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Sample records for liver support system

  1. [Liver support systems today].

    PubMed

    Rikker, Csaba

    2009-12-20

    Liver failure carries a high mortality, both the acute type with no pre-existing liver disease (acute liver failure) and the acute decompensation superimposed on a chronic liver disorder (acute on chronic liver failure). Today, liver transplantation still represents the only curative treatment for liver failure due to end-stage liver diseases. Donor organ shortage is still the major limitation and many patients die while awaiting transplantation. Due to the scarcity of donor organs, liver support technologies are being developed to support patients with severe liver failure until either an organ becomes available for transplantation or their livers recover from injury. Early devices including hemodialysis, hemoperfusion, exchange transfusion, cross-hemodialysis, cross-circulation and plasmapheresis appeared inefficient. In the present day, liver support systems' designs fall into two main categories: cell-based, so-called bioartificial and non-cell-based, also known as artificial systems. Bioartificial liver support systems use either porcine hepatocytes or human hepatoma cell lines housed within a hollow-fiber bioreactor. The system perfuses the patient's whole blood or separated plasma through the luminal space in the bioreactor. Theoretically, these methods should optimally resemble normal hepatic tissue structure and function. However, the existing bioartificial systems are far from ideal solution in terms of immunological, infectological, oncological and financial problems and must still be thought of as experimental. The artificial systems are already available for the clinicians in limited quantities. These non-cell-based devices are intended to remove protein-bound and water-soluble toxins without providing synthetic function, which can be partially replaced with substitution of the failing substances (plasma proteins, coagulation factors). These systems include the hemodiabsorption (Liver Dialysis Unit) which is commercially available in the United States

  2. Liver support systems.

    PubMed

    Santoro, Antonio; Mancini, Elena; Ferramosca, Emiliana; Faenza, Stefano

    2007-01-01

    Liver insufficiency is a dramatic syndrome with multiple organ involvement. A multiplicity of toxic substances (hydrophilic like ammonia and lipophilic like bilirubin or bile acids or mercaptans) are released into the systemic circulation, thus altering many enzymatic cellular processes. Patients frequently die while on the transplantation waiting list because of organ scarcity. Systems supporting liver function may be useful to avoid further complications due to the typical toxic state, 'bridging' the patients to the transplantation, or, in the event of an acute decompensation of a chronic liver disease, sustain liver function long enough to permit the organ's regeneration and functional recovery. An ideal liver support system should substitute the main functions of the liver (detoxification, synthesis and regulation). Extracorporeal systems now available may be totally artificial or bioartificial. While the first are only able to perform detoxification, the second may add the functions of synthesis (plasma proteins, coagulation factors) and regulation (neurotransmitters). Bioartificial liver working with isolated hepatocytes and a synthetic membrane in an extracorporeal system are however still far from being ready for clinical use. At present, liver insufficiency may be treated with an extracorporeal support technology aimed either at detoxification alone or at a real purification. Charcoal hemoperfusion or exchange/absorption resins may be used for blood detoxification. Blood or plasma exchange, from a theoretical point of view, could be suitable for a polyvalent intoxication, such as liver failure; however, the multicompartmental distribution of some solutes largely endangers the efficacy of these procedures. Selective plasmapheresis techniques are now available for some solutes (e.g. styrene for bilirubin) and may progressively reduce the plasma levels and presumably the deposits of the solute. Novel treatments introduced to improve detoxification, mainly of

  3. Liver support systems: promise and reality.

    PubMed

    Wigg, Alan J; Padbury, Robert T

    2005-12-01

    Effective liver support is needed for a variety of indications. A large number of both biological (containing hepatocytes) and non-biological extracorporeal liver support systems have been described in the literature over the last 50 years. Despite this, there is a paucity of good quality randomized control data examining the effectiveness of these therapies in human liver failure. In this review article, we examine the available data, with particular emphasis on the current front runners, the MARS and HepatAssist systems. Other problems associated with the development of these liver support systems are also discussed. Although promising in animal studies, we conclude that the use of these technologies is not supported currently by a sufficient evidence base to recommend them for routine clinical use and that a lack of understanding about the critical functions required of a liver support system is retarding a more rational approach to the design of these systems.

  4. Cell sources, liver support systems and liver tissue engineering: alternatives to liver transplantation.

    PubMed

    Lee, Soo Young; Kim, Han Joon; Choi, Dongho

    2015-05-01

    The liver is the largest organ in the body; it has a complex architecture, wide range of functions and unique regenerative capacity. The growing incidence of liver diseases worldwide requires increased numbers of liver transplant and leads to an ongoing shortage of donor livers. To meet the huge demand, various alternative approaches are being investigated including, hepatic cell transplantation, artificial devices and bioprinting of the organ itself. Adult hepatocytes are the preferred cell sources, but they have limited availability, are difficult to isolate, propagate poor and undergo rapid functional deterioration in vitro. There have been efforts to overcome these drawbacks; by improving culture condition for hepatocytes, providing adequate extracellular matrix, co-culturing with extra-parenchymal cells and identifying other cell sources. Differentiation of human stem cells to hepatocytes has become a major interest in the field of stem cell research and has progressed greatly. At the same time, use of decellularized organ matrices and 3 D printing are emerging cutting-edge technologies for tissue engineering, opening up new paths for liver regenerative medicine. This review provides a compact summary of the issues, and the locations of liver support systems and tissue engineering, with an emphasis on reproducible and useful sources of hepatocytes including various candidates formed by differentiation from stem cells.

  5. Cell Sources, Liver Support Systems and Liver Tissue Engineering: Alternatives to Liver Transplantation

    PubMed Central

    Lee, Soo Young; Kim, Han Joon; Choi, Dongho

    2015-01-01

    The liver is the largest organ in the body; it has a complex architecture, wide range of functions and unique regenerative capacity. The growing incidence of liver diseases worldwide requires increased numbers of liver transplant and leads to an ongoing shortage of donor livers. To meet the huge demand, various alternative approaches are being investigated including, hepatic cell transplantation, artificial devices and bioprinting of the organ itself. Adult hepatocytes are the preferred cell sources, but they have limited availability, are difficult to isolate, propagate poor and undergo rapid functional deterioration in vitro. There have been efforts to overcome these drawbacks; by improving culture condition for hepatocytes, providing adequate extracellular matrix, co-culturing with extra-parenchymal cells and identifying other cell sources. Differentiation of human stem cells to hepatocytes has become a major interest in the field of stem cell research and has progressed greatly. At the same time, use of decellularized organ matrices and 3 D printing are emerging cutting-edge technologies for tissue engineering, opening up new paths for liver regenerative medicine. This review provides a compact summary of the issues, and the locations of liver support systems and tissue engineering, with an emphasis on reproducible and useful sources of hepatocytes including various candidates formed by differentiation from stem cells. PMID:26019753

  6. [Establishment and significance of an extracorporeal bioartificial liver support system].

    PubMed

    Wang, Y; Wang, Y; Li, M

    1997-10-01

    This experiment was carried out to establish an optimal extracorporeal bioartificial liver support system (EBLSS) and furnish a new therapy for hepatic failure. For this purpose, human hepatocytes were isolated by two-stage perfusion method and cultured by spheroidal aggregates method. Besides, hollow fiber tube was used as bioreactor and the hemodialysis instrument was refited to serve as supplementary circulation unit, which was composed of EBLSS and was tried in normal dogs. A total of 2 x 10(10) human hepatocytes with a viability of 94% was obtained. These hepatocytes became multicellular spheroidal aggregates under non-adherent conditions. After 5 hours circulating on EBLSS, the hepatocytes remained active. At the same time, the monitoring system revealed a normal vital sign in dogs and the laboratory tests found their serum total protein and albumin were increased. These results show that the key technology of bioartificial liver has been dereloped basically and this EBLSS is effective and safe, providing a foundation for the support and treatment of hepatic failure with bioartificial liver.

  7. Construction of devices in bioartificial liver support system.

    PubMed

    Liu, Jianfeng; Li, Ming; Yang, Wei; Lou, Hanfen

    2005-01-01

    An automatic control device in Bioartificial Liver Support System is designed and implemented. Details of the hardware structure, design of the control system and the applied software in the device are described. Main controller uses the WS-843AW industrial control computer; precision electromagnetic valves are selected as implements to control the flux of three-gases (oxygen, carbon dioxide and nitrogen). The interconnected rule of controlled parameters in the system is analysed, and then matched by the mass balance equation. By a series of logic judgements of signals from sensors and direct digital calculations (DDC), a simple proportional plus integral (PI) controller can firstly manipulate the operations of electromagnetic valves, and then the on-line and off-line predictive control algorithm is used in accordance with practical experience to meet the requirements of the parameters in the culture and metabolism of hepatocytes. Software based on Visual C++ is implemented. All these serve to ensure high operational reliability, expansibility and better maneuverability of the whole system. Experiments show that this method can achieve sound performances in practice although there exist very strong coupling, dead-delay and lots of non-linear factors in the bioreactor. The controlling range is: Dissolved Oxygen 0-200±5%; pH 6-8±0.05pH; Temperature 20-45±0.1°C. The device can work in a steady state, and the control precision is high. It can meet the needs in the Bioartificial Liver Support System, and hopefully improve clinical therapeutic effect.

  8. Prometheus system: a technological support in liver failure.

    PubMed

    Santoro, A; Faenza, S; Mancini, E; Ferramosca, E; Grammatico, F; Zucchelli, A; Facchini, M G; Pinna, A D

    2006-05-01

    The Prometheus system is a plasma filtration treatment coupling adsorption and hemodialysis (FPSA) aimed to blood purification in liver failure. After separation through an albumin-permeable membrane, plasma enters a secondary circuit where protein-bound toxic substances are removed by two adsorbers; p01, a neutral resin, and p02, an anion exchanger. Plasma is then returned to the venous line, where a high-flux hemodialyzer removes water-soluble substances. We used the Prometheus system in 12 patients with acute or acute-on-chronic liver insufficiency: eight cirrhosis, one posttransplant dysfunction, and three secondary liver insult (two cardiogenic shock and one rhabdomyolysis). All patients were severely hyperbilirubinemic, hypercholemic, and hyperammonemic. Twenty-eight sessions each lasting 340 +/- 40 minutes were performed (2.5/patient). The mean total bilirubin decreased from 33.6 +/- 20 to 22.2 +/- 13.6 mg/dL (P < .001); the reduction ratios for cholic acid and ammonia were 48.6% and 51.6%, respectively. The pre- to postsession urea reduction was 57.6% +/- 9.5% and creatinine 42.7% +/- 10%. A significant reduction was observed in the circulating levels of soluble interleukin (IL) 2 receptor (pre: 2687.2 +/- 1434.7; post: 1977.1 +/- 602 Ul/ml; P < .001) and in IL 6 (pre: 56.1 +/- 11.1; post: 35.9 +/- 10.3 pg/mL, P = .05). During treatments the hemodynamics were stable. Two patients received liver transplantations. The secondary liver insult was completely overcome in all three patients. The overall survival at 30 days was 41.6% (5/12 patients). Prometheus, based on FPSA, produced high clearance for protein-bound and water soluble markers, which resulted in high treatment efficacy.

  9. [Extracorporeal liver support of liver failure].

    PubMed

    Gerth, Hans Ulrich; Pohlen, Michele; Pavenstädt, Hermann; Schmidt, Hartmut

    2017-03-14

    Extracorporeal liver support can be classified into cell-free, artificial methods (artificial liver support, ALS) and cell-based bioartificial methods (bioartificial liver support, BLS). ALS improves biochemical parameters of liver failure by the simultaneous removal of protein-bound and water-soluble substances. Here, the MARS therapy belongs to the most studied methods with a proved beneficial effect on hepatic encephalopathy (HE), hepatorenal syndrome (HRS) or hyperbilirubinemia. However, a general survival advantage of any liver support for liver failure has not been shown yet and is restricted to meta-analyses or patient subgroups. There are no prospective randomized studies on the treatment of liver failure by intoxication. However, several case series report positive treatment effects using the MARS system, particularly in mushroom poisoning or acetaminophen intoxication. In acute liver failure (ALF) studies, the usage of BLS showed no survival advantage. Using ALS systems, a positive effect on mortality could be demonstrated in patient subgroups after several consecutive MARS therapies. The first randomized controlled trial demonstrating a survival benefit used large-volume plasmapheresis. Apparently, immunomodulatory and hemodynamic effects of the treatment play a crucial role in this context. In patients with acute-on-chronic liver failure (ACLF) accompanied by hyperbilirubinemia without any further organ failure (singular hepatic dysfunction), prognostic favorable effects by using a BLS system have been shown. However, once other extrahepatic organ systems are affected, indicating a progressive transition to multi-organ failure, a survival advantage could be achieved with the MARS and Prometheus system. Decisive for a successful therapy is the exact indication of the respective liver dialysis procedure for this very heterogeneous disease. Future studies are needed to define more accurate patient selection criteria for each liver support.

  10. Propylthiouracil-induced liver failure and artificial liver support systems: a case report and review of the literature

    PubMed Central

    Wu, Dong-Bo; Chen, En-Qiang; Bai, Lang; Tang, Hong

    2017-01-01

    Background Antithyroid drugs carry a potential risk of hepatotoxicity. Propylthiouracil (PTU) is commonly prescribed for patients with hyperthyroidism. PTU, however, can induce liver injury, ranging from mild asymptomatic elevation of aminotransferases to acute liver failure (ALF). Case presentation This case reports on a 16-year-old Chinese girl with hyperthyroidism, who was admitted to our hospital for jaundice, nausea, and fatigue associated with severe hyperbilirubinemia and coagulopathy. She had been prescribed PTU 5 months earlier. There was no history of hypersensitivity to drugs, viral liver diseases, blood transfusion, or surgery. On the basis of her symptoms and the clinical data, she was diagnosed with PTU-induced ALF. Due to the limited number of available donor organs for liver transplantation, she was started on treatment with artificial liver support system (ALSS). After four sessions of ALSS, her clinical signs and symptoms were found to be markedly improved, and she was discharged 25 days after admission. Four months later, her liver function normalized. Conclusion Although PTU-induced liver failure is rare in clinical practice, liver function should be appropriately monitored during treatment with PTU. PTU-induced ALF in this patient was successfully managed with an ALSS, suggesting that the latter may be an alternative to liver transplantation. PMID:28138249

  11. Clinical translation of bioartificial liver support systems with human pluripotent stem cell-derived hepatic cells

    PubMed Central

    Sakiyama, Ryoichi; Blau, Brandon J; Miki, Toshio

    2017-01-01

    There is currently a pressing need for alternative therapies to liver transplantation. The number of patients waiting for a liver transplant is substantially higher than the number of transplantable donor livers, resulting in a long waiting time and a high waiting list mortality. An extracorporeal liver support system is one possible approach to overcome this problem. However, the ideal cell source for developing bioartificial liver (BAL) support systems has yet to be determined. Recent advancements in stem cell technology allow researchers to generate highly functional hepatocyte-like cells from human pluripotent stem cells (hPSCs). In this mini-review, we summarize previous clinical trials with different BAL systems, and discuss advantages of and potential obstacles to utilizing hPSC-derived hepatic cells in clinical-scale BAL systems. PMID:28373763

  12. Extracorporeal liver support-albumin dialysis with the Molecular Adsorbent Recirculating System (MARS).

    PubMed

    Mitzner, Steffen R

    2011-05-01

    Extracorporeal liver support has been a much studied topic throughout the last 50 years. Albumin dialysis as a therapeutic option for patients with acute liver failure or acute decompensation of chronic liver disease was introduced in the mid-nineties. The Molecular Adsorbent Recirculating System (MARS) is based on the concept of albumin dialysis and allows for the removal of protein-bound as well as water-soluble toxins. Besides its role as a sufficient volume expander human serum albumin is an important scavenger for molecules with pathophysiological relevance in liver failure. Albumin dialysis enables the selective regeneration of patient's albumin resulting in an increase of albumin binding capacity. Clinically, an improvement of central and local hemodynamics as well as liver-, brain-, and kidney-functions were observed. Thus, the treatment can contribute to liver regeneration and stabilization of vital organ functions and thus help to bridge patients to liver transplantation or to recovery of native liver function. Proper patient selection is critical for clinical success. Aggressive treatment of infections and sepsis seems to be a decisive pre-requisite for its safe and efficient use. Cautious anticoagulation with heparin is the common standard. Citrate use is recommended for patients prone to bleeding. Today, albumin dialysis MARS is among the best studied liver support methods. It appears as a valuable therapeutic tool for the treatment of various complications of of liver failure, especially hemodynamic instability and hepatic encephalopathy. Further studies will need to help defining the optimal patient selection and technical process parameters such as session length and frequency of treatment.

  13. The role of molecular adsorbent recirculating system dialysis for extracorporeal liver support in children.

    PubMed

    Schaefer, Betti; Schmitt, Claus Peter

    2013-09-01

    The majority of children with acute, acute-on-chronic, and progressive chronic liver failure require liver transplantation. Since organ availability is limited, extracorporeal liver support systems are increasingly applied to bridge the time until transplantation. At present, four different devices are available: the molecular adsorbent recirculating system (MARS), Prometheus dialysis, plasma exchange combined with hemodialysis (PE/HD), and single-pass albumin dialysis (SPAD). Randomized trials in adults have demonstrated efficient toxin removal, improved portal hypertension, hemodynamic stability, and improved hepatic encephalopathy compared with standard medical therapy. None of the liver support systems has yet been evaluated systematically in children. Knowledge of the specific indications and technical features of the different devices is essential if applied in children. MARS combines albumin dialysis with conventional hemodialysis and allows for efficient removal of water and protein-bound toxins without exogenous protein delivery and the associated infectious and allergic risks. It has successfully been applied in children with otherwise intractable cholestatic pruritus and with liver failure. The benefits, however, need to be balanced against the costs and the risk of volume and nitrogen overload if repeated plasma infusion is required. In cases of active bleeding, plasma exchange in combination with hemodialysis should be preferred.

  14. Removal of bile acids by two different extracorporeal liver support systems in acute-on-chronic liver failure.

    PubMed

    Stadlbauer, Vanessa; Krisper, Peter; Beuers, Ulrich; Haditsch, Bernd; Schneditz, Daniel; Jung, Aleksandra; Putz-Bankuti, Csilla; Holzer, Herwig; Trauner, Michael; Stauber, Rudolf E

    2007-01-01

    Acute-on-chronic liver failure (ACLF) is accompanied by marked intrahepatic cholestasis leading to accumulation of cytotoxic bile acids. Extracorporeal liver support systems efficiently remove bile acids, but their effect on bile acid composition in ACLF is unknown. The aim of the present study was to compare elimination of individual plasma bile acids by albumin dialysis (Molecular Adsorbents Recirculating System, MARS) and fractionated plasma separation (Prometheus). Eight consecutive patients with ACLF underwent alternating 6-hour sessions with MARS or Prometheus in a randomized, cross-over design. Serum samples were obtained before, during, and after each treatment, and individual bile acids including cholic acid and chenodeoxycholic acid (CDCA) were measured by gas chromatography. MARS and Prometheus removed total bile acids to a similar extent (reduction ratio, 45% and 46%, respectively). Both devices cleared cholic acid more efficiently than did CDCA. The molar fraction of CDCA (fCDCA) was elevated at baseline and correlated with the degree of liver dysfunction. Prometheus but not MARS treatments further increased fCDCA. Although both devices eliminate total bile acids to a similar extent, clearance of individual bile acids is different, leading to a slight change of the bile acid profile toward hydrophobic bile acids during Prometheus treatments.

  15. The molecular adsorbent recirculating system as a liver support system: summary of Mexican experience.

    PubMed

    Cisneros-Garza, Laura Esthela; Muñoz-Ramírez, Ma del Rosario; Muñoz-Espinoza, Linda Elsa; Ruiz Velasco, José Antonio Velarde; Moreno-Alcántar, Rosalba; Marín-López, Eduardo; Méndez-Sánchez, Nahum

    2014-01-01

    The aim of this study was to assess the effects of the molecular absorbent recirculating system (MARS) on patients with acute liver failure (ALF) and liver failure with cirrhosis (AoCLF) as well as in cholestatic patients with intractable pruritus in a Mexican population. From August 2003 to December 2011, MARS was used in 38 patients with ALF, 15 patients with AoCLF, and 17 cholestatic patients with intractable pruritus. The patients were examined using a standard liver function test and for vital signs, presence of ascites and encephalopathy before and after each treatment. The therapeutic response, patient status, follow-up status, and need for liver transplantation were determined. Seventy-nine MARS procedures were performed. MARS was used for ALF in 54.3% of patients, AoCLF in 24.2%, and cholestatic disease in 21.5%. There were significant improvements in serum bilirubin (p = 0.000), aspartate aminotransferase (p = 0.000), alanine aminotransferase (p = 0.030), gamma-glytamyl transpeptidase (p = 0.044), alkaline phosphatase (p = 0.006), and encephalopathy grade (p = 0.000). Thirty-eight ALF patients were listed for emergency liver transplantation and treated with MARS; 20 of these patients died on a waiting list, 18 survived. only four underwent liver transplantation and 14 (37%) recovered without transplantation after the MARS procedure. MARS is a safe and effective procedure, especially for ALF patients. Our results suggest that MARS therapy can contribute to native liver recovery in ALF patients.

  16. Proteomic analysis of proteins bound to adsorption units of extracorporeal liver support system under clinical conditions.

    PubMed

    Mares, Jan; Thongboonkerd, Visith; Tuma, Zdenek; Moravec, Jiri; Karvunidis, Thomas; Matejovic, Martin

    2009-04-01

    Fractionated Plasma Separation, Adsorption and Dialysis (Prometheus) has a well-documented capacity to remove protein-bound organic toxins in patients with liver failure. However, the compositions of adsorbed proteins remain unknown. Elution of both adsorbers constituting Prometheus system was performed following a 6-h session in a patient with acute on chronic liver failure. Sodium dodecylsulphate was employed to elute proteins from the neutral adsorber (P1), while acetic acid was applied to the cationic one (P2). Eluted proteins were resolved by two-dimensional gel electrophoresis (2-DE) and identified by mass spectrometry (MS). Totally, 4113 and 8280 mg of proteins were obtained from P1 and P2 eluates, 2-DE yielded 148 and 163 protein fractions in P1 and P2, respectively. MS identified 18 unique proteins in P1, and 30 unique proteins in P2 sample. Proteins with the highest selective adsorption (as determined by eluate to plasma ratio) included transthyretin (37), trypsin-2 (29), prothrombin (23), hyaluronan-binding protein 2 (13) and plasma retinol-binding protein (8.7), all of which adsorbed to P2. We identified a large number of proteins removed by extracorporeal liver support system. A selective adsorption was demonstrated in a subset of proteins depending on the type of adsorber and proteins' characteristics.

  17. Albumin dialysis in artificial liver support systems: open-loop or closed-loop dialysis mode?

    PubMed

    Pei, Yingying; Sun, Yize; Sun, Sijie; Gao, Dayong; Ding, Weiping

    2015-01-01

    In artificial liver support systems, the open-loop albumin dialysis mode (OLM) is usually used to remove protein-bound toxins from the blood of patients with liver failure. However, there is still interest in the closed-loop albumin dialysis mode (CLM) because this mode may enable not only the regeneration and reuse of albumin but also the miniaturization of artificial liver systems. In this article, we compared the two modes under a fixed amount of albumin in dialysate experimentally and theoretically. The results show that according to the detoxification efficiency in the 3 hour dialysis for removing albumin-bound bilirubin, CLM is better than OLM. The usage efficiency of albumin in CLM is also higher. Moreover, the advantage of CLM is more significant when the concentration of bilirubin in blood is lower. Under a given amount of albumin in dialysate, if the concentration of bilirubin in blood is high, one may further increase the performance of CLM by means of increasing the flow rate of the albumin dialysate or using the highly concentrated albumin dialysate.

  18. Development of a Support Vector Machine - Based Image Analysis System for Focal Liver Lesions Classification in Magnetic Resonance Images

    NASA Astrophysics Data System (ADS)

    Gatos, I.; Tsantis, S.; Karamesini, M.; Skouroliakou, A.; Kagadis, G.

    2015-09-01

    Purpose: The design and implementation of a computer-based image analysis system employing the support vector machine (SVM) classifier system for the classification of Focal Liver Lesions (FLLs) on routine non-enhanced, T2-weighted Magnetic Resonance (MR) images. Materials and Methods: The study comprised 92 patients; each one of them has undergone MRI performed on a Magnetom Concerto (Siemens). Typical signs on dynamic contrast-enhanced MRI and biopsies were employed towards a three class categorization of the 92 cases: 40-benign FLLs, 25-Hepatocellular Carcinomas (HCC) within Cirrhotic liver parenchyma and 27-liver metastases from Non-Cirrhotic liver. Prior to FLLs classification an automated lesion segmentation algorithm based on Marcov Random Fields was employed in order to acquire each FLL Region of Interest. 42 texture features derived from the gray-level histogram, co-occurrence and run-length matrices and 12 morphological features were obtained from each lesion. Stepwise multi-linear regression analysis was utilized to avoid feature redundancy leading to a feature subset that fed the multiclass SVM classifier designed for lesion classification. SVM System evaluation was performed by means of leave-one-out method and ROC analysis. Results: Maximum accuracy for all three classes (90.0%) was obtained by means of the Radial Basis Kernel Function and three textural features (Inverse- Different-Moment, Sum-Variance and Long-Run-Emphasis) that describe lesion's contrast, variability and shape complexity. Sensitivity values for the three classes were 92.5%, 81.5% and 96.2% respectively, whereas specificity values were 94.2%, 95.3% and 95.5%. The AUC value achieved for the selected subset was 0.89 with 0.81 - 0.94 confidence interval. Conclusion: The proposed SVM system exhibit promising results that could be utilized as a second opinion tool to the radiologist in order to decrease the time/cost of diagnosis and the need for patients to undergo invasive examination.

  19. Effect of extracorporeal liver support by molecular adsorbents recirculating system and Prometheus on redox state of albumin in acute-on-chronic liver failure.

    PubMed

    Oettl, Karl; Stadlbauer, Vanessa; Krisper, Peter; Stauber, Rudolf E

    2009-10-01

    Oxidative stress is believed to play an important role in acute-on-chronic liver failure (AoCLF). Albumin, an important transport vehicle, was found to be severely oxidized in AoCLF patients. Extracorporeal liver support systems may exert beneficial effects in AoCLF via removal of albumin-bound toxins. At present, two systems are commercially available, the molecular adsorbents recirculating system (MARS) and fractionated plasma separation, adsorption and dialysis (FPAD, also known as Prometheus). The aim of this study was to compare the effect of MARS and Prometheus treatments on the redox state of human serum albumin. Eight patients with AoCLF underwent alternating treatments with either MARS or Prometheus in a randomized cross-over design. Sixteen treatments (eight MARS and eight Prometheus) were available for analysis. The fraction of human mercaptalbumin (HMA), human nonmercaptalbumin-1 (HNA1), and human nonmercaptalbumin-2 (HNA2) were measured before and after single MARS and Prometheus treatments and during follow-up. In AoCLF patients the oxidized fractions of albumin, HNA1, and HNA2 were markedly increased. Both MARS and Prometheus treatments resulted in a shift of HNA1 to HMA, while HNA2 was not significantly affected. This shift in albumin fractions was transient and disappeared within 24 h after treatment. There were no significant differences between MARS and Prometheus treatments with respect to the redox state of albumin. Both MARS and Prometheus treatments lead to transient improvements of the redox state of albumin, which could be beneficial in the treatment of AoCLF.

  20. A novel personal health system with integrated decision support and guidance for the management of chronic liver disease.

    PubMed

    Kiefer, Stephan; Schäfer, Michael; Bransch, Marco; Brimmers, Peter; Bartolomé, Diego; Baños, Janie; Orr, James; Jones, Dave; Jara, Maximilian; Stockmann, Martin

    2014-01-01

    A personal health system platform for the management of patients with chronic liver disease that incorporates a novel approach to integrate decision support and guidance through care pathways for patients and their doctors is presented in this paper. The personal health system incorporates an integrated decision support engine that guides patients and doctors through the management of the disease by issuing tasks and providing recommendations to both the care team and the patient and by controlling the execution of a Care Flow Plan based on the results of tasks and the monitored health status of the patient. This Care Flow Plan represents a formal, business process based model of disease management designed off-line by domain experts on the basis of clinical guidelines, knowledge of care pathways and an organisational model for integrated, patient-centred care. In this way, remote monitoring and treatment are dynamically adapted to the patient's actual condition and clinical symptoms and allow flexible delivery of care with close integration of specialists, therapists and care-givers.

  1. Personal view: current role of artificial liver support devices.

    PubMed

    O'Grady, J

    2006-06-01

    Enthusiasm for liver support devices, particularly cell-based biological systems and albumin dialysis, increased over the last decade and there has been considerable clinical activity both within and without the construct of clinical trials. Most data have been generated on patients with acute liver failure or in patients with decompensation of chronic liver disease, often referred to as acute-on-chronic liver failure. In acute liver failure liver, liver support devices are more realistically being used as a 'bridge' to liver transplantation rather than to transplant-free survival. In acute-on-chronic liver failure the clinical objective of attaining clinical stability with treatment appears more achievable. The so-called bioartificial liver device, based on porcine hepatocytes, is the most extensively evaluated biological device. A sizeable clinical trial failed to demonstrate efficacy, but secondary analyses suggest it would be unwise to assume futility had been established with this device. Molecular adsorbent recirculating system leads the way in the non-biological category in terms of the number of patients treated, but data from large clinical trials are not yet available. One of the strongest conclusions of this review is that the amount of high-quality data available on liver support devices dramatically understates the effort and money that have been expended in their assessment. It is very clear that randomized controlled trials are mandatory to establish clinical efficacy, but it is less clear how the ideal trial should be constructed.

  2. Nutritional support for liver disease.

    PubMed

    Koretz, Ronald L; Avenell, Alison; Lipman, Timothy O

    2012-05-16

    Weight loss and muscle wasting are commonly found in patients with end-stage liver disease. Since there is an association between malnutrition and poor clinical outcome, such patients (or those at risk of becoming malnourished) are often given parenteral nutrition, enteral nutrition, or oral nutritional supplements. These interventions have costs and adverse effects, so it is important to prove that their use results in improved morbidity or mortality, or both. To assess the beneficial and harmful effects of parenteral nutrition, enteral nutrition, and oral nutritional supplements on the mortality and morbidity of patients with underlying liver disease. The following computerised databases were searched: the Cochrane Hepato-Biliary Group Controlled Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library), MEDLINE, EMBASE, and Science Citation Index Expanded (January 2012). In addition, reference lists of identified trials and review articles and Clinicaltrials.gov were searched. Trials identified in a previous systematic handsearch of Index Medicus were also considered. Handsearches of a number of medical journals, including abstracts from annual meetings, were done. Experts in the field and manufacturers of nutrient formulations were contacted for potential references. Randomised clinical trials (parallel or cross-over design) comparing groups of patients with any underlying liver disease who received, or did not receive, enteral or parenteral nutrition or oral nutritional supplements were identified without restriction on date, language, or publication status. Six categories of trials were separately considered: medical or surgical patients receiving parenteral nutrition, enteral nutrition, or supplements. The following data were sought in each report: date of publication; geographical location; inclusion and exclusion criteria; the type of nutritional support and constitution of the nutrient formulation; duration of

  3. Hybrid bioartificial liver support in cynomolgus monkeys with D-galactosamine-induced acute liver failure.

    PubMed

    Zhang, Zhi; Zhao, Yi-Chao; Cheng, Yuan; Jian, Guo-Deng; Pan, Ming-Xin; Gao, Yi

    2014-12-14

    To evaluate a hybrid bioartificial liver support system (HBALSS) in cynomolgus monkeys with acute liver failure. To establish a model of acute liver failure, 0.3 g/kg of D-galactosamine was injected intravenously into cynomolgus monkeys. Chinese human liver cells were introduced into a perfusion bioreactor to carry out hybrid bioartificial liver support treatment. Forty-eight hours after the injection, one group of cynomolgus monkeys received HBALSS care, and a second experimental group received no treatment. Clinical manifestations of all animals, survival time, liver and kidney functions and serum biochemistry changes were recorded. Simultaneous detection of the number, viability and function of hepatocytes in the hybrid bioartificial liver were also performed. Forty-eight hours after the injection of D-galactosamine, serum biochemistry levels were significantly increased, whereas albumin levels and the Fischer index were significantly reduced compared to baseline (all Ps < 0.05). Of the ten monkeys in the HBALSS treatment group, five survived, with an average duration of survival of 128 ± 3 h. All cynomolgus monkeys in the control group died, with a duration of survival of 112 ± 2 h. Survival time was significantly longer with HBALSS treatment (P < 0.05). Moreover, the number, viability and function of hepatocytes were maintained at a high level with HBALSS. The novel hybrid bioartificial liver plays a significant role in liver support by significantly reducing serum biochemistry levels and extending animal survival time.

  4. Liver involvement in systemic infection

    PubMed Central

    Minemura, Masami; Tajiri, Kazuto; Shimizu, Yukihiro

    2014-01-01

    The liver is often involved in systemic infections, resulting in various types of abnormal liver function test results. In particular, hyperbilirubinemia in the range of 2-10 mg/dL is often seen in patients with sepsis, and several mechanisms for this phenomenon have been proposed. In this review, we summarize how the liver is involved in various systemic infections that are not considered to be primarily hepatotropic. In most patients with systemic infections, treatment for the invading microbes is enough to normalize the liver function tests. However, some patients may show severe liver injury or fulminant hepatic failure, requiring intensive treatment of the liver. PMID:25276279

  5. Systemic abnormalities in liver disease

    PubMed Central

    Minemura, Masami; Tajiri, Kazuto; Shimizu, Yukihiro

    2009-01-01

    Systemic abnormalities often occur in patients with liver disease. In particular, cardiopulmonary or renal diseases accompanied by advanced liver disease can be serious and may determine the quality of life and prognosis of patients. Therefore, both hepatologists and non-hepatologists should pay attention to such abnormalities in the management of patients with liver diseases. PMID:19554648

  6. Bioartificial liver systems: why, what, whither?

    PubMed

    Gerlach, Jörg C; Zeilinger, Katrin; Patzer Ii, John F

    2008-07-01

    Acute liver disease is a life-threatening condition for which liver transplantation is the only recognized effective therapy. While etiology varies considerably, the clinical course of acute liver failure is common among the etiologies: encephalopathy progressing toward coma and multiple organ failure. Detoxification processes, such as molecular adsorbent recirculating system (MARS) and Prometheus, have had limited success in altering blood chemistries positively in clinical evaluations, but have not been shown to be clinically effective with regard to patient survival or other clinical outcomes in any Phase III prospective, randomized trial. Bioartificial liver systems, which use liver cells (hepatocytes) to provide metabolic support as well as detoxification, have shown promising results in early clinical evaluations, but again have not demonstrated clinical significance in any Phase III prospective, randomized trial. Cell transplantation therapy has had limited success but is not practicable for wide use owing to a lack of cells (whole-organ transplantation has priority). New approaches in regenerative medicine for treatment of liver disease need to be directed toward providing a functional cell source, expandable in large quantities, for use in various applications. To this end, a novel bioreactor design is described that closely mimics the native liver cell environment and is easily scaled from microscopic (<1 ml cells) to clinical ( approximately 600 ml cells) size, while maintaining the same local cell environment throughout the bioreactor. The bioreactor is used for study of primary liver cell isolates, liver-derived cell lines and stem/progenitor cells.

  7. Albumin regeneration in liver support-comparison of different methods.

    PubMed

    Mitzner, Steffen; Klammt, Sebastian; Stange, Jan; Schmidt, Reinhart

    2006-04-01

    Albumin is the most abundant human plasma protein. Among many other functions it is an important transporter of hydrophobic internal and external substances such as intermediate and end products of metabolism and drugs. In liver failure the albumin binding capacity is decreased because of a disproportion between available albumin molecules caused by decreased hepatic synthesis and hydrophobic toxins because of decreased hepatic clearance. The resulting increase in plasma and tissue concentrations of these substances is associated with multiple organ dysfunctions frequently seen in severe liver failure. The scope of the present article is to compare different liver support strategies with regard to their ability to regenerate the patients albumin pool by removing albumin-bound toxins. Most prominent technique in this group is the molecular adsorbent recirculating system (MARS). It will be compared with single pass albumin dialysis (SPAD), fractionated plasma separation and adsorption system (FPSA, Prometheus), and plasma perfusion/bilirubin adsorption with special regard to efficacy and selectivity.

  8. Supporting liver transplantation by clinical pathway intelligence.

    PubMed

    Kirchner, K; Malessa, Ch; Herzberg, N; Krumnow, S; Habrecht, O; Scheuerlein, H; Bauschke, A; Settmacher, U

    2013-06-01

    A reproducible and transparent quality of clinical treatments plays an important role in the performance of a hospital. In liver transplantation (LT), this is particularly important for patient safety, resource planning, documentation, and quality management. Thus, the clinical pathway for LT was documented in an electronic format within our research project PIGE. Data from clinical information systems were linked to this pathway, which allows for process monitoring (the assessment of the current state for every patient in the LT process) and a retrospective analysis of all treatments in addition to all data pertaining to the treatment, for example, cost, time, number of personnel, etc.

  9. Prometheus: from legend to the real liver support therapy.

    PubMed

    Rifai, K; Tetta, C; Ronco, C

    2007-10-01

    A large number of patients develop liver disease that may evolve into progressive chronic failure. Artificial liver support systems (e.g., MARS and Prometheus) are considered in the framework of the steady increase in the number of patients who could possibly benefit from these blood purification devices. Albumin dialysis and adsorption are now two integrated concepts. The present know-how enabling us to appropriately modify several intrinsic characteristics of the adsorbents--e.g., their chemical nature, the particle and pore size distribution, as well as a larger surface offered to adsorption--has helped in better fine-tuning liver support systems to improve adsorption kinetics and flow characteristics specifically for the intended clinical application. These properties together with an improved biocompatibility have made possible the development of adsorptive techniques for which clearances and total removal rates of target compound would be unthinkable with conventional hemodialysis or hemofiltration. Several adsorptive techniques are already available commercially for the treatment of sepsis and septic shock and of acute liver failure, but controlled studies with clinical end points are still lacking.

  10. Extracorporeal liver support therapy with Prometheus in patients with liver failure in the intensive care unit.

    PubMed

    Oppert, Michael; Rademacher, Sibylle; Petrasch, Kathrin; Jörres, Achim

    2009-10-01

    Acute liver failure (ALF) and acute-on-chronic liver failure (AoCLF) are associated with a high mortality. In these patients an accumulation of both water-soluble and water-insoluble, protein-bound, metabolic waste products occurs. Conventional extracorporeal blood purification techniques based on diffusion and/or convection such as hemodialysis or hemofiltration may only eliminate small molecular weight, water-soluble compounds. In recent years, fractionated plasma separation and adsorption (FPSA) with the Prometheus system has been introduced for extracorporeal liver support therapy. To date, however, only limited data is available regarding the effect of this treatment on mortality and outcome of patients with advanced liver disease. Here we report on our experience with 23 patients with severe liver failure who were treated with Prometheus in our medical intensive care unit. Fourteen patients had AoCLF, and nine patients experienced ALF. The median bilirubin level at the start of Prometheus therapy was 30.5 mg/dL and the median Acute Physiology and Chronic Health Evaluation II (APACHE II) score was 26. During 40 individual treatment sessions lasting 5-6 h, Prometheus therapy reduced serum bilirubin levels from 23.7 mg/dL to 15.0 mg/dL (median values) (P < 0.001), and the overall survival was 26%. ALF patients had a better survival compared to AoCLF patients (44% vs. 22%; P = 0.022). Apart from one patient who developed hemodynamic instability during a treatment session, Prometheus therapy was well tolerated without relevant side-effects. In conclusion, extracorporeal liver support therapy with Prometheus is a novel and safe treatment option in patients with severe liver failure. In this series, patients with ALF showed a significantly better outcome with Prometheus therapy compared to AoCLF patients.

  11. Artificial and bioartificial liver support systems for acute and acute-on-chronic hepatic failure: A meta-analysis and meta-regression.

