE in different compartments of the upper airway model showed a very different distribution pattern of aerosol deposition during inspiration and expiration, with preferential deposition in oral and pharyngeal compartments, respectively. These compartmental deposition patterns were very consistent and only slightly dependent on particle size or flow rate. Total deposition for inspiration and expiration was reasonably well-mimicked by the RANS simulation method we employed, and more convincingly so in the upper range of the Stk and Re number. However, compartmental deposition patterns showed discrepancies between experiments and RANS simulations, particularly during expiration.

  5. On the generation of internal wave modes by surface waves

    NASA Astrophysics Data System (ADS)

    Harlander, Uwe; Kirschner, Ian; Maas, Christian; Zaussinger, Florian

    2016-04-01

    Internal gravity waves play an important role in the ocean since they transport energy and momentum and the can lead to mixing when they break. Surface waves and internal gravity waves can interact. On the one hand, long internal waves imply a slow varying shear current that modifies the propagation of surface waves. Surface waves generated by the atmosphere can, on the other hand, excite internal waves by nonlinear interaction. Thereby a surface wave packet consisting of two close frequencies can resonate with a low frequency internal wave (Phillips, 1966). From a theoretical point of view, the latter has been studied intensively by using a 2-layer model, i.e. a surface layer with a strong density contrast and an internal layer with a comparable weak density contrast (Ball, 1964; Craig et al., 2010). In the present work we analyse the wave coupling for a continuously stratified fluid using a fully non-linear 2D numerical model (OpenFoam) and compare this with laboratory experiments (see Lewis et al. 1974). Surface wave modes are used as initial condition and the time development of the dominant surface and internal waves are studied by spectral and harmonic analysis. For the simple geometry of a box, the results are compared with analytical spectra of surface and gravity waves. Ball, F.K. 1964: Energy transfer between external and internal gravity waves. J. Fluid Mech. 19, 465. Craig, W., Guyenne, P., Sulem, C. 2010: Coupling between internal and surface waves. Natural Hazards 57, 617-642. Lewis, J.E., Lake, B.M., Ko, D.R.S 1974: On the interaction of internal waves and surfacr gravity waves, J. Fluid Mech. 63, 773-800. Phillips, O.M. 1966: The dynamics of the upper ocean, Cambridge University Press, 336pp.

  6. Initial Assessment of the Ares I-X Launch Vehicle Upper Stage to Vibroacoustic Flight Environments

    NASA Technical Reports Server (NTRS)

    Larko, Jeffrey M.; Hughes, William O.

    2008-01-01

    The Ares I launch vehicle will be NASA s first new launch vehicle since 1981. Currently in design, it will replace the Space Shuttle in taking astronauts to the International Space Station, and will eventually play a major role in humankind s return to the Moon and eventually to Mars. Prior to any manned flight of this vehicle, unmanned test readiness flights will be flown. The first of these readiness flights, named Ares I-X, is scheduled to be launched in April 2009. The NASA Glenn Research Center is responsible for the design, manufacture, test and analysis of the Ares I-X upper stage simulator (USS) element. As part of the design effort, the structural dynamic response of the Ares I-X launch vehicle to its vibroacoustic flight environments must be analyzed. The launch vehicle will be exposed to extremely high acoustic pressures during its lift-off and aerodynamic stages of flight. This in turn will cause high levels of random vibration on the vehicle's outer surface that will be transmitted to its interior. Critical flight equipment, such as its avionics and flight guidance components are susceptible to damage from this excitation. This study addresses the modelling, analysis and predictions from examining the structural dynamic response of the Ares I-X upper stage to its vibroacoustic excitations. A statistical energy analysis (SEA) model was used to predict the high frequency response of the vehicle at locations of interest. Key to this study was the definition of the excitation fields corresponding to lift off acoustics and the unsteady aerodynamic pressure fluctuations during flight. The predicted results will be used by the Ares I-X Project to verify the flight qualification status of the Ares I-X upper stage components.

  7. Real-time inverse kinematics for the upper limb: a model-based algorithm using segment orientations.

    PubMed

    Borbély, Bence J; Szolgay, Péter

    2017-01-17

    Model based analysis of human upper limb movements has key importance in understanding the motor control processes of our nervous system. Various simulation software packages have been developed over the years to perform model based analysis. These packages provide computationally intensive-and therefore off-line-solutions to calculate the anatomical joint angles from motion captured raw measurement data (also referred as inverse kinematics). In addition, recent developments in inertial motion sensing technology show that it may replace large, immobile and expensive optical systems with small, mobile and cheaper solutions in cases when a laboratory-free measurement setup is needed. The objective of the presented work is to extend the workflow of measurement and analysis of human arm movements with an algorithm that allows accurate and real-time estimation of anatomical joint angles for a widely used OpenSim upper limb kinematic model when inertial sensors are used for movement recording. The internal structure of the selected upper limb model is analyzed and used as the underlying platform for the development of the proposed algorithm. Based on this structure, a prototype marker set is constructed that facilitates the reconstruction of model-based joint angles using orientation data directly available from inertial measurement systems. The mathematical formulation of the reconstruction algorithm is presented along with the validation of the algorithm on various platforms, including embedded environments. Execution performance tables of the proposed algorithm show significant improvement on all tested platforms. Compared to OpenSim's Inverse Kinematics tool 50-15,000x speedup is achieved while maintaining numerical accuracy. The proposed algorithm is capable of real-time reconstruction of standardized anatomical joint angles even in embedded environments, establishing a new way for complex applications to take advantage of accurate and fast model-based inverse

  8. Observations Of General Learning Patterns In An Upper-Level Thermal Physics Course

    NASA Astrophysics Data System (ADS)

    Meltzer, David E.

    2009-11-01

    I discuss some observations from using interactive-engagement instructional methods in an upper-level thermal physics course over a two-year period. From the standpoint of the subject matter knowledge of the upper-level students, there was a striking persistence of common learning difficulties previously observed in students enrolled in the introductory course, accompanied, however, by some notable contrasts between the groups. More broadly, I comment on comparisons and contrasts regarding general pedagogical issues among different student sub-populations, for example: differences in the receptivity of lower- and upper-level students to diagrammatic representations; varying receptivity to tutorial-style instructional approach within the upper-level population; and contrasting approaches to learning among physics and engineering sub-populations in the upper-level course with regard to use of symbolic notation, mathematical equations, and readiness to employ verbal explanations.

  9. Upper Elementary Students' Motivation to Read Fiction and Nonfiction

    ERIC Educational Resources Information Center

    Parsons, Allison Ward; Parsons, Seth A.; Malloy, Jacquelynn A.; Gambrell, Linda B.; Marinak, Barbara A.; Reutzel, D. Ray; Applegate, Mary D.; Applegate, Anthony J.; Fawson, Parker C.