    PubMed

    Zheng, Zhen; Li, Xu; Li, Zhiliang; Ma, Xiaochun

    2013-10-01

    Artificial and bioartificial liver support systems (LSSs) appear to be safe and effective in the treatment of acute and acute-on-chronic hepatic failure (AHF and AOCHF); however, individually published studies and previous meta-analyses have revealed inconclusive results. The aim of the present meta-analysis was to derive a more precise estimation of the benefits and disadvantages of artificial and bioartificial LSSs for patients with AHF and AOCHF. A literature search was conducted in the PubMed, Embase, Web of Science and Chinese Biomedical (CBM) databases for publications prior to March 1, 2013. Crude relative risks (RRs) or standardized mean differences (SMDs) with 95% confidence intervals (95% CI) were calculated using either the fixed effects or random effects models. Nineteen randomized controlled trials (RCTs) were included, which comprised a total of 566 patients with AHF and 371 patients with AOCHF. The meta-analysis showed that artificial LSS therapy significantly reduced mortality in patients with AOCHF; however, it had no apparent effect on total mortality in patients with AHF. The results also indicated that the use of bioartificial LSSs was correlated with decreased mortality in patients with AHF. A significant reduction in the bridging to liver transplantation was observed in patients with AOCHF following artificial LSS therapy; however, similar results were not observed in patients with AHF. Patients with AHF and those with AOCHF showed significant reductions in total bilirubin levels following artificial LSS therapy. There were no significantly increased risks of hepatic encephalopathy or bleeding in either the patients with AHF or AOCHF following artificial or bioartificial LSS therapies. Univariate and multivariate meta-regression analyses confirmed that none of the factors explained the heterogeneity. The present meta-analysis indicated that artificial LSSs reduce mortality in patients with AOCHF, while the use of bioartificial LSSs was

  12. Artificial and bioartificial liver support systems for acute and acute-on-chronic hepatic failure: A meta-analysis and meta-regression

    PubMed Central

    ZHENG, ZHEN; LI, XU; LI, ZHILIANG; MA, XIAOCHUN

    2013-01-01

    Artificial and bioartificial liver support systems (LSSs) appear to be safe and effective in the treatment of acute and acute-on-chronic hepatic failure (AHF and AOCHF); however, individually published studies and previous meta-analyses have revealed inconclusive results. The aim of the present meta-analysis was to derive a more precise estimation of the benefits and disadvantages of artificial and bioartificial LSSs for patients with AHF and AOCHF. A literature search was conducted in the PubMed, Embase, Web of Science and Chinese Biomedical (CBM) databases for publications prior to March 1, 2013. Crude relative risks (RRs) or standardized mean differences (SMDs) with 95% confidence intervals (95% CI) were calculated using either the fixed effects or random effects models. Nineteen randomized controlled trials (RCTs) were included, which comprised a total of 566 patients with AHF and 371 patients with AOCHF. The meta-analysis showed that artificial LSS therapy significantly reduced mortality in patients with AOCHF; however, it had no apparent effect on total mortality in patients with AHF. The results also indicated that the use of bioartificial LSSs was correlated with decreased mortality in patients with AHF. A significant reduction in the bridging to liver transplantation was observed in patients with AOCHF following artificial LSS therapy; however, similar results were not observed in patients with AHF. Patients with AHF and those with AOCHF showed significant reductions in total bilirubin levels following artificial LSS therapy. There were no significantly increased risks of hepatic encephalopathy or bleeding in either the patients with AHF or AOCHF following artificial or bioartificial LSS therapies. Univariate and multivariate meta-regression analyses confirmed that none of the factors explained the heterogeneity. The present meta-analysis indicated that artificial LSSs reduce mortality in patients with AOCHF, while the use of bioartificial LSSs was

  13. [Nutritional support in patients with liver cirrhosis].

    PubMed

    Rivera Irigoin, Robin; Abilés, Jimena

    2012-10-01

    Given the liver's multiple synthetic, regulatory and detoxifying functions, one of the characteristics accompanying severe hepatocellular dysfunction is the presence of malnutrition. This disorder is highly frequent in liver cirrhosis, even in the relatively early stages of the disease. Independently of the cause of the cirrhosis, poor nutritional status is associated with a worse prognosis and therefore early intervention to correct nutrient deficiency can prolong life expectancy, improve quality of life, reduce complications and increase the probability of successful transplantation. The present article reviews current knowledge of the diagnosis and management of malnutrition in patients with cirrhosis. Special attention is paid to the concept of the late evening snack and its characteristics, composition and probable benefits in the course of the disease.

  14. Implementation of an interactive liver surgery planning system

    NASA Astrophysics Data System (ADS)

    Wang, Luyao; Liu, Jingjing; Yuan, Rong; Gu, Shuguo; Yu, Long; Li, Zhitao; Li, Yanzhao; Li, Zhen; Xie, Qingguo; Hu, Daoyu

    2011-03-01

    Liver tumor, one of the most wide-spread diseases, has a very high mortality in China. To improve success rates of liver surgeries and life qualities of such patients, we implement an interactive liver surgery planning system based on contrastenhanced liver CT images. The system consists of five modules: pre-processing, segmentation, modeling, quantitative analysis and surgery simulation. The Graph Cuts method is utilized to automatically segment the liver based on an anatomical prior knowledge that liver is the biggest organ and has almost homogeneous gray value. The system supports users to build patient-specific liver segment and sub-segment models using interactive portal vein branch labeling, and to perform anatomical resection simulation. It also provides several tools to simulate atypical resection, including resection plane, sphere and curved surface. To match actual surgery resections well and simulate the process flexibly, we extend our work to develop a virtual scalpel model and simulate the scalpel movement in the hepatic tissue using multi-plane continuous resection. In addition, the quantitative analysis module makes it possible to assess the risk of a liver surgery. The preliminary results show that the system has the potential to offer an accurate 3D delineation of the liver anatomy, as well as the tumors' location in relation to vessels, and to facilitate liver resection surgeries. Furthermore, we are testing the system in a full-scale clinical trial.

  15. Artificial liver support in pigs with acetaminophen-induced acute liver failure

    PubMed Central

    He, Guo-Lin; Feng, Lei; Cai, Lei; Zhou, Chen-Jie; Cheng, Yuan; Jiang, Ze-Sheng; Pan, Ming-Xin; Gao, Yi

    2017-01-01

    AIM To establish a reversible porcine model of acute liver failure (ALF) and treat it with an artificial liver system. METHODS Sixteen pigs weighing 30-35 kg were chosen and administered with acetaminophen (APAP) to induce ALF. ALF pigs were then randomly assigned to either an experimental group (n = 11), in which a treatment procedure was performed, or a control group (n = 5). Treatment was started 20 h after APAP administration and continued for 8 h. Clinical manifestations of all animals, including liver and kidney functions, serum biochemical parameters and survival times were analyzed. RESULTS Twenty hours after APAP administration, the levels of serum aspartate aminotransferase, total bilirubin, creatinine and ammonia were significantly increased, while albumin levels were decreased (P < 0.05). Prothrombin time was found to be extended with progression of ALF. After continuous treatment for 8 h (at 28 h), aspartate aminotransferase, total bilirubin, creatinine, and ammonia showed a decrease in comparison with the control group (P < 0.05). A cross-section of livers revealed signs of vacuolar degeneration, nuclear fragmentation and dissolution. Concerning survival, porcine models in the treatment group survived for longer times with artificial liver system treatment (P < 0.05). CONCLUSION This model is reproducible and allows for quantitative evaluation of new liver systems, such as a bioartificial liver. The artificial liver system (ZHJ-3) is safe and effective for the APAP-induced porcine ALF model. PMID:28566885

  16. Prospects of the use of hepatic cells for extracorporeal liver support.

    PubMed

    Gerlach, Jörg C

    2005-01-01

    Hybrid extracorporeal liver support is an option to assist liver transplantation therapy. An overview on liver cell bioreactors is given and our own development is described. Furthermore, the prospects of the utilization of human liver cells from discarded transplantation organs due to steatosis, cirrhosis or traumatic injury, and liver progenitor cells are discussed. Our Modular Extracorporeal Liver Support (MELS) concept proposes an integrative aproach for the treatment of hepatic failure with appropriate extracorporeal therapy units, tailored to suit the actual clinical needs of each patient. The CellModule is a specific bioreactor (charged actually with primary human liver cells, harvested from human donor livers found to be unsuitable for transplantation). The DetoxModule enables albumin-dialysis for the removal of albumin-bound toxins, reducing the biochemical burden of the liver cells, and replacing the bile excretion of hepatocytes in the bioreactor. A Dialysis Module for continuous veno-venous hemofiltration can be added to the system if required in hepato-renal syndrome.

  17. Reactor vessel support system

    DOEpatents

    Golden, Martin P.; Holley, John C.

    1982-01-01

    A reactor vessel support system includes a support ring at the reactor top supported through a box ring on a ledge of the reactor containment. The box ring includes an annular space in the center of its cross-section to reduce heat flow and is keyed to the support ledge to transmit seismic forces from the reactor vessel to the containment structure. A coolant channel is provided at the outside circumference of the support ring to supply coolant gas through the keyways to channels between the reactor vessel and support ledge into the containment space.

  18. Expeditionary Fire Support System

    DTIC Science & Technology

    2006-02-06

    safeties. The actual answer is that older caramel colored propellants bags were not reliable and became unstable with the least amount of inclement...Expeditionary Fire Support System Subject Area Warfighting EWS 2006 Contemporary Issues Paper Expeditionary Fire Support System By...James N. Mattis about the deployment to Camp Rhino, Afghanistan was that he needed organic fire support. The major issue of his helicopter-borne

  19. Vessel structural support system

    DOEpatents

    Jenko, James X.; Ott, Howard L.; Wilson, Robert M.; Wepfer, Robert M.

    1992-01-01

    Vessel structural support system for laterally and vertically supporting a vessel, such as a nuclear steam generator having an exterior bottom surface and a side surface thereon. The system includes a bracket connected to the bottom surface. A support column is pivotally connected to the bracket for vertically supporting the steam generator. The system also includes a base pad assembly connected pivotally to the support column for supporting the support column and the steam generator. The base pad assembly, which is capable of being brought to a level position by turning leveling nuts, is anchored to a floor. The system further includes a male key member attached to the side surface of the steam generator and a female stop member attached to an adjacent wall. The male key member and the female stop member coact to laterally support the steam generator. Moreover, the system includes a snubber assembly connected to the side surface of the steam generator and also attached to the adjacent wall for dampening lateral movement of the steam generator. In addition, the system includes a restraining member of "flat" attached to the side surface of the steam generator and a bumper attached to the adjacent wall. The flat and the bumper coact to further laterally support the steam generator.

  20. Cryogenic support system

    DOEpatents

    Nicol, Thomas H.; Niemann, Ralph C.; Gonczy, John D.

    1988-01-01

    A support system is disclosed for restraining large masses at very low or cryogenic temperatures. The support system employs a tie bar that is pivotally connected at opposite ends to an anchoring support member and a sliding support member. The tie bar extends substantially parallel to the longitudinal axis of the cold mass assembly, and comprises a rod that lengthens when cooled and a pair of end attachments that contract when cooled. The rod and end attachments are sized so that when the tie bar is cooled to cryogenic temperature, the net change in tie bar length is approximately zero. Longitudinal force directed against the cold mass assembly is distributed by the tie bar between the anchoring support member and the sliding support member.

  1. Cryogenic support system

    DOEpatents

    Nicol, T.H.; Niemann, R.C.; Gonczy, J.D.

    1988-11-01

    A support system is disclosed for restraining large masses at very low or cryogenic temperatures. The support system employs a tie bar that is pivotally connected at opposite ends to an anchoring support member and a sliding support member. The tie bar extends substantially parallel to the longitudinal axis of the cold mass assembly, and comprises a rod that lengthens when cooled and a pair of end attachments that contract when cooled. The rod and end attachments are sized so that when the tie bar is cooled to cryogenic temperature, the net change in tie bar length is approximately zero. Longitudinal force directed against the cold mass assembly is distributed by the tie bar between the anchoring support member and the sliding support member. 7 figs.

  2. Clearing of toxic substances: are there differences between the available liver support devices?

    PubMed

    Krisper, Peter; Stadlbauer, Vanessa; Stauber, Rudolf E

    2011-09-01

    Toxins accumulating in liver failure split into water solved (e.g. ammonia) and albumin bound substances (e.g. bilirubin). Because the latter cannot be removed by conventional haemodialysis, special liver support systems have been developed. The majority of data concerning elimination efficiency exist for the cell-free devices Molecular Adsorbent Recirculating System (MARS) and Prometheus, as they have been commercially available in Europe since many years. Overall, Prometheus provides higher clearances for most liver toxins, especially if they are tightly albumin bound. However, for bile acids and cytokines no such differences could be found. Single pass albumin dialysis (SPAD) can be assumed to be equally effective as MARS. None of the bioartificial liver support systems being developed is on the market today and published clearance data are scarce. In general, clearance efficiency for albumin bound substances is relatively low in all systems currently available. Besides optimizing biocompatibility and selectivity, future technologies should also focus on improved detoxification efficiency of liver support devices.

  3. Biological Life Support Systems

    NASA Technical Reports Server (NTRS)

    1997-01-01

    Session MP2 includes short reports on: (1) Crew Regenerative Life Support in Long Duration Space Missions; (2) Bioconversion Systems for Food and Water on Long Term Space Missions; (3) Novel Laboratory Approaches to Multi-purpose Aquatic Biogenerative Closed-Loop Food Production Systems; and (4) Artificial Neural Network Derived Plant Growth Models.

  4. Group Support Systems (GSS)

    NASA Technical Reports Server (NTRS)

    Hamel, Gary P.; Wijesinghe, R.

    1996-01-01

    Groupware is a term describing an emerging computer software technology enhancing the ability of people to work together as a group, (a software driven 'group support system'). This project originated at the beginning of 1992 and reports were issued describing the activity through May 1995. These reports stressed the need for process as well as technology. That is, while the technology represented a computer assisted method for groups to work together, the Group Support System (GSS) technology als required an understanding of the facilitation process electronic meetings demand. Even people trained in traditional facilitation techniques did not necessarily aimlessly adopt groupware techniques. The latest phase of this activity attempted to (1) improve the facilitation process by developing training support for a portable groupware computer system, and (2) to explore settings and uses for the portable groupware system using different software, such as Lotus Notes.

  5. Steam generator support system

    DOEpatents

    Moldenhauer, James E.

    1987-01-01

    A support system for connection to an outer surface of a J-shaped steam generator for use with a nuclear reactor or other liquid metal cooled power source. The J-shaped steam generator is mounted with the bent portion at the bottom. An arrangement of elongated rod members provides both horizontal and vertical support for the steam generator. The rod members are interconnected to the steam generator assembly and a support structure in a manner which provides for thermal distortion of the steam generator without the transfer of bending moments to the support structure and in a like manner substantially minimizes forces being transferred between the support structure and the steam generator as a result of seismic disturbances.

  6. Steam generator support system

    DOEpatents

    Moldenhauer, J.E.

    1987-08-25

    A support system for connection to an outer surface of a J-shaped steam generator for use with a nuclear reactor or other liquid metal cooled power source is disclosed. The J-shaped steam generator is mounted with the bent portion at the bottom. An arrangement of elongated rod members provides both horizontal and vertical support for the steam generator. The rod members are interconnected to the steam generator assembly and a support structure in a manner which provides for thermal distortion of the steam generator without the transfer of bending moments to the support structure and in a like manner substantially minimizes forces being transferred between the support structure and the steam generator as a result of seismic disturbances. 4 figs.

  7. Renal replacement therapy in special settings: extracorporeal support devices in liver failure.

    PubMed

    Cerdá, Jorge; Tolwani, Ashita; Gibney, Noel; Tiranathanagul, Khajohn

    2011-01-01

    Hepatorenal syndrome (HRS) type I is a unique form of acute kidney injury resulting from renal vasoconstriction in the setting of systemic and splanchnic arterial vasodilation in patients with end-stage liver disease. The only definitive treatment currently available is liver or liver-kidney transplantation. The goal of extracorporeal support (ECS) systems in HRS is to bridge eligible liver failure patients to transplantation or functional recovery by means of detoxification, assistance with biosynthesis of key metabolic products, and regulation of inflammation. ECS systems in liver disease can be divided into two broad categories: cell-based and noncell-based systems. While cell-based systems aim to provide functions similar to those of normal hepatocytes, noncell-based systems do not incorporate tissue; they provide detoxification utilizing membranes and adsorbents. There are no standard guidelines for the application of ECS systems. Published studies are too small and show considerable differences in primary indication, primary endpoint, and treatment protocols for "intervention" and "standard" treatment groups. This article reviews the available evidence regarding the optimal use of ECS devices in HRS, makes evidence-based practice recommendations, and delineates key questions for future studies.

  8. Liver support by extracorporeal blood purification: a clinical observation.

    PubMed

    Stange, J; Mitzner, S R; Klammt, S; Freytag, J; Peszynski, P; Loock, J; Hickstein, H; Korten, G; Schmidt, R; Hentschel, J; Schulz, M; Löhr, M; Liebe, S; Schareck, W; Hopt, U T

    2000-09-01

    Liver failure associated with excretory insufficiency and jaundice results in an endogenous accumulation of toxins involved in the impairment of cardiovascular, kidney, and cerebral function. Moreover, these toxins have been shown to damage the liver itself by inducing hepatocellular apoptosis and necrosis, thus creating a vicious cycle of the disease. We report a retrospective cohort study of 26 patients with acute or chronic liver failure with intrahepatic cholestasis (bilirubin level > 20 mg/dL) who underwent a new extracorporeal blood purification treatment. A synthetic hydrophilic/hydrophobic domain-presenting semipermeable membrane (pore size < albumin size, 100-nm thick) was used for extracorporeal blood detoxification using dialysis equipment. The opposite side was rinsed with ligandin-like proteins as molecular adsorbents that were regenerated online using a chromatography-like recycling system (molecular adsorbent recirculating system [MARS]). Bile acid and bilirubin levels, representing the previously described toxins, were reduced by 16% to 53% and 10% to 90% of the initial concentration by a single treatment of 6 to 8 hours, respectively. Toxicity testing of patient plasma onto primary rat hepatocytes by live/dead fluorescence microscopy showed cell-damaging effects of jaundiced plasma that were not observed after treatment. Patients with a worsening of Child-Turcotte-Pugh (CTP) index before the treatments showed a significant improvement of this index during a period of 2 to 14 single treatments with an average of 14 days. After withdrawal of MARS treatment, this improvement was sustained in all long-term survivors. Ten patients represented a clinical status equivalent to the United Network for Organ Sharing (UNOS) status 2b (group A1), and all survived. Sixteen patients represented a clinical status equivalent to UNOS status 2a, and 7 of these patients survived (group A2), whereas 9 patients (group B) died. We conclude that in acute excretory failure

  9. Advanced Life Support Systems

    NASA Technical Reports Server (NTRS)

    Barta, Daniel J.

    2004-01-01

    This presentation is planned to be a 10-15 minute "catalytic" focused presentation to be scheduled during one of the working sessions at the TIM. This presentation will focus on Advanced Life Support technologies key to future human Space Exploration as outlined in the Vision, and will include basic requirements, assessment of the state-of-the-art and gaps, and include specific technology metrics. The presentation will be technical in character, lean heavily on data in published ALS documents (such as the Baseline Values and Assumptions Document) but not provide specific technical details or build to information on any technology mentioned (thus the presentation will be benign from an export control and a new technology perspective). The topics presented will be focused on the following elements of Advanced Life Support: air revitalization, water recovery, waste management, thermal control, habitation systems, food systems and bioregenerative life support.

  10. Alleviating liver failure conditions using an integrated hybrid cryogel based cellular bioreactor as a bioartificial liver support

    PubMed Central

    Damania, Apeksha; Hassan, Mohsin; Shirakigawa, Nana; Mizumoto, Hiroshi; Kumar, Anupam; Sarin, Shiv K.; Ijima, Hiroyuki; Kamihira, Masamichi; Kumar, Ashok

    2017-01-01

    Conventionally, some bioartificial liver devices are used with separate plasmapheresis unit to separate out plasma from whole blood and adsorbent column to detoxify plasma before it passes through a hepatocytes-laden bioreactor. We aim to develop a hybrid bioreactor that integrates the separate modules in one compact design improving the efficacy of the cryogel based bioreactor as a bioartificial liver support. A plasma separation membrane and an activated carbon cloth are placed over a HepG2-loaded cryogel scaffold in a three-chambered bioreactor design. This bioreactor is consequently connected extracorporeally to a rat model of acute liver failure for 3 h and major biochemical parameters studied. Bilirubin and aspartate transaminase showed a percentage decrease of 20–60% in the integrated bioreactor as opposed to 5–15% in the conventional setup. Urea and ammonia levels which showed negligible change in the conventional setup increase (40%) and decrease (18%), respectively in the integrated system. Also, an overall increase of 5% in human albumin in rat plasma indicated bioreactor functionality in terms of synthetic functions. These results were corroborated by offline evaluation of patient plasma. Hence, integrating the plasmapheresis and adsorbent units with the bioreactor module in one compact design improves the efficacy of the bioartificial liver device. PMID:28079174

  11. Visual management support system

    Treesearch

    Lee Anderson; Jerry Mosier; Geoffrey Chandler

    1979-01-01

    The Visual Management Support System (VMSS) is an extension of an existing computer program called VIEWIT, which has been extensively used by the U. S. Forest Service. The capabilities of this program lie in the rapid manipulation of large amounts of data, specifically opera-ting as a tool to overlay or merge one set of data with another. VMSS was conceived to...

  12. Three-dimensional perfusion bioreactor culture supports differentiation of human fetal liver cells.

    PubMed

    Schmelzer, Eva; Triolo, Fabio; Turner, Morris E; Thompson, Robert L; Zeilinger, Katrin; Reid, Lola M; Gridelli, Bruno; Gerlach, Jörg C

    2010-06-01

    The ability of human fetal liver cells to survive, expand, and form functional tissue in vitro is of high interest for the development of bioartificial extracorporeal liver support systems, liver cell transplantation therapies, and pharmacologic models. Conventional static two-dimensional culture models seem to be inadequate tools. We focus on dynamic three-dimensional perfusion technologies and developed a scaled-down bioreactor, providing decentralized mass exchange with integral oxygenation. Human fetal liver cells were embedded in a hyaluronan hydrogel within the capillary system to mimic an in vivo matrix and perfusion environment. Metabolic performance was monitored daily, including glucose consumption, lactate dehydrogenase activity, and secretion of alpha-fetoprotein and albumin. At culture termination cells were analyzed for proliferation and liver-specific lineage-dependent cytochrome P450 (CYP3A4/3A7) gene expression. Occurrence of hepatic differentiation in bioreactor cultures was demonstrated by a strong increase in CYP3A4/3A7 gene expression ratio, lower alpha-fetoprotein, and higher albumin secretion than in conventional Petri dish controls. Cells in bioreactors formed three-dimensional structures. Viability of cells was higher in bioreactors than in control cultures. In conclusion, the culture model implementing three-dimensionality, constant perfusion, and integral oxygenation in combination with a hyaluronan hydrogel provides superior conditions for liver cell survival and differentiation compared to conventional culture.

  13. Central nervous system complications after liver transplantation.

    PubMed

    Kim, Jeong-Min; Jung, Keun-Hwa; Lee, Soon-Tae; Chu, Kon; Roh, Jae-Kyu

    2015-08-01

    We investigated the diversity of central nervous system complications after liver transplantation in terms of clinical manifestations and temporal course. Liver transplantation is a lifesaving option for end stage liver disease patients but post-transplantation neurologic complications can hamper recovery. Between 1 January 2001 and 31 December 2010, patients who had undergone liver transplantation at a single tertiary university hospital were included. We reviewed their medical records and brain imaging data and classified central nervous system complications into four categories including vascular, metabolic, infectious and neoplastic. The onset of central nervous system complications was grouped into five post-transplantation intervals including acute (within 1 month), early subacute (1-3 months), late subacute (3-12 months), chronic (1-3 years), and long-term (after 3 years). During follow-up, 65 of 791 patients (8.2%) experienced central nervous system complications, with 30 occurring within 1 month after transplantation. Vascular etiology was the most common (27 patients; 41.5%), followed by metabolic (23; 35.4%), infectious (nine patients; 13.8%), and neoplastic (six patients). Metabolic encephalopathy with altered consciousness was the most common etiology during the acute period, followed by vascular disorders. An initial focal neurologic deficit was detected in vascular and neoplastic complications, whereas metabolic and infectious etiologies presented with non-focal symptoms. Our study shows that the etiology of central nervous system complications after liver transplantation changes over time, and initial symptoms can help to predict etiology.

  14. Advances in liver transplantation allocation systems

    PubMed Central

    Schilsky, Michael L; Moini, Maryam

    2016-01-01

    With the growing number of patients in need of liver transplantation, there is a need for adopting new and modifying existing allocation policies that prioritize patients for liver transplantation. Policy should ensure fair allocation that is reproducible and strongly predictive of best pre and post transplant outcomes while taking into account the natural history of the potential recipients liver disease and its complications. There is wide acceptance for allocation policies based on urgency in which the sickest patients on the waiting list with the highest risk of mortality receive priority. Model for end-stage liver disease and Child-Turcotte-Pugh scoring system, the two most universally applicable systems are used in urgency-based prioritization. However, other factors must be considered to achieve optimal allocation. Factors affecting pre-transplant patient survival and the quality of the donor organ also affect outcome. The optimal system should have allocation prioritization that accounts for both urgency and transplant outcome. We reviewed past and current liver allocation systems with the aim of generating further discussion about improvement of current policies. PMID:26973389

  15. Advances in liver transplantation allocation systems.

    PubMed

    Schilsky, Michael L; Moini, Maryam

    2016-03-14

    With the growing number of patients in need of liver transplantation, there is a need for adopting new and modifying existing allocation policies that prioritize patients for liver transplantation. Policy should ensure fair allocation that is reproducible and strongly predictive of best pre and post transplant outcomes while taking into account the natural history of the potential recipients liver disease and its complications. There is wide acceptance for allocation policies based on urgency in which the sickest patients on the waiting list with the highest risk of mortality receive priority. Model for end-stage liver disease and Child-Turcotte-Pugh scoring system, the two most universally applicable systems are used in urgency-based prioritization. However, other factors must be considered to achieve optimal allocation. Factors affecting pre-transplant patient survival and the quality of the donor organ also affect outcome. The optimal system should have allocation prioritization that accounts for both urgency and transplant outcome. We reviewed past and current liver allocation systems with the aim of generating further discussion about improvement of current policies.

  16. An Evaluation of the Usefulness of Extracorporeal Liver Support Techniques in Patients Hospitalized in the ICU for Severe Liver Dysfunction Secondary to Alcoholic Liver Disease

    PubMed Central

    Piechota, Mariusz; Piechota, Anna

    2016-01-01

    Background The mortality rate in patients with severe liver dysfunction secondary to alcoholic liver disease (ALD) who do not respond to the standard treatment is exceptionally high. Objectives The main aim of this study was to evaluate the usefulness of applying extracorporeal liver support techniques to treat this group of patients. Patients and Methods The data from 23 hospital admissions of 21 patients with ALD who were admitted to the department of anesthesiology and intensive therapy (A&IT) at the Dr Wł. Biegański Regional Specialist Hospital in Łódź between March 2013 and July 2015 were retrospectively analyzed. Results A total of 111 liver dialysis procedures were performed during the 23 hospitalizations, including 13 dialyses using fractionated plasma separation and adsorption (FPSA) with the Prometheus® system, and 98 procedures using the single pass albumin dialysis (SPAD) system. Upon admission to the intensive care unit (ICU), the median (interquartile range [IQR]) Glasgow coma scale (GCS), sequential organ failure assessment (SOFA), acute physiology and chronic health evaluation (APACHE) II, and simplified acute physiology score (SAPS) II scores were 15 (14 - 15), 9 (7 - 13), 17 (14 - 24), and 32 (22 - 50), respectively. The ICU, 30-day, and three-month mortality rates were 43.48%, 39.13%, and 73.91%, respectively. As determined by the receiver operative characteristic (ROC) analysis for single-factor models, the significant predictors of death in the ICU included the patients’ SOFA, APACHE II, SAPS II, and model of end-stage liver disease modified by the united network for organ sharing (MELD UNOS Modification) scores; the duration of stay (in days) in the A&IT Department; and bile acid, creatinine and albumin levels upon ICU admission. The ROC analysis indicated the significant discriminating power of the SOFA, APACHE II, SAPS II, and MELD UNOS modification scores on the three-month mortality rate. Conclusions The application of

  17. [Enteral Nutritional Support in Gastrointestinal and Liver Diseases].

    PubMed

    Kim, Eun Ran

    2015-06-01

    Nutritional support is important because malnutrition is a major contributor to increased morbidity and mortality, decreased quality of life, increased length of hospital stay, and higher healthcare costs. Patients with gastrointestinal disease are at an increased risk of nutritional deterioration due to therapeutic dietary restriction, fasting for the diagnostic tests, loss of appetite due to anorexia or altered nutritional requirement caused by the disease itself. Therefore, it is important that gastroenterologists are aware of the nutritional status of patients and plan a treatment strategy considering patient's nutritional status. Enteral nutrition is preferred to parenteral nutrition as it is more physiologic, has fewer complications, help to prevent mucosal atrophy and maintain gut barrier function, which decrease intestinal bacterial translocation. Hence, enteral nutrition has been considered to be the most effective route for nutritional support. In this article, we will review enteral nutrition (oral nutritional supplements, enteral tube feeding) as a treatment for the patients with gastrointestinal, liver and pancreatic disease at risk of malnutrition.

  18. Data mining support systems

    NASA Astrophysics Data System (ADS)

    Zhao, Yinliang; Yao, JingTao; Yao, Yiyu

    2004-04-01

    The main stream of research in data mining (or knowledge discovery in databases) focuses on algorithms and automatic or semi-automatic processes for discovering knowledge hidden in data. In this paper, we adopt a more general and goal oriented view of data mining. Data mining is regarded as a field of study covering the theories, methodologies, techniques, and activities with the goal of discovering new and useful knowledge. One of its objectives is to design and implement data mining systems. A miner solves problems of data mining manually, or semi-automatically by using such systems. However, there is a lack of studies on how to assist a miner in solving data mining problems. From the experiences and lessons of decision support systems, we introduce the concept of data mining support systems (DMSS). We draw an analogy between the field of decision-making and the field of data mining, and between the role of a manager and the role of a data miner. A DMSS is an active and highly interactive computer system that assists data mining activities. The needs and the basic features of DMSS are discussed.

  19. Technology insight: artificial extracorporeal liver support--how does Prometheus compare with MARS?

    PubMed

    Krisper, Peter; Stauber, Rudolf E

    2007-05-01

    Artificial extracorporeal liver support or 'liver dialysis' has been used in patients with severe liver failure with increasing frequency since the Molecular Adsorbents Recirculating System (MARS), a variant of albumin dialysis, was introduced in 1999. Nevertheless, liver dialysis must still be thought of as experimental because its contribution to improved patient survival has not been proven in large randomized trials. Prometheus is a novel device for fractionated plasma separation via an albumin-permeable filter that was developed to improve removal of albumin-bound toxins. Initial studies have proven clinical use of Prometheus to be feasible and safe. Head-to-head comparisons of Prometheus and MARS have shown treatment with the former to be more efficient with respect to removal of most albumin-bound and water-solved markers. As controlled studies with clinical end points are lacking, it is not known whether the observed greater detoxification capacity of Prometheus will translate into clinical benefit; two small studies indicate that there might be a beneficial effect in hepatic encephalopathy and pruritus. In a recent randomized comparison of MARS and Prometheus, however, hemodynamic improvement was observed in response to MARS, but not Prometheus, treatment. A large randomized controlled trial investigating the effect of Prometheus on survival--the HELIOS study--has been initiated. First results are expected in 2008 and will be crucial to establishing a role for Prometheus in the field of extracorporeal liver support.

  20. Case-based reasoning support for liver disease diagnosis.

    PubMed

    Chuang, Chun-Ling

    2011-09-01

    In Taiwan, as well as in the other countries around the world, liver disease has reigned over the list of leading causes of mortality, and its resistance to early detection renders the disease even more threatening. It is therefore crucial to develop an auxiliary system for diagnosing liver disease so as to enhance the efficiency of medical diagnosis and to expedite the delivery of proper medical treatment. The study accordingly integrated the case-based reasoning (CBR) model into several common classification methods of data mining techniques, including back-propagation neural network (BPN), classification and regression tree, logistic regression, and discriminatory analysis, in an attempt to develop a more efficient model for early diagnosis of liver disease and to enhance classification accuracy. To minimize possible bias, this study used a ten-fold cross-validation to select a best model for more precise diagnosis results and to reduce problems caused by false diagnosis. Through a comparison of five single models, BPN and CBR emerged to be the top two methods in terms of overall performance. For enhancing diagnosis performance, CBR was integrated with other methods, and the results indicated that the accuracy and sensitivity of each CBR-added hybrid model were higher than those of each single model. Of all the CBR-added hybrid models, the BPN-CBR method took the lead in terms of diagnosis capacity with an accuracy rate of 95%, a sensitivity of 98%, and a specificity of 94%. After comparing the five single and hybrid models, the study found BPN-CBR the best model capable of helping physicians to determine the existence of liver disease, achieve an accurate diagnosis, diminish the possibility of a false diagnosis being given to sick people, and avoid the delay of clinical treatment. Copyright © 2011 Elsevier B.V. All rights reserved.

  1. The elusive goal of liver support--quest for the Holy Grail.

    PubMed

    Williams, Roger

    2006-01-01

    The history of liver support devices is traced from early attempts with dialysis based on the known dialysability of ammonia--the major identified toxin in liver failure--and exchange transfusion with removal of protein-bound toxins, to the later techniques based on whole organ perfusion in extracorporeal circuits. Perfusion through charcoal as an adsorbent represented a major advance and remains a component of more recently introduced devices based on bioreactors of cultured hepatocytes and in the albumin dialysis techniques of molecular adsorbent recirculating system and the Prometheus device. The latter are the most highly efficient to date in toxin removal but whether survival is improved and the need for liver transplantation remain to be proven.

  2. The Circulatory System in Liver Disease.

    PubMed

    Hollenberg, Steven M; Waldman, Brett

    2016-07-01

    In the cirrhotic liver, distortion of the normal liver architecture is caused by structural and vascular changes. Portal hypertension is often associated with a hyperdynamic circulatory syndrome in which cardiac output and heart rate are increased and systemic vascular resistance is decreased. The release of several vasoactive substances is the primary factor involved in the reduction of mesenteric arterial resistance, resulting in sodium and water retention with eventual formation of ascites. Management of these patients with acute cardiac dysfunction often requires invasive hemodynamic monitoring in an intensive care unit setting to tailor decisions regarding use of fluids and vasopressors. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Using ultrasonography to monitor liver blood flow for liver transplant from donors supported on extracorporeal membrane oxygenation.

    PubMed

    Zhu, Xian-Sheng; Wang, Sha-Sha; Cheng, Qi; Ye, Chuang-Wen; Huo, Feng; Li, Peng

    2016-02-01

    Extracorporeal membrane oxygenation (ECMO) has been used to support brain-dead donors for liver procurement. This study investigated the potential role of ultrasonographic monitoring of hepatic perfusion as an aid to improve the viability of liver transplants obtained from brain-dead donors who are supported on ECMO. A total of 40 brain-dead patients maintained on ECMO served as the study population. Hepatic blood flow was monitored using ultrasonography, and perioperative optimal perfusion was maintained by calibrating ECMO. Liver function tests were performed to assess the viability of the graft. The hepatic arterial blood flow was well maintained with no significant changes observed before and after ECMO (206 ± 32 versus 241 ± 45 mL/minute; P = 0.06). Similarly, the portal venous blood flow was also maintained throughout (451 ± 65 versus 482 ± 77 mL/minute; P = 0.09). No significant change in levels of total bilirubin, alanine transaminase, and lactic acid were reported during ECMO (P = 0.17, P = 0.08, and P = 0.09, respectively). Before the liver is procured, ultrasonographic monitoring of hepatic blood flow could be a valuable aid to improve the viability of a liver transplant by allowing for real-time calibration of ECMO perfusion in brain-dead liver donors. In our study, ultrasonographic monitoring helped prevent warm ischemic injury to the liver graft by avoiding both overperfusion and underperfusion of the liver. © 2015 American Association for the Study of Liver Diseases.

  4. New method of hepatocyte transplantation and extracorporeal liver support.

    PubMed Central

    Demetriou, A A; Whiting, J; Levenson, S M; Chowdhury, N R; Schechner, R; Michalski, S; Feldman, D; Chowdhury, J R

    1986-01-01

    A technique has been developed by the authors that allows hepatocyte attachment on collagen-coated microcarriers resulting in prolonged hepatocyte viability and function both in vivo and in vitro. Rat hepatocytes were obtained by portal vein collagenase perfusion. Intraperitoneally transplanted microcarrier-attached normal hepatocytes into congeneic Gunn rats were functioning 3-4 weeks later, as shown by the presence and persistence of conjugated bilirubin in recipient bile, sustained decrease in serum bilirubin, uptake of Tc99m-DESIDA, and morphologic criteria. Intraperitoneal transplantation of normal microcarrier-attached hepatocytes into genetically albumin deficient rats (NAR) resulted in marked increase in plasma albumin levels (6 days without and 21 days with Cyclosporin A immunosuppression). Microcarrier-attached hepatocytes transplanted after 2 weeks of storage at -80 C into congeneic Gunn rats were viable and functional as assessed by criteria outlined above. An extracorporeal liver perfusion system was developed using the microcarrier-attached hepatocytes that was capable of synthesizing and conjugating bilirubin and synthesizing liver-specific proteins. Images FIGS. 5A and B. FIG. 7. FIG. 8. FIG. 9. FIG. 12. PMID:3530153

  5. The Prometheus device for extracorporeal support of combined liver and renal failure.

    PubMed

    Rifai, Kinan; Ernst, Thomas; Kretschmer, Ulrich; Hafer, Carsten; Haller, Hermann; Manns, Michael Peter; Fliser, Danilo

    2005-01-01

    Prometheus is a newly developed extracorporeal liver support system that combines removal of albumin-bound substances (adsorption on resin adsorbers) and water-soluble substances (diffusion during high-flux hemodialysis). Therefore, it is a promising treatment option for patients with hepatorenal syndrome (HRS). We studied 10 patients with HRS in a prospective clinical study. All patients underwent 2 consecutive Prometheus treatments. A variety of clinical and biochemical parameters were assessed. Prometheus treatment was uncomplicated and safe. A statistically significant improvement of serum creatinine and urea concentrations as well as blood pH was observed after Prometheus treatment. Furthermore, liver detoxification was supported by a significant decrease of serum levels of conjugated bilirubin, bile acids and ammonia. Prometheus is a safe treatment for patients with HRS. Both, albumin-bound and water-soluble substances were effectively removed. Controlled studies will evaluate the effect of this new treatment option on survival in patients with HRS. (c) 2005 S. Karger AG, Basel.

  6. Uncoupling the systemic circulation and the Ex Vivo circuit during experimental isolated liver perfusion.

    PubMed

    Lhuillier, Franck; Pouyet, Michel; Méchet, Isabelle; Liotard, Dominique; Merle, Eric; Delafosse, Bertrand; Goudable, Joelle; Vianey-Saban, Christine; Viale, Jean-Paul

    2006-01-01

    Performing an ex vivo liver perfusion as a transient liver support requires perfusing the liver with a flow of 1 ml/min per kg of liver, which could reach 25% of the cardiac output when a human liver is used. This high flow could be detrimental in patients with acute liver failure. Therefore, in an ischemic-induced liver failure pig model, we developed a circuit allowing low flows going out of and into the systemic circulation, whereas the flow going through the ex vivo liver is maintained at a high value. This was obtained by uncoupling the ex vivo circuit from the systemic circulation. Ex vivo liver perfusion was performed in a closed circuit with a flow averaging 1 ml/min per kg of ex vivo liver (700 to 800 ml/min, according to the weight of the livers we used). It was linked to the systemic circulation with input and output flows equal to that used during hemodialysis (200 ml/min). Compared with previously reported direct circuits, this perfusion system was well tolerated from a circulatory point of view. After the induction of ischemic liver failure, the ex vivo liver perfusion led to an increase in urea, branched amino acids to aromatic amino acid ratio, and fractional clearance of indocyanine green and galactose and to a decrease in ammonia and lactic acid. This system allowed the ex vivo liver to keep its clearing properties despite a low extracorporeal flow. It represents an extracorporeal circuit that could be used in place of the direct extracorporeal high-flow liver perfusion.

  7. Albumin dialysis with a noncell artificial liver support device in patients with acute liver failure: a randomized, controlled trial.

    PubMed

    Saliba, Faouzi; Camus, Christophe; Durand, François; Mathurin, Philippe; Letierce, Alexia; Delafosse, Bertrand; Barange, Karl; Perrigault, Pierre François; Belnard, Magali; Ichaï, Philippe; Samuel, Didier

    2013-10-15

    Albumin dialysis with the Molecular Adsorbent Recirculating System (MARS) (Gambro, Lund, Sweden), a noncell artificial liver support device, may be beneficial in acute liver failure (ALF). To determine whether MARS improves survival in ALF. Randomized, controlled trial. (ClinicalTrials.gov: NCT00224705). 16 French liver transplantation centers. 102 patients with ALF. Conventional treatment (n = 49) or MARS with conventional treatment (n = 53), stratified according to whether paracetamol caused ALF. 6-month survival and secondary end points, including adverse events. 102 patients (mean age, 40.4 years [SD, 13]) were in the modified intention-to-treat (mITT) population. The per-protocol analysis (49 conventional, 39 MARS) included patients with at least 1 session of MARS of 5 hours or more. Six-month survival was 75.5% (95% CI, 60.8% to 86.2%) with conventional treatment and 84.9% (CI, 71.9% to 92.8%) with MARS (P = 0.28) in the mITT population and 75.5% (CI, 60.8% to 86.2%) with conventional treatment and 82.9% (CI, 65.9% to 91.9%) with MARS (P = 0.50) in the per-protocol population. In patients with paracetamol-related ALF, the 6-month survival rate was 68.4% (CI, 43.5% to 86.4%) with conventional treatment and 85.0% (CI, 61.1% to 96.0%) with MARS (P = 0.46) in the mITT population. Sixty-six of 102 patients had transplantation (41.0% among paracetamol-induced ALF; 79.4% among non-paracetamol-induced ALF) (P < 0.001). Adverse events did not significantly differ between groups. The short delay from randomization to liver transplantation (median, 16.2 hours) precludes definitive efficacy or safety evaluations. This randomized trial of MARS in patients with ALF was unable to provide definitive efficacy or safety conclusions because many patients had transplantation before administration of the intervention. Acute liver failure not caused by paracetamol was associated with greater 6-month patient survival. Assistance Publique-Hôpitaux de Paris.

  8. [The liver and the immune system].

    PubMed

    Jakab, Lajos

    2015-07-26

    The liver is known to be the metabolic centre of the organism and is under the control of the central nervous system. It has a peculiar tissue structure and its anatomic localisation defines it as part of the immune system having an individual role in the defence of the organism. The determinant of its particular tissue build-up is the sinusoid system. In addition to hepatocytes, one cell row "endothelium", stellate cells close to the external surface, Kupffer cells tightly to its inner surface, as well as dendritic cells and other cell types (T and B lymphocytes, natural killer and natural killer T-cells, mast cells, granulocytes) are present. The multitudes and variety of cells make it possible to carry out the tasks according to the assignment of the organism. The liver is a member of the immune system having immune cells largely in an activated state. Its principal tasks are the assurance of the peripheral immune tolerance of the organism with the help of the haemopoetic cells and transforming growth factor-β. The liver takes part in the determination of the manner of the non-specific immune response of the organism. In addition to acute phase reaction of the organism, the liver has a role in the adaptive/specific immune response. These functions include retardation of the T and B lymphocytes and the defence against harmful pathogens. With the collaboration of transforming growth factor-β, immunoglobulins and their subclasses are inhibited just as the response of the T lymphocytes. The only exception is the undisturbed immunoglobulin A production. Particularly important is the intensive participation of the liver in the acute phase reaction of the organism, which is organised and guided by the coordinated functions of the cortico-hypothalamo-hypophysis-adrenal axis. Beside cellular elements, hormones, adhesion molecules, chemokines and cytokines are also involved in the cooperation with the organs. Acute phase reactants play a central role in these processes

  9. Removal selectivity of Prometheus: a new extracorporeal liver support device.

    PubMed

    Rifai, Kinan; Ernst, Thomas; Kretschmer, Ulrich; Haller, Hermann; Manns, Michael Peter; Fliser, Danilo

    2006-02-14

    To evaluate whether treatment with the Prometheus reg system significantly affects cytokines, coagulation factors and other plasma proteins. We studied nine patients with acute-on-chronic liver failure and accompanying renal failure. Prometheus reg therapy was performed on 2 consecutive days for up to 6 h in all patients. Several biochemical parameters and blood counts were assessed at regular time points during Prometheus reg treatment. We observed a significant decrease of both protein-bound (e.g. bile acids) and water-soluble (e.g. ammonia) substances after Prometheus reg therapy. Even though leukocytes increased during treatment (P<0.01), we found no significant changes of C-reactive protein, interleukin-6, and tumor necrosis factor-alpha plasma levels (all P>0.5). Further, antithrombin 3, factor II and factor V plasma levels did not decrease during Prometheus reg therapy (all P>0.5), and the INR remained unchanged (P=0.4). Plasma levels of total protein, albumin, and fibrinogen were also not altered during Prometheus reg treatment (all P>0.5). Finally, platelet count did not change significantly during therapy (P=0.6). Despite significant removal of protein-bound and water-soluble substances, Prometheus reg therapy did not affect the level of cytokines, coagulation factors or other plasma proteins. Thus, the filters and adsorbers used in the system are highly effective and specific for water-soluble substances and toxins bound to the albumin fraction.

  10. Effect of extracorporeal liver support by MARS and Prometheus on serum cytokines in acute-on-chronic liver failure

    PubMed Central

    Stadlbauer, Vanessa; Krisper, Peter; Aigner, Reingard; Haditsch, Bernd; Jung, Aleksandra; Lackner, Carolin; Stauber, Rudolf E

    2006-01-01

    Introduction Cytokines are believed to play an important role in acute-on-chronic liver failure (ACLF). Extracorporeal liver support systems may exert beneficial effects in ACLF via removal of cytokines. At present, two systems are commercially available, the Molecular Adsorbent Recirculating System (MARS™) and Fractionated Plasma Separation, Adsorption and Dialysis (Prometheus™). The aim of this study was to compare the effects of MARS and Prometheus treatments on serum cytokine levels and their clearances. Methods Eight patients with ACLF underwent alternating treatments with either MARS or Prometheus in a randomized cross-over design. Thirty-four treatments (17 MARS, 17 Prometheus) were available for analysis. Serum cytokines were measured before and after each treatment, and cytokine clearance was calculated from paired arterial and venous samples and effective plasma flow one hour after the start of treatment. Results Baseline serum levels of interleukin (IL)-6, IL-8, IL-10, tumor necrosis factor-alpha (TNF-α), and soluble TNF-α receptor 1 were significantly elevated in patients with ACLF. Measurable plasma clearances were detected for all cytokines tested, but no significant changes in serum levels of any cytokine were found after treatments with MARS or Prometheus. In MARS treatments, IL-10 was cleared from plasma more efficiently than IL-6. Clearance of IL-10 was higher in Prometheus than in MARS treatments. Conclusion Cytokines are cleared from plasma by both MARS and Prometheus, but neither system is able to change serum cytokine levels. This discrepancy is probably due to a high rate of cytokine production in patients with ACLF. PMID:17156425

  11. Effect of extracorporeal liver support by MARS and Prometheus on serum cytokines in acute-on-chronic liver failure.

    PubMed

    Stadlbauer, Vanessa; Krisper, Peter; Aigner, Reingard; Haditsch, Bernd; Jung, Aleksandra; Lackner, Carolin; Stauber, Rudolf E

    2006-01-01

    Cytokines are believed to play an important role in acute-on-chronic liver failure (ACLF). Extracorporeal liver support systems may exert beneficial effects in ACLF via removal of cytokines. At present, two systems are commercially available, the Molecular Adsorbent Recirculating System (MARS) and Fractionated Plasma Separation, Adsorption and Dialysis (Prometheus). The aim of this study was to compare the effects of MARS and Prometheus treatments on serum cytokine levels and their clearances. Eight patients with ACLF underwent alternating treatments with either MARS or Prometheus in a randomized cross-over design. Thirty-four treatments (17 MARS, 17 Prometheus) were available for analysis. Serum cytokines were measured before and after each treatment, and cytokine clearance was calculated from paired arterial and venous samples and effective plasma flow one hour after the start of treatment. Baseline serum levels of interleukin (IL)-6, IL-8, IL-10, tumor necrosis factor-alpha (TNF-alpha), and soluble TNF-alpha receptor 1 were significantly elevated in patients with ACLF. Measurable plasma clearances were detected for all cytokines tested, but no significant changes in serum levels of any cytokine were found after treatments with MARS or Prometheus. In MARS treatments, IL-10 was cleared from plasma more efficiently than IL-6. Clearance of IL-10 was higher in Prometheus than in MARS treatments. Cytokines are cleared from plasma by both MARS and Prometheus, but neither system is able to change serum cytokine levels. This discrepancy is probably due to a high rate of cytokine production in patients with ACLF.

  12. Extended mission life support systems

    NASA Technical Reports Server (NTRS)

    Quattrone, P. D.

    1985-01-01

    Extended manned space missions which include interplanetary missions require regenerative life support systems. Manned mission life support considerations are placed in perspective and previous manned space life support system technology, activities and accomplishments in current supporting research and technology (SR&T) programs are reviewed. The life support subsystem/system technologies required for an enhanced duration orbiter (EDO) and a space operations center (SOC), regenerative life support functions and technology required for manned interplanetary flight vehicles, and future development requirements are outlined. The Space Shuttle Orbiters (space transportation system) is space cabin atmosphere is maintained at Earth ambient pressure of 14.7 psia (20% O2 and 80% N2). The early Shuttle flights will be seven-day flights, and the life support system flight hardware will still utilize expendables.

  13. Removal selectivity of Prometheus: A new extracorporeal liver support device

    PubMed Central

    Rifai, Kinan; Ernst, Thomas; Kretschmer, Ulrich; Haller, Hermann; Manns, Michael Peter; Fliser, Danilo

    2006-01-01

    AIM: To evaluate whether treatment with the Prometheus® system significantly affects cytokines, coagulation factors and other plasma proteins. METHODS: We studied nine patients with acute-on-chronic liver failure and accompanying renal failure. Prometheus® therapy was performed on 2 consecutive days for up to 6 h in all patients. Several biochemical parameters and blood counts were assessed at regular time points during Prometheus® treatment. RESULTS: We observed a significant decrease of both protein-bound (e.g. bile acids) and water-soluble (e.g. ammonia) substances after Prometheus® therapy. Even though leukocytes increased during treatment (P < 0.01), we found no significant changes of C-reactive protein, interleukin-6, and tumor necrosis factor-α plasma levels (all P  > 0.5). Further, antithrombin 3, factor II and factor V plasma levels did not decrease during Prometheus® therapy (all P  > 0.5), and the INR remained unchanged (P  = 0.4). Plasma levels of total protein, albumin, and fibrinogen were also not altered during Prometheus® treatment (all P  > 0.5). Finally, platelet count did not change significantly during therapy (P = 0.6). CONCLUSION: Despite significant removal of protein-bound and water-soluble substances, Prometheus® therapy did not affect the level of cytokines, coagulation factors or other plasma proteins. Thus, the filters and adsorbers used in the system are highly effective and specific for water-soluble substances and toxins bound to the albumin fraction. PMID:16521224

  14. [Habitability and life support systems].

    PubMed

    Nefedov, Iu G; Adamovich, B A

    1988-01-01

    This paper discusses various aspects of space vehicle habitability and life support systems. It describes variations in the chemical and microbial composition of an enclosed atmosphere during prolonged real and simulated flights. The paper gives a detailed description of life support systems and environmental investigations onboard the Mir station. It also outlines the development of space vehicle habitability and life support systems as related to future flights.

  15. Extracorporeal support with a cadaver liver as a bridge to transplantation.

    PubMed

    Fristoe, L W; Merrill, J H; Kangas, J A; Vogel, J E; Stammers, A H; Langnas, A N; Fox, I J; Shaw, B W

    1993-01-01

    Extracorporeal liver perfusion (ECLP) has been used for detoxifying blood in patients in class IV hepatic encephalopathy. Palliation of the moribund patient utilizing extracorporeal devices with cross-circulation of a cadaver liver has been documented for over three decades. Common problems associated with this procedure which appear in the literature include cadaver liver distention, increased resistance to blood flow, and limited time of extracorporeal support due to cadaver liver failure. This report summarizes the experiences of the perfusion team in utilizing an extracorporeal circuit with an otherwise nontransplantable cadaveric liver, to support the decompensating hepatic patient as a bridge to transplantation. Between January and July 1992, three patients were supported for hepatic failure with ECLP. Two patients were placed on ECLP with a modified circuit containing two positive displacement pumps and one centrifugal pump. The third patient was placed on ECLP with a circuit that contained two centrifugal pumps and one positive displacement pump. Patient age ranged from 6 to 38 years and length of support ranged from 24 to 72 hours. In all three patients, a centrifugal pump was placed in the suprahepatic inferior vena cava line to facilitate cadaver liver drainage and decompression. Intensive monitoring of both patient and cadaver liver hemodynamics, hepatic function, and hematological status was performed. All three patients were successfully weaned from ECLP. Two patients received successful orthotopic liver transplantation. The third died of complications unrelated to ECLP after support was discontinued.(ABSTRACT TRUNCATED AT 250 WORDS)

  16. Designing Electronic Performance Support Systems.

    ERIC Educational Resources Information Center

    Barker, Philip; Banerji, Ashok

    1995-01-01

    Outlines the basic nature of performance support and describes a generic model that can be used to facilitate electronic performance support system (EPSS) development. Performance measures are discussed; performance support guidelines are summarized; and a case study of the use of an EPSS is presented. (LRW)

  17. Supported liquid membrane system

    SciTech Connect

    Takigawa, D.Y.; Bush, H. Jr.

    1990-12-31

    A cell apparatus for a supported liquid membrane including opposing faceplates, each having a spirally configured groove, an inlet groove at a first end of the spirally configured groove, and an outlet groove at the other end of the spirally configured groove, within the opposing faces of the faceplates, a microporous membrane situated between the grooved faces of the faceplates, said microporous membrane containing an extractant mixture selective for a predetermined chemical species within the pores of said membrane, means for aligning the grooves of the faceplates in an directly opposing configuration with the porous membrane being situated therebetween, such that the aligned grooves form a pair of directly opposing channels, separate feed solution and stripping solution compartments connected to respective channels between the faceplates and the membrane, separate pumping means for passing feed solution and stripping solution through the channels is provided.

  18. Support systems design and analysis

    NASA Technical Reports Server (NTRS)

    Ferguson, R. M.

    1985-01-01

    The integration of Kennedy Space Center (KSC) ground support systems with the new launch processing system and new launch vehicle provided KSC with a unique challenge in system design and analysis for the Space Transportation System. Approximately 70 support systems are controlled and monitored by the launch processing system. Typical systems are main propulsion oxygen and hydrogen loading systems, environmental control life support system, hydraulics, etc. An End-to-End concept of documentation and analysis was chosen and applied to these systems. Unique problems were resolved in the areas of software analysis, safing under emergency conditions, sampling rates, and control loop analysis. New methods of performing End-to-End reliability analyses were implemented. The systems design approach selected and the resolution of major problem areas are discussed.

  19. Reactor vessel support system. [LMFBR

    DOEpatents

    Golden, M.P.; Holley, J.C.

    1980-05-09

    A reactor vessel support system includes a support ring at the reactor top supported through a box ring on a ledge of the reactor containment. The box ring includes an annular space in the center of its cross-section to reduce heat flow and is keyed to the support ledge to transmit seismic forces from the reactor vessel to the containment structure. A coolant channel is provided at the outside circumference of the support ring to supply coolant gas through the keyways to channels between the reactor vessel and support ledge into the containment space.

  20. Bioreactor Technologies to Support Liver Function In Vitro

    PubMed Central

    Ebrahimkhani, Mohammad R; Neiman, Jaclyn A Shepard; Raredon, Micah Sam B; Hughes, David J; Griffith, Linda G

    2014-01-01

    Liver is a central nexus integrating metabolic and immunologic homeostasis in the human body, and the direct or indirect target of most molecular therapeutics. A wide spectrum of therapeutic and technological needs drive efforts to capture liver physiology and pathophysiology in vitro, ranging from prediction of metabolism and toxicity of small molecule drugs, to understanding off-target effects of proteins, nucleic acid therapies, and targeted therapeutics, to serving as disease models for drug development. Here we provide perspective on the evolving landscape of bioreactor-based models to meet old and new challenges in drug discovery and development, emphasizing design challenges in maintaining long-term liver-specific function and how emerging technologies in biomaterials and microdevices are providing new experimental models. PMID:24607703

  1. Life Support Systems Microbial Challenges

    NASA Technical Reports Server (NTRS)

    Roman, Monserrate C.

    2009-01-01

    This viewgraph presentation reviews the current microbial challenges of environmental control and life support systems. The contents include: 1) Environmental Control and Life Support Systems (ECLSS) What is it?; 2) A Look Inside the International Space Station (ISS); 3) The Complexity of a Water Recycling System; 4) ISS Microbiology Acceptability Limits; 5) Overview of Current Microbial Challenges; 6) In a Perfect World What we Would like to Have; and 7) The Future.

  2. The nitric oxide donor S-nitrosoglutathione reduces apoptotic primary liver cell loss in a three-dimensional perfusion bioreactor culture model developed for liver support.

    PubMed

    Prince, Jose M; Vodovotz, Yoram; Baun, Matthew J; Monga, Satdarshan Pal; Billiar, Timothy R; Gerlach, Jörg C

    2010-03-01

    Artificial extracorporeal support for hepatic failure has met with limited clinical success. In hepatocytes, nitric oxide (NO) functions as an antiapoptotic modulator in response to a variety of stresses. We hypothesized that NO administration would yield improved viability and hepatocellular restructuring in a four-compartment, hollow fiber-based bioreactor with integral oxygenation for dynamic three-dimensional perfusion of hepatic cells in bioartificial liver support systems. Isolated adult rat liver cells were placed in culture medium alone (control) or medium supplemented with various concentrations of an NO donor (S-nitrosoglutathione [GSNO]) in the bioreactors. Media samples were obtained from the cell perfusion circuit to monitor cellular response. After 24 and 72 h, histology biopsies were taken to investigate spontaneous restructuring of the cells. Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay was performed to quantify apoptotic nuclei. Control bioreactors exhibited 47.9 +/- 2.9% (mean +/- standard error of the mean) apoptotic nuclei. In contrast, NO-treated bioreactors exhibited a biphasic response. Fewer apoptotic nuclei were seen in the 200 and 500 microM GSNO groups (14.4 +/- 0.4%). No effect was observed in the 10 microM GSNO group (47.3%), and increased TUNEL staining was observed in the 1000 microM GSNO group (82.6%). Media lactate dehydrogenase levels were lower in bioreactor groups treated with 200 or 500 microM GSNO (310 +/- 38 IU/L) compared with the control group (919 +/- 188 IU/L; p < 0.05). Protein synthesis was not affected, as measured by albumin levels in the media (115 +/- 19 microg/day/cell inoculum in GSNO-treated bioreactors at 24 h vs. 110 +/- 13 in controls; p = 0.851). Histologically, all of the bioreactor groups exhibited liver cell aggregates with some attached to the bioreactor capillaries. Increased numbers of cells in the aggregates and superior spontaneous restructuring of the cells were seen at

  3. [Hemoperitoneum supporting difficult diagnosis of diffuse hepatocarcinoma in liver cirrhosis].

    PubMed

    Vignoli, A; Cioni, G; Sardini, C; Tincani, E; Cristani, A; Ventura, E

    1994-04-01

    The cases of two patients with liver cirrhosis HCV-related, admitted in our Department in consequence of the development of ascites, anemia and clinical deterioration, are reported. Both patients had all major risk factors for hepatocellular carcinoma and anamnestic and physical findings suggesting this diagnosis; nevertheless, the alpha-1-fetoprotein serum levels and the ultrasonographic findings were not diagnostic for primary hepatic neoplasm. Explorative paracentesis was diagnostic, demonstrating the presence of hemoperitoneum (the hematocrit ratio in the ascitic fluid was 12 and 10, respectively). Magnetic resonance revealed extensive diffuse hepatocellular carcinoma on both cases. Hemoperitoneum, in patients with liver cirrhosis, in face of non diagnostic levels of alpha-1-fetoprotein and ultrasonographic findings, can be indicative of the spontaneous rupture of a diffuse type of hepatocellular carcinoma.

  4. Ergonomically neutral arm support system

    DOEpatents

    Siminovitch, Michael J; Chung, Jeffrey Y; Dellinges, Steven; Lafever, Robin E

    2005-08-02

    An ergonomic arm support system maintains a neutral position for the forearm. A mechanical support structure attached to a chair or other mounting structure supports the arms of a sitting or standing person. The system includes moving elements and tensioning elements to provide a dynamic balancing force against the forearms. The support structure is not fixed or locked in a rigid position, but is an active dynamic system that is maintained in equipoise by the continuous operation of the opposing forces. The support structure includes an armrest connected to a flexible linkage or articulated or pivoting assembly, which includes a tensioning element such as a spring. The pivoting assembly moves up and down, with the tensioning element providing the upward force that balances the downward force of the arm.

  5. Life-Support-System Analyzer

    NASA Technical Reports Server (NTRS)

    Seshan, Panchalam K.; Ferrall, Joseph F.; Rohatgi, Naresh K.

    1993-01-01

    Paper describes software system, called Generic Modular Flow Schematic (GMFS), developed for use in synthesis, mathematical modeling, and analysis of life-support systems aboard spacecraft, ranging from simple open-loop configurations to complex closed-loop ones. GMFS also compares alternative systems.

  6. Towards Evolutional Authoring Support Systems

    ERIC Educational Resources Information Center

    Aroyo, Lora; Mizoguchi, Riichiro

    2004-01-01

    The ultimate aim of this research is to specify and implement a general authoring framework for content and knowledge engineering for Intelligent Educational Systems (IES). In this context we attempt to develop an authoring tool supporting this framework that is powerful in its functionality, generic in its support of instructional strategies and…

  7. Systematic review: unmet supportive care needs in people diagnosed with chronic liver disease

    PubMed Central

    Valery, Patricia C; Powell, Elizabeth; Moses, Neta; Volk, Michael L; McPhail, Steven M; Clark, Paul J; Martin, Jennifer

    2015-01-01

    Objective People with chronic liver disease, particularly those with decompensated cirrhosis, experience several potentially debilitating complications that can have a significant impact on activities of daily living and quality of life. These impairments combined with the associated complex treatment mean that they are faced with specific and high levels of supportive care needs. We aimed to review reported perspectives, experiences and concerns of people with chronic liver disease worldwide. This information is necessary to guide development of policies around supportive needs screening tools and to enable prioritisation of support services for these patients. Design Systematic searches of PubMed, MEDLINE, CINAHL and PsycINFO from the earliest records until 19 September 2014. Data were extracted using standardised forms. A qualitative, descriptive approach was utilised to analyse and synthesise data. Results The initial search yielded 2598 reports: 26 studies reporting supportive care needs among patients with chronic liver disease were included, but few of them were patient-reported needs, none used a validated liver disease-specific supportive care need assessment instrument, and only three included patients with cirrhosis. Five key domains of supportive care needs were identified: informational or educational (eg, educational material, educational sessions), practical (eg, daily living), physical (eg, controlling pruritus and fatigue), patient care and support (eg, support groups), and psychological (eg, anxiety, sadness). Conclusions While several key domains of supportive care needs were identified, most studies included hepatitis patients. There is a paucity of literature describing the supportive care needs of the chronic liver disease population likely to have the most needs—namely those with cirrhosis. Assessing the supportive care needs of people with chronic liver disease have potential utility in clinical practice for facilitating timely referrals

  8. Challenge of liver disease in systemic lupus erythematosus: Clues for diagnosis and hints for pathogenesis

    PubMed Central

    Bessone, Fernando; Poles, Natalia; Roma, Marcelo G

    2014-01-01

    Systemic lupus erythematosus (SLE) encompass a broad spectrum of liver diseases. We propose here to classify them as follows: (1) immunological comorbilities (overlap syndromes); (2) non-immunological comorbilities associated to SLE; and (3) a putative liver damage induced by SLE itself, referred to as “lupus hepatitis”. In the first group, liver injury can be ascribed to overlapping hepatopathies triggered by autoimmune mechanisms other than SLE occurring with higher incidence in the context of lupus (e.g., autoimmune hepatitis, primary biliary cirrhosis). The second group includes non-autoimmune liver diseases, such as esteatosis, hepatitis C, hypercoagulation state-related liver lesions, hyperplasic parenchymal and vascular lesions, porphyria cutanea tarda, and drug-induced hepatotoxicity. Finally, the data in the literature to support the existence of a hepatic disease produced by SLE itself, or the occurrence of a SLE-associated prone condition that increases susceptibility to acquire other liver diseases, is critically discussed. The pathological mechanisms underlying each of these liver disorders are also reviewed. Despite the high heterogeneity in the literature regarding the prevalence of SLE-associated liver diseases and, in most cases, lack of histopathological evidence or clinical studies large enough to support their existence, it is becoming increasingly apparent that liver is an important target of SLE. Consequently, biochemical liver tests should be routinely carried out in SLE patients to discard liver disorders, particularly in those patients chronically exposed to potentially hepatotoxic drugs. Diagnosing liver disease in SLE patients is always challenging, and the systematization of the current information carried out in this review is expected to be of help both to attain a better understanding of pathogenesis and to build an appropriate work-up for diagnosis. PMID:25018850

  9. Malnutrition and Nutritional Support in Alcoholic Liver Disease: a Review.

    PubMed

    Chao, Andrew; Waitzberg, Dan; de Jesus, Rosangela Passos; Bueno, Allain A; Kha, Victor; Allen, Karen; Kappus, Matthew; Medici, Valentina

    2016-12-01

    Malnutrition is associated with alcoholic liver disease (ALD) and related complications such as hepatic encephalopathy and increased rate of infections. Avoidance of prolonged fasting and overly restrictive diets is important to avoid poor nutrition. Adequate intake of calories, protein, and micronutrients via frequent small meals and evening supplements and/or enteral and parenteral nutrition when indicated has been associated with reduced mortality and morbidity in patients with ALD. Modification of protein/fat sources and composition in addition to probiotic supplementation are promising interventions for decreased progression of ALD and its complications.

  10. Rhode Island Model Evaluation & Support System: Support Professional. Edition II

    ERIC Educational Resources Information Center

    Rhode Island Department of Education, 2015

    2015-01-01

    Rhode Island educators believe that implementing a fair, accurate, and meaningful evaluation and support system for support professionals will help improve student outcomes. The primary purpose of the Rhode Island Model Support Professional Evaluation and Support System (Rhode Island Model) is to help all support professionals do their best work…

  11. [Remote radiation planning support system].

    PubMed

    Atsumi, Kazushige; Nakamura, Katsumasa; Yoshidome, Satoshi; Shioyama, Yoshiyuki; Sasaki, Tomonari; Ohga, Saiji; Yoshitake, Tadamasa; Shinoto, Makoto; Asai, Kaori; Sakamoto, Katsumi; Hirakawa, Masakazu; Honda, Hiroshi

    2012-08-01

    We constructed a remote radiation planning support system between Kyushu University Hospital (KUH) in Fukuoka and Kyushu University Beppu Hospital (KBH) in Oita. Between two institutions, radiology information system for radiotherapy division (RT-RIS) and radiation planning system (RTPS) were connected by virtual private network (VPN). This system enables the radiation oncologists at KUH to perform radiotherapy planning for the patients at KBH. The detail of the remote radiation planning support system in our institutions is as follows: The radiation oncologist at KBH performs radiotherapy planning and the data of the patients are sent anonymously to the radiation oncologists at KUH. The radiation oncologists at KUH receive the patient's data, access to RTPS at KBH, verify or change the radiation planning at KBH: Radiation therapy is performed at KBH according to the confirmed plan by the radiation oncologists at KUH. Our remote radiation planning system is useful for providing radiation therapy with safety and accuracy.

  12. Modifying Health Behavior for Liver Fluke and Cholangiocarcinoma Prevention with the Health Belief Model and Social Support Theory.

    PubMed

    Padchasuwan, Natnapa; Kaewpitoon, Soraya J; Rujirakul, Ratana; Wakkuwattapong, Parichart; Norkaew, Jun; Kujapun, Jirawoot; Ponphimai, Sukanya; Chavenkun, Wasugree; Kompor, Pontip; Kaewpitoon, Natthawut

    2016-01-01

    The liver fluke Opisthorchis viverrini is a serious health problem in Thailand. Infection is associated with cholangiocarcinoma (CCA), endemic among human populations in northeast and north Thailand where raw fish containing fluke metacercariae are frequently consumed. Recently, Thailand public health authorities have been organized to reduce morbidity and mortality particularly in the northeast through O. viverrini and CCA screening projects. Health modfication is one of activities included in this campaign, but systemic guidelines of modifying and developing health behavior for liver flukes and CCA prevention in communities towards health belief and social support theory are still various and unclear. Here we review the guidelines for modifying and developing health behavior among populations in rural communities to strengthen understanding regarding perceived susceptibility, severity, benefits, and barriers to liver fluke and CCA prevention. This model may be useful for public health of cancers and related organizations to further health behavior change in endemic areas.

  13. Implantable micropump system for augmented liver perfusion.

    PubMed

    Marseille, O; Habib, N; Reul, H; Rau, G

    1998-06-01

    Liver cirrhosis, a worldwide health problem, decreases the blood flow through the liver. This in turn leads to dangerous portal hypertension and decreased metabolic function within the liver. To improve this situation, a new concept is proposed which involves introducing a microaxial blood pump into the portal vein. This device is intended to increase blood flow through the liver and to enhance hepatic function. Furthermore, high pressures will be reduced to physiological levels. The microaxial pump with its single stage impeller is powered by a proximally integrated microelectric motor. The pump unit is completely immersed within the blood vessel. Heat caused by electrical and mechanical losses will be transported into the blood. In vitro optimization of the pump design was accomplished using both hydraulic and hemolysis tests.

  14. An Organotypic Liver System for Tumor Progression

    DTIC Science & Technology

    2007-04-01

    parenchymal cells from the GFP- transgenic rats establish channel-filled organoid cultures in the bioreactor similar to non-GFP- transgenic animal ...Task 3. Seed bioreactors with cells. This task has been fully established. We have generated liver bioreactors with transgenic hepatocytes and...novel technology, liver, bioreactor 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a. NAME OF RESPONSIBLE

  15. An automated diagnosis system of liver disease using artificial immune and genetic algorithms.

    PubMed

    Liang, Chunlin; Peng, Lingxi

    2013-04-01

    The rise of health care cost is one of the world's most important problems. Disease prediction is also a vibrant research area. Researchers have approached this problem using various techniques such as support vector machine, artificial neural network, etc. This study typically exploits the immune system's characteristics of learning and memory to solve the problem of liver disease diagnosis. The proposed system applies a combination of two methods of artificial immune and genetic algorithm to diagnose the liver disease. The system architecture is based on artificial immune system. The learning procedure of system adopts genetic algorithm to interfere the evolution of antibody population. The experiments use two benchmark datasets in our study, which are acquired from the famous UCI machine learning repository. The obtained diagnosis accuracies are very promising with regard to the other diagnosis system in the literatures. These results suggest that this system may be a useful automatic diagnosis tool for liver disease.

  16. Decision Support Systems in Libraries.

    ERIC Educational Resources Information Center

    Heindel, Allan; Napier, H. Albert

    Following a review of the contributions of computers and managerial science/operations research to the management of libraries, this paper introduces the concept of decision support systems. DSS, a blending of these techniques, can lead to more effective decisions by library managers. A case study of the utilization of a DSS in the budgeting…

  17. Fetal liver hepatic progenitors are supportive stromal cells for hematopoietic stem cells.

    PubMed

    Chou, Song; Lodish, Harvey F

    2010-04-27

    Previously we showed that the ~2% of fetal liver cells reactive with an anti-CD3epsilon monoclonal antibody support ex vivo expansion of both fetal liver and bone marrow hematopoietic stem cells (HSCs); these cells express two proteins important for HSC ex vivo expansion, IGF2, and angiopoietin-like 3. Here we show that these cells do not express any CD3 protein and are not T cells; rather, we purified these HSC-supportive stromal cells based on the surface phenotype of SCF(+)DLK(+). Competitive repopulating experiments show that SCF(+)DLK(+) cells support the maintenance of HSCs in ex vivo culture. These are the principal fetal liver cells that express not only angiopoietin-like 3 and IGF2, but also SCF and thrombopoietin, two other growth factors important for HSC expansion. They are also the principal fetal liver cells that express CXCL12, a factor required for HSC homing, and also alpha-fetoprotein (AFP), indicating that they are fetal hepatic stem or progenitor cells. Immunocytochemistry shows that >93% of the SCF(+) cells express DLK and Angptl3, and a portion of SCF(+) cells also expresses CXCL12. Thus SCF(+)DLK(+) cells are a highly homogenous population that express a complete set of factors for HSC expansion and are likely the primary stromal cells that support HSC expansion in the fetal liver.

  18. Bioartificial liver: current status.

    PubMed

    Pless, G; Sauer, I M

    2005-11-01

    Liver failure remains a life-threatening syndrome. With the growing disparity between the number of suitable donor organs and the number of patients awaiting transplantation, efforts have been made to optimize the allocation of organs, to find alternatives to cadaveric liver transplantation, and to develop extracorporeal methods to support or replace the function of the failing organ. An extracorporeal liver support system has to provide the main functions of the liver: detoxification, synthesis, and regulation. The understanding that the critical issue of the clinical syndrome in liver failure is the accumulation of toxins not cleared by the failing liver led to the development of artificial filtration and adsorption devices (artificial liver support). Based on this hypothesis, the removal of lipophilic, albumin-bound substances, such as bilirubin, bile acids, metabolites of aromatic amino acids, medium-chain fatty acids, and cytokines, should be beneficial to the clinical course of a patient in liver failure. Artificial detoxification devices currently under clinical evaluation include the Molecular Adsorbent Recirculating System (MARS), Single-Pass Albumin Dialysis (SPAD), and the Prometheus system. The complex tasks of regulation and synthesis remain to be addressed by the use of liver cells (bioartificial liver support). The Extracorporeal Liver Assist Device (ELAD), HepatAssist, Modular Extracorporeal Liver Support system (MELS), and the Amsterdam Medical Center Bioartificial Liver (AMC-BAL) are bioartificial systems. This article gives a brief overview on these artificial and bioartificial devices and discusses remaining obstacles.

  19. [Organ replacement therapy - extracorporeal liver assist devices].

    PubMed

    Sinner, Barbara; Kirchner, Gabriele I

    2016-09-01

    Liver failure is a disease with a high mortality rate. Often liver transplantation is the sole therapeutic option. On the one hand, liver support systems probably support the liver to allow regeneration, on the other hand they are an option to bridge for transplantation. This article gives an overview on the clinically used liver assist devices (molecular adsorbent recirculating system [MARS], Prometheus system, single-pass albumin dialysis [SPAD], plasmapheresis) and discusses the applications in liver failure.

  20. The Virtual Liver Network: systems understanding from bench to bedside.

    PubMed

    Henney, Adriano; Coaker, Hannah

    2014-01-01

    Adriano Henney speaks to Hannah Coaker, Commissioning Editor. After achieving a PhD in medicine and spending many years in academic research in the field of cardiovascular disease, Adriano Henney was recruited by Zeneca Pharmaceuticals from a British Heart Foundation Senior Fellowship, where he led the exploration of new therapeutic approaches in atherosclerosis, specifically focusing on his research interests in vascular biology. Following the merger with Astra to form AstraZeneca, Henney became responsible for exploring strategic improvements to the company's approaches to pharmaceutical target identification and the reduction of attrition in early development, directing projects across research sites and across functional project teams in the USA, Sweden and the UK. This resulted in the creation of a new multidisciplinary department that focused on pathway mapping, modeling and simulation and supporting projects across research and development, which evolved into the establishment of the practice of systems biology within the company. Here, projects prototyped the application of mechanistic disease-modeling approaches in order to support the discovery of innovative new medicines, such as Iressa®. Since leaving AstraZeneca, Henney has continued his interest in systems biology, synthetic biology and systems medicine through his company, Obsidian Biomedical Consulting Ltd. He now directs a major €50 million German national flagship program – the Virtual Liver Network – which is currently the largest systems biology program in Europe.

  1. Modified pediatric end-stage liver disease scoring system and pediatric liver transplantation in Brazil.

    PubMed

    Neto, Joao Seda; Carone, Eduardo; Pugliese, Renata P S; Fonseca, Eduardo A; Porta, Gilda; Miura, Irene; Danesi, Vera B; Guimaraes, Teresa C; Godoy, Andre L; Porta, Adriana; Vincenzi, Rodrigo; Carnevale, Francisco; Kondo, Mario; Chapchap, Paulo

    2010-04-01

    The Pediatric End-Stage Liver Disease (PELD) scoring system is a formula developed to provide a continuous numerical assessment of the risk of death in order to allocate livers to children in need of transplantation. The PELD scoring system was introduced in Brazil in July 2006. An important change was made in the system: the final number for listing patients less than 12 years old for transplantation was the calculated PELD score multiplied by 3. The consequences of this allocation policy were analyzed in 2 ways in this research: nationally and in the state of São Paulo (SP State). In the analysis of the national data, a comparison of the pre-PELD era (July 2003 to July 2006) and the post-PELD era (August 2006 to April 2009) showed that the total number of pediatric transplants for children under 12 years of age decreased 7%. Regionally, in SP State, there was a 62% increase in the number of deceased donor liver transplantation procedures for the pediatric population after the introduction of the modified PELD system. There was also a 6.1-fold increase in split liver transplantation as well as a statistically significant decrease in the time on the waiting list (P < 0.001). In conclusion, changing the allocation policy in Brazil in order to benefit pediatric patients on the waiting list had different results according to analyses of national and regional data. A significant increase in deceased donor liver transplantation/split liver transplantation and a shorter time on the waiting list were observed in SP State. The modified PELD scoring system is simple and optimizes the utilization of deceased donor liver grafts in centers performing pediatric transplants. (c) 2010 AASLD

  2. Photobioreactors in Life Support Systems.

    PubMed

    Wagner, Ines; Braun, Markus; Slenzka, Klaus; Posten, Clemens

    2016-01-01

    Life support systems for long-term space missions or extraterrestrial installations have to fulfill major functions such as purification of water and regeneration of atmosphere as well as the generation of food and energy. For almost 60 years ideas for biological life support systems have been collected and various concepts have been developed and tested. Microalgae as photosynthetic organisms have played a major role in most of these concepts. This review deals with the potentials of using eukaryotic microalgae for life support systems and highlights special requirements and frame conditions for designing space photobioreactors especially regarding illumination and aeration. Mono- and dichromatic illumination based on LEDs is a promising alternative for conventional systems and preliminary results yielded higher photoconversion efficiencies (PCE) for dichromatic red/blue illumination than white illumination. Aeration for microgravity conditions should be realized in a bubble-free manner, for example, via membranes. Finally, a novel photobioreactor concept for space application is introduced being parameterized and tested with the microalga Chlamydomonas reinhardtii. This system has already been tested during two parabolic flight campaigns.

  3. The Life Support Database system

    NASA Technical Reports Server (NTRS)

    Likens, William C.

    1991-01-01

    The design and implementation of the database system are described with specific reference to data available from the Build-1 version and techniques for its utilization. The review of the initial documents for the Life Support Database is described in terms of title format and sequencing, and the users are defined as participants in NASA-sponsored life-support research. The software and hardware selections are based respectively on referential integrity and compatibility, and the implementation of the user interface is achieved by means of an applications-programming tool. The current Beta-Test implementation of the system includes several thousand acronyms and bibliographic references as well as chemical properties and exposure limits, equipment, construction materials, and mission data. In spite of modifications in the database the system is found to be effective and a potentially significant resource for the aerospace community.

  4. Modeling Advance Life Support Systems

    NASA Technical Reports Server (NTRS)

    Pitts, Marvin; Sager, John; Loader, Coleen; Drysdale, Alan

    1996-01-01

    Activities this summer consisted of two projects that involved computer simulation of bioregenerative life support systems for space habitats. Students in the Space Life Science Training Program (SLSTP) used the simulation, space station, to learn about relationships between humans, fish, plants, and microorganisms in a closed environment. One student complete a six week project to modify the simulation by converting the microbes from anaerobic to aerobic, and then balancing the simulation's life support system. A detailed computer simulation of a closed lunar station using bioregenerative life support was attempted, but there was not enough known about system restraints and constants in plant growth, bioreactor design for space habitats and food preparation to develop an integrated model with any confidence. Instead of a completed detailed model with broad assumptions concerning the unknown system parameters, a framework for an integrated model was outlined and work begun on plant and bioreactor simulations. The NASA sponsors and the summer Fell were satisfied with the progress made during the 10 weeks, and we have planned future cooperative work.

  5. Operator Performance Support System (OPSS)

    NASA Technical Reports Server (NTRS)

    Conklin, Marlen Z.

    1993-01-01

    In the complex and fast reaction world of military operations, present technologies, combined with tactical situations, have flooded the operator with assorted information that he is expected to process instantly. As technologies progress, this flow of data and information have both guided and overwhelmed the operator. However, the technologies that have confounded many operators today can be used to assist him -- thus the Operator Performance Support Team. In this paper we propose an operator support station that incorporates the elements of Video and Image Databases, productivity Software, Interactive Computer Based Training, Hypertext/Hypermedia Databases, Expert Programs, and Human Factors Engineering. The Operator Performance Support System will provide the operator with an integrating on-line information/knowledge system that will guide expert or novice to correct systems operations. Although the OPSS is being developed for the Navy, the performance of the workforce in today's competitive industry is of major concern. The concepts presented in this paper which address ASW systems software design issues are also directly applicable to industry. the OPSS will propose practical applications in how to more closely align the relationships between technical knowledge and equipment operator performance.