    2018-01-01

    This research explores upper elementary students' motivation to read fiction and nonfiction. Using expectancy-value theory, the researchers developed separate surveys to measure motivation to read fiction and nonfiction. Researchers administered surveys to 1,104 upper elementary students (grades 3-6) in multiple locations across the United States…

  10. Analysis of dynamic smile and upper lip curvature in young Chinese

    PubMed Central

    Liang, Ling-Zhi; Hu, Wen-Jie; Zhang, Yan-Ling; Chung, Kwok-Hung

    2013-01-01

    During smile evaluation and anterior esthetic construction, the anatomic and racial variations should be considered in order to achieve better matching results. The aims of this study were to validate an objective method for recording spontaneous smile process and to categorize the smile and upper lip curvature of Chinese Han-nationality youth. One hundred and eighty-eight Chinese Han-nationality youths (88 males and 100 females) ranged from 20 to 35 years of age were selected. Spontaneous smiles were elicited by watching comical movies and the dynamics of the spontaneous smile were captured continuously with a digital video camera. All subjects' smiles were categorized into three types: commissure, cuspid and gummy smile based on video editing software and final images. Subjects' upper lip curvatures were also measured and divided into three groups: upward, straight and downward. Reliability analysis was conducted to obtain intra-rater reliabilities on twice measurements. The Pearson Chi-square test was used to compare differences for each parameters (α=0.05). In smile classification, 60.6% commissure smile, 33.5% cuspid smile and 5.9% gummy smile were obtained. In upper lip measurement, 26.1% upward, 39.9% straight and 34.0% downward upper lip curvature were determined. The commissure smile group showed statistically significant higher percentage of straight (46.5%) and upward (40.4%) in upper lip curvatures (P<0.05), while cuspid smile group (65.1%) and gummy smile group (72.7%) showed statistically significant higher frequency in downward upper lip curvature (P<0.05). It is evident that differences in upper lip curvature and smile classification exist based on race, when comparing Chinese subjects with those of Caucasian descent, and gender. PMID:23558343

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

    PubMed

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

    2015-01-01

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

  12. BOREAS AFM-5 Level-1 Upper Air Network Data

    NASA Technical Reports Server (NTRS)

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

    2000-01-01

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

  13. Elongated uvula and diagnostic utility of spirometry in upper airway obstruction

    PubMed Central

    Paliwal, Rajiv; Patel, Satish; Patel, Purvesh; Soni, Hiren

    2010-01-01

    Elongated uvula is relatively an uncommon condition. Upper airway obstruction is often a missed complication of such a rare condition. Clinical presentations of upper airway obstruction often mimic asthma. Hence it is very easily mis-diagnosed as asthma. Spirometry offers a very simple test to diagnose upper airway obstruction very early and easily. Once diagnosed, the management of elongated uvula, almost exclusively, is surgical excision leading to total cure. Here is a case report of such a rare condition. PMID:20539769

  14. Underwater Flow Visualization Methods in the Upper Layer of the Ocean.

    DTIC Science & Technology

    1981-05-22

    AD-A107 919 NAVAL RESEARCH LAB WASHINGTON DC F/G 8/3 UNDERWATER FLOW VISUALIZATION METHODS IN T1E UPPER LAYER OF THE-ETC(U) AMAY 81 J R MCGRATH, C M...S.bOti1.) S. TYPE OF REPORT I PERIOD COVERED UNDERWATER FLOW VISUALIZATION METHODS Interim report on a continuingNRL problem. IN THE UPPER LAYER OF THE...56 UNDERWATER FLOW VISUALIZATION METHODS IN THE UPPER LAYER OF THE OCEAN 1. INTRODUCTION a) Purpose This report documents the

  15. Upper Hybrid Effects in Artificial Ionization

    NASA Astrophysics Data System (ADS)

    Papadopoulos, K.; Eliasson, B. E.

    2014-12-01

    A most fascinating result of recent ionospheric experiments has been the discovery of artificial ionization by Pedersen et al. (GRL, 37, L02106, 2010). The Artificial Ionospheric Layers (AIL) were the result of F-region O-mode HF irradiation using the HAARP ionospheric heater operating at 3.6 MW power. As demonstrated by Eliasson et al. (JGR, 117, A10321, 2012) the physics controlling the observed phenomenon and its threshold can be summarized as: " Collisional ionization due to high energy (~ 20 eV) electron tails generated by the interaction of strong Langmuir turbulence with plasma heated at the upper hybrid resonance and transported at the reflection height". The objective of the current presentation is to explore the role of the upper hybrid heating in the formation of AIL and its implications to future experiments involving HF heaters operating in middle and equatorial latitudes.

  16. Gender differences in extreme mathematical achievement: an international perspective on biological and social factors.

    PubMed

    Penner, Andrew M

    2008-01-01

    Genetic and other biological explanations have reemerged in recent scholarship on the underrepresentation of women in mathematics and the sciences. This study engages this debate by using international data-including math achievement scores from the Third International Mathematics and Sciences Study and country-level data from the World Bank, the United Nations, the International Labour Organization, the World Values Survey, and the International Social Survey Programme-to demonstrate the importance of social factors and to estimate an upper bound for the impact of genetic factors. The author argues that international variation provides a valuable opportunity to present simple and powerful arguments for the continued importance of social factors. In addition, where previous research has, by and large, focused on differences in population means, this work examines gender differences throughout the distribution. The article shows that there is considerable variation in gender differences internationally, a finding not easily explained by strictly biological theories. Modeling the cross-national variation in gender differences with country-level predictors reveals that differences among high achievers are related to gender inequality in the labor market and differences in the overall status of men and women.

  17. Capturing remote mixing due to internal tides using multi-scale modeling tool: SOMAR-LES

    NASA Astrophysics Data System (ADS)

    Santilli, Edward; Chalamalla, Vamsi; Scotti, Alberto; Sarkar, Sutanu

    2016-11-01

    Internal tides that are generated during the interaction of an oscillating barotropic tide with the bottom bathymetry dissipate only a fraction of their energy near the generation region. The rest is radiated away in the form of low- high-mode internal tides. These internal tides dissipate energy at remote locations when they interact with the upper ocean pycnocline, continental slope, and large scale eddies. Capturing the wide range of length and time scales involved during the life-cycle of internal tides is computationally very expensive. A recently developed multi-scale modeling tool called SOMAR-LES combines the adaptive grid refinement features of SOMAR with the turbulence modeling features of a Large Eddy Simulation (LES) to capture multi-scale processes at a reduced computational cost. Numerical simulations of internal tide generation at idealized bottom bathymetries are performed to demonstrate this multi-scale modeling technique. Although each of the remote mixing phenomena have been considered independently in previous studies, this work aims to capture remote mixing processes during the life cycle of an internal tide in more realistic settings, by allowing multi-level (coarse and fine) grids to co-exist and exchange information during the time stepping process.

  18. Shoulder Strength Requirements for Upper Limb Functional Tasks: Do Age and Rotator Cuff Tear Status Matter?

    PubMed

    Santago, Anthony C; Vidt, Meghan E; Li, Xiaotong; Tuohy, Christopher J; Poehling, Gary G; Freehill, Michael T; Saul, Katherine R

    2017-12-01

    Understanding upper limb strength requirements for daily tasks is imperative for early detection of strength loss that may progress to disability due to age or rotator cuff tear. We quantified shoulder strength requirements for 5 upper limb tasks performed by 3 groups: uninjured young adults and older adults, and older adults with a degenerative supraspinatus tear prior to repair. Musculoskeletal models were developed for each group representing age, sex, and tear-related strength losses. Percentage of available strength used was quantified for the subset of tasks requiring the largest amount of shoulder strength. Significant differences in strength requirements existed across tasks: upward reach 105° required the largest average strength; axilla wash required the largest peak strength. However, there were limited differences across participant groups. Older adults with and without a tear used a larger percentage of their shoulder elevation (p < .001, p < .001) and external rotation (p < .001, p = .017) strength than the young adults, respectively. Presence of a tear significantly increased percentage of internal rotation strength compared to young (p < .001) and uninjured older adults (p = .008). Marked differences in strength demand across tasks indicate the need for evaluating a diversity of functional tasks to effectively detect early strength loss, which may lead to disability.

  19. 42 CFR 447.512 - Drugs: Aggregate upper limits of payment.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...: Aggregate upper limits of payment. (a) Multiple source drugs. Except for brand name drugs that are certified... applies. (b) Other drugs. The agency payments for brand name drugs certified in accordance with paragraph... brand name drugs. (1) The upper limit for payment for multiple source drugs for which a specific limit...

  20. 3. EAST FACADE OF THE UPPER FALLS GATE HOUSE, FOREBAY ...

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

    3. EAST FACADE OF THE UPPER FALLS GATE HOUSE, FOREBAY IN LEFT FOREGROUND, SPOKANE CITY HALL IN LEFT BACKGROUND, LOOKING WEST. - Washington Water Power Spokane River Upper Falls Hydroelectric Development, Gate House, Spokane River, approximately 0.5 mile northeast of intersection of Spokane Falls Boulevard & Post Street, Spokane, Spokane County, WA

  1. Vocational Career Decision-Making of Finnish Upper Secondary School Students

    ERIC Educational Resources Information Center

    Meriläinen, Matti; Puhakka, Helena; Sinkkonen, Hanna-Maija

    2014-01-01

    The aim of this research was to clarify the characteristics of Finnish upper secondary school students as vocational decision-makers. The focus was especially on what skills and competences were related to decision-making at different phases of the decision-making process. Altogether, 216 upper secondary school students filled in the…

  2. Thrust vector control of upper stage with a gimbaled thruster during orbit transfer

    NASA Astrophysics Data System (ADS)

    Wang, Zhaohui; Jia, Yinghong; Jin, Lei; Duan, Jiajia

    2016-10-01

    In launching Multi-Satellite with One-Vehicle, the main thruster provided by the upper stage is mounted on a two-axis gimbal. During orbit transfer, the thrust vector of this gimbaled thruster (GT) should theoretically pass through the mass center of the upper stage and align with the command direction to provide orbit transfer impetus. However, it is hard to be implemented from the viewpoint of the engineering mission. The deviations of the thrust vector from the command direction would result in large velocity errors. Moreover, the deviations of the thrust vector from the upper stage mass center would produce large disturbance torques. This paper discusses the thrust vector control (TVC) of the upper stage during its orbit transfer. Firstly, the accurate nonlinear coupled kinematic and dynamic equations of the upper stage body, the two-axis gimbal and the GT are derived by taking the upper stage as a multi-body system. Then, a thrust vector control system consisting of the special attitude control of the upper stage and the gimbal rotation of the gimbaled thruster is proposed. The special attitude control defined by the desired attitude that draws the thrust vector to align with the command direction when the gimbal control makes the thrust vector passes through the upper stage mass center. Finally, the validity of the proposed method is verified through numerical simulations.

  3. The association between upper trapezius activity and thorax movement in classical singing.

    PubMed

    Pettersen, V; Westgaard, R H

    2004-12-01

    This study aimed to examine in classical singing the phasing of the activity in upper trapezius (TR) to upper and lower thorax movement and to the phasing of activity in the intercostals (INT) and in the lateral abdominal (OBL) muscles. Electromyographic (EMG) activity was recorded from the TR, INT, and OBL muscles on the right side. Thorax movement (TX) was traced with two strain gauge sensors placed around the upper and lower thorax. Four professional opera singers (soprano, mezzo, tenor, and baritone) and four advanced student classical singers (three sopranos and one mezzo) participated. Three of the professional singers were 33 years, and one was 40 years. The students were between 23 and 30 years. Different arias, freely chosen by the singers from their professional repertoire, served as the singing task for the opera singers. All students sang "Summertime" from Porgy and Bess. All subjects performed their task three times with variation in vocal loudness (normal, forte, piano). Thereafter, for all subjects, a biofeedback (BF) procedure was performed on TR to lower TR activity and a repeat performance of the singing tasks was carried out. EMG activity from the three recording sites and upper and lower TX circumference were compared before and after BF. A phasing of upper TR activity to INT and OBL activity was discovered, all muscles supporting the expiration phase. During phonation, the upper TR contributes in the compression of upper TX, thus serving as an accessory muscle of expiration. Group results from both opera singers and student singers showed that EMG activity was significantly lowered after BF. The lowered TR activity resulted in an expanded upper TX circumference and less TX respiratory movement after BF.

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

    PubMed

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

    2017-06-01

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

  5. Validity of peptic ulcer disease and upper gastrointestinal bleeding diagnoses in administrative databases: a systematic review protocol.

    PubMed

    Montedori, Alessandro; Abraha, Iosief; Chiatti, Carlos; Cozzolino, Francesco; Orso, Massimiliano; Luchetta, Maria Laura; Rimland, Joseph M; Ambrosio, Giuseppe

    2016-09-15

    Administrative healthcare databases are useful to investigate the epidemiology, health outcomes, quality indicators and healthcare utilisation concerning peptic ulcers and gastrointestinal bleeding, but the databases need to be validated in order to be a reliable source for research. The aim of this protocol is to perform the first systematic review of studies reporting the validation of International Classification of Diseases, 9th Revision and 10th version (ICD-9 and ICD-10) codes for peptic ulcer and upper gastrointestinal bleeding diagnoses. MEDLINE, EMBASE, Web of Science and the Cochrane Library databases will be searched, using appropriate search strategies. We will include validation studies that used administrative data to identify peptic ulcer disease and upper gastrointestinal bleeding diagnoses or studies that evaluated the validity of peptic ulcer and upper gastrointestinal bleeding codes in administrative data. The following inclusion criteria will be used: (a) the presence of a reference standard case definition for the diseases of interest; (b) the presence of at least one test measure (eg, sensitivity, etc) and (c) the use of an administrative database as a source of data. Pairs of reviewers will independently abstract data using standardised forms and will evaluate quality using the checklist of the Standards for Reporting of Diagnostic Accuracy (STARD) criteria. This systematic review protocol has been produced in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocol (PRISMA-P) 2015 statement. Ethics approval is not required given that this is a protocol for a systematic review. We will submit results of this study to a peer-reviewed journal for publication. The results will serve as a guide for researchers validating administrative healthcare databases to determine appropriate case definitions for peptic ulcer disease and upper gastrointestinal bleeding, as well as to perform outcome research using

  6. Cerebral gas embolism due to upper gastrointestinal endoscopy.

    PubMed

    ter Laan, Mark; Totte, Erik; van Hulst, Rob A; van der Linde, Klaas; van der Kamp, Wim; Pierie, Jean-Pierre E

    2009-07-01

    Cerebral gas embolism as a result of upper gastrointestinal endoscopy is a rare complication and bares a high morbidity. A patient is presented who underwent an upper endoscopy for evaluation of a gastric-mediastinal fistula after subtotal oesophagectomy and gastric tube reconstruction because of oesophageal cancer. During the procedure, cerebral gas emboli developed resulting in an acute left-sided hemiparesis. After hyperbaric oxygen therapy, the patient recovered almost completely. The aetiology and treatment is discussed based on the reviewed literature. Once cerebral gas emboli are recognized, patient outcome can be improved by hyperbaric oxygen therapy.