  6. Effect of social support and donation-related concerns on ambivalence of living liver donor candidates.

    PubMed

    Lai, Yun-Chieh; Lee, Wei-Chen; Juang, Yeong-Yuh; Yen, Lee-Lan; Weng, Li-Chueh; Chou, Hsueh Fen

    2014-11-01

    Ambivalence in the decision-making process for living liver donors has the potential to result in their experiencing a negative mental status. To promote donor candidates' well-being, it is important to study the factors related to ambivalence. Thus, the aim of this study was to explore the ambivalence of living liver donor candidates and to investigate the effect of social support and donation-related concerns on their ambivalence. A cross-sectional design was used. In total, 100 living liver donor candidates who underwent a preoperative evaluation between April and October 2009 were recruited for the study. Participants completed a self-administered questionnaire that contained items related to ambivalence, donation-related concerns, and social support. The mean score for ambivalence was 3.14 (standard deviation = 1.8), and the median was 3. Only 7% of the study sample reported no ambivalence during the assessment stage. Ambivalence was positively correlated with donation-related concerns (physical concerns, r = 0.39; psychosocial concerns, r = 0.43; financial concerns, r = 0.29) and negatively correlated with social support (r = -0.16 to -0.33). Those with psychosocial concerns had significantly worse ambivalence (β = 0.29, P = 0.03), but social support mitigated ambivalence (β = -0.34, P = 0.01). When intimacy and social support were included in the model, the effect of psychosocial concerns on ambivalence became nonsignificant (β = 0.24, P = 0.08). Ambivalence is common among living liver donor candidates, but instrumental social support can mediate the negative effect of donation-related concerns. Recommendations include providing appropriate social support to minimize donation-related concerns and, thus, to reduce the ambivalence of living liver candidates.

  7. Satellite operations support expert system

    NASA Technical Reports Server (NTRS)

    1985-01-01

    The Satellite Operations Support Expert System is an effort to identify aspects of satellite ground support activity which could profitably be automated with artificial intelligence (AI) and to develop a feasibility demonstration for the automation of one such area. The hydrazine propulsion subsystems (HPS) of the International Sun Earth Explorer (ISEE) and the International Ultraviolet Explorer (IUS) were used as applications domains. A demonstration fault handling system was built. The system was written in Franz Lisp and is currently hosted on a VAX 11/750-11/780 family machine. The system allows the user to select which HPS (either from ISEE or IUE) is used. Then the user chooses the fault desired for the run. The demonstration system generates telemetry corresponding to the particular fault. The completely separate fault handling module then uses this telemetry to determine what and where the fault is and how to work around it. Graphics are used to depict the structure of the HPS, and the telemetry values displayed on the screen are continually updated. The capabilities of this system and its development cycle are described.

  8. Automated Inventory Manager Support System

    DTIC Science & Technology

    1993-05-01

    SUPPORT SYSTEM CONTENTS 1 Executive snumary 2 Introduction and background 3 Analysis metodology 4 Premodernzation baseline 5 Incurred costs and accrued...Document SDF Statistical Demnnd Foruast SL Saety Leve SMC Smell Multiuser Computer SPD Special Purpose Dar sscs Standard Supply Control Study WLT Total...AIMS Workload Data 3.7 3-6 Microcomputer/Printer Maintenance Cost 3.9 4-1 Standard Supply Control Study Before AIMS 4.2 4-2 AIMS Summary Cost 13

  9. Apollo Portable Life Support System

    NASA Image and Video Library

    1968-06-11

    S68-34580 (1968) --- With its exterior removed, the Apollo portable life support system (PLSS) can be easily studied. The PLSS is worn as a backpack over the Extravehicular Mobility Unit (EMU), a multi-layered spacesuit used for outside-the-spacecraft activity. JSC photographic frame no. S68-34582 is a close-up view of the working parts of the PLSS.

  10. Apollo Portable Life Support System

    NASA Image and Video Library

    1968-06-11

    S68-34582 (1968) --- With its exterior removed, the Apollo portable life support system (PLSS) can be easily studied. The PLSS is worn as a backpack over the Extravehicular Mobility Unit (EMU) a multi-layered spacesuit used for outside-the-spacecraft activity. JSC photographic frame no. S68-34582 is a wider view of the exposed interior working parts of the PLSS and its removed cover.

  11. Perioperative nutritional support and fluid therapy in patients with liver diseases.

    PubMed

    Sun, Yongliang; Yang, Zhiying; Tan, Haidong

    2014-06-01

    The prevalence of liver dysfunction and malnutrition is common among patients with obstructive jaundice or cirrhosis, the poor nutrition status in patients with indications for hepatic resection increases the risk of postoperative complications and/or mortality. Hepatic surgery significantly affects body's metabolism and environment. Therefore, it is very important for patients with liver diseases undergoing hepatic surgery to receive essential nutritional support and fluid therapy during perioperative period. There are several principles in nutritional support and fluid therapy that surgeons need to pay attention to, for example, time, nutritional approach, fluid volume, choice of fat emulsions and amino acids. Some issues, such as albumin and plasma application, choice of crystalloid and colloid, liver protective therapy, also need further attention.

  12. Prometheus--a new extracorporeal system for the treatment of liver failure.

    PubMed

    Rifai, Kinan; Ernst, Thomas; Kretschmer, Ulrich; Bahr, Matthias J; Schneider, Andrea; Hafer, Carsten; Haller, Hermann; Manns, Michael P; Fliser, Danilo

    2003-12-01

    Extracorporeal detoxification systems for supportive therapy of liver failure have recently gained much interest. We herein report results from the first clinical application of Prometheus, a new liver support system in which albumin-bound substances are directly removed from blood by special adsorber. In a simultaneous step, high-flux hemodialysis is performed. We assessed safety, adsorber efficiency and clinical efficacy of the Prometheus system. Eleven patients with acute-on-chronic liver failure and accompanying renal failure were treated with Prometheus on 2 consecutive days for >4 h. Prometheus treatment significantly improved serum levels of conjugated bilirubin, bile acids, ammonia, cholinesterase, creatinine, urea and blood pH. There were no significant changes in hemoglobin and platelet levels, whereas leucocytes increased without signs of systemic infection. No treatment-related complications except a blood pressure drop in two patients with systemic infection were noted. In one patient (Child-Pugh score: 15) Prometheus treatment could not be completed due to onset of uncontrolled bleeding 16 h after dialysis. Prometheus is a safe supportive therapy for patients with liver failure. A significant improvement of the biochemical milieu was observed already after two treatments. Prospective controlled studies with the Prometheus system are necessary to evaluate hard clinical end-points.

  13. The Nitric Oxide Donor S-Nitrosoglutathione Reduces Apoptotic Primary Liver Cell Loss in a Three-Dimensional Perfusion Bioreactor Culture Model Developed for Liver Support

    PubMed Central

    Prince, Jose M.; Vodovotz, Yoram; Baun, Matthew J.; Monga, Satdarshan Pal; Billiar, Timothy R.

    2010-01-01

    Introduction Artificial extracorporeal support for hepatic failure has met with limited clinical success. In hepatocytes, nitric oxide (NO) functions as an antiapoptotic modulator in response to a variety of stresses. We hypothesized that NO administration would yield improved viability and hepatocellular restructuring in a four-compartment, hollow fiber-based bioreactor with integral oxygenation for dynamic three-dimensional perfusion of hepatic cells in bioartificial liver support systems. Methods Isolated adult rat liver cells were placed in culture medium alone (control) or medium supplemented with various concentrations of an NO donor (S-nitrosoglutathione [GSNO]) in the bioreactors. Media samples were obtained from the cell perfusion circuit to monitor cellular response. After 24 and 72 h, histology biopsies were taken to investigate spontaneous restructuring of the cells. Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay was performed to quantify apoptotic nuclei. Results Control bioreactors exhibited 47.9 ± 2.9% (mean ± standard error of the mean) apoptotic nuclei. In contrast, NO-treated bioreactors exhibited a biphasic response. Fewer apoptotic nuclei were seen in the 200 and 500 μM GSNO groups (14.4 ± 0.4%). No effect was observed in the 10 μM GSNO group (47.3%), and increased TUNEL staining was observed in the 1000 μM GSNO group (82.6%). Media lactate dehydrogenase levels were lower in bioreactor groups treated with 200 or 500 μM GSNO (310 ± 38 IU/L) compared with the control group (919 ± 188 IU/L; p < 0.05). Protein synthesis was not affected, as measured by albumin levels in the media (115 ± 19 μg/day/cell inoculum in GSNO-treated bioreactors at 24 h vs. 110 ± 13 in controls; p = 0.851). Histologically, all of the bioreactor groups exhibited liver cell aggregates with some attached to the bioreactor capillaries. Increased numbers of cells in the aggregates and

  14. Atypical giant haemangioma of liver with systemic inflammatory manifestations.

    PubMed

    Khalid, Mohd; Ahmad, Mehtab; Jain, Amit; Rizvi, Imran

    2013-01-25

    Haemangioma is the most common benign tumour of the liver. Most of them are small in size (less than 4 cm) and are often asymptomatic and discovered incidentally on modern diagnostic imaging. Lesions with a diameter larger than 4 cm are called giant haemangiomas, and these are usually located in the right hepatic lobe. Although haemangioma is the most frequent benign tumour of the liver, 'giant' haemangiomas are rare. Such lesions may give rise to symptoms requiring treatment. In this case report, we describe the case of a 50-year-old Indian man who presented with giant liver haemangioma and systemic inflammatory manifestations.

  15. Regenerative life support system research

    NASA Technical Reports Server (NTRS)

    1988-01-01

    Sections on modeling, experimental activities during the grant period, and topics under consideration for the future are contained. The sessions contain discussions of: four concurrent modeling approaches that were being integrated near the end of the period (knowledge-based modeling support infrastructure and data base management, object-oriented steady state simulations for three concepts, steady state mass-balance engineering tradeoff studies, and object-oriented time-step, quasidynamic simulations of generic concepts); interdisciplinary research activities, beginning with a discussion of RECON lab development and use, and followed with discussions of waste processing research, algae studies and subsystem modeling, low pressure growth testing of plants, subsystem modeling of plants, control of plant growth using lighting and CO2 supply as variables, search for and development of lunar soil simulants, preliminary design parameters for a lunar base life support system, and research considerations for food processing in space; and appendix materials, including a discussion of the CELSS Conference, detailed analytical equations for mass-balance modeling, plant modeling equations, and parametric data on existing life support systems for use in modeling.

  16. An Organotypic Liver System for Tumor Progression

    DTIC Science & Technology

    2006-04-01

    transgenic rats establish channel-filled organoid cultures in the bioreactor similar to non-GFP- transgenic animal cells, as shown here 5 days after...This task has been fully established. We have moved to generating liver bioreactors with transgenic hepatocytes and/or endothelial cells expressing...GFP to better image the interactions with the tumor cells. These cells form bioreactor structures indistinguishable from non- transgenic cells

  17. Systems simulations supporting NASA telerobotics

    NASA Technical Reports Server (NTRS)

    Harrison, F. W., Jr.; Pennington, J. E.

    1987-01-01

    Two simulation and analysis environments have been developed to support telerobotics research at the Langley Research Center. One is a high-fidelity, nonreal-time, interactive model called ROBSIM, which combines user-generated models of workspace environment, robots, and loads into a working system and simulates the interaction among the system components. Models include user-specified actuator, sensor, and control parameters, as well as kinematic and dynamic characteristics. Kinematic, dynamic, and response analyses can be selected, with system configuration, task trajectories, and arm states displayed using computer graphics. The second environment is a real-time, manned Telerobotic Systems Simulation (TRSS) which uses the facilities of the Intelligent Systems Research Laboratory (ISRL). It utilizes a hierarchical structure of functionally distributed computers communicating over both parallel and high-speed serial data paths to enable studies of advanced telerobotic systems. Multiple processes perform motion planning, operator communications, forward and inverse kinematics, control/sensor fusion, and I/O processing while communicating via common memory. Both ROBSIM and TRSS, including their capability, status, and future plans are discussed. Also described is the architecture of ISRL and recent telerobotic system studies in ISRL.

  18. Skylab food system laboratory support

    NASA Technical Reports Server (NTRS)

    Sanford, D.

    1974-01-01

    A summary of support activities performed to ensure the quality and reliability of the Skylab food system design is reported. The qualification test program was conducted to verify crew compartment compatibility, and to certify compliance of the food system with nutrition, preparation, and container requirements. Preflight storage requirements and handling procedures were also determined. Information on Skylab food items was compiled including matters pertaining to serving size, preparation information, and mineral, calorie, and protein content. Accessory hardware and the engraving of food utensils were also considered, and a stowage and orientation list was constructed which takes into account menu use sequences, menu items, and hardware stowage restrictions. A food inventory system was established and food thermal storage tests were conducted. Problems and comments pertaining to specific food items carried onboard the Skylab Workshop were compiled.

  19. System Support for Forensic Inference

    NASA Astrophysics Data System (ADS)

    Gehani, Ashish; Kirchner, Florent; Shankar, Natarajan

    Digital evidence is playing an increasingly important role in prosecuting crimes. The reasons are manifold: financially lucrative targets are now connected online, systems are so complex that vulnerabilities abound and strong digital identities are being adopted, making audit trails more useful. If the discoveries of forensic analysts are to hold up to scrutiny in court, they must meet the standard for scientific evidence. Software systems are currently developed without consideration of this fact. This paper argues for the development of a formal framework for constructing “digital artifacts” that can serve as proxies for physical evidence; a system so imbued would facilitate sound digital forensic inference. A case study involving a filesystem augmentation that provides transparent support for forensic inference is described.

  20. Lunar lander ground support system

    NASA Technical Reports Server (NTRS)

    1991-01-01

    This year's project, like the previous Aerospace Group's project, involves a lunar transportation system. The basic time line will be the years 2010-2030 and will be referred to as a second generation system, as lunar bases would be present. The project design completed this year is referred to as the Lunar Lander Ground Support System (LLGSS). The area chosen for analysis encompasses a great number of vehicles and personnel. The design of certain elements of the overall lunar mission are complete projects in themselves. For this reason the project chosen for the Senior Aerospace Design is the design of specific servicing vehicles and additions or modifications to existing vehicles for the area of concern involving servicing and maintenance of the lunar lander while on the surface.

  1. Lunar lander ground support system

    NASA Astrophysics Data System (ADS)

    This year's project, like the previous Aerospace Group's project, involves a lunar transportation system. The basic time line will be the years 2010-2030 and will be referred to as a second generation system, as lunar bases would be present. The project design completed this year is referred to as the Lunar Lander Ground Support System (LLGSS). The area chosen for analysis encompasses a great number of vehicles and personnel. The design of certain elements of the overall lunar mission are complete projects in themselves. For this reason the project chosen for the Senior Aerospace Design is the design of specific servicing vehicles and additions or modifications to existing vehicles for the area of concern involving servicing and maintenance of the lunar lander while on the surface.

  2. Advanced support systems development and supporting technologies for Controlled Ecological Life Support Systems (CELSS)

    NASA Technical Reports Server (NTRS)

    Simon, William E.; Li, Ku-Yen; Yaws, Carl L.; Mei, Harry T.; Nguyen, Vinh D.; Chu, Hsing-Wei

    1994-01-01

    A methyl acetate reactor was developed to perform a subscale kinetic investigation in the design and optimization of a full-scale metabolic simulator for long term testing of life support systems. Other tasks in support of the closed ecological life support system test program included: (1) heating, ventilation and air conditioning analysis of a variable pressure growth chamber, (2) experimental design for statistical analysis of plant crops, (3) resource recovery for closed life support systems, and (4) development of data acquisition software for automating an environmental growth chamber.

  3. Nonalcoholic fatty liver disease as a multi-systemic disease.

    PubMed

    Fotbolcu, Hakan; Zorlu, Elçin

    2016-04-28

    Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease. NAFLD includes a wide spectrum of liver conditions ranging from simple steatosis to nonalcoholic steatohepatitis and advanced hepatic fibrosis. NAFLD has been recognized as a hepatic manifestation of metabolic syndrome linked with insulin resistance. NAFLD should be considered not only a liver specific disease but also an early mediator of systemic diseases. Therefore, NAFLD is usually associated with cardiovascular disease, chronic kidney disease, type 2 diabetes, obesity, and dyslipidemia. NAFLD is highly prevalent in the general population and is associated with increased cardiovascular morbidity and mortality. The underlying mechanisms and pathogenesis of NAFLD with regard to other medical disorders are not yet fully understood. This review focuses on pathogenesis of NAFLD and its relation with other systemic diseases.

  4. Albumin dialysis with molecular adsorbent recirculating system (MARS) for the treatment of hepatic encephalopathy in liver failure.

    PubMed

    Kobashi-Margáin, Ramón A; Gavilanes-Espinar, Juan G; Gutiérrez-Grobe, Ylse; Gutiérrez-Jiménez, Angel A; Chávez-Tapia, Norberto; Ponciano-Rodríguez, Guadalupe; Uribe, Misael; Méndez Sánchez, Nahum

    2011-06-01

    Acute, acute-on-chronic and chronic liver diseases are major health issues worldwide, and most cases end with the need for liver transplantation. Up to 90% of the patients die waiting for an organ to be transplanted. Hepatic encephalopathy is a common neuropsychiatric syndrome that usually accompanies liver failure and impacts greatly on the quality of life. The molecular adsorbent recirculating system (MARS) is a recently developed form of artificial liver support that functions on a base of albumin dialysis. It facilitates the dialysis of albumin-bound and water-soluble toxins, allowing the patient to survive and even improving some clinical features of liver failure. The following manuscript reviews the technical features of MARS operation and some of the clinical trials that analyze the efficacy of the system in the therapy of liver diseases.

  5. Formation of the digestive system in zebrafish. I. Liver morphogenesis.

    PubMed

    Field, Holly A; Ober, Elke A; Roeser, Tobias; Stainier, Didier Y R

    2003-01-15

    Despite the essential functions of the digestive system, much remains to be learned about the cellular and molecular mechanisms responsible for digestive organ morphogenesis and patterning. We introduce a novel zebrafish transgenic line, the gutGFP line, that expresses GFP throughout the digestive system, and use this tool to analyze the development of the liver. Our studies reveal two phases of liver morphogenesis: budding and growth. The budding period, which can be further subdivided into three stages, starts when hepatocytes first aggregate, shortly after 24 h postfertilization (hpf), and ends with the formation of a hepatic duct at 50 hpf. The growth phase immediately follows and is responsible for a dramatic alteration of liver size and shape. We also analyze gene expression in the developing liver and find a correlation between the expression of certain transcription factor genes and the morphologically defined stages of liver budding. To further expand our understanding of budding morphogenesis, we use loss-of-function analyses to investigate factors potentially involved in this process. It had been reported that no tail mutant embryos appear to lack a liver primordium, as assessed by gata6 expression. However, analysis of gutGFP embryos lacking Ntl show that the liver is in fact present. We also find that, in these embryos, the direction of liver budding does not correlate with the direction of intestinal looping, indicating that the left/right behavior of these tissues can be uncoupled. In addition, we use the cloche mutation to analyze the role of endothelial cells in liver morphogenesis, and find that in zebrafish, unlike what has been reported in mouse, endothelial cells do not appear to be necessary for the budding of this organ.

  6. [Shearwave-based ultrasound viscoelasticity measurement system for evaluation of liver fibrosis].

    PubMed

    Wei, Tan; Xiaodong, Han; Gang, Cheng; Hazard, Christopher

    2010-09-01

    This paper describes a liver elasticity and viscosity measurement system based on existing medical ultrasound platforms. This system relies on acoustic radiation force to invoke transient response on soft tissue, and employs displacement estimation algorithms to detect the propagation of shear wave. The research proves that the velocity of the shear wave may serve as a reliable estimation of the Young's modulus and viscosity coefficient of the liver tissue, and existing commercial products may be easily adapted to support this technique without extra hardware cost.

  7. Lunar lander ground support system

    NASA Technical Reports Server (NTRS)

    1991-01-01

    The design of the Lunar Lander Ground Support System (LLGSS) is examined. The basic design time line is around 2010 to 2030 and is referred to as a second generation system, as lunar bases and equipment would have been present. Present plans for lunar colonization call for a phased return of personnel and materials to the moons's surface. During settlement of lunar bases, the lunar lander is stationary in a very hostile environment and would have to be in a state of readiness for use in case of an emergency. Cargo and personnel would have to be removed from the lander and transported to a safe environment at the lunar base. An integrated system is required to perform these functions. These needs are addressed which center around the design of a lunar lander servicing system. The servicing system could perform several servicing functions to the lander in addition to cargo servicing. The following were considered: (1) reliquify hydrogen boiloff; (2) supply power; and (3) remove or add heat as necessary. The final design incorporates both original designs and existing vehicles and equipment on the surface of the moon at the time considered. The importance of commonality is foremost in the design of any lunar machinery.

  8. Comparison and in vivo relevance of two different in vitro head space metabolic systems: liver S9 and liver slices.

    PubMed

    Mortensen, B; Løkken, T; Zahlsen, K; Nilsen, O G

    1997-07-01

    In vitro systems of high biological organization, e.g. containing intact hepatocytes, have been considered as more reliable for metabolic studies and in vivo predictions of toxicokinetics than subcellular systems. For this reason, the kinetics and metabolism of low-molecular-weight volatile chemicals, i.e. head space elimination of substrate and formation of metabolites, were compared in liver S9 and in liver slices. Two substrates, toluene and n-hexane, were used as they represent differences in metabolic pathways and physical-chemical properties. The two systems responded similarly to diethyldithiocarbamate inhibition and acetone inhibition/induction of cytochrome P-450 mediated metabolism. In contrast to liver S9, liver slices did not respond adequately to phenobarbital induction raising the question of substrate availability for P-450 enzymes in liver slices. Liver slices appeared to be superior to liver S9 when specific metabolic pathways involving phase II enzymes were investigated. However, liver S9 seemed to be at least as good as liver slices for estimation of total metabolic rate constants (Km, Vmax) as a basis for in vivo predictions. As the head space liver S9 system is faster and easier to operate than liver slices, it is a promising screening tool for the metabolism of volatile compounds and metabolic interactions.

  9. Reduced size liver transplantation from a donor supported by a Berlin Heart.

    PubMed

    Misra, M V; Smithers, C J; Krawczuk, L E; Jenkins, R L; Linden, B C; Weldon, C B; Kim, H B

    2009-11-01

    Patients on cardiac assist devices are often considered to be high-risk solid organ donors. We report the first case of a reduced size liver transplant performed using the left lateral segment of a pediatric donor whose cardiac function was supported by a Berlin Heart. The recipient was a 22-day-old boy with neonatal hemochromatosis who developed fulminant liver failure shortly after birth. The transplant was complicated by mild delayed graft function, which required delayed biliary reconstruction and abdominal wall closure, as well as a bile leak. However, the graft function improved quickly over the first week and the patient was discharged home with normal liver function 8 weeks after transplant. The presence of a cardiac assist device should not be considered an absolute contraindication for abdominal organ donation. Normal organ procurement procedures may require alteration due to the unusual technical obstacles that are encountered when the donor has a cardiac assist device.

  10. Systems engineering considerations for operational support systems

    NASA Technical Reports Server (NTRS)

    Aller, Robert O.

    1993-01-01

    Operations support as considered here is the infrastructure of people, procedures, facilities and systems that provide NASA with the capability to conduct space missions. This infrastructure involves most of the Centers but is concentrated principally at the Johnson Space Center, the Kennedy Space Center, the Goddard Space Flight Center, and the Jet Propulsion Laboratory. It includes mission training and planning, launch and recovery, mission control, tracking, communications, data retrieval and data processing.

  11. A CAD system for B-mode fatty liver ultrasound images using texture features.

    PubMed

    Subramanya, M B; Kumar, Vinod; Mukherjee, Shaktidev; Saini, Manju

    2015-02-01

    The present study proposes a computer-aided diagnosis (CAD) system for the diagnosis of grades of fatty liver disease, namely mild, moderate and severe fatty liver along with normal liver tissue. Fifty-three B-mode ultrasound images consisting of 12 normal, 14 mild, 14 moderate and 13 severe fatty liver images are used. Based on the visual interpretations by the radiologists, region of interests (ROIs) from within the liver and one ROI from the diaphragm region are considered from each image. The texture features of these ROIs are combined in three ways to form ratio features, inverse ratio features and additive features. The sub-sets of optimal features are obtained by a differential evolution feature selection (DEFS) algorithm and a support vector machine (SVM) has been used for the classification task. The Laws ratio features have shown better performance with an average accuracy and standard deviation of 84.9±3.2. Hence, the CAD system could be useful to the radiologists in diagnosing grades of fatty liver disease.

  12. Space Transportation System (STS): Emergency support

    NASA Technical Reports Server (NTRS)

    Janoski, T.; Nicholson, L.

    1991-01-01

    The DSN (Deep Space Network) mission support requirements for emergency support of the Space Transportation System (STS) are summarized. Coverage would be provided by the DSN during emergencies that would prevent communications between the shuttle and the White Sands TDRSS receiving station. The DSN support requirements are defined through the presentation of tables and narratives describing the spacecraft flight profile; DSN support coverage; frequency assignments; support parameters for telemetry, command and support systems; and tracking support responsibility.

  13. Liver failure, life support, family support, and palliation: an inside story.

    PubMed

    Guy, Victoria

    2006-09-01

    My sister was admitted to the intensive-care-unit (ICU) five months before she died. At the time of admission her life-support wishes were not discussed with her. During her time in the ICU, we, the family, were given hope that she may survive. As with most families, we wanted my sister to live. During her progression from ICU to step-down unit to ward unit, the plan of care was not discussed, and goals were not set. Many medical teams were involved in my sister's care, and many looked at individual body parts instead of the whole person. I am a Registered Nurse at the same hospital where my sister was being cared for. Through many family meetings I was regarded as a medical professional, not as a sister. Knowing the medical system yet going through this as a family member has given me the opportunity to gain insight into what should have happened. If code status had been discussed we would have known my sisters wishes. If relevant literature pertaining to her disease and her slim chance of recovery had been brought to our attention, my sister could have died at home as she wished, and perhaps could have lived her final days in comfort.

  14. Regulation of the glycine cleavage system in rat liver

    SciTech Connect

    Hampson, R.K.

    1984-01-01

    Catabolism of glycine, via the glycine cleavage system was investigated in isolated, fully functional, rat liver mitochondria, and the isolated perfused rat liver. Metabolic flux through the glycine cleavage system, which catalyzes the tetrahydrofolate-dependent cleavage of glycine yielding carbon dioxide, ammonia, N/sup 5/,N/sup 10/-methylenetetrahydrofolate, and NADH + H/sup +/, was monitored by measuring the production of /sup 14/CO/sub 2/ from (1-/sup 14/C)glycine. The glycine cleavage system was demonstrated to be responsible for nearly all /sup 14/CO/sub 2/ production from (1-/sup 14/C)glycine in both isolated mitochondria and the perfused rat liver. Glycine decarboxylation by rat liver mitochondria was highly sensitive to the metabolic state in which the mitochondria were maintained. Production of /sup 14/CO/sub 2/ from (1-/sup 14/C)glycine was stimulated in State 3 over State 4 and was maximal in the uncoupled state. Alternatively, respiratory inhibitors, such as rotenone, and reducing substrates, inhibited mitochondrial glycine decarboxylation strongly. Propionate stimulated glycine decarboxylation by rat liver mitochondria with a concomitant decrease in the measured intramitochondrial NADPH content. Incubation of mitochondria with propionate evoked a large decrease in the measured intramitochondrial ATP content and a large increase in AMP content. Manipulation of the intramitochondrial adenine nucleotide profile demonstrated that no direct correlation existed between rates of mitochondrial glycine decarboxylation and the intramitochondrial content of either ATP, ADP, or AMP.

  15. Solar energy decision support system

    NASA Astrophysics Data System (ADS)

    Ramachandra, T. V.; Rajeev Kumar, J.; Vamsee Krishna, S.; Shruthi, B. V.

    2006-03-01

    Energy plays a prominent role in human society. As a result of technological and industrial developments, the demand for energy is rapidly increasing. Existing power sources that are mainly fossil fuel based are leaving an unacceptable legacy of waste and pollution apart from diminishing stock of fuels. Hence, the focus is now shifted to large-scale propagation of renewable energy. Renewable energy technologies are clean sources of energy that have a much lower environmental impact than conventional energy technologies. Solar energy is one such renewable energy. Most renewable energy comes either directly or indirectly from the sun. Estimation of solar energy potential of a region requires detailed solar radiation climatology, and it is necessary to collect extensive radiation data of high accuracy covering all climatic zones of the region. In this regard, a decision support system (DSS) would help to estimate solar energy potential considering the regions’ energy requirement. This article explains the design and implementation of DSS for assessment of solar energy. The DSS with executive information systems and reporting tools helps to tap vast data resources and deliver information. The main hypothesis is that this tool can be used to form a core of practical methodology that is resilient and can be used by decision-making bodies to assess various scenarios. It also offers means of entering, accessing and interpreting the information for the purpose of sound decision-making.

  16. Solar energy decision support system

    NASA Astrophysics Data System (ADS)

    Ramachandra, T. V.; Jha, Rajeev Kumar; Vamsee Krishna, S.; Shruthi, B. V.

    2005-12-01

    Energy plays a prominent role in human society. As a result of technological and industrial development, the demand for energy is rapidly increasing. Existing power sources that are mainly fossil fuel based are leaving an unacceptable legacy of waste and pollution apart from diminishing stock of fuels. Hence, the focus is now shifted to large-scale propagation of renewable energy. Renewable energy technologies are clean sources of energy that have a much lower environmental impact than conventional energy technologies. Solar energy is one such renewable energy. Most renewable energy comes either directly or indirectly from the sun. Estimation of solar energy potential of a region requires detailed solar radiation climatology, and it is necessary to collect extensive radiation data of high accuracy covering all climatic zones of the region. In this regard, a decision support system (DSS) would help in estimating solar energy potential considering the region's energy requirement. This article explains the design and implementation of DSS for assessment of solar energy. The DSS with executive information systems and reporting tools helps to tap vast data resources and deliver information. The main hypothesis is that this tool can be used to form a core of practical methodology that will result in more resilient in time and can be used by decision-making bodies to assess various scenarios. It also offers means of entering, accessing, and interpreting the information for the purpose of sound decision making.

  17. Cumene hydroperoxide-supported denitrification of 2-nitropropane in uninduced mouse liver microsomes.

    PubMed

    Marker, E K; Kulkarni, A P

    1986-01-01

    Cumene hydroperoxide supported oxidative denitrification of 2-nitropropane was investigated in uninduced mouse liver microsomes. The cytochrome P-450 peroxygenase catalyzed reaction resulted in the production of nitrite and acetone. Several lines of evidence suggested the involvement of multiple forms of cytochrome P-450. Acetone production was at least two times greater than nitrite release possibly due to sequestration of nitrite in the reaction mixtures.

  18. Peritoneal Albumin Dialysis as a Novel Approach for Liver Support: Study in a Porcine Model of Acute Hepatic Failure.

    PubMed

    Defterevos, Georgios; Nastos, Constantinos; Papalois, Apostolos; Kalimeris, Konstantinos; Margelos, Vassileios; Fragulidis, George; Pafiti, Agathi; Mikrovas, Aggeliki; Nomikos, Tzortzis; Smyrniotis, Vassilios; Arkadopoulos, Nikolaos

    2016-08-01

    Artificial liver support gained considerable interest in recent years due to the development of various albumin dialysis systems, which prolong survival of some patients with acute liver failure (ALF). Τhis study aims to examine the role of peritoneal albumin dialysis in a postoperative ALF model. ALF was induced in 14 female Landrace pigs by a combination of major liver resection (70-75% of total parenchyma) and ischemic-reperfusion injury on the liver remnant. Animals were randomly divided in two groups (n = 7 each). Both were monitored for 12 h of reperfusion and received peritoneal dialysis for 6 h, beginning 6 h after reperfusion. The albumin group received an albumin-rich solution and the control group received albumin-free solution. The control group gradually developed intracranial hypertension, whereas, in the albumin group, rise in the intracranial pressure was substantially attenuated (P < 0.01, t = 12 h). Albumin-treated animals had significantly lower levels of ammonia (P < 0.01), total bile acids (P < 0.01), free fatty acids (P < 0.05), lactate (P < 0.01), and total bilirubin (P < 0.05). Liver malondialdehyde and protein carbonyl were significantly reduced (P = 0.007 and P = 0.001 at t = 12 h) after albumin dialysis. Results suggest that this method may become a useful adjunct in the management of ALF, thus, justifying further study. © 2016 Wiley Periodicals, Inc. and International Center for Artificial Organs and Transplantation.

  19. Epigenetic effects of ethanol on the liver and gastrointestinal system.

    PubMed

    Shukla, Shivendra D; Lim, Robert W

    2013-01-01

    The widening web of epigenetic regulatory mechanisms also encompasses ethanol-induced changes in the gastrointestinal (GI)-hepatic system. In the past few years, increasing evidence has firmly established that alcohol modifies several epigenetic parameters in the GI tract and liver. The major pathways affected include DNA methylation, different site-specific modifications in histone proteins, and microRNAs. Ethanol metabolism, cell-signaling cascades, and oxidative stress have been implicated in these responses. Furthermore, ethanol-induced fatty liver (i.e., steatohepatitis) and progression of liver cancer (i.e., hepatic carcinoma) may be consequences of the altered epigenetics. Modification of gene and/or protein expression via epigenetic changes also may contribute to the cross-talk among the GI tract and the liver as well as to systemic changes involving other organs. Thus, epigenetic effects of ethanol may have a central role in the various pathophysiological responses induced by ethanol in multiple organs and mediated via the liver-GI axis.

  20. Liver hemangioma and vascular liver diseases in patients with systemic lupus erythematosus

    PubMed Central

    Berzigotti, Annalisa; Frigato, Marilena; Manfredini, Elena; Pierpaoli, Lucia; Mulè, Rita; Tiani, Carolina; Zappoli, Paola; Magalotti, Donatella; Malavolta, Nazzarena; Zoli, Marco

    2011-01-01

    AIM: To investigate whether systemic lupus erythematosus (SLE) is associated with benign focal liver lesions and vascular liver diseases, since these have been occasionally reported in SLE patients. METHODS: Thirty-five consecutive adult patients with SLE and 35 age- and sex-matched healthy controls were evaluated. Hepatic and portal vein patency and presence of focal liver lesions were studied by colour-Doppler ultrasound, computerized tomography and magnetic resonance were used to refine the diagnosis, clinical data of SLE patients were reviewed. RESULTS: Benign hepatic lesions were common in SLE patients (54% vs 14% controls, P < 0.0001), with hemangioma being the most commonly observed lesion in the two groups. SLE was associated with the presence of single hemangioma [odds ratios (OR) 5.05; 95% confidence interval (CI) 1.91-13.38] and multiple hemangiomas (OR 4.13; 95% CI 1.03-16.55). Multiple hemangiomas were associated with a longer duration of SLE (9.9 ± 6.5 vs 5.5 ± 6.4 years; P = 0.04). Imaging prior to SLE onset was available in 9 patients with SLE and hemangioma, showing absence of lesions in 7/9. The clinical data of our patients suggest that SLE possibly plays a role in the development of hemangioma. In addition, a Budd-Chiari syndrome associated with nodular regenerative hyperplasia (NRH), and a NRH associated with hepatic hemangioma were observed, both in patients hospitalized for abdominal symptoms, suggesting that vascular liver diseases should be specifically investigated in this population. CONCLUSION: SLE is associated with 5-fold increased odds of liver hemangiomas, suggesting that these might be considered among the hepatic manifestations of SLE. PMID:22110281

  1. Bioregenerative life-support systems.

    PubMed

    Mitchell, C A

    1994-11-01

    Long-duration future habitation of space involving great distances from Earth and/or large crew sizes (eg, lunar outpost, Mars base) will require a controlled ecological life-support system (CELSS) to simultaneously revitalize atmosphere (liberate oxygen and fix carbon dioxide), purify water (via transpiration), and generate human food (for a vegetarian diet). Photosynthetic higher plants and algae will provide the essential functions of biomass productivity in a CELSS, and a combination of physicochemical and bioregenerative processes will be used to regenerate renewable resources from waste materials. Crop selection criteria for a CELSS include nutritional use characteristics as well as horticultural characteristics. Cereals, legumes, and oilseed crops are used to provide the major macronutrients for the CELSS diet. A National Aeronautics and Space Administration (NASA) Specialized Center of Research and Training (NSCORT) was established at Purdue University to establish proof of the concept of the sustainability of a CELSS. The Biosphere 2 project in Arizona is providing a model for predicted and unpredicted situations that arise as a result of closure in a complex natural ecosystem.

  2. Bioregenerative life-support systems

    NASA Technical Reports Server (NTRS)

    Mitchell, C. A.

    1994-01-01

    Long-duration future habitation of space involving great distances from Earth and/or large crew sizes (eg, lunar outpost, Mars base) will require a controlled ecological life-support system (CELSS) to simultaneously revitalize atmosphere (liberate oxygen and fix carbon dioxide), purify water (via transpiration), and generate human food (for a vegetarian diet). Photosynthetic higher plants and algae will provide the essential functions of biomass productivity in a CELSS, and a combination of physicochemical and bioregenerative processes will be used to regenerate renewable resources from waste materials. Crop selection criteria for a CELSS include nutritional use characteristics as well as horticultural characteristics. Cereals, legumes, and oilseed crops are used to provide the major macronutrients for the CELSS diet. A National Aeronautics and Space Administration (NASA) Specialized Center of Research and Training (NSCORT) was established at Purdue University to establish proof of the concept of the sustainability of a CELSS. The Biosphere 2 project in Arizona is providing a model for predicted and unpredicted situations that arise as a result of closure in a complex natural ecosystem.

  3. Bioregenerative life-support systems

    NASA Technical Reports Server (NTRS)

    Mitchell, C. A.

    1994-01-01

    Long-duration future habitation of space involving great distances from Earth and/or large crew sizes (eg, lunar outpost, Mars base) will require a controlled ecological life-support system (CELSS) to simultaneously revitalize atmosphere (liberate oxygen and fix carbon dioxide), purify water (via transpiration), and generate human food (for a vegetarian diet). Photosynthetic higher plants and algae will provide the essential functions of biomass productivity in a CELSS, and a combination of physicochemical and bioregenerative processes will be used to regenerate renewable resources from waste materials. Crop selection criteria for a CELSS include nutritional use characteristics as well as horticultural characteristics. Cereals, legumes, and oilseed crops are used to provide the major macronutrients for the CELSS diet. A National Aeronautics and Space Administration (NASA) Specialized Center of Research and Training (NSCORT) was established at Purdue University to establish proof of the concept of the sustainability of a CELSS. The Biosphere 2 project in Arizona is providing a model for predicted and unpredicted situations that arise as a result of closure in a complex natural ecosystem.

  4. 49 CFR 193.2609 - Support systems.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 3 2013-10-01 2013-10-01 false Support systems. 193.2609 Section 193.2609 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY...: FEDERAL SAFETY STANDARDS Maintenance § 193.2609 Support systems. Each support system or foundation of each...

  5. 49 CFR 193.2609 - Support systems.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 3 2011-10-01 2011-10-01 false Support systems. 193.2609 Section 193.2609 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY...: FEDERAL SAFETY STANDARDS Maintenance § 193.2609 Support systems. Each support system or foundation of each...

  6. 49 CFR 193.2609 - Support systems.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 3 2012-10-01 2012-10-01 false Support systems. 193.2609 Section 193.2609 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY...: FEDERAL SAFETY STANDARDS Maintenance § 193.2609 Support systems. Each support system or foundation of each...

  7. 49 CFR 193.2609 - Support systems.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 3 2010-10-01 2010-10-01 false Support systems. 193.2609 Section 193.2609 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY...: FEDERAL SAFETY STANDARDS Maintenance § 193.2609 Support systems. Each support system or foundation of each...

  8. Anatomy of a Decision Support System.

    ERIC Educational Resources Information Center

    Chachra, Vinod; Heterick, Robert C.

    1982-01-01

    The decision support system (DSS) environment, the functional requirements of a DSS, and the architectural requirements of the computer systems and communications network necessary to support a DSS are discussed. Changes in the computing environment that are necessary to implement decision support systems are suggested. (Author/MLW)

  9. A bioenergetics systems evaluation of ketogenic diet liver effects.

    PubMed

    Hutfles, Lewis J; Wilkins, Heather M; Koppel, Scott J; Weidling, Ian W; Selfridge, J Eva; Tan, Eephie; Thyfault, John P; Slawson, Chad; Fenton, Aron W; Zhu, Hao; Swerdlow, Russell H

    2017-09-01

    Ketogenic diets induce hepatocyte fatty acid oxidation and ketone body production. To further evaluate how ketogenic diets affect hepatocyte bioenergetic infrastructure, we analyzed livers from C57Bl/6J male mice maintained for 1 month on a ketogenic or standard chow diet. Compared with the standard diet, the ketogenic diet increased cytosolic and mitochondrial protein acetylation and also altered protein succinylation patterns. SIRT3 protein decreased while SIRT5 protein increased, and gluconeogenesis, oxidative phosphorylation, and mitochondrial biogenesis pathway proteins were variably and likely strategically altered. The pattern of changes observed can be used to inform a broader systems overview of how ketogenic diets affect liver bioenergetics.

  10. Metric half-span model support system

    NASA Technical Reports Server (NTRS)

    Jackson, C. M., Jr.; Dollyhigh, S. M.; Shaw, D. S. (Inventor)

    1982-01-01

    A model support system used to support a model in a wind tunnel test section is described. The model comprises a metric, or measured, half-span supported by a nonmetric, or nonmeasured half-span which is connected to a sting support. Moments and forces acting on the metric half-span are measured without interference from the support system during a wind tunnel test.