  7. Stenting of the Upper Gastrointestinal Tract: Current Status

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

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

    2010-08-15

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

  8. Upper Gastrointestinal Tract Motility Disorders in Women, Gastroparesis, and Gastroesophageal Reflux Disease.

    PubMed

    Zia, Jasmine K; Heitkemper, Margaret M

    2016-06-01

    This article reviews the sex differences in upper gastrointestinal (GI) motility for both healthy and common dysmotility conditions. It focuses on gastroesophageal reflux disease and other esophageal motor disorders for the esophagus and on gastroparesis and accelerated gastric emptying for the stomach. It also describes differences in upper GI motility signs and symptoms during each female hormonal stage (ie, menstrual cycle, pregnancy, perimenopause, menopause) for both healthy participants and those suffering from one of the aforementioned upper GI dysmotility conditions. More research still needs to be conducted to better understand sex differences in upper GI motility. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Parameterizing Gravity Waves and Understanding Their Impacts on Venus' Upper Atmosphere

    NASA Technical Reports Server (NTRS)

    Brecht, A. S.; Bougher, S. W.; Yigit, Erdal

    2018-01-01

    The complexity of Venus’ upper atmospheric circulation is still being investigated. Simulations of Venus’ upper atmosphere largely depend on the utility of Rayleigh Friction (RF) as a driver and necessary process to reproduce observations (i.e. temperature, density, nightglow emission). Currently, there are additional observations which provide more constraints to help characterize the driver(s) of the circulation. This work will largely focus on the impact parameterized gravity waves have on Venus’ upper atmosphere circulation within a three dimensional hydrodynamic model (Venus Thermospheric General Circulation Model).

  10. Upper wide-angle viewing system for ITER.

    PubMed

    Lasnier, C J; McLean, A G; Gattuso, A; O'Neill, R; Smiley, M; Vasquez, J; Feder, R; Smith, M; Stratton, B; Johnson, D; Verlaan, A L; Heijmans, J A C

    2016-11-01

    The Upper Wide Angle Viewing System (UWAVS) will be installed on five upper ports of ITER. This paper shows major requirements, gives an overview of the preliminary design with reasons for some design choices, examines self-emitted IR light from UWAVS optics and its effect on accuracy, and shows calculations of signal-to-noise ratios for the two-color temperature output as a function of integration time and divertor temperature. Accurate temperature output requires correction for vacuum window absorption vs. wavelength and for self-emitted IR, which requires good measurement of the temperature of the optical components. The anticipated signal-to-noise ratio using presently available IR cameras is adequate for the required 500 Hz frame rate.

  11. An upper limit for stratospheric hydrogen peroxide

    NASA Technical Reports Server (NTRS)

    Chance, K. V.; Traub, W. A.

    1984-01-01

    It has been postulated that hydrogen peroxide is important in stratospheric chemistry as a reservoir and sink for odd hydrogen species, and for its ability to interconvert them. The present investigation is concerned with an altitude dependent upper limit curve for stratospheric hydrogen peroxide, taking into account an altitude range from 21.5 to 38.0 km for January 23, 1983. The data employed are from balloon flight No. 1316-P, launched from the National Scientific Balloon Facility (NSBF) in Palestine, Texas. The obtained upper limit curve lies substantially below the data reported by Waters et al. (1981), even though the results are from the same latitude and are both wintertime measurements.

  12. Removal of press-through-packs impacted in the upper esophagus using an overtube.

    PubMed

    Seo, Yeon-Seok; Park, Jong-Jae; Kim, Ji-Hoon; Kim, Jin-Yong; Yeon, Jong-Eun; Kim, Jae-Seon; Byun, Kwan-Soo; Bak, Young-Tae

    2006-09-28

    Foreign bodies in the upper esophagus should be removed as soon as possible to avoid serious complications. However, removals of foreign bodies in the upper esophagus are very difficult, especially if they have sharp edges, such as press-through-packs (PTPs). We experienced four cases of the impacted PTPs in the upper esophagus which was successfully extracted endoscopically with the overtube. Because two edges of PTPs were so firmly impacted in the esophageal wall in all cases, the PTPs were not movable in the upper esophagus. However, after insertion of the overtube, PTPs became movable and were successfully extracted and no serious complications occurred after extraction of PTPs. In one case, insertion of the overtube rapidly expanded the upper esophagus and PTP progressed to the gastric cavity and it could be extracted with the endoscopic protector hood. The endoscopic removal with the overtube was a simple, safe and effective technique for the removal of the impacted PTPs in upper esophagus.

  13. Removal of press-through-packs impacted in the upper esophagus using an overtube

    PubMed Central

    Seo, Yeon Seok; Park, Jong-Jae; Kim, Ji Hoon; Kim, Jin Yong; Yeon, Jong Eun; Kim, Jae Seon; Byun, Kwan Soo; Bak, Young-Tae

    2006-01-01

    Foreign bodies in the upper esophagus should be removed as soon as possible to avoid serious complications. However, removals of foreign bodies in the upper esophagus are very difficult, especially if they have sharp edges, such as press-through-packs (PTPs). We experienced four cases of the impacted PTPs in the upper esophagus which was successfully extracted endoscopically with the overtube. Because two edges of PTPs were so firmly impacted in the esophageal wall in all cases, the PTPs were not movable in the upper esophagus. However, after insertion of the overtube, PTPs became movable and were successfully extracted and no serious complications occurred after extraction of PTPs. In one case, insertion of the overtube rapidly expanded the upper esophagus and PTP progressed to the gastric cavity and it could be extracted with the endoscopic protector hood. The endoscopic removal with the overtube was a simple, safe and effective technique for the removal of the impacted PTPs in upper esophagus. PMID:17007065

  14. Nonnative Fishes in the Upper Mississippi River System

    USGS Publications Warehouse

    Irons, Kevin S.; DeLain, Steven A.; Gittinger, Eric; Ickes, Brian S.; Kolar, Cindy S.; Ostendort, David; Ratcliff, Eric N.; Benson, Amy J.; Irons, Kevin S.

    2009-01-01

    The introduction, spread, and establishment of nonnative species is widely regarded as a leading threat to aquatic biodiversity and consequently is ranked among the most serious environmental problems facing the United States today. This report presents information on nonnative fish species observed by the Long Term Resource Monitoring Program on the Upper Mississippi River System a nexus of North American freshwater fish diversity for the Nation. The Long Term Resource Monitoring Program, as part of the U.S. Army Corps of Engineers' Environmental Management Plan, is the Nation's largest river monitoring program and stands as the primary source of standardized ecological information on the Upper Mississippi River System. The Long Term Resource Monitoring Program has been monitoring fish communities in six study areas on the Upper Mississippi River System since 1989. During this period, more than 3.5 million individual fish, consisting of 139 species, have been collected. Although fish monitoring activities of the Long Term Resource Monitoring Program focus principally on entire fish communities, data collected by the Program are useful for detecting and monitoring the establishment and spread of nonnative fish species within the Upper Mississippi River System Basin. Sixteen taxa of nonnative fishes, or hybrids thereof, have been observed by the Long Term Resource Monitoring Program since 1989, and several species are presently expanding their distribution and increasing in abundance. For example, in one of the six study areas monitored by the Long Term Resource Monitoring Program, the number of established nonnative species has increased from two to eight species in less than 10 years. Furthermore, contributions of those eight species can account for up to 60 percent of the total annual catch and greater than 80 percent of the observed biomass. These observations are critical because the Upper Mississippi River System stands as a nationally significant pathway for

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

    PubMed

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

    2011-07-07

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

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

    PubMed Central

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

    2011-01-01

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

  17. Abrupt Upper-Plate Tilting Upon Slab-Transition-Zone Collision

    NASA Astrophysics Data System (ADS)

    Crameri, F.; Lithgow-Bertelloni, C. R.

    2017-12-01

    During its sinking, the remnant of a surface plate crosses and interacts with multiple boundaries in Earth's interior. The most-prominent dynamic interaction arises at the upper-mantle transition zone where the sinking plate is strongly affected by the higher-viscosity lower mantle. Within our numerical model, we unravel, for the first time, that this very collision of the sinking slab with the transition zone induces a sudden, dramatic downward tilt of the upper plate towards the subduction trench. The slab-transition zone collision sets parts of the higher-viscosity lower mantle in motion. Naturally, this then induces an overall larger return flow cell that, at its onset, tilts the upper plate abruptly by around 0.05 degrees and over around 10 Millions of years. Such a significant and abrupt variation in surface topography should be clearly visible in temporal geologic records of large-scale surface elevation and might explain continental-wide tilting as observed in Australia since the Eocene or North America during the Phanerozoic. Unravelling this crucial mantle-lithosphere interaction was possible thanks to state-of-the-art numerical modelling (powered by StagYY; Tackley 2008, PEPI) and post-processing (powered by StagLab; www.fabiocrameri.ch/software). The new model that is introduced here to study the dynamically self-consistent temporal evolution of subduction features accurate subduction-zone topography, robust single-sided plate sinking, stronger plates close to laboratory values, an upper-mantle phase transition and, crucially, simple continents at a free surface. A novel, fully-automated post-processing includes physical model diagnostics like slab geometry, mantle flow pattern, upper-plate tilt angle and trench location.

  18. Supplemental Carbon Dioxide Stabilizes the Upper Airway in Volunteers Anesthetized with Propofol.

    PubMed

    Ruscic, Katarina Jennifer; Bøgh Stokholm, Janne; Patlak, Johann; Deng, Hao; Simons, Jeroen Cedric Peter; Houle, Timothy; Peters, Jürgen; Eikermann, Matthias

    2018-05-10

    Propofol impairs upper airway dilator muscle tone and increases upper airway collapsibility. Preclinical studies show that carbon dioxide decreases propofol-mediated respiratory depression. We studied whether elevation of end-tidal carbon dioxide (PETCO2) via carbon dioxide insufflation reverses the airway collapsibility (primary hypothesis) and impaired genioglossus muscle electromyogram that accompany propofol anesthesia. We present a prespecified, secondary analysis of previously published experiments in 12 volunteers breathing via a high-flow respiratory circuit used to control upper airway pressure under propofol anesthesia at two levels, with the deep level titrated to suppression of motor response. Ventilation, mask pressure, negative pharyngeal pressure, upper airway closing pressure, genioglossus electromyogram, bispectral index, and change in end-expiratory lung volume were measured as a function of elevation of PETCO2 above baseline and depth of propofol anesthesia. PETCO2 augmentation dose-dependently lowered upper airway closing pressure with a decrease of 3.1 cm H2O (95% CI, 2.2 to 3.9; P < 0.001) under deep anesthesia, indicating improved upper airway stability. In parallel, the phasic genioglossus electromyogram increased by 28% (23 to 34; P < 0.001). We found that genioglossus electromyogram activity was a significant modifier of the effect of PETCO2 elevation on closing pressure (P = 0.005 for interaction term). Upper airway collapsibility induced by propofol anesthesia can be reversed in a dose-dependent manner by insufflation of supplemental carbon dioxide. This effect is at least partly mediated by increased genioglossus muscle activity.

  19. Validation of the iHealth BP3 upper-arm blood pressure monitor, for clinic use and self-measurement, according to the European Society of Hypertension International Protocol revision 2010.

    PubMed

    Chen, Can; Shang, Fujun; Wang, Jiepin; Chen, Jianghong; Ji, Na; Wan, Yi

    2012-12-01

    This study aimed to evaluate the performance of the iHealth BP3 upper-arm blood pressure monitor, which is designed for clinic use and self-measurement of blood pressure using Apple touch devices as an interface. The European Society of Hypertension International Protocol (ESH-IP) revision 2010 for the validation of blood pressure measuring devices in adults was followed precisely. Ninty-nine couples of test device and reference blood pressure measurements were obtained during the study (three pairs for each of the 33 participants). The 33 participants, age 47.1±12.3 years (age range 27-69 years) and arm circumference 30.0±4.4 cm, had a mean systolic blood pressure (SBP) of 143.9±27.4 mmHg and a mean diastolic blood pressure (DBP) of 90.1±18.3 mmHg. The device passed all of the requirements fulfilling the standards of the protocol, and the mean±SD device-observer difference was 2.8±4.2 mmHg for SBP and -0.4±3.5 mmHg for DBP. According to the results of the validation study on the basis of the ESH-IP revision 2010, the iHealth BP3 can be recommended for clinic use and self-measurement in an adult population. © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins.

  20. Kinematic MRI study of upper-airway biomechanics using electrical muscle stimulation

    NASA Astrophysics Data System (ADS)

    Brennick, Michael J.; Margulies, Susan S.; Ford, John C.; Gefter, Warren B.; Pack, Allan I.

    1997-05-01

    We have developed a new and powerful method to study the movement and function of upper airway muscles. Our method is to use direct electrical stimulation of individual upper airway muscles, while performing state of the art high resolution magnetic resonance imaging (MRI). We have adapted a paralyzed isolated UA cat model so that positive or negative static pressure in the UA can be controlled at specific levels while electrical muscle stimulation is applied during MRI. With these techniques we can assess the effect of muscle stimulation on airway cross-sectional area compliance and soft tissue motion. We are reporting the preliminary results and MRI techniques which have enabled us to examine changes in airway dimensions which result form electrical stimulation of specific upper airway dilator muscles. The results of this study will be relevant to the development of new clinical treatments for obstructive sleep apnea by providing new information as to exactly how upper airway muscles function to dilate the upper airway and the strength of stimulation required to prevent the airway obstruction when overall muscle tone may not be sufficient to maintain regular breathing.

  1. Bronchovascular anatomy of the upper lobes: evaluation with thin-section CT.

    PubMed

    Lee, K S; Bae, W K; Lee, B H; Kim, I Y; Choi, E W; Lee, B H

    1991-12-01

    The anatomy of the bronchovascular trees of the upper lobes was evaluated with thin-section computed tomography (CT) in 50 patients. In all patients, the subsegmental bronchi could be seen, except the right B2b, left B1 + 2c, and left B3c. Regular anatomic relationships were seen between the right A3b and B3b (A3b was seen along the medial aspect of B3b in 45 patients [90%]), right A2a and B2a (A2a was seen along the posteromedial aspect of B2a in 45 patients [90%]), and left A1 + 2c and B1 + 2c (A1 + 2c was seen along the posterior aspect of B1 + 2c in 41 patients [82%]). Four patterns of bronchial branching were seen in the left upper lobe. The lateral branch of the posterior segmental vein of the upper lobes was an anatomic landmark dividing the anterior and posterior segments of the upper lobes. Three kinds of venous drainage patterns were identified in both the right and left upper lobes.

  2. Advanced Launch Vehicle Upper Stages Using Liquid Propulsion and Metallized Propellants

    NASA Technical Reports Server (NTRS)

    Palaszewski, Bryan A.

    1990-01-01

    Metallized propellants are liquid propellants with a metal additive suspended in a gelled fuel or oxidizer. Typically, aluminum (Al) particles are the metal additive. These propellants provide increase in the density and/or the specific impulse of the propulsion system. Using metallized propellant for volume-and mass-constrained upper stages can deliver modest increases in performance for low earth orbit to geosynchronous earth orbit (LEO-GEO) and other earth orbital transfer missions. Metallized propellants, however, can enable very fast planetary missions with a single-stage upper stage system. Trade studies comparing metallized propellant stage performance with non-metallized upper stages and the Inertial Upper Stage (IUS) are presented. These upper stages are both one- and two-stage vehicles that provide the added energy to send payloads to altitudes and onto trajectories that are unattainable with only the launch vehicle. The stage designs are controlled by the volume and the mass constraints of the Space Transportation System (STS) and Space Transportation System-Cargo (STS-C) launch vehicles. The influences of the density and specific impulse increases enabled by metallized propellants are examined for a variety of different stage and propellant combinations.