  11. Distribution of elastic system fibres in human fetal liver.

    PubMed Central

    Monte, A; Costa, A; Porto, L C

    1996-01-01

    Elastic system fibres are extracellular matrix components found in different organs for which they provide elasticity and some mechanical resistance. Oxytalan, elaunin and elastic fibres, which possess graduated amounts of elastin, are the 3 forms of elastic system fibres that are identifiable by their tinctorial and ultrastructural features. The distribution of these fibres in adult human liver is well-established but little, if anything, is known about them in fetal liver. The distribution of elastic system fibres was therefore investigated in human fetal liver, and the process of elastogenesis characterised. Specimens of liver from 24 human fetuses ranging in age from 13 to 38 wk postfertilisation were studied. The results are presented in relation to gestational age and the size of the portal tracts. Portal tracts exhibited a network of oxytalan fibres at 13 wk; elaunin fibres appeared later after 20 wk postfertilisation. Elastogenesis occurred more rapidly in venous than in arterial walls, and in veins it was more evident in the adventitia. A microfibrillar network of oxytalan fibres was observed around biliary ducts from the outset of their development. Elastogenesis follows the sequence oxytalan, elaunin and elastic fibres, but the elastogenetic process only completes its maturation in arterial walls, thus leading to the internal elastic lamina. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5 PMID:8763481

  12. LiverCancerMarkerRIF: a liver cancer biomarker interactive curation system combining text mining and expert annotations

    PubMed Central

    Dai, Hong-Jie; Wu, Johnny Chi-Yang; Lin, Wei-San; Reyes, Aaron James F.; dela Rosa, Mira Anne C.; Syed-Abdul, Shabbir; Tsai, Richard Tzong-Han; Hsu, Wen-Lian

    2014-01-01

    Biomarkers are biomolecules in the human body that can indicate disease states and abnormal biological processes. Biomarkers are often used during clinical trials to identify patients with cancers. Although biomedical research related to biomarkers has increased over the years and substantial effort has been expended to obtain results in these studies, the specific results obtained often contain ambiguities, and the results might contradict each other. Therefore, the information gathered from these studies must be appropriately integrated and organized to facilitate experimentation on biomarkers. In this study, we used liver cancer as the target and developed a text-mining–based curation system named LiverCancerMarkerRIF, which allows users to retrieve biomarker-related narrations and curators to curate supporting evidence on liver cancer biomarkers directly while browsing PubMed. In contrast to most of the other curation tools that require curators to navigate away from PubMed and accommodate distinct user interfaces or Web sites to complete the curation process, our system provides a user-friendly method for accessing text-mining–aided information and a concise interface to assist curators while they remain at the PubMed Web site. Biomedical text-mining techniques are applied to automatically recognize biomedical concepts such as genes, microRNA, diseases and investigative technologies, which can be used to evaluate the potential of a certain gene as a biomarker. Through the participation in the BioCreative IV user-interactive task, we examined the feasibility of using this novel type of augmented browsing-based curation method, and collaborated with curators to curate biomarker evidential sentences related to liver cancer. The positive feedback received from curators indicates that the proposed method can be effectively used for curation. A publicly available online database containing all the aforementioned information has been constructed at http

  13. LiverCancerMarkerRIF: a liver cancer biomarker interactive curation system combining text mining and expert annotations.

    PubMed

    Dai, Hong-Jie; Wu, Johnny Chi-Yang; Lin, Wei-San; Reyes, Aaron James F; Dela Rosa, Mira Anne C; Syed-Abdul, Shabbir; Tsai, Richard Tzong-Han; Hsu, Wen-Lian

    2014-01-01

    Biomarkers are biomolecules in the human body that can indicate disease states and abnormal biological processes. Biomarkers are often used during clinical trials to identify patients with cancers. Although biomedical research related to biomarkers has increased over the years and substantial effort has been expended to obtain results in these studies, the specific results obtained often contain ambiguities, and the results might contradict each other. Therefore, the information gathered from these studies must be appropriately integrated and organized to facilitate experimentation on biomarkers. In this study, we used liver cancer as the target and developed a text-mining-based curation system named LiverCancerMarkerRIF, which allows users to retrieve biomarker-related narrations and curators to curate supporting evidence on liver cancer biomarkers directly while browsing PubMed. In contrast to most of the other curation tools that require curators to navigate away from PubMed and accommodate distinct user interfaces or Web sites to complete the curation process, our system provides a user-friendly method for accessing text-mining-aided information and a concise interface to assist curators while they remain at the PubMed Web site. Biomedical text-mining techniques are applied to automatically recognize biomedical concepts such as genes, microRNA, diseases and investigative technologies, which can be used to evaluate the potential of a certain gene as a biomarker. Through the participation in the BioCreative IV user-interactive task, we examined the feasibility of using this novel type of augmented browsing-based curation method, and collaborated with curators to curate biomarker evidential sentences related to liver cancer. The positive feedback received from curators indicates that the proposed method can be effectively used for curation. A publicly available online database containing all the aforementioned information has been constructed at http

  14. Integrated Control System Engineering Support.

    DTIC Science & Technology

    1984-12-01

    corporation , or conveying any rights or permission to manufacture, use, or sell any patented invention that may in any way be related thereto. "- This...Monitor Unit C Computers/COMMON Storage Location * CCB Configuration Control Board CCC Cruise Camber Control CDC Control Data Corporation CDR...the areas of support software (drivers, interfaces, corrections), flight processor development (in- corporation of new hardware), concept test support

  15. Epigenetic Effects of Ethanol on the Liver and Gastrointestinal System

    PubMed Central

    Shukla, Shivendra D.; Lim, Robert W.

    2013-01-01

    The widening web of epigenetic regulatory mechanisms also encompasses ethanol-induced changes in the gastrointestinal (GI)–hepatic system. In the past few years, increasing evidence has firmly established that alcohol modifies several epigenetic parameters in the GI tract and liver. The major pathways affected include DNA methylation, different site-specific modifications in histone proteins, and microRNAs. Ethanol metabolism, cell-signaling cascades, and oxidative stress have been implicated in these responses. Furthermore, ethanol-induced fatty liver (i.e., steatohepatitis) and progression of liver cancer (i.e., hepatic carcinoma) may be consequences of the altered epigenetics. Modification of gene and/or protein expression via epigenetic changes also may contribute to the cross-talk among the GI tract and the liver as well as to systemic changes involving other organs. Thus, epigenetic effects of ethanol may have a central role in the various pathophysiological responses induced by ethanol in multiple organs and mediated via the liver–GI axis. PMID:24313164

  16. Facility Systems, Ground Support Systems, and Ground Support Equipment General Design Requirements

    NASA Technical Reports Server (NTRS)

    Thaxton, Eric A.; Mathews, Roger E.

    2014-01-01

    This standard establishes requirements and guidance for design and fabrication of ground systems (GS) that includes: ground support equipment (GSE), ground support systems (GSS), and facility ground support systems (F GSS) to provide uniform methods and processes for design and development of robust, safe, reliable, maintainable, supportable, and cost-effective GS in support of space flight and institutional programs and projects.

  17. Decision time for clinical decision support systems.

    PubMed

    O'Sullivan, Dympna; Fraccaro, Paolo; Carson, Ewart; Weller, Peter

    2014-08-01

    Clinical decision support systems are interactive software systems designed to help clinicians with decision-making tasks, such as determining a diagnosis or recommending a treatment for a patient. Clinical decision support systems are a widely researched topic in the computer science community, but their inner workings are less well understood by, and known to, clinicians. This article provides a brief explanation of clinical decision support systems and some examples of real-world systems. It also describes some of the challenges to implementing these systems in clinical environments and posits some reasons for the limited adoption of decision-support systems in practice. It aims to engage clinicians in the development of decision support systems that can meaningfully help with their decision-making tasks and to open a discussion about the future of automated clinical decision support as a part of healthcare delivery. © 2014 Royal College of Physicians.

  18. Professional Growth & Support System Self-Assessment

    ERIC Educational Resources Information Center

    Education Resource Strategies, 2013

    2013-01-01

    The "Professional Growth & Support System Self-Assessment" is designed to help school systems evaluate their current Professional Growth & Support strategy. The self-assessment is organized around the "Eight Principles of Strategic Professional Growth & Support." Each section allows school leaders to identify the…

  19. Developing Information Systems for Competitive Intelligence Support.

    ERIC Educational Resources Information Center

    Hohhof, Bonnie

    1994-01-01

    Discusses issues connected with developing information systems for competitive intelligence support; defines the elements of an effective competitive information system; and summarizes issues affecting system design and implementation. Highlights include intelligence information; information needs; information sources; decision making; and…

  20. Support Systems for Treatment Integrity

    ERIC Educational Resources Information Center

    Goense, Pauline Brigitta; Boendermaker, Leonieke; van Yperen, Tom

    2016-01-01

    Objective: This systematic review evaluates the content of effective support provided to practitioners of evidence-based interventions in order to establish and maintain treatment integrity. Method: Four articles covering six outcome studies are included in this review, these studies (1) adequately operationalized treatment integrity procedures…

  1. Support Systems for Treatment Integrity

    ERIC Educational Resources Information Center

    Goense, Pauline Brigitta; Boendermaker, Leonieke; van Yperen, Tom

    2016-01-01

    Objective: This systematic review evaluates the content of effective support provided to practitioners of evidence-based interventions in order to establish and maintain treatment integrity. Method: Four articles covering six outcome studies are included in this review, these studies (1) adequately operationalized treatment integrity procedures…

  2. CD151 supports VCAM-1-mediated lymphocyte adhesion to liver endothelium and is upregulated in chronic liver disease and hepatocellular carcinoma.

    PubMed

    Wadkin, James C R; Patten, Daniel A; Kamarajah, Sivesh K; Shepherd, Emma L; Novitskaya, Vera; Berditchevski, Fedor; Adams, David H; Weston, Chris J; Shetty, Shishir

    2017-08-01

    CD151, a member of the tetraspanin family of receptors, is a lateral organizer and modulator of activity of several families of transmembrane proteins. It has been implicated in the development and progression of several cancers, but its role in chronic inflammatory disease is less well understood. Here we show that CD151 is upregulated by distinct microenvironmental signals in a range of chronic inflammatory liver diseases and in primary liver cancer, in which it supports lymphocyte recruitment. CD151 was highly expressed in endothelial cells of the hepatic sinusoids and neovessels developing in fibrotic septa and tumor margins. Primary cultures of human hepatic sinusoidal endothelial cells (HSECs) expressed CD151 at the cell membrane and in intracellular vesicles. CD151 was upregulated by VEGF and HepG2 conditioned media but not by proinflammatory cytokines. Confocal microscopy confirmed that CD151 colocalized with the endothelial adhesion molecule/immunoglobulin superfamily member, VCAM-1. Functional flow-based adhesion assays with primary human lymphocytes and HSECs demonstrated a 40% reduction of lymphocyte adhesion with CD151 blockade. Inhibition of lymphocyte adhesion was similar between VCAM-1 blockade and a combination of CD151/VCAM-1 blockade, suggesting a collaborative role between the two receptors. These studies demonstrate that CD151 is upregulated within the liver during chronic inflammation, where it supports lymphocyte recruitment via liver endothelium. We propose that CD151 regulates the activity of VCAM-1 during lymphocyte recruitment to the human liver and could be a novel anti-inflammatory target in chronic liver disease and hepatocellular cancer prevention.NEW & NOTEWORTHY Chronic hepatitis is characterized by lymphocyte accumulation in liver tissue, which drives fibrosis and carcinogenesis. Here, we demonstrate for the first time that the tetraspanin CD151 supports lymphocyte adhesion to liver endothelium. We show that CD151 is upregulated in

  3. The PDGF system and its antagonists in liver fibrosis.

    PubMed

    Borkham-Kamphorst, Erawan; Weiskirchen, Ralf

    2016-04-01

    Platelet derived growth factor (PDGF) signaling plays an important role in activated hepatic stellate cells and portal fibroblast proliferation, chemotaxis, migration and cell survival. PDGF receptors and ligands are upregulated in experimental liver fibrotic models as well as in human liver fibrotic diseases. Blocking of PDGF signaling ameliorates experimental liver fibrogenesis. The plurality of molecular and cellular activities of PDGF and its involvement in initiation, progression and resolution of hepatic fibrogenesis offers an infinite number of therapeutic possibilities. These include the application of therapeutic antibodies (e.g. AbyD3263, MOR8457) which specifically sequester individual PDGF isoforms or the inhibition of PDGF isoforms by synthetic aptamers. In particular, the isolation of innovative slow off-rate modified aptamers (e.g., SOMAmer SL1 and SL5) that carry functional groups absent in natural nucleic acids by the Systematic Evolution of Ligands by EXponential (SELEX) enrichment technique offers the possibility to design high affinity aptamers that target PDGF isoforms for clinical purposes. Dominant-negative soluble PDGF receptors are also effective in attenuation of hepatic stellate cell proliferation and hepatic fibrogenesis. Moreover, some multikinase inhibitors targeting PDGF signaling have been intensively tested during the last decade and are on the way into advanced preclinical studies and clinical trials. This narrative review aims to gauge the recent progression of research into PDGF systems and liver fibrosis.

  4. [Molecular Adsorbent Recirculating System in liver function replacement therapy].

    PubMed

    Marangoni, R

    2005-01-01

    The molecular adsorbent recirculating system (MARS) method removes from the blood catabolites either free in the plasma water such as uremic toxins and ammonia, taking advantage of dialysis or free albumin bound ones, like hepatic toxins, transferring them from the albumin in the blood to the albumin circulating in a closed loop where toxins are removed by adsorbtion on resins (charcoal and ion exchange resin). The efficacy of the method in removing the hepatic toxins either in the acute or in the acute on chronic liver failure is demonstrated in numerous studies. Based on these findings, 10 patients affected by acute on chronic liver failure were treated. The results demonstrated that the method, powerfully removing ammonia, bilirubin and bile acids (taken as method efficacy markers), reduced the blood concentrations of these molecules remarkably; allowing the elimination of the refractory pruritus (due to the lowering of plasma bile acid levels), an almost constant symptom in chronic liver diseases, especially with cholestasis, and improves other parameters (cholinesterase, alkaline phosphatase and prothrombin activity). These results agree with those reported in the literature concerning the efficacy of MARS in the replacement of the liver detoxifying function.

  5. Environmental Control and Life Support Systems and Power Systems ...

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

    Environmental Control and Life Support Systems and Power Systems - Space Transportation System, Orbiter Discovery (OV-103), Lyndon B. Johnson Space Center, 2101 NASA Parkway, Houston, Harris County, TX

  6. 42 CFR 441.555 - Support system.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Support system. 441.555 Section 441.555 Public... system. For each service delivery model available, States must provide, or arrange for the provision of, a support system that meets all of the following conditions: (a) Appropriately assesses and counsels...

  7. 42 CFR 441.555 - Support system.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Support system. 441.555 Section 441.555 Public... system. For each service delivery model available, States must provide, or arrange for the provision of, a support system that meets all of the following conditions: (a) Appropriately assesses and counsels...

  8. Academic Support Systems: A Networked Approach.

    ERIC Educational Resources Information Center

    Klingenstein, Kenneth

    1984-01-01

    Academic support systems are characterized as those activities that center around a dean's office--office automation/information systems, institutional research and electronic communication. The basic and design and implementation issues that are encountered in providing these support systems are examined. (Author/MLW)

  9. Joint Command Decision Support System

    DTIC Science & Technology

    2011-06-01

    Greenley et al. 2006) resulted in the identification of a set of overarching principles for the implementation of Joint Command Decision Support (Hales...and adjustment of resources, and longer term feasibility planning. As highlighted in the Joint Staff Front End Analysis report ( Greenley et al. 2006...Townsend (2006). The Federal Response to Hurricane Katrina Lessons Learned, Washington, D.C. February 2006. Greenley , A., Baker, K. & Cochran, L. (2006

  10. Digital Fire Control Systems Support

    DTIC Science & Technology

    2012-09-27

    Systems ( DFCS ) for the M119A2 and M777A2. The DFCS is a fully integrated digital fire control system that has weapon platform application to the...Lightweight 155 mm (LW155) Towed Howitzer and the M119A2 Lightweight 105mm Towed Howitzer. 15. SUBJECT TERMS Digital Fire Control Systems ( DFCS ) 16...Joint Lightweight 155, has been tasked to develop and maintain the Digital Fire Control Systems ( DFCS ) for the M119A2 and M777A2. The DFCS is a fully

  11. Unmanned systems win unexpected support

    SciTech Connect

    Schneiderman, R.

    1991-09-01

    A review of unmanned aerial vehicles (UAVs) is presented in which emphasis is given to recent mission accomplishments and current directions of research. Existing and new military UAV programs are listed with reference to funding, the type of vehicle, and level of development. Several trends are established including the reliance of UVAs on global positioning satellites and advanced electronics and the growth of the UVA industry. UVAs that are in advanced stages of development or have been deployed include short-range UAV such as the Pioneer, the Pointer, the Sky Owl, and the Hunter. Key UAV systems are described such as the Advanced Tactical Airborne Reconnaissance System, the Maritime Vertical Takeoff and Landing, and other VTOL systems. Very small UVAs and Exdrones are also discussed, and a weather reconnaissance system and surveillance systems are mentioned.

  12. X-30 ground support system requirements

    NASA Astrophysics Data System (ADS)

    Carter, Percy B.

    1992-12-01

    A summary is presented of the Ground Systems Associate Contractor's (GSAC) responsibility for all stationary facilities and systems that support final assembly of the X-30 aircraft and the follow on flight test program. This includes process systems, building structures and infrastructure. The GSAC is also responsible for coordination of all ground support systems necessary for the flight test program exclusive of purely electronic systems.

  13. Role of the autonomic nervous system in rat liver regeneration.

    PubMed

    Xu, Cunshuan; Zhang, Xinsheng; Wang, Gaiping; Chang, Cuifang; Zhang, Lianxing; Cheng, Qiuyan; Lu, Ailing

    2011-05-01

    To study the regulatory role of autonomic nervous system in rat regenerating liver, surgical operations of rat partial hepatectomy (PH) and its operation control (OC), sympathectomy combining partial hepatectomy (SPH), vagotomy combining partial hepatectomy (VPH), and total liver denervation combining partial hepatectomy (TDPH) were performed, then expression profiles of regenerating livers at 2 h after operation were detected using Rat Genome 230 2.0 array. It was shown that the expressions of 97 genes in OC, 230 genes in PH, 253 genes in SPH, 187 genes in VPH, and 177 genes in TDPH were significantly changed in biology. The relevance analysis showed that in SPH, genes involved in stimulus response, immunity response, amino acids and K(+) transport, amino acid catabolism, cell adhesion, cell proliferation mediated by JAK-STAT, Ca(+), and platelet-derived growth factor receptor, cell growth and differentiation through JAK-STAT were up-regulated, while the genes involved in chromatin assembly and disassembly, and cell apoptosis mediated by MAPK were down-regulated. In VPH, the genes associated with chromosome modification-related transcription factor, oxygen transport, and cell apoptosis mediated by MAPK pathway were up-regulated, but the genes associated with amino acid catabolism, histone acetylation-related transcription factor, and cell differentiation mediated by Wnt pathway were down-regulated. In TDPH, the genes related to immunity response, growth and development of regenerating liver, cell growth by MAPK pathway were up-regulated. Our data suggested that splanchnic and vagal nerves could regulate the expressions of liver regeneration-related genes.

  14. Characterization of primary human hepatocyte spheroids as a model system for drug-induced liver injury, liver function and disease

    PubMed Central

    Bell, Catherine C.; Hendriks, Delilah F. G.; Moro, Sabrina M. L.; Ellis, Ewa; Walsh, Joanne; Renblom, Anna; Fredriksson Puigvert, Lisa; Dankers, Anita C. A.; Jacobs, Frank; Snoeys, Jan; Sison-Young, Rowena L.; Jenkins, Rosalind E.; Nordling, Åsa; Mkrtchian, Souren; Park, B. Kevin; Kitteringham, Neil R.; Goldring, Christopher E. P.; Lauschke, Volker M.; Ingelman-Sundberg, Magnus

    2016-01-01

    Liver biology and function, drug-induced liver injury (DILI) and liver diseases are difficult to study using current in vitro models such as primary human hepatocyte (PHH) monolayer cultures, as their rapid de-differentiation restricts their usefulness substantially. Thus, we have developed and extensively characterized an easily scalable 3D PHH spheroid system in chemically-defined, serum-free conditions. Using whole proteome analyses, we found that PHH spheroids cultured this way were similar to the liver in vivo and even retained their inter-individual variability. Furthermore, PHH spheroids remained phenotypically stable and retained morphology, viability, and hepatocyte-specific functions for culture periods of at least 5 weeks. We show that under chronic exposure, the sensitivity of the hepatocytes drastically increased and toxicity of a set of hepatotoxins was detected at clinically relevant concentrations. An interesting example was the chronic toxicity of fialuridine for which hepatotoxicity was mimicked after repeated-dosing in the PHH spheroid model, not possible to detect using previous in vitro systems. Additionally, we provide proof-of-principle that PHH spheroids can reflect liver pathologies such as cholestasis, steatosis and viral hepatitis. Combined, our results demonstrate that the PHH spheroid system presented here constitutes a versatile and promising in vitro system to study liver function, liver diseases, drug targets and long-term DILI. PMID:27143246

  15. Integrated Support Software System (ISSS).

    DTIC Science & Technology

    1985-04-01

    Electrical Harness Data Systems ( EHDS ) 18 5.2.3 Defense Mapping Agency (DMA) Contract 19 * *-5.2.4 Advanced Technology 19 6.0 Lessons Learned 20 6.1...design philosophy was the discovery of the subtle distinction between "integrating" and "interlacing" tools. Not all of the various components of ISSS...Systems ( EHDS ), Defense Mapping Agency (DMA) Modern Programming Environment (MPE) contract, and the Advanced Technology Group. 5.2.1 Use by Production

  16. Critiquing Systems for Decision Support

    DTIC Science & Technology

    2006-02-01

    errors and deficiencies. An example of a comparative critic is the ATTENDING system ( anaesthesiology ), which first parses the user’s solution into a...design tools at the times when those tools are useful. 9. Experiential critics provide reminders of past experiences with similar designs or design...technique for hypertension rather than the broader field of anaesthesiology ; and (2) critiquing systems are most appropriate for tasks that require

  17. Controlled Ecological Life Support System. Life Support Systems in Space Travel

    NASA Technical Reports Server (NTRS)

    Macelroy, R. D. (Editor); Smernoff, D. T. (Editor); Klein, H. P. (Editor)

    1985-01-01

    Life support systems in space travel, in closed ecological systems were studied. Topics discussed include: (1) problems of life support and the fundamental concepts of bioregeneration; (2) technology associated with physical/chemical regenerative life support; (3) projection of the break even points for various life support techniques; (4) problems of controlling a bioregenerative life support system; (5) data on the operation of an experimental algal/mouse life support system; (6) industrial concepts of bioregenerative life support; and (7) Japanese concepts of bioregenerative life support and associated biological experiments to be conducted in the space station.

  18. Supporting Multiple Cognitive Processing Styles Using Tailored Support Systems

    SciTech Connect

    Tuan Q. Tran; Karen M. Feigh; Amy R. Pritchett

    2007-08-01

    According to theories of cognitive processing style or cognitive control mode, human performance is more effective when an individual’s cognitive state (e.g., intuition/scramble vs. deliberate/strategic) matches his/her ecological constraints or context (e.g., utilize intuition to strive for a "good-enough" response instead of deliberating for the "best" response under high time pressure). Ill-mapping between cognitive state and ecological constraints are believed to lead to degraded task performance. Consequently, incorporating support systems which are designed to specifically address multiple cognitive and functional states e.g., high workload, stress, boredom, and initiate appropriate mitigation strategies (e.g., reduce information load) is essential to reduce plant risk. Utilizing the concept of Cognitive Control Models, this paper will discuss the importance of tailoring support systems to match an operator's cognitive state, and will further discuss the importance of these ecological constraints in selecting and implementing mitigation strategies for safe and effective system performance. An example from the nuclear power plant industry illustrating how a support system might be tailored to support different cognitive states is included.

  19. Tongue motor training support system.

    PubMed

    Sasaki, Makoto; Onishi, Kohei; Nakayama, Atsushi; Kamata, Katsuhiro; Stefanov, Dimitar; Yamaguchi, Masaki

    2014-01-01

    In this paper, we introduce a new tongue-training system that can be used for improvement of the tongue's range of motion and muscle strength after dysphagia. The training process is organized in game-like manner. Initially, we analyzed surface electromyography (EMG) signals of the suprahyoid muscles of five subjects during tongue-training motions. This test revealed that four types tongue training motions and a swallowing motion could be classified with 93.5% accuracy. Recognized EMG signals during tongue motions were designed to allow control of a mouse cursor via intentional tongue motions. Results demonstrated that simple PC games could be played by tongue motions, achieving in this way efficient, enjoyable and pleasant tongue training. Using the proposed method, dysphagia patients can choose games that suit their preferences and/or state of mind. It is expected that the proposed system will be an efficient tool for long-term tongue motor training and maintaining patients' motivation.

  20. An Intelligent Support System for Course Design.

    ERIC Educational Resources Information Center

    Paquette, Gilbert; And Others

    1994-01-01

    Discusses instructional design and describes the development of a support system for course design called AGD (French acronym for Didactic Engineering Workbench). Highlights include categories of computer tools that support course design, including computer-assisted instruction, instructional design expert systems, and job aids; knowledge modeling…

  1. Instructional Support Software System. Final Report.

    ERIC Educational Resources Information Center

    McDonnell Douglas Astronautics Co. - East, St. Louis, MO.

    This report describes the development of the Instructional Support System (ISS), a large-scale, computer-based training system that supports both computer-assisted instruction and computer-managed instruction. Written in the Ada programming language, the ISS software package is designed to be machine independent. It is also grouped into functional…

  2. Decision Support Systems: The Need, The Challenge.

    ERIC Educational Resources Information Center

    Roberts, Michael M.

    1982-01-01

    The evolution of decision support systems (DSS) has enabled computer and information technology to assist the management process of decision making. Decision support systems are designed to look forward in time, to forecast outcomes of uncertain events. A 70-item bibliography is included. (MLW)

  3. Administrators' Personal and Social Support Systems.

    ERIC Educational Resources Information Center

    Lindle, Jane Clark; Miller, Linda Demarco

    This study maintains that social support systems alleviate the physical and psychological effects of stress; however, the school administrator often has no peers in the same building and therefore stands apart from any of the built in support systems developed by the subculture within his school. Further, as discovered through interviews with 35…

  4. Continuous Learning Environments: Online Performance Support Systems.

    ERIC Educational Resources Information Center

    Forman, David C.; Kaplan, Sandra J.

    1994-01-01

    Describes technology-based systems that offer performance support, called online performance support systems (OPSS), that help increase productivity and efficiency. Changes in information-related, organization-related, and learning-related factors in corporations are considered; OPSS components are explained, including user-centered design; and…

  5. Developing Sustainable Life Support System Concepts

    NASA Technical Reports Server (NTRS)

    Thomas, Evan A.

    2010-01-01

    Sustainable spacecraft life support concepts may allow the development of more reliable technologies for long duration space missions. Currently, life support technologies at different levels of development are not well evaluated against each other, and evaluation methods do not account for long term reliability and sustainability of the hardware. This paper presents point-of-departure sustainability evaluation criteria for life support systems, that may allow more robust technology development, testing and comparison. An example sustainable water recovery system concept is presented.

  6. Far Forward Life Support System.

    DTIC Science & Technology

    1998-08-01

    device to a replaceable NBC filter (c) IV fluids infusion pump with functional display and alarm (d) User interface for inputs from external devices... input settings, power, alarm resets, and sensor calibrations (e) Pulse oximeter sensor for monitoring oxygen saturation in blood stream 14 (f...monitoring (i) Controller to sensor interface (j) Data acquisition and recording system that will: 1. accept user inputs on patient identification

  7. Calorie restricted diet induces alternative pathways of lipid metabolism for support of proliferative processes in regenerating liver.

    PubMed

    Bozhkov, A I; Menzianova, N C

    2009-01-01

    This study deals with quality and quantity lipid composition of blood serum and liver, DNA synthesis activity (incorporation of H3-thymidine) in liver in 24 h after partial hepatectomy (PH) in 22-month-old Wistar rats, maintained for 21 months on calorie restricted diet (CRD) and on standard diet ad libitum (SD). The contain of lipids in blood serum and activity of RA-label incorporation (14C-Na-acetate) in serum lipids in 24 h after PH were the same in CRD-fed and SD-fed animals. Quantitative and qualitative composition of lipids in microsomes of regenerating liver also was the same for both groups of rats. In regenerating liver of CRD-fed animals lipid contain in cytosol was 1,8-fold more, but pool of lipid droplets (LD) was 1.5-fold less than in regenerating liver of SD-fed animals. Activity of RA-label incorporation in lipids of microsomes, cytosol and LD pool of regenerating liver of CRD-fed animals was significantly higher, than in SD-fed ones. Activity of RA-label incorporation in lipid fractions and its distribution among cytosol lipids and LD pool lipids differed significantly between SD- and CRD-fed animals. Activity of DNA synthesis in regenerating liver of 22-month-old animals on CRD and SD was the same. It is supposed that calorie restriction induces alternative pathways of lipid metabolism to support proliferation processes in liver after PH.

  8. Development of a New Diagnostic System for Human Liver Diseases Based on Conventional Ultrasonic Diagnostic Equipment

    NASA Astrophysics Data System (ADS)

    Kikuchi, Tsuneo; Nakazawa, Toshihiro; Harada, Akimitsu; Sato, Hiroaki; Maruyama, Yukio; Sato, Sojun

    2001-05-01

    In this paper, the authors present the experimental results of using a quantitative ultrasonic diagnosis technique for human liver diseases using the fractal dimension (FD) of the shape of the power spectra (PS) of RF signals. We have developed an experimental system based on a conventional ultrasonic diagnostic system. As a result, we show that normal livers, fatty livers and liver cirrhosis can be identified using the FD values.

  9. Systemic symptoms in non-alcoholic fatty liver disease.

    PubMed

    Newton, Julia L

    2010-01-01

    Non-alcoholic fatty liver disease (NAFLD) is the most common liver disorder in the Western world and the incidence of the disease is constantly increasing. Most patients with NAFLD do not present with symptoms directly attributable to their underlying liver disease. It is increasingly recognized, however, that those with NAFLD describe a range of non-specific symptoms, which include fatigue and daytime sleepiness, may be the presenting problem and can impact dramatically upon quality of life in this patient group. The recognition of systemic symptoms in NAFLD has important implications for patients as many are potentially modifiable with targeted interventions. Fatigue appears to be a significant problem in NAFLD and the severity of fatigue is not associated with severity of NAFLD or any parameters of liver damage. Instead, fatigue in these patients shows a strong relationship with the symptom of daytime sleepiness and autonomic dysfunction. Daytime sleepiness can frequently be associated with obstructive sleep apnoea in those with NAFLD and is therefore treatable with evidence-based interventions. Recent studies have confirmed the presence of autonomic nervous system dysfunction in those with early stages of NAFLD. The presence of autonomic nervous system dysfunction leads to symptoms such as postural dizziness and syncope and is also associated with a number of clinical consequences in hepatic and non-hepatic diseases such as cognitive dysfunction, falls and fall-related injuries. On direct questioning, problems with memory and concentration are frequently described by those with NAFLD, with our studies confirming that 50% of NAFLD patients experience mild cognitive symptoms and up to 46% moderate or severe cognitive impairment. There were no positive correlations between cognitive symptoms and biochemical or histological markers of liver damage severity, confirming that cognitive impairment in early-stage NAFLD is not related to hepatic encephalopathy. Falls are

  10. Advanced Group Support Systems and Facilities

    NASA Technical Reports Server (NTRS)

    Noor, Ahmed K. (Compiler); Malone, John B. (Compiler)

    1999-01-01

    The document contains the proceedings of the Workshop on Advanced Group Support Systems and Facilities held at NASA Langley Research Center, Hampton, Virginia, July 19-20, 1999. The workshop was jointly sponsored by the University of Virginia Center for Advanced Computational Technology and NASA. Workshop attendees came from NASA, other government agencies, industry, and universities. The objectives of the workshop were to assess the status of advanced group support systems and to identify the potential of these systems for use in future collaborative distributed design and synthesis environments. The presentations covered the current status and effectiveness of different group support systems.

  11. Business Management System Support Analysis

    NASA Technical Reports Server (NTRS)

    Parikh, Jay

    2008-01-01

    The purpose of this research project was to develop a searchable database compiled with internal and external audit findings/observations. The data will correspond to the findings and observations from the date of Center-wide implementation of the ISO 9001-2000 standard to the present (2003-2008). It was derived and extracted from several sources and was in multiple formats. Once extracted, categorization of the findings/observations would be possible. The final data was mapped to the ISO 9001-2000 standard with the understanding that it will be displayed graphically. The data will be used to verify trends, associate risks, and establish timelines to identify strengths and weaknesses to determine areas of improvement in the Kennedy Space Center Business Management System Internal Audit Program.

  12. The effectiveness of a novel cartridge-based bioreactor design in supporting liver cells.

    PubMed

    Niu, Mei; Hammond, Paul; Coger, Robin N

    2009-10-01

    There are a number of applications--ranging from temporary strategies for organ failure to pharmaceutical testing--that rely on effective bioreactor designs. The significance of these devices is that they provide an environment for maintaining cells in a way that allows them to perform key cellular and tissue functions. In the current study, a novel cartridge-based bioreactor was developed and evaluated. Its unique features include its capacity for cell support and the adaptable design of its cellular space. Specifically, it is able to accommodate functional and reasonably sized tissue (>2.0 x 10(8) cells), and can be easily modified to support a range of anchorage-dependent cells. To evaluate its efficacy, it was applied to liver support in the current study. This involved evaluating the performance of rat primary hepatocytes within the unique cartridges in culture--sans bioreactor--and after being loaded within the novel bioreactor. Compared to collagen sandwich culture functional controls, hepatocytes within the unique cartridge design demonstrated significantly higher albumin production and urea secretion rates when cultured under dynamic flow conditions--reaching peak values of 170 +/- 22 microg/10(6) cells/day and 195 +/- 18 microg/10(6) cells/day, respectively. The bioreactor's effectiveness in supporting live and functioning primary hepatocytes is also presented. Cell viability at the end of 15 days of culture in the new bioreactor was 84 +/- 18%, suggesting that the new design is effective in maintaining primary hepatocytes for at least 2 weeks in culture. Liver-specific functions of urea secretion, albumin synthesis, and cytochrome P450 activity were also assessed. The results indicate that hepatocytes are able to achieve good functional performance when cultured within the novel bioreactor. This is especially true in the case of cytochrome P450 activity, where by day 15 of culture, hepatocytes within the bioreactor reached values that were 56.6% higher

  13. Supportive therapies for prevention of hepatocellular carcinoma recurrence and preservation of liver function.

    PubMed

    Takami, Taro; Yamasaki, Takahiro; Saeki, Issei; Matsumoto, Toshihiko; Suehiro, Yutaka; Sakaida, Isao

    2016-08-28

    Hepatocellular carcinoma (HCC) is one of the deadliest cancers in the world and is associated with a high risk of recurrence. The development of a wide range of new therapies is therefore essential. In this study, from the perspective of supportive therapy for the prevention of HCC recurrence and preservation of liver function in HCC patients, we surveyed a variety of different therapeutic agents. We show that branched chain amino acids (BCAA) supplementation and late evening snack with BCAA, strategies that address issues of protein-energy malnutrition, are important for liver cirrhotic patients with HCC. For chemoprevention of HCC recurrence, we show that viral control after radical treatment is important. We also reviewed the therapeutic potential of antiviral drugs, sorafenib, peretinoin, iron chelators. Sorafenib is a kinase inhibitor and a standard therapy in the treatment of advanced HCC. Peretinoin is a vitamin A-like molecule that targets the retinoid nuclear receptor to induce apoptosis and inhibit tumor growth in HCC cells. Iron chelators, such as deferoxamine and deferasirox, act to prevent cancer cell growth. These chelators may have potential as combination therapies in conjunction with peretinoin. Finally, we review the potential inhibitory effect of bone marrow cells on hepatocarcinogenesis.

  14. Automated CPX support system preliminary design phase

    NASA Technical Reports Server (NTRS)

    Bordeaux, T. A.; Carson, E. T.; Hepburn, C. D.; Shinnick, F. M.

    1984-01-01

    The development of the Distributed Command and Control System (DCCS) is discussed. The development of an automated C2 system stimulated the development of an automated command post exercise (CPX) support system to provide a more realistic stimulus to DCCS than could be achieved with the existing manual system. An automated CPX system to support corps-level exercise was designed. The effort comprised four tasks: (1) collecting and documenting user requirements; (2) developing a preliminary system design; (3) defining a program plan; and (4) evaluating the suitability of the TRASANA FOURCE computer model.

  15. Life Support Systems Microbial Challenges

    NASA Technical Reports Server (NTRS)

    Roman, Monsi C.

    2010-01-01

    Many microbiological studies were performed during the development of the Space Station Water Recovery and Management System from1990-2009. Studies include assessments of: (1) bulk phase (planktonic) microbial population (2) biofilms, (3) microbially influenced corrosion (4) biofouling treatments. This slide presentation summarizes the studies performed to assess the bulk phase microbial community during the Space Station Water Recovery Tests (WRT) from 1990 to 1998. This report provides an overview of some of the microbiological analyses performed during the Space Station WRT program. These tests not only integrated several technologies with the goal of producing water that met NASA s potable water specifications, but also integrated humans, and therefore human flora into the protocols. At the time these tests were performed, not much was known (or published) about the microbial composition of these types of wastewater. It is important to note that design changes to the WRS have been implemented over the years and results discussed in this report might be directly related to test configurations that were not chosen for the final flight configuration. Results microbiological analyses performed Conclusion from the during the WRT showed that it was possible to recycle water from different sources, including urine, and produce water that can exceed the quality of municipally produced water.

  16. A decision-supported outpatient practice system.

    PubMed Central

    Barrows, R. C.; Allen, B. A.; Smith, K. C.; Arni, V. V.; Sherman, E.

    1996-01-01

    We describe a Decision-supported Outpatient Practice (DOP) system developed and now in use at the Columbia-Presbyterian Medical Center. DOP is an automated ambulatory medical record system that integrates in-patient and ambulatory care data, and incorporates active and passive decision support mechanisms with a view towards improving the quality of primary care. Active decision support occurs in the form of event-driven reminders created within a remote clinical information system with its central data repository and decision support system (DSS). Novel features of DOP include patient specific health maintenance task lists calculated by the remote DSS. uses of a semantically structured controlled medical vocabulary to support clinical results review and provider data entry, and exploitation of an underlying ambulatory data model that provides for an explicit record of evolution of insight regarding patient management. Benefits, challenges, and plans are discussed. PMID:8947774

  17. Network support for system initiated checkpoints

    DOEpatents

    Chen, Dong; Heidelberger, Philip

    2013-01-29

    A system, method and computer program product for supporting system initiated checkpoints in parallel computing systems. The system and method generates selective control signals to perform checkpointing of system related data in presence of messaging activity associated with a user application running at the node. The checkpointing is initiated by the system such that checkpoint data of a plurality of network nodes may be obtained even in the presence of user applications running on highly parallel computers that include ongoing user messaging activity.

  18. Climate data system supports FIRE

    NASA Technical Reports Server (NTRS)

    Olsen, Lola M.; Iascone, Dominick; Reph, Mary G.

    1990-01-01

    The NASA Climate Data System (NCDS) at Goddard Space Flight Center is serving as the FIRE Central Archive, providing a centralized data holding and data cataloging service for the FIRE project. NCDS members are carrying out their responsibilities by holding all reduced observations and data analysis products submitted by individual principal investigators in the agreed upon format, by holding all satellite data sets required for FIRE, by providing copies of any of these data sets to FIRE investigators, and by producing and updating a catalog with information about the FIRE holdings. FIRE researchers were requested to provide their reduced data sets in the Standard Data Format (SDF) to the FIRE Central Archive. This standard format is proving to be of value. An improved SDF document is now available. The document provides an example from an actual FIRE SDF data set and clearly states the guidelines for formatting data in SDF. NCDS has received SDF tapes from a number of investigators. These tapes were analyzed and comments provided to the producers. One product which is now available is William J. Syrett's sodar data product from the Stratocumulus Intensive Field Observation. Sample plots from all SDF tapes submitted to the archive will be available to FSET members. Related cloud products are also available through NCDS. Entries describing the FIRE data sets are being provided for the NCDS on-line catalog. Detailed information for the Extended Time Observations is available in the general FIRE catalog entry. Separate catalog entries are being written for the Cirrus Intensive Field Observation (IFO) and for the Marine Stratocumulus IFO. Short descriptions of each FIRE data set will be installed into the NCDS Summary Catalog.