  3. Effects of Cadmium and Mercury on the Upper Part of Skeletal Muscle Glycolysis in Mice

    PubMed Central

    Ortega, Fernando; Westerhoff, Hans V.; Gelpí, Josep Lluis; Centelles, Josep J.; Cascante, Marta

    2014-01-01

    The effects of pre-incubation with mercury (Hg2+) and cadmium (Cd2+) on the activities of individual glycolytic enzymes, on the flux and on internal metabolite concentrations of the upper part of glycolysis were investigated in mouse muscle extracts. In the range of metal concentrations analysed we found that only hexokinase and phosphofructokinase, the enzymes that shared the control of the flux, were inhibited by Hg2+ and Cd2+. The concentrations of the internal metabolites glucose-6-phosphate and fructose-6-phosphate did not change significantly when Hg2+ and Cd2+ were added. A mathematical model was constructed to explore the mechanisms of inhibition of Hg2+ and Cd2+ on hexokinase and phosphofructokinase. Equations derived from detailed mechanistic models for each inhibition were fitted to the experimental data. In a concentration-dependent manner these equations describe the observed inhibition of enzyme activity. Under the conditions analysed, the integral model showed that the simultaneous inhibition of hexokinase and phosphofructokinase explains the observation that the concentrations of glucose-6-phosphate and fructose-6-phosphate did not change as the heavy metals decreased the glycolytic flux. PMID:24489641

  4. EMG-Torque correction on Human Upper extremity using Evolutionary Computation

    NASA Astrophysics Data System (ADS)

    JL, Veronica; Parasuraman, S.; Khan, M. K. A. Ahamed; Jeba DSingh, Kingsly

    2016-09-01

    There have been many studies indicating that control system of rehabilitative robot plays an important role in determining the outcome of the therapy process. Existing works have done the prediction of feedback signal in the controller based on the kinematics parameters and EMG readings of upper limb's skeletal system. Kinematics and kinetics based control signal system is developed by reading the output of the sensors such as position sensor, orientation sensor and F/T (Force/Torque) sensor and there readings are to be compared with the preceding measurement to decide on the amount of assistive force. There are also other works that incorporated the kinematics parameters to calculate the kinetics parameters via formulation and pre-defined assumptions. Nevertheless, these types of control signals analyze the movement of the upper limb only based on the movement of the upper joints. They do not anticipate the possibility of muscle plasticity. The focus of the paper is to make use of the kinematics parameters and EMG readings of skeletal system to predict the individual torque of upper extremity's joints. The surface EMG signals are fed into different mathematical models so that these data can be trained through Genetic Algorithm (GA) to find the best correlation between EMG signals and torques acting on the upper limb's joints. The estimated torque attained from the mathematical models is called simulated output. The simulated output will then be compared with the actual individual joint which is calculated based on the real time kinematics parameters of the upper movement of the skeleton when the muscle cells are activated. The findings from this contribution are extended into the development of the active control signal based controller for rehabilitation robot.

  5. A new free-floating planet in the Upper Scorpius association

    NASA Astrophysics Data System (ADS)

    Peña Ramírez, K.; Béjar, V. J. S.; Zapatero Osorio, M. R.

    2016-02-01

    We report on a deep photometric survey covering an area of 1.17 deg2 in the young Upper Scorpius stellar association using VIMOS Iz and UKIDSS ZJHK data that was taken with several years in between. The search for the least massive population of Upper Scorpius (~5-10 Myr, 145 pc) is performed on the basis of various optical and infrared color-color and color-magnitude diagrams, including WISE photometry, in the magnitude interval J = 14.5-19 mag (completeness), which corresponds to substellar masses from 0.028 through 0.004 M⊙ at the age and distance of Upper Scorpius. We also present the proper motion analysis of the photometric candidates, finding that two objects successfully pass all photometric and astrometric criteria for membership in the young stellar association. One of them, USco J155150.2-213457, is a new discovery. We obtained low resolution, near-infrared spectroscopy (R ~ 450, 0.85-2.35 μm) of this new finding using the FIRE instrument. We confirmed its low-gravity atmosphere expected for an Upper Scorpius member (weak alkaline lines, strong VO absorption, peaked H-band pseudocontinuum). By comparison with spectroscopic standards, we derive a spectral type of L6 ± 1, and estimate a mass of ≈0.008-0.010 M⊙ for USco J155150.2-213457. The colors and spectral slope of this object resemble those of other young, cool members of Upper Scorpius and σ Orionis (~3 Myr) and field, high gravity dwarfs of related classification in contrast with the very red indices of field, low gravity, L-type dwarfs of intermediate age. USco J155150.2-213457, which does not show infrared flux excesses up to 4.5 μm, becomes one of the least massive and latest type objects known in the entire Upper Scorpius stellar association.

  6. Upper respiratory tract infection in children, domestic temperatures, and humidity.

    PubMed Central

    Ross, A; Collins, M; Sanders, C

    1990-01-01

    STUDY OBJECTIVE--The aim of the study was to seek for a possible association between the incidence of upper respiratory tract infections and air temperature and humidity in the home. DESIGN--Recordings of temperature and relative humidity were made in living rooms and children's bedrooms over a six month period and related to incidence of upper respiratory tract infection. SETTING--The study was carried out in one general practice of 10,000 patients. PATIENTS--297 children aged 24-59 months were studied, selected in random order from the practice age-sex register. MEASUREMENTS AND MAIN RESULTS--Temperature and humidity recordings were made with thermohygrograph recorders over six days. Upper respiratory tract infections were recorded (a) retrospectively over the previous 12 months, and (b) during the study period. Past history of acute otitis media and recent family history of respiratory infection were also obtained. No significant association was found between the variables, although the bedrooms of children with reported upper respiratory tract infections were cooler overnight than those of non-infected children (mean difference 0.8 degrees C, 95% confidence limits 0.7 degrees C). No association was found between reported or recorded upper respiratory tract infections and age or type of home, family size, level of occupancy, social class, or smoking habits. Only 15 children (5%) were identified by their parents as having had asthma, but 58 (19.5%) had had a "wheezy chest". A greater proportion of children who wheezed slept in cooler bedrooms, had gas fires rather than central heating, and had more smokers in the house. CONCLUSIONS--No association between upper respiratory tract infection and domestic temperature or humidity levels could be shown in this study. Since dampness is repeatedly presented as a health risk, further study is required. PMID:2370503

  7. Upper-extremity phocomelia reexamined: a longitudinal dysplasia.

    PubMed

    Goldfarb, Charles A; Manske, Paul R; Busa, Riccardo; Mills, Janith; Carter, Peter; Ezaki, Marybeth