  19. CONTROL OF GLUTAMATE OXIDATION IN BRAIN AND LIVER MITOCHONDRIAL SYSTEMS.

    PubMed

    BALAZS, R

    1965-05-01

    1. Glutamate oxidation in brain and liver mitochondrial systems proceeds mainly through transamination with oxaloacetate followed by oxidation of the alpha-oxoglutarate formed. Both in the presence and absence of dinitrophenol in liver mitochondria this pathway accounted for almost 80% of the uptake of glutamate. In brain preparations the transamination pathway accounted for about 90% of the glutamate uptake. 2. The oxidation of [1-(14)C]- and [5-(14)C]-glutamate in brain preparations is compatible with utilization through the tricarboxylic acid cycle, either after the formation of alpha-oxoglutarate or after decarboxylation to form gamma-aminobutyrate. There is no indication of gamma-decarboxylation of glutamate. 3. The high respiratory control ratio obtained with glutamate as substrate in brain mitochondrial preparations is due to the low respiration rate in the absence of ADP: this results from the low rate of formation of oxaloacetate under these conditions. When oxaloacetate is made available by the addition of malate or of NAD(+), the respiration rate is increased to the level obtained with other substrates. 4. When the transamination pathway of glutamate oxidation was blocked with malonate, the uptake of glutamate was inhibited in the presence of ADP or ADP plus dinitrophenol by about 70 and 80% respectively in brain mitochondrial systems, whereas the inhibition was only about 50% in dinitrophenol-stimulated liver preparations. In unstimulated liver mitochondria in the presence of malonate there was a sixfold increase in the oxidation of glutamate by the glutamate-dehydrogenase pathway. Thus the operating activity of glutamate dehydrogenase is much less than the ;free' (non-latent) activity. 5. The following explanation is put forward for the control of glutamate metabolism in liver and brain mitochondrial preparations. The oxidation of glutamate by either pathway yields alpha-oxoglutarate, which is further metabolized. Since aspartate aminotransferase is

  20. [Liver cirrhosis and encephalopathy: clinical and metabolic consequences and nutritional support].

    PubMed

    Mesejo, A; Juan, M; Serrano, A

    2008-05-01

    Cirrhosis represents the final stage of many chronic liver diseases and is associated to more or less pronounced hyponutrition, independently of the etiology, particularly at advanced stages. Its origin is multifactorial, with three factors contributing to it: a) limitation or decrease of intake; b) impairment in nutrients digestion or absorption; and c) the interference with nutrients metabolism. A poor nutritional status is associated with a poor survival prognosis. Whether caloric-protein malnourishment (CPM) is an independent predictor of mortality or only a marker of the severity of liver failure is subject to controversy. There is no consensus on which are the best diagnostic criteria for CPM in cirrhosis. Assessment of hyponutrition is extremely difficult since both the disease itself and the triggering or etiologic factors affect many of the parameters used. Metabolic impairments mimic a hypercatabolic state. These patients have decreased carbohydrate utilization and storage capacity and increased protein and fat catabolism leading to depletion of protein and lipid reserves. These abnormalities together with decreased nutrients intake and absorption are the bases for CPM. The most important metabolic impairment in patients with advanced liver disease is the change in amino acids metabolism. The plasma levels of branched amino acids (BAA) are decreased and of aromatic amino acids (AAA) are increased, which has therapeutic implications. Among the consequences of the structural impairments taking place in cirrhosis, we may highlight hepatic encephalopathy, defined as impaired central nervous system functioning that manifests as a series of neuropsychiatric, neuromuscular, and behavioral symptoms. These are due to the inability of the diseased liver to metabolize neurotoxins that accumulate in the brain affecting neurotransmitters and are attributed to the toxic effect of ammonium on the brain tissue. Nutritional therapy brings benefits in the different stages

  1. NASA Advanced Exploration Systems: Advancements in Life Support Systems

    NASA Technical Reports Server (NTRS)

    Shull, Sarah A.; Schneider, Walter F.

    2016-01-01

    The NASA Advanced Exploration Systems (AES) Life Support Systems (LSS) project strives to develop reliable, energy-efficient, and low-mass spacecraft systems to provide environmental control and life support systems (ECLSS) critical to enabling long duration human missions beyond low Earth orbit (LEO). Highly reliable, closed-loop life support systems are among the capabilities required for the longer duration human space exploration missions assessed by NASA’s Habitability Architecture Team.

  2. The lymphatic vascular system in liver diseases: its role in ascites formation.

    PubMed

    Chung, Chuhan; Iwakiri, Yasuko

    2013-06-01

    The lymphatic system is part of the circulatory system and plays a key role in normal vascular function. Its failure plays a crucial role in the development and maintenance of various diseases including liver diseases. Lymphangiogenesis (the growth of lymphatic vessels) and changes in the properties of lymphatic vessels are associated with pathogenesis of tumor metastases, ascites formation, liver fibrosis/cirrhosis and portal hypertension. Despite its significant role in liver diseases and its importance as a potential therapeutic target for those diseases, the lymphatic vascular system of the liver is poorly understood. Therefore, how the lymphatic vascular system in general and lymphangiogenesis in particular are mechanistically related to the pathogenesis and maintenance of liver diseases are largely unknown. This article summarizes: 1) the lymphatic vascular system; 2) its role in liver tumors, liver fibrosis/cirrhosis and portal hypertension; and 3) its role in ascites formation.

  3. Mathematical Modeling Of Life-Support Systems

    NASA Technical Reports Server (NTRS)

    Seshan, Panchalam K.; Ganapathi, Balasubramanian; Jan, Darrell L.; Ferrall, Joseph F.; Rohatgi, Naresh K.

    1994-01-01

    Generic hierarchical model of life-support system developed to facilitate comparisons of options in design of system. Model represents combinations of interdependent subsystems supporting microbes, plants, fish, and land animals (including humans). Generic model enables rapid configuration of variety of specific life support component models for tradeoff studies culminating in single system design. Enables rapid evaluation of effects of substituting alternate technologies and even entire groups of technologies and subsystems. Used to synthesize and analyze life-support systems ranging from relatively simple, nonregenerative units like aquariums to complex closed-loop systems aboard submarines or spacecraft. Model, called Generic Modular Flow Schematic (GMFS), coded in such chemical-process-simulation languages as Aspen Plus and expressed as three-dimensional spreadsheet.

  4. Mathematical Modeling Of Life-Support Systems

    NASA Technical Reports Server (NTRS)

    Seshan, Panchalam K.; Ganapathi, Balasubramanian; Jan, Darrell L.; Ferrall, Joseph F.; Rohatgi, Naresh K.

    1994-01-01

    Generic hierarchical model of life-support system developed to facilitate comparisons of options in design of system. Model represents combinations of interdependent subsystems supporting microbes, plants, fish, and land animals (including humans). Generic model enables rapid configuration of variety of specific life support component models for tradeoff studies culminating in single system design. Enables rapid evaluation of effects of substituting alternate technologies and even entire groups of technologies and subsystems. Used to synthesize and analyze life-support systems ranging from relatively simple, nonregenerative units like aquariums to complex closed-loop systems aboard submarines or spacecraft. Model, called Generic Modular Flow Schematic (GMFS), coded in such chemical-process-simulation languages as Aspen Plus and expressed as three-dimensional spreadsheet.

  5. Assessment of readiness for clinical decision support to aid laboratory monitoring of immunosuppressive care at U.S. liver transplant centers.

    PubMed

    Jacobs, J; Weir, C; Evans, R S; Staes, C

    2014-01-01

    Following liver transplantation, patients require lifelong immunosuppressive care and monitoring. Computerized clinical decision support (CDS) has been shown to improve post-transplant immunosuppressive care processes and outcomes. The readiness of transplant information systems to implement computerized CDS to support post-transplant care is unknown. a) Describe the current clinical information system functionality and manual and automated processes for laboratory monitoring of immunosuppressive care, b) describe the use of guidelines that may be used to produce computable logic and the use of computerized alerts to support guideline adherence, and c) explore barriers to implementation of CDS in U.S. liver transplant centers. We developed a web-based survey using cognitive interviewing techniques. We surveyed 119 U.S. transplant programs that performed at least five liver transplantations per year during 2010-2012. Responses were summarized using descriptive analyses; barriers were identified using qualitative methods. Respondents from 80 programs (67% response rate) completed the survey. While 98% of programs reported having an electronic health record (EHR), all programs used paper-based manual processes to receive or track immunosuppressive laboratory results. Most programs (85%) reported that 30% or more of their patients used external laboratories for routine testing. Few programs (19%) received most external laboratory results as discrete data via electronic interfaces while most (80%) manually entered laboratory results into the EHR; less than half (42%) could integrate internal and external laboratory results. Nearly all programs had guidelines regarding pre-specified target ranges (92%) or testing schedules (97%) for managing immunosuppressive care. Few programs used computerized alerting to notify transplant coordinators of out-of-range (27%) or overdue laboratory results (20%). Use of EHRs is common, yet all liver transplant programs were largely

  6. Design Rules for Life Support Systems

    NASA Technical Reports Server (NTRS)

    Jones, Harry

    2002-01-01

    This paper considers some of the common assumptions and engineering rules of thumb used in life support system design. One general design rule is that the longer the mission, the more the life support system should use recycling and regenerable technologies. A more specific rule is that, if the system grows more than half the food, the food plants will supply all the oxygen needed for the crew life support. There are many such design rules that help in planning the analysis of life support systems and in checking results. These rules are typically if-then statements describing the results of steady-state, "back of the envelope," mass flow calculations. They are useful in identifying plausible candidate life support system designs and in rough allocations between resupply and resource recovery. Life support system designers should always review the design rules and make quick steady state calculations before doing detailed design and dynamic simulation. This paper develops the basis for the different assumptions and design rules and discusses how they should be used. We start top-down, with the highest level requirement to sustain human beings in a closed environment off Earth. We consider the crew needs for air, water, and food. We then discuss atmosphere leakage and recycling losses. The needs to support the crew and to make up losses define the fundamental life support system requirements. We consider the trade-offs between resupplying and recycling oxygen, water, and food. The specific choices between resupply and recycling are determined by mission duration, presence of in-situ resources, etc., and are defining parameters of life support system design.

  7. Liver Imaging Reporting and Data System: an expert consensus statement

    PubMed Central

    Elsayes, Khaled M; Kielar, Ania Z; Agrons, Michelle M; Szklaruk, Janio; Tang, An; Bashir, Mustafa R; Mitchell, Donald G; Do, Richard K; Fowler, Kathryn J; Chernyak, Victoria; Sirlin, Claude B

    2017-01-01

    The increasing incidence and high morbidity and mortality of hepatocellular carcinoma (HCC) have inspired the creation of the Liver Imaging Reporting and Data System (LI-RADS). LI-RADS aims to reduce variability in exam interpretation, improve communication, facilitate clinical therapeutic decisions, reduce omission of pertinent information, and facilitate the monitoring of outcomes. LI-RADS is a dynamic process, which is updated frequently. In this article, we describe the LI-RADS 2014 version (v2014), which marks the second update since the initial version in 2011. PMID:28255543

  8. Metabonomic analysis of hepatitis B virus-induced liver failure: identification of potential diagnostic biomarkers by fuzzy support vector machine.

    PubMed

    Mao, Yong; Huang, Xin; Yu, Ke; Qu, Hai-bin; Liu, Chang-xiao; Cheng, Yi-yu

    2008-06-01

    Hepatitis B virus (HBV)-induced liver failure is an emergent liver disease leading to high mortality. The severity of liver failure may be reflected by the profile of some metabolites. This study assessed the potential of using metabolites as biomarkers for liver failure by identifying metabolites with good discriminative performance for its phenotype. The serum samples from 24 HBV-induced liver failure patients and 23 healthy volunteers were collected and analyzed by gas chromatography-mass spectrometry (GC-MS) to generate metabolite profiles. The 24 patients were further grouped into two classes according to the severity of liver failure. Twenty-five commensal peaks in all metabolite profiles were extracted, and the relative area values of these peaks were used as features for each sample. Three algorithms, F-test, k-nearest neighbor (KNN) and fuzzy support vector machine (FSVM) combined with exhaustive search (ES), were employed to identify a subset of metabolites (biomarkers) that best predict liver failure. Based on the achieved experimental dataset, 93.62% predictive accuracy by 6 features was selected with FSVM-ES and three key metabolites, glyceric acid, cis-aconitic acid and citric acid, are identified as potential diagnostic biomarkers.

  9. Using and Evaluating Administrative Decision Support Systems.

    ERIC Educational Resources Information Center

    King, William R.

    1981-01-01

    Computer technology is rapidly being integrated into decision support systems that far surpass the potential of other information systems. To take advantage of this potential, the administrator must be able to evaluate these systems in terms that are relevant to the organization. (Author/MLW)

  10. A Hyperknowledge Framework of Decision Support Systems.

    ERIC Educational Resources Information Center

    Chang, Ai-Mei; And Others

    1994-01-01

    Presents a hyperknowledge framework of decision support systems (DSS). This framework formalizes specifics about system functionality, representation of knowledge, navigation of the knowledge system, and user-interface traits as elements of a DSS environment that conforms closely to human cognitive processes in decision making. (Contains 52…

  11. Developing Electronic Performance Support Systems for Professionals.

    ERIC Educational Resources Information Center

    Law, Michael P.; And Others

    This paper discusses a variety of development strategies and issues involved in the development of electronic performance support systems (EPSS) for professionals. The topics of front-end analysis, development, and evaluation are explored in the context of a case study involving the development of an EPSS to support teachers in the use of…

  12. 42 CFR 441.555 - Support system.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ..., a support system that meets all of the following conditions: (a) Appropriately assesses and counsels... service plan and, if applicable, service budget. (iv) Grievance process. (v) Information on the risks and... accessing services, supports, and resources. (xi) Development of risk management agreements. (A) The...

  13. Tactical Decision Making and Decision Support Systems.

    ERIC Educational Resources Information Center

    Harmon, Joel I.

    1986-01-01

    The use of computerized decision support systems in higher education for making tactical institutional decisions is reviewed, with attention to the kind of administrative problems that lie somewhere between programmed to nonprogrammed decisions and require a combination of computer support and administrative judgment. (MSE)

  14. Closed-Loop Life Support Systems

    NASA Technical Reports Server (NTRS)

    Fisher, John W.

    2003-01-01

    Contents include the following: 1. Advanced life support requirements document-high level: (a) high level requirements and standards, (b) advanced life support requirements documents-air, food, water. 2. Example technologies that satisfy requrements: air system-carbon dioxide removal. 3. Air-sabatter. 4. International Space Station water treatment subsystem.5. Direct osmotic concentrator. 6. Mass, volume and power estimates.

  15. In vitro evidence in rainbow trout supporting glucosensing mediated by sweet taste receptor, LXR, and mitochondrial activity in Brockmann bodies, and sweet taste receptor in liver.

    PubMed

    Otero-Rodiño, Cristina; Velasco, Cristina; Álvarez-Otero, Rosa; López-Patiño, Marcos A; Míguez, Jesús M; Soengas, José L

    2016-10-01

    We previously obtained evidence in rainbow trout peripheral tissues such as liver and Brockmann bodies (BB) for the presence and response to changes in circulating levels of glucose (induced by intraperitoneal hypoglycaemic and hyperglycaemic treatments) of glucosensing mechanisms others than that mediated by glucokinase (GK). There were based on mitochondrial production of reactive oxygen species (ROS) leading to increased expression of uncoupling protein 2 (UCP2), and sweet taste receptor in liver and BB, and on liver X receptor (LXR) and sodium/glucose co-transporter 1 (SGLT-1) in BB. We aimed in the present study to obtain further in vitro evidence for the presence and functioning of these systems. In a first experiment, pools of sliced liver and BB were incubated for 6h at 15°C in modified Hanks' medium containing 2, 4, or 8mM d-glucose, and we assessed the response of parameters related to these glucosensing mechanisms. In a second experiment, pools of sliced liver and BB were incubated for 6h at 15°C in modified Hanks' medium with 8mM d-glucose alone (control) or containing 1mM phloridzin (SGLT-1 antagonist), 20μM genipin (UCP2 inhibitor), 1μM trolox (ROS scavenger), 100μM bezafibrate (T1R3 inhibitor), and 50μM geranyl-geranyl pyrophosphate (LXR inhibitor). The results obtained in both experiments support the presence and functioning of glucosensor mechanisms in liver based on sweet taste receptor whereas in BB the evidence support those based on LXR, mitochondrial activity and sweet taste receptor.

  16. Molecular adsorbent recirculating system (MARS) in acute liver injury and graft dysfunction: Results from a case-control study

    PubMed Central

    Thölking, Gerold; Pavenstädt, Hermann; Brand, Marcus; Wilms, Christian; Hüsing-Kabar, Anna; Görlich, Dennis; Kabar, Iyad; Schmidt, Hartmut H. J.

    2017-01-01

    Background The primary therapeutic goals in the treatment of liver injury are to support liver regeneration or bridge the gap to liver transplantation (LT). Molecular adsorbent recirculating system (MARS) therapy has shown beneficial effects for specific symptoms of liver failure; however, general survival advantages have not yet been demonstrated. Aim We studied the effects of MARS therapy compared to standard medical treatment (SMT) in two patient cohorts: in patients with an acute liver injury and in those with graft dysfunction (GD). Methods We report on our experience over a 6.5-year period with 73 patients treated with SMT or with SMT and MARS (MARS group). In total, 53 patients suffered from acute liver injury in their native liver without a preexisting liver disease (SMT: n = 31, MARS: n = 22), and 20 patients showed a severe GD after LT (SMT: n = 10, MARS: n = 10). Results The entire cohort was predominantly characterized by hemodynamically and respiratorily stable patients with a low hepatic encephalopathy (HE) grade and a model of end-stage liver disease (MELD) score of 20.57 (MARS) or 22.51 (SMT, p = 0.555). Within the MARS group, the median number of extracorporeal therapy sessions was four (range = 3–5 sessions). Independent of the underlying etiology, MARS improved the patients’ bilirubin values in the short term compared to SMT alone. In patients with acute liver injury, this response was sustained even after the end of MARS therapy. By contrast, the majority of patients with GD and an initial response to MARS therapy experienced worsened hyperbilirubinemia. No differences in 28-day mortality were observed with respect to acute liver injury (MARS 5.3% (95% CI: 0–15.3); SMT 3.3% (95% CI: 0–9.8), p = 0.754) or GD (MARS 20.0% (95% CI: 0–44.7), SMT 11.1% (95% CI: 0–31.7), p = 0.478). Conclusions Although it did not improve 28-day mortality, MARS therapy improved the short-term response in patients with acute liver injury as well as in those

  17. Molecular adsorbent recirculating system (MARS) in acute liver injury and graft dysfunction: Results from a case-control study.

    PubMed

    Gerth, Hans U; Pohlen, Michele; Thölking, Gerold; Pavenstädt, Hermann; Brand, Marcus; Wilms, Christian; Hüsing-Kabar, Anna; Görlich, Dennis; Kabar, Iyad; Schmidt, Hartmut H J

    2017-01-01

    The primary therapeutic goals in the treatment of liver injury are to support liver regeneration or bridge the gap to liver transplantation (LT). Molecular adsorbent recirculating system (MARS) therapy has shown beneficial effects for specific symptoms of liver failure; however, general survival advantages have not yet been demonstrated. We studied the effects of MARS therapy compared to standard medical treatment (SMT) in two patient cohorts: in patients with an acute liver injury and in those with graft dysfunction (GD). We report on our experience over a 6.5-year period with 73 patients treated with SMT or with SMT and MARS (MARS group). In total, 53 patients suffered from acute liver injury in their native liver without a preexisting liver disease (SMT: n = 31, MARS: n = 22), and 20 patients showed a severe GD after LT (SMT: n = 10, MARS: n = 10). The entire cohort was predominantly characterized by hemodynamically and respiratorily stable patients with a low hepatic encephalopathy (HE) grade and a model of end-stage liver disease (MELD) score of 20.57 (MARS) or 22.51 (SMT, p = 0.555). Within the MARS group, the median number of extracorporeal therapy sessions was four (range = 3-5 sessions). Independent of the underlying etiology, MARS improved the patients' bilirubin values in the short term compared to SMT alone. In patients with acute liver injury, this response was sustained even after the end of MARS therapy. By contrast, the majority of patients with GD and an initial response to MARS therapy experienced worsened hyperbilirubinemia. No differences in 28-day mortality were observed with respect to acute liver injury (MARS 5.3% (95% CI: 0-15.3); SMT 3.3% (95% CI: 0-9.8), p = 0.754) or GD (MARS 20.0% (95% CI: 0-44.7), SMT 11.1% (95% CI: 0-31.7), p = 0.478). Although it did not improve 28-day mortality, MARS therapy improved the short-term response in patients with acute liver injury as well as in those with GD. In cases of acute hepatic injury, the use of

  18. A Decision Support System for Academic Scheduling.

    ERIC Educational Resources Information Center

    Burleson, Donald K.; Leivano, Rodrigo J.

    1986-01-01

    Describes the use of a decision support system to operate on a database for academic scheduling. Discusses the scheduling environment, database subsystem, dialog subsystem, modeling subsystem, and output formats. (JM)

  19. QA CLASSIFICATION ANALYSIS OF GROUND SUPPORT SYSTEMS

    SciTech Connect

    D. W. Gwyn

    1996-10-29

    The purpose and objective of this analysis is to determine if the permanent function Ground Support Systems (CI: BABEEOOOO) are quality-affecting items and if so, to establish the appropriate Quality Assurance (QA) classification.

  20. A System Costs Planning Decision Support System

    DTIC Science & Technology

    1988-09-01

    York: Wiley and Sons, 1975, pp. 15-16. Lipsey , R. G., and Steiner, P. 0., Economics , New York: Harper and Row, 1969, ch. 11. Lloyd, C., Microeconomic...of the Highest Utility, an imposed spending ceiling, a minimum desired utility, or any possible combination of economic and/or political...Applica- tions," in M. Beckmann and H. P. Kunzi (eds.), Lecture Notes in Economics and Mathematical Systems, p. 208, Springer-Verlag, New York, 1981

  1. A Microphysiological System Model of Therapy for Liver Micrometastases

    PubMed Central

    Clark, Amanda M.; Wheeler, Sarah E.; Taylor, Donald P.; Pillai, Venkateswaran C.; Young, Carissa L.; Prantil-Baun, Rachelle; Nguyen, Transon; Stolz, Donna B.; Borenstein, Jeffrey T.; Lauffenburger, Douglas A.; Venkataramanan, Raman; Griffith, Linda G.; Wells, Alan

    2015-01-01

    Metastasis accounts for almost 90% of cancer-associated mortality. The effectiveness of cancer therapeutics is limited by the protective microenvironment of the metastatic niche and consequently these disseminated tumors remain incurable. Metastatic disease progression continues to be poorly understood due to the lack of appropriate model systems. To address this gap in understanding, we propose an all-human microphysiological system that facilitates the investigation of cancer behavior in the liver metastatic niche. This existing LiverChip is a 3D-system modeling the hepatic niche; it incorporates a full complement of human parenchymal and non-parenchymal cells and effectively recapitulates micrometastases. Moreover, this system allows for real-time monitoring of micrometastasis and assessment of human-specific signaling. It is being utilized to further our understanding of the efficacy of chemotherapeutics by examining the activity of established and novel agents on micrometastases under conditions replicating diurnal variations in hormones, nutrients and mild inflammatory states using programmable microdispensers. These inputs affect the cues that govern tumor cell responses. Three critical signaling groups are targeted: the glucose/insulin responses, the stress hormone cortisol and the gut microbiome in relation to inflammatory cues. Currently, the system sustains functioning hepatocytes for a minimum of 15 days; confirmed by monitoring hepatic function (urea, α-1-antitrypsin, fibrinogen, and cytochrome P450) and injury (AST and ALT). Breast cancer cell lines effectively integrate into the hepatic niche without detectable disruption to tissue and preliminary evidence suggests growth attenuation amongst a subpopulation of breast cancer cells. xMAP technology combined with systems biology modeling are also employed to evaluate cellular crosstalk and illustrate communication networks in the early microenvironment of micrometastases. This model is anticipated to

  2. Renin angiotensin system in liver diseases: Friend or foe?

    PubMed Central

    Simões e Silva, Ana Cristina; Miranda, Aline S; Rocha, Natália P; Teixeira, Antônio L

    2017-01-01

    In the last three decades, the understanding of the renin angiotensin system (RAS) has been changed by the discoveries of functional local systems, novel biologically active peptides, additional specific receptors, alternative pathways of angiotensin (Ang) II generation, and new roles for enzymes and precursor components other than those in Ang II synthesis. In this regard, the discovery that Ang-(1-7) opposes the pressor, proliferative, pro-fibrotic, and pro-inflammatory effects mediated by Ang II has contributed to the realization that the RAS is composed of two axes. The first axis consists of the angiotensin-converting enzyme (ACE), with Ang II as the end product, and the angiotensin type 1 (AT1) receptor as the main effector mediating the biological actions of Ang II. The second axis results from ACE2-mediated hydrolysis of Ang II, leading to the production of Ang-(1-7), with the Mas receptor as the main effector conveying the vasodilatory, anti-proliferative, anti-fibrotic, and anti-inflammatory effects of Ang-(1-7). Experimental and clinical studies have shown that both axes of the RAS may take part in the pathogenesis of liver diseases. In this manuscript, we summarize the current evidence regarding the role of RAS in hepatic cirrhosis and its complications, including hemodynamic changes and hepatorenal syndrome. The therapeutic potential of the modulation of RAS molecules in liver diseases is also discussed. PMID:28596676

  3. Effect of Prometheus liver assist system on systemic hemodynamics in patients with cirrhosis: A randomized controlled study

    PubMed Central

    Dethloff, Thomas; Tofteng, Flemming; Frederiksen, Hans-Jorgen; Hojskov, Michael; Hansen, Bent Adel; Larsen, Fin Stolze

    2008-01-01

    AIM: To evaluate treatment safety and hemodynamic changes during a single 6-h treatment with the Prometheus™ liver assist system in a randomized, controlled study. METHODS: Twenty-four patients were randomized to either the study group or to one of two control groups: Fractionated Plasma Separation Adsorption and Dialysis, Prometheus™ system (Study group; n = 8); Molecular Adsorbent Recirculation System (MARS)™ (Control group 1, n = 8); or hemodialysis (Control group 2; n = 8). All patients included in the study had decompensated cirrhosis at the time of the inclusion into the study. Circulatory changes were monitored with a Swan-Ganz catheter and bilirubin and creatinine were monitored as measures of protein-bound and water-soluble toxins. RESULTS: Systemic hemodynamics did not differ between treatment and control groups apart from an increase in arterial pressure in the MARS group (P = 0.008). No adverse effects were observed in any of the groups. Creatinine levels significantly decreased in the MARS group (P = 0.03) and hemodialysis group (P = 0.04). Platelet count deceased in the Prometheus group (P = 0.04). CONCLUSION: Extra-corporal liver support with Prometheus is proven to be safe in patients with end-stage liver disease but does not exert the beneficial effects on arterial pressure as seen in the MARS group. PMID:18395908

  4. Effect of Prometheus liver assist system on systemic hemodynamics in patients with cirrhosis: a randomized controlled study.

    PubMed

    Dethloff, Thomas; Tofteng, Flemming; Frederiksen, Hans-Jorgen; Hojskov, Michael; Hansen, Bent-Adel; Larsen, Fin-Stolze

    2008-04-07

    To evaluate treatment safety and hemodynamic changes during a single 6-h treatment with the Prometheus liver assist system in a randomized, controlled study. Twenty-four patients were randomized to either the study group or to one of two control groups: Fractionated Plasma Separation Adsorption and Dialysis, Prometheus system (Study group; n = 8); Molecular Adsorbent Recirculation System (MARS) (Control group 1, n = 8); or hemodialysis (Control group 2; n = 8). All patients included in the study had decompensated cirrhosis at the time of the inclusion into the study. Circulatory changes were monitored with a Swan-Ganz catheter and bilirubin and creatinine were monitored as measures of protein-bound and water-soluble toxins. Systemic hemodynamics did not differ between treatment and control groups apart from an increase in arterial pressure in the MARS group (P = 0.008). No adverse effects were observed in any of the groups. Creatinine levels significantly decreased in the MARS group (P = 0.03) and hemodialysis group (P = 0.04). Platelet count deceased in the Prometheus group (P = 0.04). Extra-corporal liver support with Prometheus is proven to be safe in patients with endstage liver disease but does not exert the beneficial effects on arterial pressure as seen in the MARS group.

  5. Toxicology of a Peruvian botanical remedy to support healthy liver function.

    PubMed

    Semple, Hugh A; Sloley, B Duff; Cabanillas, José; Chiu, Andrea; Aung, Steven K H; Green, Francis H Y

    2016-06-01

    The purpose of these studies was to determine the safety of a botanical treatment for supporting healthy liver function developed in Peru. The formulation, A4+, contains extracts of Curcuma longa L. rhizome (A4R), Cordia lutea Lam. flower (A4F) and Annona muricata L. leaf (A4L). The tests were used to support an application for a non-traditional Natural Health Product Licence from the Natural Health Product Directorate of Health Canada and future clinical trials. Besides reviewing the scientific and clinical information from Peru on the ingredients and conducting an initial Ames test for mutagenicity, we analysed A4+ for its chemical profile and tested genotoxicity (micronucleus test) and general toxicity (28-day repeated dose). A4+ and extracts from the three plants provided distinctive chemical fingerprints. A4L contained acetogenins, requiring a second chromatographic method to produce a specific fingerprint. The Ames test proved positive at the highest concentration (5,000 μg/mL) but A4+ showed no evidence of genotoxicity in the more specific mouse micronucleus test. The 28-day repeated dose (general toxicity) study in rats showed no toxicity at 2,000 mg/kg. We conclude that under the conditions of these studies, A4+ shows no evidence of toxicity at the levels indicated. A no observed adverse effect level (NOAEL) of 2,000 mg/kg was assigned.

  6. Life support systems for Mars transit

    NASA Technical Reports Server (NTRS)

    Macelroy, R. D.; Kliss, M.; Straight, C.

    1992-01-01

    The structural elements of life-support systems are reviewed in order to assess the suitability of specific features for use during a Mars mission. Life-support requirements are estimated by means of an approximate input/output analysis, and the advantages are listed relating to the use of recycling and regeneration techniques. The technological options for regeneration are presented in categories such as CO2 reduction, organics removal, polishing, food production, and organics oxidation. These data form the basis of proposed mission requirements and constraints as well as the definition of what constitutes an adequate reserve. Regenerative physical/chemical life-support systems are championed based exclusively on the mass savings inherent in the technology. The resiliency and 'soft' failure modes of bioregenerative life-support systems are identified as areas of investigation.

  7. Rock support system development test plan

    SciTech Connect

    Patricio, J.G. . Rockwell Hanford Operations)

    1984-03-30

    The Test Plan has been prepared to support design activities for the development of a rock support system for a Nuclear Waste Repository in Basalt (NWRB). The rock support system is assumed to consist of a combination of shotcrete and rock bolts. The seven testing activities include mix development and physical testing of shotcrete, durability testing of shotcrete, durability testing of rock bolt grouts, field tests on rock bolts, field testing of shotcrete, and heated room test. The objective of the Test Plan is to develop required data through combined laboratory, field, and office studies for design and design validation of the rock support system. The overall Test Plan is developed to provide a logical progression from laboratory tests performed to characterize fundamental thermomechanical properties of shotcrete and grouts, to field tests on rock bolts and shotcrete, and in situ performance tests. 21 refs., 15 figs., 33 tabs.

  8. Adipose tissue supports normalization of macrophage and liver lipid handling in obesity reversal.

    PubMed

    Vatarescu, Maayan; Bechor, Sapir; Haim, Yulia; Pecht, Tal; Tarnovscki, Tanya; Slutsky, Noa; Nov, Ori; Shapiro, Hagit; Shemesh, Avishai; Porgador, Angel; Bashan, Nava; Rudich, Assaf

    2017-06-01

    Adipose tissue inflammation and dysfunction are considered central in the pathogenesis of obesity-related dysmetabolism, but their role in the rapid metabolic recovery upon obesity reversal is less well defined. We hypothesized that changes in adipose tissue endocrine and paracrine mechanisms may support the rapid improvement of obesity-induced impairment in cellular lipid handling. C57Bl-6J mice were fed ad libitum either normal chow (NC) or high-fat diet (HFF) for 10 weeks. A dietary obesity reversal group was fed HFF for 8 weeks and then switched to NC for 2 weeks (HFF→NC). Whole-body glucose homeostasis rapidly nearly normalized in the HFF→NC mice (fasting glucose and insulin fully normalized, glucose and insulin tolerance tests reversed 82% to the NC group levels). During 2 weeks of the dietary reversal, the liver was significantly cleared from ectopic fat, and functionally, glucose production from pyruvate, alanine or fructose was normalized. In contrast, adipose tissue inflammation (macrophage infiltration and polarization) largely remained as in HFF, though obesity-induced adipose tissue macrophage lipid accumulation decreased by ~50%, and adipose tissue MAP kinase hyperactivation was reversed. Ex vivo, mild changes in adipose tissue adipocytokine secretion profile were noted. These corresponded to partial or full reversal of the excess cellular lipid droplet accumulation induced by HFF adipose tissue conditioned media in hepatoma or macrophage cells, respectively. We propose that early after initiating reversal of nutritional obesity, rapid metabolic normalization largely precedes resolution of adipose tissue inflammation. Nevertheless, we demonstrate a hitherto unrecognized contribution of adipose tissue to the rapid improvement in lipid handling by the liver and by macrophages. © 2017 The authors.

  9. Bench-to-beside review: Acute-on-chronic liver failure - linking the gut, liver and systemic circulation

    PubMed Central

    2011-01-01

    The concept of acute-on-chronic liver failure (ACLF) was introduced recently to describe a subset of patients with chronic liver disease presenting with profound deterioration of liver function and rapidly evolving multi-organ failure. ACLF is frequently accompanied by the development of severe inflammatory response syndrome and has a high mortality. To date, treatment options are limited and exclusively supportive. Over the last few years, some insights have been generated in the pathophysiology of ACLF. A key role for the interaction of innate immune dysfunction, enhanced bacterial translocation from the gut, and circulatory dysfunction has been proposed. In this respect, therapeutic strategies have been examined, with variable success, in experimental studies in animals and humans. This review focuses on potentially relevant pathophysiological elements in the development of ACLF and points out promising treatment modalities in ACLF. PMID:22104633

  10. Deleterious effects of disulfiram on the respiratory electron transport system of liver mitochondria.

    PubMed

    Kuroda, M A; Cuéllar, A

    1993-01-01

    1. The mechanism of action of disulfiram on the respiratory electron transport system of the liver mitochondria was studied in vitro. 2. Disulfiram inhibited the respiration supported by malate-glutamate as well as succinate. 3. Mitochondrial respiration inhibition was dependent upon alteration of -SH groups. 4. The inhibitory action of disulfiram might be related to the crosslinking of several proteins of the inner mitochondrial membrane. 5. The effects described above could be attributed to disulfiram per se and not to the main metabolite diethyldithiocarbamate.

  11. Learning to Control Advanced Life Support Systems

    NASA Technical Reports Server (NTRS)

    Subramanian, Devika

    2004-01-01

    Advanced life support systems have many interacting processes and limited resources. Controlling and optimizing advanced life support systems presents unique challenges. In particular, advanced life support systems are nonlinear coupled dynamical systems and it is difficult for humans to take all interactions into account to design an effective control strategy. In this project. we developed several reinforcement learning controllers that actively explore the space of possible control strategies, guided by rewards from a user specified long term objective function. We evaluated these controllers using a discrete event simulation of an advanced life support system. This simulation, called BioSim, designed by Nasa scientists David Kortenkamp and Scott Bell has multiple, interacting life support modules including crew, food production, air revitalization, water recovery, solid waste incineration and power. They are implemented in a consumer/producer relationship in which certain modules produce resources that are consumed by other modules. Stores hold resources between modules. Control of this simulation is via adjusting flows of resources between modules and into/out of stores. We developed adaptive algorithms that control the flow of resources in BioSim. Our learning algorithms discovered several ingenious strategies for maximizing mission length by controlling the air and water recycling systems as well as crop planting schedules. By exploiting non-linearities in the overall system dynamics, the learned controllers easily out- performed controllers written by human experts. In sum, we accomplished three goals. We (1) developed foundations for learning models of coupled dynamical systems by active exploration of the state space, (2) developed and tested algorithms that learn to efficiently control air and water recycling processes as well as crop scheduling in Biosim, and (3) developed an understanding of the role machine learning in designing control systems for

  12. 1991 NASA Life Support Systems Analysis workshop

    NASA Technical Reports Server (NTRS)

    Evanich, Peggy L.; Crabb, Thomas M.; Gartrell, Charles F.

    1992-01-01

    The 1991 Life Support Systems Analysis Workshop was sponsored by NASA Headquarters' Office of Aeronautics and Space Technology (OAST) to foster communication among NASA, industrial, and academic specialists, and to integrate their inputs and disseminate information to them. The overall objective of systems analysis within the Life Support Technology Program of OAST is to identify, guide the development of, and verify designs which will increase the performance of the life support systems on component, subsystem, and system levels for future human space missions. The specific goals of this workshop were to report on the status of systems analysis capabilities, to integrate the chemical processing industry technologies, and to integrate recommendations for future technology developments related to systems analysis for life support systems. The workshop included technical presentations, discussions, and interactive planning, with time allocated for discussion of both technology status and time-phased technology development recommendations. Key personnel from NASA, industry, and academia delivered inputs and presentations on the status and priorities of current and future systems analysis methods and requirements.

  13. Decision support system for nursing management control

    SciTech Connect

    Ernst, C.J.

    1983-01-01

    A knowledge representation approach for expert systems supporting decision processes in business is proposed. A description of a knowledge representation schema using a logic programming metalanguage is described, then the role of such a schema in a management expert system is demonstrated through the problem of nursing management control in hospitals. 18 references.

  14. Software system architecture for corporate user support

    NASA Astrophysics Data System (ADS)

    Sukhopluyeva, V. S.; Kuznetsov, D. Y.

    2017-01-01

    In this article, several existing ready-to-use solutions for the HelpDesk are reviewed. Advantages and disadvantages of these systems are identified. Architecture of software solution for a corporate user support system is presented in a form of the use case, state, and component diagrams described by using a unified modeling language (UML).

  15. Microcomputer Use in Administrative Decision Support Systems.

    ERIC Educational Resources Information Center

    Brown, Kenneth G.; Droegemueller, Lee

    1983-01-01

    Some of the major problems facing higher education over the next decade and how microcomputer-based decision support systems can be used to address these as well as everyday administrative problems are discussed. Examples using electronic spreadsheets and database management systems are provided. (Author/MLW)

  16. Developing Academic Library Decision Support Systems.

    ERIC Educational Resources Information Center

    Chorba, Ronald W.; Bommer, Michael R. W.

    1983-01-01

    The approach to designing decision support systems for academic library management which is described explores online retrieval of profiles of user productivity, resource utilization, and resource availability. Database models, implementation considerations, database management systems, a sample application, and supplementing manager's judgement…

  17. Decision Support Systems and Public Policy Analysis.

    ERIC Educational Resources Information Center

    Hall, Owen P., Jr.

    1986-01-01

    This article outlines an approach for developing and applying computerized decision support systems to the formulation and evaluation of public policy. To meet the challenge of financial resource limitations, new management systems must be developed to improve both governmental efficiency and decision-making effectiveness. (Author/BS)

  18. Systemic Thinking To Support Dine Education.

    ERIC Educational Resources Information Center

    Rude, Harvey; Gorman, Roxanne

    This paper describes systemic thinking in support of the recently established Navajo Nation Rural Systemic Initiative (RSI). The RSI aims to create a standards-based student-centered teaching and learning environment in mathematics, science, and technology in the 173 elementary and secondary schools on or near the Navajo Nation, including public,…

  19. Results of treatment of acute liver failure patients with use of the prometheus FPSA system.

    PubMed

    Grodzicki, M; Kotulski, M; Leonowicz, D; Zieniewicz, K; Krawczyk, M

    2009-10-01

    Herein we have presented the results of treatment of acute liver failure (ALF) patients with the use of the Prometheus FPSA dialysis system. To January 2009, we performed 278 FPSA procedures in 114 patients, including 52 experience and ALF. The patients who underwent the FPSA procedure consisted of 32 women and 20 men of overall mean age of 33 +/- 12 years. The causes of ALF were: Wilson's disease (n = 15), unknown origin ALF (n = 11), amanita phalloides intoxication (n = 7), paracetamol intoxication (n = 8), acute hepatitis B virus (HBV)/hepatitis C virus (HCV) infection (n = 7), liver insufficiency after parenchymal resection (n = 2) drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome (n = 1), rabdomyolysis (n = 1), or primary nonfunction (PNF) after orthotopic liver transplantation (OLT) (n = 1). All procedures were performed using the Prometheus 4008H Fresenius Medical Care liver support system. The average number of treatments per patient was 2.41 and the average time for each FPSA treatment was 6.3 hours. The average heparin dose used during the procedure was 750 IU/h. After the whole treatment regimen, we observed significant improvements in the biochemical results. The average concentrations improved: serum ammonia (before 249.2 mug/dL versus after 109.7 mug/dL); serum bilirubin (before 21.53 mg/dL versus after 8.81 mg/dL), serum aspartate aminotransferase (AST; before 2456.4 U/L versus after 1068.8 U/L); serum alanine aminotransferase (ALT; before 2958.2 U/L versus after 1595.8 U/L); serum urea (before 58.5 mg/dL versus after 21.1 mg/dL); serum creatinine (before 2.9 mg/dL versus after 1.7 mg/dL); and pH value (before 7.11 versus after 7.32). After Prometheus treatment OLT was performed in 33 patients. Among the 28 who survived (53.8%), 22 underwent OLT and 6 did not have OLT. Among the 24 patients who died (46.2%), 13 were before OLT and 11 after OLT. The Prometheus 4008H Fresenius Medical Care Liver support system was useful method of

  20. Suicidal intoxication with potassium chlorate successfully treated with renal replacement therapy and extracorporeal liver support.

    PubMed

    Sein Anand, Jacek; Barwina, Małgorzata; Zajac, Maciej; Kaletha, Krystian

    2012-01-01

    We present a case of a 22-year-old male who, in a suicide attempt, ingested approximately 200 g of potassium chlorate. Upon admission to the hospital, he presented in full respiratory failure with cyanosis. Methylene blue antidote was given but found to be ineffective. The patient was intubated and mechanical ventilation was initiated. Because of renal failure with anuria, intermittent haemodialysis (iHD) followed by continuous venovenous hemodiafiltration (CVVHDF) was performed. His hospital stay was also complicated by hemolysis, disseminated intravascular coagulation, and atrial fibrillation. Transfusions of packed red blood cells, platelets, and fresh frozen plasma were necessary to correct the deficits. He also developed liver failure and required two sessions of molecular adsorbent recirculating system (MARS) therapy. On day 14 of his hospitalization, he regained consciousness, as well as full respiratory and circulatory function. There are no controlled studies addressing management of potassium chlorate poisoning. We suggest that early renal replacement therapy should be strongly considered.

  1. Decision support systems in health economics.

    PubMed

    Quaglini, S; Dazzi, L; Stefanelli, M; Barosi, G; Marchetti, M

    1999-08-01

    This article describes a system addressed to different health care professionals for building, using, and sharing decision support systems for resource allocation. The system deals with selected areas, namely the choice of diagnostic tests, the therapy planning, and the instrumentation purchase. Decision support is based on decision-analytic models, incorporating an explicit knowledge representation of both the medical domain knowledge and the economic evaluation theory. Application models are built on top of meta-models, that are used as guidelines for making explicit both the cost and effectiveness components. This approach improves the transparency and soundness of the collaborative decision-making process and facilitates the result interpretation.

  2. Controlled ecological life support system: Transportation analysis

    NASA Technical Reports Server (NTRS)

    Gustan, E.; Vinopal, T.

    1982-01-01

    This report discusses a study utilizing a systems analysis approach to determine which NASA missions would benefit from controlled ecological life support system (CELSS) technology. The study focuses on manned missions selected from NASA planning forecasts covering the next half century. Comparison of various life support scenarios for the selected missions and characteristics of projected transportation systems provided data for cost evaluations. This approach identified missions that derived benefits from a CELSS, showed the magnitude of the potential cost savings, and indicated which system or combination of systems would apply. This report outlines the analytical approach used in the evaluation, describes the missions and systems considered, and sets forth the benefits derived from CELSS when applicable.

  3. Truss systems for longwall tailgate support -- Update

    SciTech Connect

    Stankus, J.C.; Guo, S.; Peng, S.S.

    1995-11-01

    At the 13th Conference on Ground Control in Mining, a paper was presented detailing a successful test in which a new truss system was utilized, in lieu of wood cribs, for tailgate support in the Pittsburgh seam (Stankus et al., 1994). Since that time, additional tests using this same truss system in the Pittsburgh and other seams are now complete. Also, several mines are now using trusses for full panel tailgate support with no cribs. Through an extensive instrumentation program, much data and new information has been gained from these tests and the full panel usage. From this data, no only have new concepts pertaining to tailgate support been developed, but also for headgate, pillar configuration, primary and supplemental support. In this paper, an update will be presented summarizing the result of these various tailgates.

  4. Thermodynamic considerations in solid adsorption of bound solutes for patient support in liver failure.

    PubMed

    Patzer, John F

    2008-07-01

    New detoxification modes of treatment for liver failure that use solid adsorbents to remove toxins bound to albumin in the patient bloodstream are entering clinical evaluations, frequently in head-to-head competition. While generally effective in reducing toxin concentration beyond that obtainable by conventional dialysis procedures, the solid adsorbent processes are largely the result of heuristic development. Understanding the principles and limitations inherent in competitive toxin binding, albumin versus solid adsorbent, will enhance the design process and, possibly, improve detoxification performance. An equilibrium thermodynamic analysis is presented for both the molecular adsorbent recirculating system (MARS) and fractionated plasma separation, adsorption, and dialysis system (Prometheus), two advanced systems with distinctly different operating modes but with similar equilibrium limitations. The Prometheus analysis also applies to two newer approaches: sorbent suspension reactor and microsphere-based detoxification system. Primary results from the thermodynamic analysis are that: (i) the solute-albumin binding constant is of minor importance to equilibrium once it exceeds about 10(5) L/mol; (ii) the Prometheus approach requires larger solid adsorbent columns than calculated by adsorbent solute capacity alone; and (iii) the albumin-containing recycle stream in the MARS approach is a major reservoir of removed toxin. A survey of published results indicates that MARS is operating under mass transfer control dictated by solute-albumin equilibrium in the recycle stream, and Prometheus is approaching equilibrium limits under current clinical protocols.

  5. Thermodynamic Considerations in Solid Adsorption of Bound Solutes for Patient Support in Liver Failure

    PubMed Central

    Patzer, John F.

    2008-01-01

    New detoxification modes of treatment for liver failure that use solid adsorbents to remove toxins bound to albumin in the patient bloodstream are entering clinical evaluations, frequently in head-to-head competition. While generally effective in reducing toxin concentration beyond that obtainable by conventional dialysis procedures, the solid adsorbent processes are largely the result of heuristic development. Understanding the principles and limitations inherent in competitive toxin binding, albumin versus solid adsorbent, will enhance the design process and, possibly, improve detoxification performance. An equilibrium thermodynamic analysis is presented for both the Molecular Adsorbent Recirculating System (MARS) and Fractionated Plasma Separation, Adsorption, and Dialysis System (Prometheus), two advanced systems with distinctly different operating modes but with similar equilibrium limitations. The Prometheus analysis also applies to two newer approaches: sorbent suspension reactor (SSR) and microspheres-based detoxification system (MDS). Primary results from the thermodynamic analysis are that: (1) the solute-albumin binding constant is of minor importance to equilibrium once it exceeds about 105 L mol−1; (2) the Prometheus approach requires larger solid adsorbent columns than calculated by adsorbent solute capacity alone; and (3) the albumin-containing recycle stream in the MARS approach is a major reservoir of removed toxin. A survey of published results indicates that MARS is operating under mass transfer control dictated by solute-albumin equilibrium in the recycle stream and Prometheus is approaching equilibrium limits under current clinical protocols. PMID:18638303

  6. Information integration in a decision support system.

    PubMed

    Hudson, D L; Cohen, M E; Deedwania, P C

    1994-01-01

    Electronic medical records pose a challenge because of the complex types of data which are included. Decision support systems must be able to deal effectively with these data types. In the expert system demonstrated here, a diversity of data types are included. These data are processed by three different methods. However, the different methods of processing are transparent to the user. An overall rule-based interface integrates the different methods into one comprehensive system.

  7. Far-forward life support system prototype

    NASA Astrophysics Data System (ADS)

    Wenstrand, Douglas S.; Smith, Dexter G.; Cutchis, Protagoras N.

    2001-08-01

    The Far Forward Life Support System (FFLSS) is intended for US Army use in far forward, battlefield situations. The primary patient population is young, otherwise healthy, adult males. The FFLSS must provide stabilizing medical care in the far forward environment. The device must be easily operated, highly mobile, compact and rugged, and provide automated, definitive support for a minimum of one hour. This project design, fabricated and tested a prototype FFLSS.

  8. The Correlation of Hepatic and Systemic Hemodynamics During Liver Transplantation

    PubMed Central

    Feng, An-Chieh; Chen, Teng-Wei; Fan, Hsiu-Lung; Yu, Jyh-Cherng; Hsieh, Chung-Bao

    2015-01-01

    Abstract The correlation between portal vein pressure (PVP) and flow (PVF) has not been established, and there is still lack of consensus about the optimal hemodynamics during liver transplantation (LT). We aimed to establish the correlation between systemic and hepatic hemodynamics during LT by applying the hepatokinetic power hypothesis, based on the law of energy conservation and hydrodynamics. A total of 103 adult liver transplant recipients were enrolled in this study from September 2012 to December 2014. Systemic and hepatic hemodynamics were assessed intraoperatively to calculate the hepatokinetic power status. Severe surgical complications (Clavien–Dindo grade ≥III) were recorded as the main outcome measure, and potential covariates were evaluated including recipient, donor, donor–recipient match, surgery-related factors, conventional hemodynamics, and the intraoperative hepatokinetic power profile. In multivariate analysis, hepatokinetic power gradient >4260 mL mmHg min−1100 g graft weight−1 (P = 0.001), 2.2 < ratio of hepatokinetic power from the portal vein to the hepatic artery ≤8.7 (P = 0.012), and hepatic resistance of partial grafts ≤0.006 or >0.015 min mmHg mL−1 (P = 0.012) were associated with a higher risk. None of the conventional hemodynamic parameters, such as PVP, PVF, and hepatic venous pressure gradient, entered into this regression model (c-statistic = 0.916) when competing with hepatokinetic power indexes. The hepatokinetic power hypothesis clarifies the correlation of systemic and hepatic hemodynamics in a simple, rational manner. The hepatic resistance, derived from the hepatokinetic power equation, can be quantified and has an effect on the incidence of severe surgical complications. This finding offers a new objective clinical approach to evaluate graft quality during transplantation. PMID:26512581

  9. Chip-based human liver-intestine and liver-skin co-cultures--A first step toward systemic repeated dose substance testing in vitro.

    PubMed

    Maschmeyer, Ilka; Hasenberg, Tobias; Jaenicke, Annika; Lindner, Marcus; Lorenz, Alexandra Katharina; Zech, Julie; Garbe, Leif-Alexander; Sonntag, Frank; Hayden, Patrick; Ayehunie, Seyoum; Lauster, Roland; Marx, Uwe; Materne, Eva-Maria

    2015-09-01

    Systemic repeated dose safety assessment and systemic efficacy evaluation of substances are currently carried out on laboratory animals and in humans due to the lack of predictive alternatives. Relevant international regulations, such as OECD and ICH guidelines, demand long-term testing and oral, dermal, inhalation, and systemic exposure routes for such evaluations. So-called "human-on-a-chip" concepts are aiming to replace respective animals and humans in substance evaluation with miniaturized functional human organisms. The major technical hurdle toward success in this field is the life-like combination of human barrier organ models, such as intestine, lung or skin, with parenchymal organ equivalents, such as liver, at the smallest biologically acceptable scale. Here, we report on a reproducible homeostatic long-term co-culture of human liver equivalents with either a reconstructed human intestinal barrier model or a human skin biopsy applying a microphysiological system. We used a multi-organ chip (MOC) platform, which provides pulsatile fluid flow within physiological ranges at low media-to-tissue ratios. The MOC supports submerse cultivation of an intact intestinal barrier model and an air-liquid interface for the skin model during their co-culture with the liver equivalents respectively at (1)/100.000 the scale of their human counterparts in vivo. To increase the degree of organismal emulation, microfluidic channels of the liver-skin co-culture could be successfully covered with human endothelial cells, thus mimicking human vasculature, for the first time. Finally, exposure routes emulating oral and systemic administration in humans have been qualified by applying a repeated dose administration of a model substance - troglitazone - to the chip-based co-cultures. Copyright © 2015. Published by Elsevier B.V.

  10. Lunar Surface Systems Supportability Technology Development Roadmap

    NASA Technical Reports Server (NTRS)

    Oeftering, Richard C.; Struk, Peter M.; Green, Jennifer L.; Chau, Savio N.; Curell, Philip C.; Dempsey, Cathy A.; Patterson, Linda P.; Robbins, William; Steele, Michael A.; DAnnunzio, Anthony; hide

    2011-01-01

    The Lunar Surface Systems Supportability Technology Development Roadmap is a guide for developing the technologies needed to enable the supportable, sustainable, and affordable exploration of the Moon and other destinations beyond Earth. Supportability is defined in terms of space maintenance, repair, and related logistics. This report considers the supportability lessons learned from NASA and the Department of Defense. Lunar Outpost supportability needs are summarized, and a supportability technology strategy is established to make the transition from high logistics dependence to logistics independence. This strategy will enable flight crews to act effectively to respond to problems and exploit opportunities in an environment of extreme resource scarcity and isolation. The supportability roadmap defines the general technology selection criteria. Technologies are organized into three categories: diagnostics, test, and verification; maintenance and repair; and scavenge and recycle. Furthermore, "embedded technologies" and "process technologies" are used to designate distinct technology types with different development cycles. The roadmap examines the current technology readiness level and lays out a four-phase incremental development schedule with selection decision gates. The supportability technology roadmap is intended to develop technologies with the widest possible capability and utility while minimizing the impact on crew time and training and remaining within the time and cost constraints of the program.

  11. Liver disease - resources

    MedlinePlus

    Resources - liver disease ... The following organizations are good resources for information on liver disease : American Liver Foundation -- www.liverfoundation.org Children's Liver Association for Support Services -- www.classkids.org Hepatitis ...

  12. Life support systems for Mars transit.

    PubMed

    MacElroy, R D; Kliss, M; Straight, C

    1992-01-01

    The long-held human dream of travel to the stars and planets will probably be realized within the next quarter century. Preliminary analyses by U.S. scientists and engineers suggests that a first trip to Mars could begin as early as 2016. A proposal by U.S.S.R. space planners has suggested that an effort involving the cooperation and collaboration of many nations could begin by 2011. Among the major considerations that must be made in preparation for such an excursion are solidification of the scientific, economic and philosophical rationales for such a trip made by humans, and realistic evaluations of current and projected technical capabilities. Issues in the latter category include launch and propulsion systems, long term system stability and reliability, the psychological and physiological consequences of long term exposure to the space environment, the development and use of countermeasures to deleterious human physiological responses to the space environment, and life support systems that are both capable of the immense journey and reliable enough to assure their continued operation for the duration of the voyage. Many of the issues important in the design of a life support system for a Mars trip are based on reasonably well understood data: the human requirements for food, oxygen and water. However, other issues are less well-defined, such as the demands that will be made on the system for personal cleanliness and hygiene, environmental cleanliness, prevention or reduction of environmental toxins, and psychological responses to the environment and to the diet. It is much too early to make final decisions about the characteristics of the long-duration life support system needed for travel to Mars, or for use on its surface. However, it is clear that life support systems will evolve during the next few decades form the relatively straightforward systems that are used on Shuttle and Soyuz, to increasingly more complex and regenerative systems. The Soviet Union

  13. Using Visualization in Cockpit Decision Support Systems

    SciTech Connect

    Aragon, Cecilia R.

    2005-07-01

    In order to safely operate their aircraft, pilots must makerapid decisions based on integrating and processing large amounts ofheterogeneous information. Visual displays are often the most efficientmethod of presenting safety-critical data to pilots in real time.However, care must be taken to ensure the pilot is provided with theappropriate amount of information to make effective decisions and notbecome cognitively overloaded. The results of two usability studies of aprototype airflow hazard visualization cockpit decision support systemare summarized. The studies demonstrate that such a system significantlyimproves the performance of helicopter pilots landing under turbulentconditions. Based on these results, design principles and implicationsfor cockpit decision support systems using visualization arepresented.

  14. Advanced Life Support System Value Metric

    NASA Technical Reports Server (NTRS)

    Jones, Harry W.; Rasky, Daniel J. (Technical Monitor)

    1999-01-01

    The NASA Advanced Life Support (ALS) Program is required to provide a performance metric to measure its progress in system development. Extensive discussions within the ALS program have led to the following approach. The Equivalent System Mass (ESM) metric has been traditionally used and provides a good summary of the weight, size, and power cost factors of space life support equipment. But ESM assumes that all the systems being traded off exactly meet a fixed performance requirement, so that the value and benefit (readiness, performance, safety, etc.) of all the different systems designs are considered to be exactly equal. This is too simplistic. Actual system design concepts are selected using many cost and benefit factors and the system specification is defined after many trade-offs. The ALS program needs a multi-parameter metric including both the ESM and a System Value Metric (SVM). The SVM would include safety, maintainability, reliability, performance, use of cross cutting technology, and commercialization potential. Another major factor in system selection is technology readiness level (TRL), a familiar metric in ALS. The overall ALS system metric that is suggested is a benefit/cost ratio, SVM/[ESM + function (TRL)], with appropriate weighting and scaling. The total value is given by SVM. Cost is represented by higher ESM and lower TRL. The paper provides a detailed description and example application of a suggested System Value Metric and an overall ALS system metric.

  15. Advanced Life Support System Value Metric

    NASA Technical Reports Server (NTRS)

    Jones, Harry W.; Rasky, Daniel J. (Technical Monitor)

    1999-01-01

    The NASA Advanced Life Support (ALS) Program is required to provide a performance metric to measure its progress in system development. Extensive discussions within the ALS program have led to the following approach. The Equivalent System Mass (ESM) metric has been traditionally used and provides a good summary of the weight, size, and power cost factors of space life support equipment. But ESM assumes that all the systems being traded off exactly meet a fixed performance requirement, so that the value and benefit (readiness, performance, safety, etc.) of all the different systems designs are considered to be exactly equal. This is too simplistic. Actual system design concepts are selected using many cost and benefit factors and the system specification is defined after many trade-offs. The ALS program needs a multi-parameter metric including both the ESM and a System Value Metric (SVM). The SVM would include safety, maintainability, reliability, performance, use of cross cutting technology, and commercialization potential. Another major factor in system selection is technology readiness level (TRL), a familiar metric in ALS. The overall ALS system metric that is suggested is a benefit/cost ratio, SVM/[ESM + function (TRL)], with appropriate weighting and scaling. The total value is given by SVM. Cost is represented by higher ESM and lower TRL. The paper provides a detailed description and example application of a suggested System Value Metric and an overall ALS system metric.

  16. Combined systemic elimination of MET and epidermal growth factor receptor signaling completely abolishes liver regeneration and leads to liver decompensation.

    PubMed

    Paranjpe, Shirish; Bowen, William C; Mars, Wendy M; Orr, Anne; Haynes, Meagan M; DeFrances, Marie C; Liu, Silvia; Tseng, George C; Tsagianni, Anastasia; Michalopoulos, George K

    2016-11-01

    Receptor tyrosine kinases MET and epidermal growth factor receptor (EGFR) are critically involved in initiation of liver regeneration. Other cytokines and signaling molecules also participate in the early part of the process. Regeneration employs effective redundancy schemes to compensate for the missing signals. Elimination of any single extracellular signaling pathway only delays but does not abolish the process. Our present study, however, shows that combined systemic elimination of MET and EGFR signaling (MET knockout + EGFR-inhibited mice) abolishes liver regeneration, prevents restoration of liver mass, and leads to liver decompensation. MET knockout or simply EGFR-inhibited mice had distinct and signaling-specific alterations in Ser/Thr phosphorylation of mammalian target of rapamycin, AKT, extracellular signal-regulated kinases 1/2, phosphatase and tensin homolog, adenosine monophosphate-activated protein kinase α, etc. In the combined MET and EGFR signaling elimination of MET knockout + EGFR-inhibited mice, however, alterations dependent on either MET or EGFR combined to create shutdown of many programs vital to hepatocytes. These included decrease in expression of enzymes related to fatty acid metabolism, urea cycle, cell replication, and mitochondrial functions and increase in expression of glycolysis enzymes. There was, however, increased expression of genes of plasma proteins. Hepatocyte average volume decreased to 35% of control, with a proportional decrease in the dimensions of the hepatic lobules. Mice died at 15-18 days after hepatectomy with ascites, increased plasma ammonia, and very small livers. MET and EGFR separately control many nonoverlapping signaling endpoints, allowing for compensation when only one of the signals is blocked, though the combined elimination of the signals is not tolerated; the results provide critical new information on interactive MET and EGFR signaling and the contribution of their combined absence to

  17. Advanced Life Support System Value Metric

    NASA Technical Reports Server (NTRS)

    Jones, Harry W.; Arnold, James O. (Technical Monitor)

    1999-01-01

    The NASA Advanced Life Support (ALS) Program is required to provide a performance metric to measure its progress in system development. Extensive discussions within the ALS program have reached a consensus. The Equivalent System Mass (ESM) metric has been traditionally used and provides a good summary of the weight, size, and power cost factors of space life support equipment. But ESM assumes that all the systems being traded off exactly meet a fixed performance requirement, so that the value and benefit (readiness, performance, safety, etc.) of all the different systems designs are exactly equal. This is too simplistic. Actual system design concepts are selected using many cost and benefit factors and the system specification is then set accordingly. The ALS program needs a multi-parameter metric including both the ESM and a System Value Metric (SVM). The SVM would include safety, maintainability, reliability, performance, use of cross cutting technology, and commercialization potential. Another major factor in system selection is technology readiness level (TRL), a familiar metric in ALS. The overall ALS system metric that is suggested is a benefit/cost ratio, [SVM + TRL]/ESM, with appropriate weighting and scaling. The total value is the sum of SVM and TRL. Cost is represented by ESM. The paper provides a detailed description and example application of the suggested System Value Metric.

  18. Support for User Interfaces for Distributed Systems

    NASA Technical Reports Server (NTRS)

    Eychaner, Glenn; Niessner, Albert

    2005-01-01

    An extensible Java(TradeMark) software framework supports the construction and operation of graphical user interfaces (GUIs) for distributed computing systems typified by ground control systems that send commands to, and receive telemetric data from, spacecraft. Heretofore, such GUIs have been custom built for each new system at considerable expense. In contrast, the present framework affords generic capabilities that can be shared by different distributed systems. Dynamic class loading, reflection, and other run-time capabilities of the Java language and JavaBeans component architecture enable the creation of a GUI for each new distributed computing system with a minimum of custom effort. By use of this framework, GUI components in control panels and menus can send commands to a particular distributed system with a minimum of system-specific code. The framework receives, decodes, processes, and displays telemetry data; custom telemetry data handling can be added for a particular system. The framework supports saving and later restoration of users configurations of control panels and telemetry displays with a minimum of effort in writing system-specific code. GUIs constructed within this framework can be deployed in any operating system with a Java run-time environment, without recompilation or code changes.

  19. Advanced Life Support System Value Metric

    NASA Technical Reports Server (NTRS)

    Jones, Harry W.; Arnold, James O. (Technical Monitor)

    1999-01-01

    The NASA Advanced Life Support (ALS) Program is required to provide a performance metric to measure its progress in system development. Extensive discussions within the ALS program have reached a consensus. The Equivalent System Mass (ESM) metric has been traditionally used and provides a good summary of the weight, size, and power cost factors of space life support equipment. But ESM assumes that all the systems being traded off exactly meet a fixed performance requirement, so that the value and benefit (readiness, performance, safety, etc.) of all the different systems designs are exactly equal. This is too simplistic. Actual system design concepts are selected using many cost and benefit factors and the system specification is then set accordingly. The ALS program needs a multi-parameter metric including both the ESM and a System Value Metric (SVM). The SVM would include safety, maintainability, reliability, performance, use of cross cutting technology, and commercialization potential. Another major factor in system selection is technology readiness level (TRL), a familiar metric in ALS. The overall ALS system metric that is suggested is a benefit/cost ratio, [SVM + TRL]/ESM, with appropriate weighting and scaling. The total value is the sum of SVM and TRL. Cost is represented by ESM. The paper provides a detailed description and example application of the suggested System Value Metric.

  20. HIF-1{alpha} is necessary to support gluconeogenesis during liver regeneration

    SciTech Connect

    Tajima, Toshihide; Goda, Nobuhito; Fujiki, Natsuko; Hishiki, Takako; Nishiyama, Yasumasa; Senoo-Matsuda, Nanami; Shimazu, Motohide; Soga, Tomoyoshi; Yoshimura, Yasunori; Johnson, Randall S.; Suematsu, Makoto

    2009-10-02

    Coordinated recovery of hepatic glucose metabolism is prerequisite for normal liver regeneration. To examine roles of hypoxia inducible factor-1{alpha} (HIF-1{alpha}) for hepatic glucose homeostasis during the reparative process, we inactivated the gene in hepatocytes in vivo. Following partial hepatectomy (PH), recovery of residual liver weight was initially retarded in the mutant mice by down-regulation of hepatocyte proliferation, but occurred comparably between the mutant and control mice at 72 h after PH. At this time point, the mutant mice showed lowered blood glucose levels with enhanced accumulation of glycogen in the liver. The mutant mice exhibited impairment of hepatic gluconeogenesis as assessed by alanine tolerance test. This appeared to result from reduced expression of PGK-1 and PEPCK since 3-PG, PEP and malate were accumulated to greater extents in the regenerated liver. In conclusion, these findings provide evidence for roles of HIF-1{alpha} in the regulation of gluconeogenesis under liver regeneration.

  1. Ion Thruster Support and Positioning System

    NASA Technical Reports Server (NTRS)

    Haag, Thomas W. (Inventor)

    1996-01-01

    A system for supporting and selectively positioning an ion thruster relative to a surface of a spacecraft includes three angularly spaced thruster support assemblies. Each thruster support assembly includes a frame which has a rotary actuator mounted thereon. The rotary actuator is connected to an actuator member which is rotatably connected to a thruster attachment member connected to a body of the thruster. A stabilizer member is rotatably mounted to the frame and to the thruster attachment member. The thruster is selectively movable in the pitch and yaw directions responsive to movement of the actuator members by the actuators on the thruster support assemblies. A failure of any one actuator on a thruster support assembly will generally still enable limited thruster positioning capability in two directions. In a retracted position the thruster attachment members are held in nested relation in saddles supported on the frames of the thruster support assemblies. The thruster is securely held in the retracted position during periods of high loading such as during launch of the spacecraft.

  2. Ion Thruster Support and Positioning System

    NASA Technical Reports Server (NTRS)

    Haag, Thomas W. (Inventor)

    1998-01-01

    A system for supporting and selectively positioning an ion thruster relative to a surface of a spacecraft includes three angularly spaced thruster support assemblies. Each thruster support assembly includes a frame which has a rotary actuator mounted thereon. The rotary actuator is connected to an actuator member which is rotatably connected to a thruster attachment member connected to a body of the thruster. A stabilizer member is rotatably mounted to the frame and to the thruster attachment member. The thruster is selectively movable in the pitch and yaw directions responsive to movement of the actuator members by the actuators on the thruster support assemblies. A failure of any one actuator on a thruster support assembly will generally still enable limited thruster positioning capability in two directions. In a retracted position the thruster attachment members are held in nested relation in saddles supported on the frames of the thruster support assemblies. The thruster is securely held in the retracted position during periods of high loading such as during launch of the spacecraft.

  3. Birds of a Feather: Supporting Secure Systems

    SciTech Connect

    Braswell III, H V

    2006-04-24

    Over the past few years Lawrence Livermore National Laboratory has begun the process of moving to a diskless environment in the Secure Computer Support realm. This movement has included many moving targets and increasing support complexity. We would like to set up a forum for Security and Support professionals to get together from across the Complex and discuss current deployments, lessons learned, and next steps. This would include what hardware, software, and hard copy based solutions are being used to manage Secure Computing. The topics to be discussed include but are not limited to: Diskless computing, port locking and management, PC, Mac, and Linux/UNIX support and setup, system imaging, security setup documentation and templates, security documentation and management, customer tracking, ticket tracking, software download and management, log management, backup/disaster recovery, and mixed media environments.

  4. Liver transplantation in a child with acute liver failure resulting from drug rash with eosinophilia and systemic symptoms syndrome

    PubMed Central

    Song, Seung Min; Cho, Min Sung; Oh, Seak Hee; Park, Young Seo; Kim, Dae Yeon; Lee, Sung Gyu

    2013-01-01

    Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is characterized by a severe idiosyncratic reaction including rash and fever, often with associated hepatitis, arthralgias, lymph node enlargement, or hematologic abnormalities. The mortality rate is approximately 10%, primarily owing to liver failure with massive or multiple disseminated focal necrosis. Here, we report a case of a 14-year-old girl treated with vancomycin because of a wound infection by methicillin-resistant Staphylococcus aureus, who presented with non-specific symptoms, which progressed to acute liver failure, displaying the hallmarks of DRESS syndrome. With the presence of aggravated hepatic encephalopathy and azotemia, the patient was refractory to medical treatments, she received a living-donor liver transplantation, and a cure was achieved without any sign of recurrence. Vancomycin can be a cause of DRESS syndrome. A high index of suspicion and rapid diagnosis are necessary not to miss this potentially lethal disease. PMID:23741237

  5. Liver transplantation in a child with acute liver failure resulting from drug rash with eosinophilia and systemic symptoms syndrome.

    PubMed

    Song, Seung Min; Cho, Min Sung; Oh, Seak Hee; Kim, Kyung Mo; Park, Young Seo; Kim, Dae Yeon; Lee, Sung Gyu

    2013-05-01

    Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is characterized by a severe idiosyncratic reaction including rash and fever, often with associated hepatitis, arthralgias, lymph node enlargement, or hematologic abnormalities. The mortality rate is approximately 10%, primarily owing to liver failure with massive or multiple disseminated focal necrosis. Here, we report a case of a 14-year-old girl treated with vancomycin because of a wound infection by methicillin-resistant Staphylococcus aureus, who presented with non-specific symptoms, which progressed to acute liver failure, displaying the hallmarks of DRESS syndrome. With the presence of aggravated hepatic encephalopathy and azotemia, the patient was refractory to medical treatments, she received a living-donor liver transplantation, and a cure was achieved without any sign of recurrence. Vancomycin can be a cause of DRESS syndrome. A high index of suspicion and rapid diagnosis are necessary not to miss this potentially lethal disease.

  6. Alisse : Advanced life support system evaluator

    NASA Astrophysics Data System (ADS)

    Brunet, Jean; Gerbi, Olivier; André, Philippe; Davin, Elisabeth; Avezuela Rodriguez, Raul; Carbonero, Fernando; Soumalainen, Emilia; Lasseur, Christophe

    Long duration missions, such as the establishment of permanent bases on the lunar surface or the travel to Mars, require such an amount of life support consumables (e.g. food, water and oxygen) that direct supply or re-supply from Earth is not an option anymore. Regenerative Life Support Systems are therefore necessary to sustain long-term manned space mission to increase recycling rates and so reduce the launched mass. The architecture of an Environmental Controlled Life Support System widely depends on the mission scenario. Even for a given mission scenario, different architectures could be envisaged which need to be evaluated and compared with appropriate tools. As these evaluation and comparison, based on the single criterion of Equivalent System Mass, was not considered com-prehensive enough, ESA is developing a multi-criteria evaluation tool: ALISSE (Advanced Life Support System Evaluator). The main objective of ALISSE, and of the work presented here, is the definition and implemen-tation of a metrics system, addressing the complexity of any ECLSS along its Life Cycle phases. A multi-dimensional and multi-criteria (i.e. mass, energy, efficiency, risk to human, reliability, crew time, sustainability, life cycle cost) approach is proposed through the development of a computing support platform. Each criterion being interrelated with the others, a model based system approach is used. ALISSE is expected to provide significant inputs to the ESA Concurrent Design Facility and, as a consequence, to be a highly valuable tool for decision process linked to any manned space mission. Full contact detail for the contact author : Jean Brunet Sherpa Engineering General Manager Phone : 0033(0)608097480 j.brunet@sherpa-eng.com

  7. Environmental Control and Life Support System

    NASA Technical Reports Server (NTRS)

    Ray, Charles; Adams, Alan

    1990-01-01

    Viewgraphs on the Environmental Control and Life Support System (ECLSS) for the space station are presented. The ECLSS is divided into six subsystems: temperature and humidity control (THC), atmosphere control and supply (ACS), atmosphere revitalization (AR), fire detection and suppression (FDS), water recovery management (WRM), and waste management (WM). Topics covered include: ECLSS subsystem functions; ECLSS distributed system; ECLSS functional distribution; CO2 removal; CO2 reduction; oxygen generation; urine processor; and potable water recovery.

  8. Molecular Adsorbent Recirculating System Effectively Replaces Hepatic Function in Severe Acute Liver Failure.

    PubMed

    Hanish, Steven I; Stein, Deborah M; Scalea, Joseph R; Essien, Eno-Obong; Thurman, Paul; Hutson, William R; Bartlett, Stephen T; Barth, Rolf N; Scalea, Thomas M

    2017-10-01

    Patients with severe acute liver failure (ALF) have extreme physiologic dysfunction and often die if transplantation is not immediately available. Patients may be supported with MARS (Baxter International Inc., Deerfield, IL) until transplantation or spontaneous recovery occurs. We present the largest series in the United States of MARS therapy as temporary hepatic replacement for ALF. MARS was used to support patients with severe liver trauma (SLT), in ALF patients as a bridge to transplantation (BTT), and as definitive therapy for toxic ingestion or idiopathic liver failure (DT) in a level 1 trauma center and large transplant center. Patient demographics, etiology of ALF, and laboratory values were recorded. Endpoints were patient survival ± liver transplant and/or recovery of liver function. Twenty-seven patients with severe ALF received MARS therapy. Five patients with SLT had a 60% survival with recovery of liver and renal function. Thirteen patients received MARS as a BTT, of which 9 were transplanted with a 1-year survival of 78% (program overall survival 85% at 1 year). All 4 who were not transplanted expired. Nine patients with ALF from toxic ingestion received MARS as DT with liver recovery and survival in 67%. MARS therapy resulted in significant improvement in liver function, coagulation, incidence of encephalopathy, and creatinine. MARS therapy successfully replaced hepatic function in ALF allowing time for spontaneous recovery or transplantation. Spontaneous recovery was remarkably common if support can be sustained.

  9. Control Problems in Autonomous Life Support Systems

    NASA Technical Reports Server (NTRS)

    Colombano, S.

    1982-01-01

    The problem of constructing life support systems which require little or no input of matter (food and gases) for long, or even indefinite, periods of time is addressed. Natural control in ecosystems, a control theory for ecosystems, and an approach to the design of an ALSS are addressed.

  10. A Design of Electronic Performance Support Systems.

    ERIC Educational Resources Information Center

    Sheu, Feng-Ru

    The project described in this paper, representing the initial phases of a one-year on-going project, was organized to build a supportive environment for Instructional Systems Technology (IST) doctoral students at Indiana University-Bloomington to help them prepare for the Qualifying exams. An overview is provided of steps taken to create an…

  11. Environmental control and life support systems

    NASA Technical Reports Server (NTRS)

    Ray, Charles D.

    1990-01-01

    Viewgraphs on Environmental Control and Life Support Systems (ECLSS) for Space Station Freedom are presented. Topics covered include: crew generated wastes processing and reclamation; water reclamation - pre- and post-treatment; simplified waste water processing; improved trace contaminant removal; and real time microbial analysis.

  12. 14 CFR 417.307 - Support systems.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ...) Launch vehicle tracking data, such as instantaneous vacuum impact point, drag corrected debris footprint... 14 Aeronautics and Space 4 2012-01-01 2012-01-01 false Support systems. 417.307 Section 417.307 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF...

  13. 14 CFR 417.307 - Support systems.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ...) Launch vehicle tracking data, such as instantaneous vacuum impact point, drag corrected debris footprint... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false Support systems. 417.307 Section 417.307 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF...

  14. 14 CFR 417.307 - Support systems.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ...) Launch vehicle tracking data, such as instantaneous vacuum impact point, drag corrected debris footprint... 14 Aeronautics and Space 4 2014-01-01 2014-01-01 false Support systems. 417.307 Section 417.307 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF...

  15. 14 CFR 417.307 - Support systems.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ...) Launch vehicle tracking data, such as instantaneous vacuum impact point, drag corrected debris footprint... 14 Aeronautics and Space 4 2013-01-01 2013-01-01 false Support systems. 417.307 Section 417.307 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF...

  16. Decision Support Systems for Academic Administration.

    ERIC Educational Resources Information Center

    Moore, Laurence J.; Greenwood, Allen G.

    1984-01-01

    The history and features of Decision Support Systems (DSS) and use of the approach by academic administrators are discussed. The objective of DSS is to involve the manager/decision maker in the decision-analysis process while simultaneously relieving that person of the burden of developing and performing detailed analysis. DSS represents a…

  17. SOVIET LITERATURE ON LIFE SUPPORT SYSTEMS

    DTIC Science & Technology

    This is the fifth in a report series reviewing Soviet developments in life support systems as reflected in Soviet publications. Items are selected from Soviet open literature and include scientific publications and literature of a popular type. The materials in this report deal with the following topics: space medicine and biology, space vehicle ecology, and instrumentation. (Author)

  18. Supporting Classroom Activities with the BSUL System

    ERIC Educational Resources Information Center

    Ogata, Hiroaki; Saito, Nobuji A.; Paredes J., Rosa G.; San Martin, Gerardo Ayala; Yano, Yoneo

    2008-01-01

    This paper presents the integration of ubiquitous computing systems into classroom settings, in order to provide basic support for classrooms and field activities. We have developed web application components using Java technology and configured a classroom with wireless network access and a web camera for our purposes. In this classroom, the…

  19. Supporting Classroom Activities with the BSUL System

    ERIC Educational Resources Information Center

    Ogata, Hiroaki; Saito, Nobuji A.; Paredes J., Rosa G.; San Martin, Gerardo Ayala; Yano, Yoneo

    2008-01-01

    This paper presents the integration of ubiquitous computing systems into classroom settings, in order to provide basic support for classrooms and field activities. We have developed web application components using Java technology and configured a classroom with wireless network access and a web camera for our purposes. In this classroom, the…

  20. Decision Support Systems for Academic Administration.

    ERIC Educational Resources Information Center

    Moore, Laurence J.; Greenwood, Allen G.

    1984-01-01

    The history and features of Decision Support Systems (DSS) and use of the approach by academic administrators are discussed. The objective of DSS is to involve the manager/decision maker in the decision-analysis process while simultaneously relieving that person of the burden of developing and performing detailed analysis. DSS represents a…

  1. Ham Tries Out His Life Support System

    NASA Technical Reports Server (NTRS)

    1961-01-01

    Ham tries out his combination couch and life support system in preparation for his flight in Mercury Redstone-2 (MR-2). The couch is plugged into the circuit that normally would supply the astronaut's full pressure suit. The MR-2 flight was one in a series of flights that led to the manned orbital flights of NASA's Project Mercury program.

  2. Regenerative life support system research and concepts

    NASA Technical Reports Server (NTRS)

    1988-01-01

    Life support systems that involve recycling of atmospheres, water, food and waste are so complex that models incorporating all the interactions and relationships are vital to design, development, simulations, and ultimately to control of space qualified systems. During early modeling studies, FORTRAN and BASIC programs were used to obtain numerical comparisons of the performance of different regenerative concepts. Recently, models were made by combining existing capabilities with expert systems to establish an Intelligent Design Support Environment for simpliflying user interfaces and to address the need for the engineering aspects. Progress was also made toward modeling and evaluating the operational aspects of closed loop life support systems using Time-step and Dynamic simulations over a period of time. Example models are presented which show the status and potential of developed modeling techniques. For instance, closed loop systems involving algae systeMs for atmospheric purification and food supply augmentation, plus models employing high plants and solid waste electrolysis are described and results of initial evaluations are presented.

  3. Tools for Life Support Systems Analysis

    NASA Astrophysics Data System (ADS)

    Lange, K.; Ewert, M.

    An analysis of the optimum level of closure of a life support system is a complex task involving hundreds, if not thousands, of parameters. In the absence of complete data on candidate technologies and a complete definition of the mission architecture and requirements, many assumptions are necessary. Because of the large number of parameters, it is difficult to fully comprehend and compare studies performed by different analysts. The Systems Integration, Modeling, and Analysis (SIMA) Project Element within NASA's Advanced Life Support (ALS) Project has taken measures to improve this situation by issuing documents that define ALS requirements, baseline assumptions, and reference missions. As a further step to capture and retain available knowledge and to facilitate system-level studies, various software tools are being developed. These include a database tool for storing, organizing, and updating technology parameters, modeling tools for evaluating time-average and dynamic system performance, and sizing tools for estimating overall system mass, volume, power, cooling, logistics, and crew time. This presentation describes ongoing work on the development and integration of these tools for life support systems analysis.

  4. Using PG-Liposome-Based System to Enhance Puerarin Liver-Targeted Therapy for Alcohol-Induced Liver Disease.

    PubMed

    Zhao, Ying-Zheng; Zhang, Lu; Gupta, Pardeep K; Tian, Fu-Rong; Mao, Kai-Li; Qiu, Kai-Yan; Yang, Wei; Lv, Chuan-Zhu; Lu, Cui-Tao

    2016-12-01

    A critical issue for alcohol-induced liver disease (ALD) therapeutics is the lack of a highly efficient delivery system. In this study, a Puerarin-propylene glycol-liposome system was prepared for the purpose of targeting puerarin, an isoflavon, to the liver. Transmission electron microscope (TEM) results showed the liposomes to be spherical in shape with an average diameter of 182 nm with a polydispersity index of 0.239. The zeta potential of the particles was about -30 mV. The entrapment efficiency of puerarin was above 90%. MTT-based assay in HpeG2 cells showed no significant cytotoxicity in the presence of up to 25% concentration of the system containing 3% puerarin. In vivo performance of this system was studied in mice. Pharmacokinetics and distribution of puerarin-PG-liposome system was studied relative to puerarin solution at the same dose levels. The results show that puerarin-PG-liposome prolonged drug retention time and decreased elimination of puerarin in mice (AUC of liposome system and solution was 9.5 and 4.0 mg h L(-1), respectively). Furthermore, propylene glycol (PG)-liposome system enhanced puerarin distribution into liver and spleen, while decreasing puerarin distribution in other tissues. Overall, the puerarin-PG-liposome system showed enhanced therapeutic effect in mice with ALD.