    2005-12-01

    In contrast to longitudinal deficiencies, phocomelia is considered a transverse, intercalated segmental dysplasia. Most patients demonstrate severe, but not otherwise classifiable, upper-extremity deformities, which usually cannot be placed into one of three previously described phocomelia groups. Additionally, these phocomelic extremities do not demonstrate true segmental deficits; the limb is also abnormal proximal and distal to the segmental defect. The purpose of this investigation was to present evidence that upper-extremity abnormalities in patients previously diagnosed as having phocomelia in fact represent a proximal continuum of radial or ulnar longitudinal dysplasia. The charts and radiographs of forty-one patients (sixty extremities) diagnosed as having upper-extremity phocomelia were reviewed retrospectively. On the basis of the findings on the radiographs, the disorders were categorized into three groups: (1) proximal radial longitudinal dysplasia, which was characterized by an absent proximal part of the humerus, a nearly normal distal part of the humerus, a completely absent radius, and a radial-sided hand dysplasia; (2) proximal ulnar longitudinal dysplasia, characterized by a short one-bone upper extremity that bifurcated distally and by severe hand abnormalities compatible with ulnar dysplasia; and (3) severe combined dysplasia, with type A characterized by an absence of the forearm segment (i.e., the radius and ulna) and type B characterized by absence of the arm and forearm (i.e., the hand attached to the thorax). Twenty-nine limbs in sixteen patients could be classified as having proximal radial longitudinal dysplasia. Systemic medical conditions such as thrombocytopenia-absent radius syndrome were common in those patients, but additional musculoskeletal conditions were rare. Twenty limbs in seventeen patients could be classified as having proximal ulnar longitudinal dysplasia. Associated musculoskeletal abnormalities, such as proximal femoral

  8. Update of the ICUD-SIU consultation on upper tract urothelial carcinoma 2016: treatment of low-risk upper tract urothelial carcinoma.

    PubMed

    Mandalapu, Rao S; Remzi, Mesut; de Reijke, Theo M; Margulis, Vitaly; Palou, J; Kapoor, A; Yossepowitch, Ofer; Coleman, Jonathan; Traxer, Olivier; Anderson, J Kyle; Catto, James; de la Rosette, Jean; O'Brien, Timothy; Zlotta, Anthony; Matin, Surena F

    2017-03-01

    The conservative management of upper tract urothelial carcinoma (UTUC) has historically been offered to patients with imperative indications. The recent International Consultation on Urologic Diseases (ICUD) publication on UTUC stratified treatment allocations based on high- and low-risk groups. This report updates the conservative management of the low-risk group. The ICUD for low-risk UTUC working group performed a thorough review of the literature with an assessment of the level of evidence and grade of recommendation for a variety of published studies in this disease space. We update these publications and provide a summary of that original report. There are no prospective randomized controlled studies to support surgical management guidelines. A risk-stratified approach based on clinical, endoscopic, and biopsy assessment allows selection of patients who could benefit from kidney-preserving procedures with oncological outcomes potentially similar to radical nephroureterectomy with bladder cuff excision, with the added benefit of renal function preservation. These treatments are aided by the development of high-definition flexible digital URS, multi-biopsies with the aid of access sheaths and other tools, and promising developments in the use of adjuvant topical therapy. Recent developments in imaging, minimally invasive techniques, multimodality approaches, and adjuvant topical regimens and bladder cancer prevention raise the hope for improved risk stratification and may greatly improve the endoscopic treatment for low-risk UTUC.

  9. Craniocervical chiropractic procedures – a précis of upper cervical chiropractic

    PubMed Central

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

    2015-01-01

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

  10. Pre-travel health advice-seeking behavior among US international travelers departing from Boston Logan International Airport.

    PubMed

    LaRocque, Regina C; Rao, Sowmya R; Tsibris, Athe; Lawton, Thomas; Barry, M Anita; Marano, Nina; Brunette, Gary; Yanni, Emad; Ryan, Edward T

    2010-01-01

    Globally mobile populations are at higher risk of acquiring geographically restricted infections and may play a role in the international spread of infectious diseases. Despite this, data about sources of health information used by international travelers are limited. We surveyed 1,254 travelers embarking from Boston Logan International Airport regarding sources of health information. We focused our analysis on travelers to low or low-middle income (LLMI) countries, as defined by the World Bank 2009 World Development Report. A total of 476 survey respondents were traveling to LLMI countries. Compared with travelers to upper-middle or high income (UMHI) countries, travelers to LLMI countries were younger, more likely to be foreign-born, and more frequently reported visiting family as the purpose of their trip. Prior to their trips, 46% of these travelers did not pursue health information of any type. In a multivariate analysis, being foreign-born, traveling alone, traveling for less than 14 days, and traveling for vacation each predicted a higher odds of not pursuing health information among travelers to LLMI countries. The most commonly cited reason for not pursuing health information was a lack of concern about health problems related to the trip. Among travelers to LLMI countries who did pursue health information, the internet was the most common source, followed by primary care practitioners. Less than a third of travelers to LLMI countries who sought health information visited a travel medicine specialist. In our study, 46% of travelers to LLMI countries did not seek health advice prior to their trip, largely due to a lack of concern about health issues related to travel. Among travelers who sought medical advice, the internet and primary care providers were the most common sources of information. These results suggest the need for health outreach and education programs targeted at travelers and primary care practitioners. © 2010 International Society of

  11. Mirror therapy enhances upper extremity motor recovery in stroke patients.

    PubMed

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

    2015-12-01

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

  12. Clinical presentation and manual therapy for upper quadrant musculoskeletal conditions

    PubMed Central

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

    2011-01-01

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

  13. Redox state of earth's upper mantle from kimberlitic ilmenites

    NASA Technical Reports Server (NTRS)

    Haggerty, S. E.; Tompkins, L. A.

    1983-01-01

    Temperatures and oxygen fugacities are reported on discrete ilmenite nodules in kimberlites from West Africa which demonstrate that the source region in the upper mantle is moderately oxidized, consistent with other nodule suites in kimberlites from southern Africa and the United States. A model is presented for a variety of tectonic settings, proposing that the upper mantle is profiled in redox potential, oxidized in the fertile asthenosphere but reduced in the depleted lithosphere.

  14. Long term changes in the concentration of radium in discharge waters of coal mines and Upper Silesian rivers.

    PubMed

    Chałupnik, Stanisław; Wysocka, Małgorzata; Janson, Ewa; Chmielewska, Izabela; Wiesner, Marta

    2017-05-01

    According to the latest guidelines of the International Atomic Energy Agency (IAEA, 2016), coal mining is one of the most important contributors to occupational exposure. Coal mining contributes about 45% of the total annual collective dose obtained by workers due to the exposure at places of working. One of the sources of exposure in mining are formation brines with elevated concentrations of natural radionuclides, the most common are radium 226 Ra and 228 Ra. Radium isotopes often occur in formation waters in underground collieries in the Upper Silesian region (USCB) in Poland. Significant amounts of radium remain underground in the form of radioactive deposits created as a result of spontaneous deposition or water treatment. This phenomenon leads to the increase of radiation hazard for miners. The remaining activities of 226 Ra and 228 Ra are released into the rivers with mine effluents, causing the contamination of bottom sediments and river banks. The results of radioactivity monitoring of effluents and river waters are presented here to illustrate a trend of long-term changes in environmental contamination, caused by mining industry in the Upper Silesian Region. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

    PubMed

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

    2015-04-01

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

  16. Concurrent Validity Between a Shared Curriculum, the Internal Medicine In-Training Examination, and the American Board of Internal Medicine Certifying Examination.

    PubMed

    Sisson, Stephen D; Bertram, Amanda; Yeh, Hsin-Chieh

    2015-03-01

    A core objective of residency education is to facilitate learning, and programs need more curricula and assessment tools with demonstrated validity evidence. We sought to demonstrate concurrent validity between performance on a widely shared, ambulatory curriculum (the Johns Hopkins Internal Medicine Curriculum), the Internal Medicine In-Training Examination (IM-ITE), and the American Board of Internal Medicine Certifying Examination (ABIM-CE). A cohort study of 443 postgraduate year (PGY)-3 residents at 22 academic and community hospital internal medicine residency programs using the curriculum through the Johns Hopkins Internet Learning Center (ILC). Total and percentile rank scores on ILC didactic modules were compared with total and percentile rank scores on the IM-ITE and total scores on the ABIM-CE. The average score on didactic modules was 80.1%; the percentile rank was 53.8. The average IM-ITE score was 64.1% with a percentile rank of 54.8. The average score on the ABIM-CE was 464. Scores on the didactic modules, IM-ITE, and ABIM-CE correlated with each other (P < .05). Residents completing greater numbers of didactic modules, regardless of scores, had higher IM-ITE total and percentile rank scores (P < .05). Resident performance on modules covering back pain, hypertension, preoperative evaluation, and upper respiratory tract infection was associated with IM-ITE percentile rank. Performance on a widely shared ambulatory curriculum is associated with performance on the IM-ITE and the ABIM-CE.

  17. Concurrent Validity Between a Shared Curriculum, the Internal Medicine In-Training Examination, and the American Board of Internal Medicine Certifying Examination

    PubMed Central

    Sisson, Stephen D.; Bertram, Amanda; Yeh, Hsin-Chieh

    2015-01-01

    Background A core objective of residency education is to facilitate learning, and programs need more curricula and assessment tools with demonstrated validity evidence. Objective We sought to demonstrate concurrent validity between performance on a widely shared, ambulatory curriculum (the Johns Hopkins Internal Medicine Curriculum), the Internal Medicine In-Training Examination (IM-ITE), and the American Board of Internal Medicine Certifying Examination (ABIM-CE). Methods A cohort study of 443 postgraduate year (PGY)-3 residents at 22 academic and community hospital internal medicine residency programs using the curriculum through the Johns Hopkins Internet Learning Center (ILC). Total and percentile rank scores on ILC didactic modules were compared with total and percentile rank scores on the IM-ITE and total scores on the ABIM-CE. Results The average score on didactic modules was 80.1%; the percentile rank was 53.8. The average IM-ITE score was 64.1% with a percentile rank of 54.8. The average score on the ABIM-CE was 464. Scores on the didactic modules, IM-ITE, and ABIM-CE correlated with each other (P < .05). Residents completing greater numbers of didactic modules, regardless of scores, had higher IM-ITE total and percentile rank scores (P < .05). Resident performance on modules covering back pain, hypertension, preoperative evaluation, and upper respiratory tract infection was associated with IM-ITE percentile rank. Conclusions Performance on a widely shared ambulatory curriculum is associated with performance on the IM-ITE and the ABIM-CE. PMID:26217421

  18. TMI-2 upper-core particle bed thermal behavior

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

    Kuan, P.

    1987-08-01

    Models of dryout heat fluxes of particle beds believed to be applicable to the TMI-2 upper-core particle bed are reviewed and developed. A simplified Lipinski model and a model based on flooding are shown to agree between themselves and with experiments. These models are applied to the calculation of the dryout heat flux of the TMI-2 upper-core particle bed. The TMI-2 upper-core particle bed is shown to be: (a) coolable, if little heat is transferred to it from the consolidated region below, (b) only marginally coolable, if not uncoolable, before material relocation from the consolidated region, if most of themore » heat in the consolidiated region is transferred to it, and (c) coolable, after the relocation, regardless of heat transfer from the remaining consolidated region. Based on an analogy to quenching experiments, which show that the heat flux during the quench of a particle bed is approximately equal to the dryout heat flux, the time required to quench the TMI-2 upper-core particle bed from 2000 K to the saturation temperature of water during the accident is estimated. The bed was either quenched by 225 min after the initiation of the accident (assuming no heat was transferred to it from the consolidated region) or, at the latest, by 245 min (20 min after molten material relocation to the lower plenum from the consolidated region; assuming most of the heat generated in the consolidated region, both before and after the relocation, was transferred to the particle bed).« less

  19. Disorders of Upper Limb Movements in Ataxia-Telangiectasia.

    PubMed

    Shaikh, Aasef G; Zee, David S; Mandir, Allen S; Lederman, Howard M; Crawford, Thomas O

    2013-01-01

    Ataxia-telangiectasia is known for cerebellar degeneration, but clinical descriptions of abnormal tone, posture, and movements suggest involvement of the network between cerebellum and basal ganglia. We quantitatively assessed the nature of upper-limb movement disorders in ataxia-telangiectasia. We used a three-axis accelerometer to assess the natural history and severity of abnormal upper-limb movements in 80 ataxia-telangiectasia and 19 healthy subjects. Recordings were made during goal-directed movements of upper limb (kinetic task), while arms were outstretched (postural task), and at rest. Almost all ataxia-telangiectasia subjects (79/80) had abnormal involuntary movements, such as rhythmic oscillations (tremor), slow drifts (dystonia or athetosis), and isolated rapid movements (dystonic jerks or myoclonus). All patients with involuntary movements had both kinetic and postural tremor, while 48 (61%) also had resting tremor. The tremor was present in transient episodes lasting several seconds during two-minute recording sessions of all three conditions. Percent time during which episodic tremor was present was greater for postural and kinetic tasks compared to rest. Resting tremor had higher frequency but smaller amplitude than postural and kinetic tremor. Rapid non-rhythmic movements were minimal during rest, but were triggered during sustained arm postures and goal directed arm movements suggesting they are best considered a form of dystonic jerks or action myoclonus. Advancing age did not correlate with the severity of involuntary limb movements. Abnormal upper-limb movements in ataxia-telangiectasia feature classic cerebellar impairment, but also suggest involvement of the network between the cerebellum and basal ganglia.

  20. Disorders of Upper Limb Movements in Ataxia-Telangiectasia

    PubMed Central

    Shaikh, Aasef G.; Zee, David S.; Mandir, Allen S.; Lederman, Howard M.; Crawford, Thomas O.

    2013-01-01

    Ataxia-telangiectasia is known for cerebellar degeneration, but clinical descriptions of abnormal tone, posture, and movements suggest involvement of the network between cerebellum and basal ganglia. We quantitatively assessed the nature of upper-limb movement disorders in ataxia-telangiectasia. We used a three-axis accelerometer to assess the natural history and severity of abnormal upper-limb movements in 80 ataxia-telangiectasia and 19 healthy subjects. Recordings were made during goal-directed movements of upper limb (kinetic task), while arms were outstretched (postural task), and at rest. Almost all ataxia-telangiectasia subjects (79/80) had abnormal involuntary movements, such as rhythmic oscillations (tremor), slow drifts (dystonia or athetosis), and isolated rapid movements (dystonic jerks or myoclonus). All patients with involuntary movements had both kinetic and postural tremor, while 48 (61%) also had resting tremor. The tremor was present in transient episodes lasting several seconds during two-minute recording sessions of all three conditions. Percent time during which episodic tremor was present was greater for postural and kinetic tasks compared to rest. Resting tremor had higher frequency but smaller amplitude than postural and kinetic tremor. Rapid non-rhythmic movements were minimal during rest, but were triggered during sustained arm postures and goal directed arm movements suggesting they are best considered a form of dystonic jerks or action myoclonus. Advancing age did not correlate with the severity of involuntary limb movements. Abnormal upper-limb movements in ataxia-telangiectasia feature classic cerebellar impairment, but also suggest involvement of the network between the cerebellum and basal ganglia. PMID:23826191