  5. Pressure vessel sliding support unit and system using the sliding support unit

    SciTech Connect

    Breach, Michael R.; Keck, David J.; Deaver, Gerald A.

    2013-01-15

    Provided is a sliding support and a system using the sliding support unit. The sliding support unit may include a fulcrum capture configured to attach to a support flange, a fulcrum support configured to attach to the fulcrum capture, and a baseplate block configured to support the fulcrum support. The system using the sliding support unit may include a pressure vessel, a pedestal bracket, and a plurality of sliding support units.

  6. 1992 NASA Life Support Systems Analysis workshop

    NASA Technical Reports Server (NTRS)

    Evanich, Peggy L.; Crabb, Thomas M.; Gartrell, Charles F.

    1992-01-01

    The 1992 Life Support Systems Analysis Workshop was sponsored by NASA's Office of Aeronautics and Space Technology (OAST) to integrate the inputs from, disseminate information to, and foster communication among NASA, industry, and academic specialists. The workshop continued discussion and definition of key issues identified in the 1991 workshop, including: (1) modeling and experimental validation; (2) definition of systems analysis evaluation criteria; (3) integration of modeling at multiple levels; and (4) assessment of process control modeling approaches. Through both the 1991 and 1992 workshops, NASA has continued to seek input from industry and university chemical process modeling and analysis experts, and to introduce and apply new systems analysis approaches to life support systems. The workshop included technical presentations, discussions, and interactive planning, with sufficient time allocated for discussion of both technology status and technology development recommendations. Key personnel currently involved with life support technology developments from NASA, industry, and academia provided input to the status and priorities of current and future systems analysis methods and requirements.

  7. Using Visualization in Cockpit Decision Support Systems

    NASA Technical Reports Server (NTRS)

    Aragon, Cecilia R.

    2005-01-01

    In order to safely operate their aircraft, pilots must make rapid decisions based on integrating and processing large amounts of heterogeneous information. Visual displays are often the most efficient method of presenting safety-critical data to pilots in real time. However, care must be taken to ensure the pilot is provided with the appropriate amount of information to make effective decisions and not become cognitively overloaded. The results of two usability studies of a prototype airflow hazard visualization cockpit decision support system are summarized. The studies demonstrate that such a system significantly improves the performance of helicopter pilots landing under turbulent conditions. Based on these results, design principles and implications for cockpit decision support systems using visualization are presented.

  8. Space transportation systems supporting a lunar base

    NASA Technical Reports Server (NTRS)

    Priest, C. C.; Woodcock, Gordon

    1990-01-01

    Results are presented on preliminary design studies conducted by NASA and its contractors to define the transportation vehicle for the support of a human return to the moon mission. Attention is given to the transportation needs and requirements, the design solutions to meet these requirements, the rationale for the selection of the designs, and the ground/orbital support facilities for placing these systems into routine earth-moon transportation service. The reference system includes a partially reusable lunar transfer vehicle that operates between the earth and lunar orbits and a fully reusable lunar excursion vehicle that operates between the lunar orbit and the lunar surface. The system can deliver 27 metric tons of cargo to the lunar surface in an automated flight mode, and can transport a crew of four and deliver 15 tons of cargo in a piloted mode.

  9. MODEL SYSTEMS AND EXPERIMENTAL CONDITIONS THAT LEAD TO EFFECTIVE REPOPULATION OF THE LIVER BY TRANSPLANTED CELLS

    PubMed Central

    Shafritz, David A.; Oertel, Michael

    2010-01-01

    In recent years, there has been substantial progress in transplanting cells into the liver with the ultimate goal of restoring liver mass and function in both inherited and acquired liver diseases. The basis for considering that this might be feasible is that the liver is a highly regenerative organ. After massive liver injury or surgical removal of two-thirds or more of the liver tissue, the organ can restore its mass with completely normal morphologic structure and function. It has also been found under highly selective conditions that transplanted hepatocytes can fully repopulate the liver and cure a metabolic disorder or deficiency state. Fetal liver cells can also substantially repopulate the normal liver, and it is hoped in the future that effective repopulation will be achievable with cultured cells or cell lines, pluripotent stem cells from other somatic tissues, embryonic stem cells, or induced pluripotent stem cells, which can now be generated in vitro by a variety of methods. The purpose of this review is to present the major systems that have been used for liver repopulation, the variables involved in obtaining successful repopulation and what has been achieved in these various systems to date with different cell types. PMID:20080205

  10. Supporting multiple control systems at Fermilab

    SciTech Connect

    Nicklaus, Dennis J.; /Fermilab

    2009-10-01

    The Fermilab control system, ACNET, is used for controlling the Tevatron and all of its pre-accelerators. However, other smaller experiments at Fermilab have been using different controls systems, in particular DOOCS and EPICS. This paper reports some of the steps taken at Fermilab to integrate support for these outside systems. We will describe specific tools that we have built or adapted to facilitate interaction between the architectures. We also examine some of the difficulties that arise from managing this heterogeneous environment. Incompatibilities as well as common elements will be described.

  11. Web-Based Learning Support System

    NASA Astrophysics Data System (ADS)

    Fan, Lisa

    Web-based learning support system offers many benefits over traditional learning environments and has become very popular. The Web is a powerful environment for distributing information and delivering knowledge to an increasingly wide and diverse audience. Typical Web-based learning environments, such as Web-CT, Blackboard, include course content delivery tools, quiz modules, grade reporting systems, assignment submission components, etc. They are powerful integrated learning management systems (LMS) that support a number of activities performed by teachers and students during the learning process [1]. However, students who study a course on the Internet tend to be more heterogeneously distributed than those found in a traditional classroom situation. In order to achieve optimal efficiency in a learning process, an individual learner needs his or her own personalized assistance. For a web-based open and dynamic learning environment, personalized support for learners becomes more important. This chapter demonstrates how to realize personalized learning support in dynamic and heterogeneous learning environments by utilizing Adaptive Web technologies. It focuses on course personalization in terms of contents and teaching materials that is according to each student's needs and capabilities. An example of using Rough Set to analyze student personal information to assist students with effective learning and predict student performance is presented.

  12. Preclinical detection of liver fibrosis using dual-modality photoacoustic/ultrasound system

    PubMed Central

    van den Berg, Pim J.; Bansal, Ruchi; Daoudi, Khalid; Steenbergen, Wiendelt; Prakash, Jai

    2016-01-01

    Liver fibrosis is a major cause for increasing mortality worldwide. Preclinical research using animal models is required for the discovery of new anti-fibrotic therapies, but currently relies on endpoint liver histology. In this study, we investigated a cost-effective and portable photoacoustic/ultrasound (PA/US) imaging system as a potential non-invasive alternative. Fibrosis was induced in mice using CCl4 followed by liver imaging and histological analysis. Imaging showed significantly increased PA features with higher frequency signals in fibrotic livers versus healthy livers. This corresponds to more heterogeneous liver structure resulting from collagen deposition and angiogenesis. Importantly, PA response and its frequency were highly correlated with histological parameters. These results demonstrate the preclinical feasibility of the PA imaging approach and applicability of dual PA/US system. PMID:28018726

  13. Situational adapting system supporting team situation awareness

    NASA Astrophysics Data System (ADS)

    Helldin, Tove; Erlandsson, Tina; Niklasson, Lars; Falkman, Göran

    2010-10-01

    Military fighter pilots have to make suitable decisions fast in an environment where continuously increasing flows of information from sensors, team members and databases are provided. Not only do the huge amounts of data aggravate the pilots' decision making process: time-pressure, presence of uncertain data and high workload are factors that can worsen the performance of pilot decision making. In this paper, initial ideas of how to support the pilots accomplishing their tasks are presented. Results from interviews with two fighter pilots are described as well as a discussion about how these results can guide the design of a military fighter pilot decision support system, with focus on team cooperation.

  14. Apollo 14 flight support and system performance

    NASA Technical Reports Server (NTRS)

    Rice, R. R.

    1971-01-01

    The Apollo 13 incident and subsequent oxygen tank redesign for Apollo 14 placed unique requirements on the flight support activity. A major part of this activity was the integration of the various analytical efforts into a single team function. Additionally, the first flight of the redesigned system without an orbital test required an extensive analytical base. The support team philosophy, objectives, and organization are presented. Various analytical tools that were used during the flight are discussed. Investigations made during the postflight period are considered and their impact upon subsequent flights shown.

  15. An assessment of thromboelastometry to monitor blood coagulation and guide transfusion support in liver transplantation.

    PubMed

    Blasi, Annabel; Beltran, Joan; Pereira, Arturo; Martinez-Palli, Graciela; Torrents, Abiguei; Balust, Jaume; Zavala, Elizabeth; Taura, Pilar; Garcia-Valdecasas, Juan-Carlos

    2012-09-01

    Rotation thromboelastometry (TEM) has been proposed as a convenient alternative to standard coagulation tests in guiding the treatment of coagulopathy during orthotopic liver transplantation (OLT). This study was aimed at assessing the value of TEM in monitoring blood coagulation and guide transfusion support in OLT. Standard coagulation and TEM (EXTEM and FIBTEM) tests were performed at four preestablished intraoperative time points in 236 OLTs and prospectively recorded in a dedicated database together with the main operative and transfusion data. Transfusion thresholds were based on standard coagulation tests. Spearman's rank correlation (ρ), linear regression, and receiver operating characteristic curves were used when appropriate. EXTEM maximum clot firmness (MCF(EXTEM)) was the TEM variable that best correlated with the platelet (PLT) and fibrinogen levels (ρ = 0.62 and ρ = 0.69, respectively). MCF(FIBTEM) correlated with fibrinogen level (ρ = 0.70). EXTEM clot amplitude at 10 minutes (A10(EXTEM)) was a good linear predictor of MCF(EXTEM) (R(2) =0.93). The cutoff values that best predicted the transfusion threshold for PLTs and fibrinogen were A10(EXTEM) = 35 mm and A10(FIBTEM) = 8 mm. At these values, the negative and positive predictive accuracies of TEM to predict the transfusion thresholds were 95 and 27%, respectively. A10(EXTEM) is an adequate TEM variable to guide therapeutic decisions during OLT. Patients with A10(EXTEM) of greater than 35 mm are unlikely to bleed because of coagulation deficiencies, but using A10(EXTEM) of not more than 35 mm as the sole transfusion criterion can lead to unnecessary utilization of PLTs and fibrinogen-rich products. © 2012 American Association of Blood Banks.

  16. Predicting short-term survival after liver transplantation on eight score systems: a national report from China Liver Transplant Registry.

    PubMed

    Ling, Qi; Dai, Haojiang; Zhuang, Runzhou; Shen, Tian; Wang, Weilin; Xu, Xiao; Zheng, Shusen

    2017-02-13

    To compare the performance of eight score systems (MELD, uMELD, MELD-Na. iMELD, UKELD, MELD-AS, CTP, and mCTP) in predicting the post-transplant mortality, we analyzed the data of 6,014 adult cirrhotic patients who underwent liver transplantation between January 2003 and December 2010 from the China Liver Transplant Registry database. In hepatitis B virus (HBV) group, MELD, uMELD and MELD-AS showed good predictive accuracies at 3-month mortality after liver transplantation; by comparison with other five models, MELD presented the best ability in predicting 3-month, 6-month and 1-year mortality, showing a significantly better predictive ability than UKELD and iMELD. In hepatitis C virus and Alcohol groups, the predictive ability did not differ significantly between MELD and other models. Patient survivals in different MELD categories were of statistically significant difference. Among patients with MELD score >35, a new prognostic model based on serum creatinine, need for hemodialysis and moderate ascites could identify the sickest one. In conclusion, MELD is superior to other score systems in predicting short-term post-transplant survival in patients with HBV-related liver disease. Among patients with MELD score >35, a new prognostic model can identify the sickest patients who should be excluded from waiting list to prevent wasteful transplantation.

  17. Predicting short-term survival after liver transplantation on eight score systems: a national report from China Liver Transplant Registry

    PubMed Central

    Ling, Qi; Dai, Haojiang; Zhuang, Runzhou; Shen, Tian; Wang, Weilin; Xu, Xiao; Zheng, Shusen

    2017-01-01

    To compare the performance of eight score systems (MELD, uMELD, MELD-Na. iMELD, UKELD, MELD-AS, CTP, and mCTP) in predicting the post-transplant mortality, we analyzed the data of 6,014 adult cirrhotic patients who underwent liver transplantation between January 2003 and December 2010 from the China Liver Transplant Registry database. In hepatitis B virus (HBV) group, MELD, uMELD and MELD-AS showed good predictive accuracies at 3-month mortality after liver transplantation; by comparison with other five models, MELD presented the best ability in predicting 3-month, 6-month and 1-year mortality, showing a significantly better predictive ability than UKELD and iMELD. In hepatitis C virus and Alcohol groups, the predictive ability did not differ significantly between MELD and other models. Patient survivals in different MELD categories were of statistically significant difference. Among patients with MELD score >35, a new prognostic model based on serum creatinine, need for hemodialysis and moderate ascites could identify the sickest one. In conclusion, MELD is superior to other score systems in predicting short-term post-transplant survival in patients with HBV-related liver disease. Among patients with MELD score >35, a new prognostic model can identify the sickest patients who should be excluded from waiting list to prevent wasteful transplantation. PMID:28198820

  18. Life Support Systems for Lunar Landers

    NASA Technical Reports Server (NTRS)

    Anderson, Molly

    2008-01-01

    Engineers designing life support systems for NASA s next Lunar Landers face unique challenges. As with any vehicle that enables human spaceflight, the needs of the crew drive most of the lander requirements. The lander is also a key element of the architecture NASA will implement in the Constellation program. Many requirements, constraints, or optimization goals will be driven by interfaces with other projects, like the Crew Exploration Vehicle, the Lunar Surface Systems, and the Extravehicular Activity project. Other challenges in the life support system will be driven by the unique location of the vehicle in the environments encountered throughout the mission. This paper examines several topics that may be major design drivers for the lunar lander life support system. There are several functional requirements for the lander that may be different from previous vehicles or programs and recent experience. Some of the requirements or design drivers will change depending on the overall Lander configuration. While the configuration for a lander design is not fixed, designers can examine how these issues would impact their design and be prepared for the quick design iterations required to optimize a spacecraft.

  19. Controlled Ecological Life Support Systems (CELSS)

    NASA Technical Reports Server (NTRS)

    Majumdar, M.

    1985-01-01

    One of the major problems facing researchers in the design of a life support system is to construct it so that it will be capable of regulating waste materials and gases, while at the same time supporting the inhabitants with adequate food and oxygen. The basis of any gaseous life supporting cycle is autotrophs (plants that photosynthesize). The major problem is to get the respiratory quotient (RQ) of the animals to be equivalent to the assimilatory quotient (AQ) of the plants. A technique is being developed to control the gas exchange. The goal is to determine the feasibility of manipulating the plant's AQ by altering the plants environment in order to eliminate the mismatch between the plant's AQ and the animal's RQ.

  20. Intelligent decision support systems for mechanical ventilation.

    PubMed

    Tehrani, Fleur T; Roum, James H

    2008-11-01

    An overview of different methodologies used in various intelligent decision support systems (IDSSs) for mechanical ventilation is provided. The applications of the techniques are compared in view of today's intensive care unit (ICU) requirements. Information available in the literature is utilized to provide a methodological review of different systems. Comparisons are made of different systems developed for specific ventilation modes as well as those intended for use in wider applications. The inputs and the optimized parameters of different systems are discussed and rule-based systems are compared to model-based techniques. The knowledge-based systems used for closed-loop control of weaning from mechanical ventilation are also described. Finally, in view of increasing trend towards automation of mechanical ventilation, the potential utility of intelligent advisory systems for this purpose is discussed. IDSSs for mechanical ventilation can be quite helpful to clinicians in today's ICU settings. To be useful, such systems should be designed to be effective, safe, and easy to use at patient's bedside. In particular, these systems must be capable of noise removal, artifact detection and effective validation of data. Systems that can also be adapted for closed-loop control/weaning of patients at the discretion of the clinician, may have a higher potential for use in the future.

  1. Decision support system for theater missile defense

    NASA Astrophysics Data System (ADS)

    Gonsalves, Paul; Burge, Janet; Popp, Ben

    2003-08-01

    Military services require C4I systems that support a full spectrum of operations. This is specifically relevant to the theatre missile defense (TMD) mission planning and analysis community where there have been several recent concept changes; advancements in information technology, sensors, and weapons; and expansion in the diversity and capabilities of potential adversaries. To fully support campaign development and analysis in this new environment, there is a need for systems and tools that enhance understanding of adversarial behavior, assess potential threat capabilities and vulnerabilities, perform C4I system trades, and provide methods to identify macro-level novel or emergent combat tactics and behavior derived from simpler micro-level rules. Such systems must also be interactive, collaborative, and semi-autonomous, providing the INTEL analyst with the means for exploration and potential exploitation of novel enemy behavior patterns. To address these issues we have developed an Intelligent Threat Assessment Processor (ITAP) to provide prediction and interpretation of enemy courses of actions (eCOAs) for the TMD domain. This system uses a combination of genetic algorithm-based optimization in tandem with the spatial analysis and visualization capabilities of a commercial-off-the-shelf (COTS) geographic information system to generate and evaluate potential eCOAs.

  2. Nuclear reactor pressure vessel support system

    DOEpatents

    Sepelak, George R.

    1978-01-01

    A support system for nuclear reactor pressure vessels which can withstand all possible combinations of stresses caused by a postulated core disrupting accident during reactor operation. The nuclear reactor pressure vessel is provided with a flange around the upper periphery thereof, and the flange includes an annular vertical extension formed integral therewith. A support ring is positioned atop of the support ledge and the flange vertical extension, and is bolted to both members. The plug riser is secured to the flange vertical extension and to the top of a radially outwardly extension of the rotatable plug. This system eliminates one joint through which fluids contained in the vessel could escape by making the fluid flow path through the joint between the flange and the support ring follow the same path through which fluid could escape through the plug risers. In this manner, the sealing means to prohibit the escape of contained fluids through the plug risers can also prohibit the escape of contained fluid through the securing joint.

  3. Nanoparticles Evading The Reticuloendothelial System: Role of The Supported Bilayer

    PubMed Central

    Li, Shyh-Dar; Huang, Leaf

    2009-01-01

    Summary We have previously shown that the PEGylated LPD (liposome-polycation-DNA) nanoparticles were highly efficient in delivering siRNA to the tumor with low liver uptake. Its mechanism of evading the reticuloendothelial system (RES) is reported here. In LPD, nucleic acids were condensed with protamine into a compact core, which was then coated by two cationic lipid bilayers with the inner bilayer stabilized by charge-charge interaction (also called the supported bilayer). Finally, a detergent-like molecule, polyethylene glycol (PEG)-phospholipid is post-inserted into the lipid bilayer to modify the surface of LPD. The dynamic light scattering (DLS) data showed that LPD had improved stability compared to cationic liposomes after incubation with a high concentration of DSPE-PEG2000, which is known to disrupt the bilayer. LPD prepared with a multivalent cationic lipid, DSGLA, had enhanced stability compared to those containing DOTAP, a monovalent cationic lipid, suggesting that stronger charge-charge interaction in the supported bilayer contributed to a higher stability. Distinct nanoparticle structure was found in the PEGylated LPD by transmission electron microscopy, while the cationic liposomes were transformed into tubular micelles. Size exclusion chromatography data showed that approximately 60% of the total cationic lipids, which were located in the outer bilayer of LPD, were stripped off during the PEGylation; and about 20% of the input DSPE-PEG2000 was incorporated into the inner bilayer with about 10.6 mol% of DSPE-PEG2000 presented on the particle surface. This led to complete charge shielding, low liver sinusoidal uptake, and 32.5% injected dose delivered to the NCI-H460 tumor in a xenograft model. PMID:19595666

  4. Water Systems Project 1: Current Systems and Regulatory Support

    EPA Science Inventory

    Water Systems Project 1 objectives: 1) Supply research results to support federal regulations and guidance; 2) provide strategies to regions, states, and communities for improved regulatory compliance, and 3) provide rapid and effective emergency response where appropriate (e.g. ...

  5. Water Systems Project 1: Current Systems and Regulatory Support

    EPA Science Inventory

    Water Systems Project 1 objectives: 1) Supply research results to support federal regulations and guidance; 2) provide strategies to regions, states, and communities for improved regulatory compliance, and 3) provide rapid and effective emergency response where appropriate (e.g. ...

  6. Support system for management of shares ergonomic.

    PubMed

    da Rocha, Raphael Pacheco; Vidal, Mario Cesar Rodriguez

    2012-01-01

    This article discusses the development of a computerized support to demands for treatment of a wide spectrum and diverse nature. Developed under SPM platform (Situação, Problema e Melhoria), the practitioner seeks to provide an ergonomic aid from the identification and characterization of the processes of analysis demands. The interest of a technological support the practice of ergonomics is a domestic origin, which already features a wide universe. For purposes of this article will be drawn the line defined by the universe in the Federal Public Service occupations within the guidelines set Subsystem Integrated System for Health Care Workers of the Federal Government. The development of this system initially intended to assist the practitioner in ergonomics mapping situations in which the federal public servant has been undergoing for the second time that can classify and then treat them.

  7. Advanced technologies to support earth orbiting systems

    NASA Technical Reports Server (NTRS)

    Rosen, Robert; Johnston, Gordon I.

    1992-01-01

    Within NASA, the Office of Aeronautics and Space Technology (OAST) is conducting a major, ongoing engineering research and technology program directed toward the support of future programs, with a major focus on technology for future space science missions. OAST is conducting a substantial effort to identify the technologies required to support the evolution of Mission to Planet Earth. The effort consists of studies, workshops, and technology research programs to explore: (1) new concepts for multisatellite, earth-observing instrumentation and sensor sets; (2) information system advances for continuous and reliable processing of terabit per day data streams; and (3) infrastructure development, including spacecraft bus technology and operations for substantial performance, cost, and reliabiltiy gains. This paper discusses the technological needs of future earth science systems, reviews current and planned activities, and highlights significant achievements in the research and technology program.

  8. Advanced technologies to support earth orbiting systems

    NASA Technical Reports Server (NTRS)

    Rosen, Robert; Johnston, Gordon I.

    1992-01-01

    Within NASA, the Office of Aeronautics and Space Technology (OAST) is conducting a major, ongoing engineering research and technology program directed toward the support of future programs, with a major focus on technology for future space science missions. OAST is conducting a substantial effort to identify the technologies required to support the evolution of Mission to Planet Earth. The effort consists of studies, workshops, and technology research programs to explore: (1) new concepts for multisatellite, earth-observing instrumentation and sensor sets; (2) information system advances for continuous and reliable processing of terabit per day data streams; and (3) infrastructure development, including spacecraft bus technology and operations for substantial performance, cost, and reliabiltiy gains. This paper discusses the technological needs of future earth science systems, reviews current and planned activities, and highlights significant achievements in the research and technology program.

  9. Executive Support Systems: An Innovation Decision Perspective

    DTIC Science & Technology

    1990-01-01

    account . The exception and annotation ability of MIDS alerted the executives to what was happening and prevented a ripple effect of overreactions...information directly to these executives, an executive support system (ESS) allows more effective analysis, control, planning, and decision making...Automated improve- ments to the management process have the potential to highly leverage the executive’s effectiveness . An ESS is a concept, a clustered IT

  10. Regulation of drug-metabolizing enzymes by local and systemic liver injuries

    PubMed Central

    Guo, Yan; Hu, Bingfang; Xie, Yang; Billiar, Timothy R.; Sperry, Jason L.; Huang, Min; Xie, Wen

    2016-01-01

    Introduction Drug metabolism and disposition are critical in maintaining the chemical and functional homeostasis of xenobiotics/drugs and endobiotics. The liver plays an essential role in drug metabolism and disposition due to its abundant expression of drug-metabolizing enzymes (DMEs) and transporters. There is growing evidence to suggest that many hepatic and systemic diseases can affect drug metabolism and disposition by regulating the expression and/or activity of DMEs and transporters in the liver. Areas covered This review focuses on the recent progress on the regulation of DMEs by local and systemic liver injuries. Liver ischemia and reperfusion (I/R) and sepsis are used as examples of local and systemic injury, respectively. The reciprocal effect of the expression and activity of DMEs on animals' sensitivity to local and systemic liver injuries is also discussed. Expert opinion Local and systemic liver injuries have a major effect on the expression and activity of DMEs in the liver. Understanding the disease effect on DMEs is clinically important due to the concern of disease-drug interactions. Future studies are necessary to understand the mechanism by which liver injury regulates DMEs. Human studies are also urgently needed in order to determine whether the results in animals can be replicated in human patients. PMID:26751558

  11. Regulation of drug-metabolizing enzymes by local and systemic liver injuries.

    PubMed

    Guo, Yan; Hu, Bingfang; Xie, Yang; Billiar, Timothy R; Sperry, Jason L; Huang, Min; Xie, Wen

    2016-01-01

    Drug metabolism and disposition are critical in maintaining the chemical and functional homeostasis of xenobiotics/drugs and endobiotics. The liver plays an essential role in drug metabolism and disposition due to its abundant expression of drug-metabolizing enzymes (DMEs) and transporters. There is growing evidence to suggest that many hepatic and systemic diseases can affect drug metabolism and disposition by regulating the expression and/or activity of DMEs and transporters in the liver. This review focuses on the recent progress on the regulation of DMEs by local and systemic liver injuries. Liver ischemia and reperfusion (I/R) and sepsis are used as examples of local and systemic injury, respectively. The reciprocal effect of the expression and activity of DMEs on animals' sensitivity to local and systemic liver injuries is also discussed. Local and systemic liver injuries have a major effect on the expression and activity of DMEs in the liver. Understanding the disease effect on DMEs is clinically important due to the concern of disease-drug interactions. Future studies are necessary to understand the mechanism by which liver injury regulates DMEs. Human studies are also urgently needed in order to determine whether the results in animals can be replicated in human patients.

  12. Liver-inherent immune system: its role in blood-stage malaria.

    PubMed

    Wunderlich, Frank; Al-Quraishy, Saleh; Dkhil, Mohamed A

    2014-01-01

    The liver is well known as that organ which is obligately required for the intrahepatocyte development of the pre-erythrocytic stages of the malaria-causative agent Plasmodium. However, largely neglected is the fact that the liver is also a central player of the host defense against the morbidity- and mortality-causing blood stages of the malaria parasites. Indeed, the liver is equipped with a unique immune system that acts locally, however, with systemic impact. Its main "antipodal" functions are to recognize and to generate effective immunoreactivity against pathogens on the one hand, and to generate tolerance to avoid immunoreactivity with "self" and harmless substances as dietary compounds on the other hand. This review provides an introductory survey of the liver-inherent immune system: its pathogen recognition receptors including Toll-like receptors (TLRs) and its major cell constituents with their different facilities to fight and eliminate pathogens. Then, evidence is presented that the liver is also an essential organ to overcome blood-stage malaria. Finally, we discuss effector responses of the liver-inherent immune system directed against blood-stage malaria: activation of TLRs, acute phase response, phagocytic activity, cytokine-mediated pro- and anti-inflammatory responses, generation of "protective" autoimmunity by extrathymic T cells and B-1 cells, and T cell-mediated repair of liver injuries mainly produced by malaria-induced overreactions of the liver-inherent immune system.

  13. Telescience Support Center Data System Software

    NASA Technical Reports Server (NTRS)

    Rahman, Hasan

    2010-01-01

    The Telescience Support Center (TSC) team has developed a databasedriven, increment-specific Data Require - ment Document (DRD) generation tool that automates much of the work required for generating and formatting the DRD. It creates a database to load the required changes to configure the TSC data system, thus eliminating a substantial amount of labor in database entry and formatting. The TSC database contains the TSC systems configuration, along with the experimental data, in which human physiological data must be de-commutated in real time. The data for each experiment also must be cataloged and archived for future retrieval. TSC software provides tools and resources for ground operation and data distribution to remote users consisting of PIs (principal investigators), bio-medical engineers, scientists, engineers, payload specialists, and computer scientists. Operations support is provided for computer systems access, detailed networking, and mathematical and computational problems of the International Space Station telemetry data. User training is provided for on-site staff and biomedical researchers and other remote personnel in the usage of the space-bound services via the Internet, which enables significant resource savings for the physical facility along with the time savings versus traveling to NASA sites. The software used in support of the TSC could easily be adapted to other Control Center applications. This would include not only other NASA payload monitoring facilities, but also other types of control activities, such as monitoring and control of the electric grid, chemical, or nuclear plant processes, air traffic control, and the like.

  14. The VST secondary mirror support system

    NASA Astrophysics Data System (ADS)

    Schipani, P.; Perrotta, F.; Molfese, C.; Caputi, O.; Ferragina, L.; Marty, L.; Capaccioli, M.; Gallieni, D.; Fumi, P.; Anaclerio, E.; Lazzarini, P.; De Paris, G.

    2008-07-01

    The VST telescope is equipped with an active optics system based on a wavefront sensor, a set of axial actuators to change the primary mirror shape and a secondary mirror positioner stage. The secondary mirror positioning capability allows the correction of defocus and coma optical aberrations, mainly caused by incorrect relative positions of the optics. The secondary mirror positioner is a 6-6 Stewart platform (also called "hexapod"). It is a parallel robot with a mobile platform moved by 6 linear actuators acting simultaneously. This paper describes the secondary mirror support system and the current status of the work.

  15. Ground support system methodology and architecture

    NASA Technical Reports Server (NTRS)

    Schoen, P. D.

    1991-01-01

    A synergistic approach to systems test and support is explored. A building block architecture provides transportability of data, procedures, and knowledge. The synergistic approach also lowers cost and risk for life cycle of a program. The determination of design errors at the earliest phase reduces cost of vehicle ownership. Distributed scaleable architecture is based on industry standards maximizing transparency and maintainability. Autonomous control structure provides for distributed and segmented systems. Control of interfaces maximizes compatibility and reuse, reducing long term program cost. Intelligent data management architecture also reduces analysis time and cost (automation).

  16. Bioregenerative life support systems for microgravity

    NASA Technical Reports Server (NTRS)

    Nevill, Gail E., Jr.; Hessel, Michael I., Jr.; Rodriguez, Jose; Morgan, Steve (Editor)

    1993-01-01

    NASA's Controlled Ecological Life Support System (CELSS) project centers on growing plants and recycling wastes in space. The current version of the biomass production chamber (BPC) uses a hydroponic system for nutrient delivery. To optimize plant growth and conserve system resources, the content of the nutrient solution which feeds the plants must be constantly monitored. The macro-nutrients (greater than ten ppm) in the solution include nitrogen, phosphorous, potassium, calcium, magnesium, and sulphur; the micro-nutrients (less than ten ppm) include iron, copper, manganese, zinc, and boron. The goal of this project is to construct a computer-controlled system of ion detectors that will accurately measure the concentrations of several necessary ions in solution. The project focuses on the use of a sensor array to eliminate problems of interference and temperature dependence.

  17. Thermal control extravehicular life support system

    NASA Technical Reports Server (NTRS)

    1975-01-01

    The results of a comprehensive study which defined an Extravehicular Life Support System Thermal Control System (TCS) are presented. The design of the prototype hardware and a detail summary of the prototype TCS fabrication and test effort are given. Several heat rejection subsystems, water management subsystems, humidity control subsystems, pressure control schemes and temperature control schemes were evaluated. Alternative integrated TCS systems were studied, and an optimum system was selected based on quantitative weighing of weight, volume, cost, complexity and other factors. The selected subsystem contains a sublimator for heat rejection, bubble expansion tank for water management, a slurper and rotary separator for humidity control, and a pump, a temperature control valve, a gas separator and a vehicle umbilical connector for water transport. The prototype hardware complied with program objectives.

  18. A COMPUTERIZED OPERATOR SUPPORT SYSTEM PROTOTYPE

    SciTech Connect

    Thomas A. Ulrich; Roger Lew; Ronald L. Boring; Ken Thomas

    2015-03-01

    A computerized operator support system (COSS) is proposed for use in nuclear power plants to assist control room operators in addressing time-critical plant upsets. A COSS is a collection of technologies to assist operators in monitoring overall plant performance and making timely, informed decisions on appropriate control actions for the projected plant condition. A prototype COSS was developed in order to demonstrate the concept and provide a test bed for further research. The prototype is based on four underlying elements consisting of a digital alarm system, computer-based procedures, piping and instrumentation diagram system representations, and a recommender module for mitigation actions. The initial version of the prototype is now operational at the Idaho National Laboratory using the Human System Simulation Laboratory.

  19. Facility Systems, Ground Support Systems, and Ground Support Equipment General Design Requirements

    NASA Technical Reports Server (NTRS)

    Thaxton, Eric A.

    2014-01-01

    KSC-DE-512-SM establishes overall requirements and best design practices to be used at the John F. Kennedy Space Center (KSC) for the development of ground systems (GS) in support of operations at launch, landing, and retrieval sites. These requirements apply to the design and development of hardware and software for ground support equipment (GSE), ground support systems (GSS), and facility ground support systems (F-GSS) used to support the KSC mission for transportation, receiving, handling, assembly, test, checkout, servicing, and launch of space vehicles and payloads and selected flight hardware items for retrieval. This standards manual supplements NASA-STD-5005 by including KSC-site-specific and local environment requirements. These requirements and practices are optional for equipment used at manufacturing, development, and test sites.

  20. JPSS Common Ground System Multimission Support

    NASA Astrophysics Data System (ADS)

    Jamilkowski, M. L.; Miller, S. W.; Grant, K. D.

    2013-12-01

    NOAA & NASA jointly acquire the next-generation civilian operational weather satellite: Joint Polar Satellite System (JPSS). JPSS contributes the afternoon orbit & restructured NPOESS ground system (GS) to replace the current Polar-orbiting Operational Environmental Satellite (POES) system run by NOAA. JPSS sensors will collect meteorological, oceanographic, climatological & solar-geophysical observations of the earth, atmosphere & space. The JPSS GS is the Common Ground System (CGS), consisting of Command, Control, & Communications (C3S) and Interface Data Processing (IDPS) segments, both developed by Raytheon Intelligence, Information & Services (IIS). CGS now flies the Suomi National Polar-orbiting Partnership (S-NPP) satellite, transfers its mission data between ground facilities and processes its data into Environmental Data Records for NOAA & Defense (DoD) weather centers. CGS will expand to support JPSS-1 in 2017. The JPSS CGS currently does data processing (DP) for S-NPP, creating multiple TBs/day across over two dozen environmental data products (EDPs). The workload doubles after JPSS-1 launch. But CGS goes well beyond S-NPP & JPSS mission management & DP by providing data routing support to operational centers & missions worldwide. The CGS supports several other missions: It also provides raw data acquisition, routing & some DP for GCOM-W1. The CGS does data routing for numerous other missions & systems, including USN's Coriolis/Windsat, NASA's SCaN network (including EOS), NSF's McMurdo Station communications, Defense Meteorological Satellite Program (DMSP), and NOAA's POES & EUMETSAT's MetOp satellites. Each of these satellite systems orbits the Earth 14 times/day, downlinking data once or twice/orbit at up to 100s of MBs/second, to support the creation of 10s of TBs of data/day across 100s of EDPs. Raytheon and the US government invested much in Raytheon's mission-management, command & control and data-processing products & capabilities. CGS's flexible

  1. Power Management in Regenerative Life Support Systems

    NASA Technical Reports Server (NTRS)

    Crawford, Sekou; Pawlowski, Christopher; Finn, Cory; Mead, Susan C. (Technical Monitor)

    1999-01-01

    Effective management of power can reduce the cost of launch and operation of regenerative life support systems. Variations in power may be quite severe and may manifest as surges or spikes, While the power plant may have some ability to deal with these variations, with batteries for example, over-capacity is expensive and does nothing to address the fundamental issue of excessive demand. Because the power unit must be sized to accommodate the largest demand, avoiding power spikes has the potential to reduce the required size of the power plant while at the same time increasing the dependability of the system. Scheduling of processors can help to reduce potential power spikes. However, not all power-consuming equipment is easily scheduled. Therefore, active power management is needed to further decrease the risk of surges or spikes. We investigate the use of a hierarchical scheme to actively manage power for a model of a regenerative life support system. Local level controllers individually determine subsystem power usage. A higher level controller monitors overall system power and detects surges or spikes. When a surge condition is detected, the higher level controller conducts an 'auction' and describes subsystem power usage to re-allocate power. The result is an overall reduction in total power during a power surge. The auction involves each subsystem making a 'bid' to buy or sell power based on local needs. However, this re-allocation cannot come at the expense of life support function. To this end, participation in the auction is restricted to those processes meeting certain tolerance constraints. These tolerances represent acceptable limits within which system processes can be operated. We present a simulation model and discuss some of our results.

  2. Power Management in Regenerative Life Support Systems

    NASA Technical Reports Server (NTRS)

    Crawford, Sekou; Pawlowski, Christopher; Finn, Cory; Mead, Susan C. (Technical Monitor)

    1999-01-01

    Effective management of power can reduce the cost of launch and operation of regenerative life support systems. Variations in power may be quite severe and may manifest as surges or spikes, While the power plant may have some ability to deal with these variations, with batteries for example, over-capacity is expensive and does nothing to address the fundamental issue of excessive demand. Because the power unit must be sized to accommodate the largest demand, avoiding power spikes has the potential to reduce the required size of the power plant while at the same time increasing the dependability of the system. Scheduling of processors can help to reduce potential power spikes. However, not all power-consuming equipment is easily scheduled. Therefore, active power management is needed to further decrease the risk of surges or spikes. We investigate the use of a hierarchical scheme to actively manage power for a model of a regenerative life support system. Local level controllers individually determine subsystem power usage. A higher level controller monitors overall system power and detects surges or spikes. When a surge condition is detected, the higher level controller conducts an 'auction' and describes subsystem power usage to re-allocate power. The result is an overall reduction in total power during a power surge. The auction involves each subsystem making a 'bid' to buy or sell power based on local needs. However, this re-allocation cannot come at the expense of life support function. To this end, participation in the auction is restricted to those processes meeting certain tolerance constraints. These tolerances represent acceptable limits within which system processes can be operated. We present a simulation model and discuss some of our results.

  3. Locoregional therapy and systemic cetuximab to treat colorectal liver metastases

    PubMed Central

    Fiorentini, Giammaria; Aliberti, Camillo; Sarti, Donatella; Coschiera, Paolo; Tilli, Massimo; Mulazzani, Luca; Giordani, Paolo; Graziano, Francesco; Gonzalez, Alfonso Marqués; Marcos, Raul García; Mugnoz, Fernando Gómez; Cantore, Maurizio; Ricci, Stefano; Catalano, Vincenzo; Mambrini, Andrea

    2015-01-01

    AIM: To investigate efficacy and safety of second-line treatment with irinotecan-loaded drug-eluting beads (DEBIRI) and cetuximab (DEBIRITUX) of unresectable colorectal liver metastases. METHODS: Patients with the following characteristics were included in the study: unresectable hepatic metastases from colorectal carcinoma (CRC-LM), progression after first line chemotherapy (any type of chemotherapeutic drug and combination was allowed), second line treatment (mandatory), which included for each patient (unregarding the KRas status) two cycles of DEBIRI (using 100-300 μm beads loaded with irinotecan at a total dose 200 mg) followed by 12 cycles of cetuximab that was administered weekly at a first dose of 400 mg/m2 and then 250 mg/m2; good performance status (0-2) and liver functionality (alanine aminotransferase and gamma-glutamyl transferase not exceeding three times the upper limit of normal, total bilirubin not exceeding 2.5 mg/mL). Data were collected retrospectively and included: tumor response (evaluated monthly for 6 mo then every 3 mo), overall response rate (ORR), KRas status, type and intensity of adverse events (G according to the Common Terminology Criteria for Adverse Events v3.0, CTCAE), overall survival (OS) and progression free survival (PFS). RESULTS: Forty consecutive cases of CRC hepatic metastases were included in the study. Median duration of DEBIRITUX was 4.4 mo (range, 4.0-6.5). Sixteen patients (40%) received the planned 2 cycles of DEBIRI and an average of 10 cetuximab cycles. ORR of the whole sample was 50%, in particular 4 patients were complete responders (10%) and 16 (40%) partial responders. The most observed side effects (G2) were: post-embolization syndrome (30%), diarrhea (25%), skin rushes (38%) and asthenia (35%). The retrospective evaluation of KRas status (24 wild type, 16 mutated) showed that the group of patients with wild type KRas had ORR significantly higher than mutant KRas. Median follow-up was 29 mo (8-48 range

  4. Solitary Extramedullary Plasmacytoma of the Liver without Systemic Monoclonal Gammopathy

    PubMed Central

    Lee, Jun-Young; Kim, Hyun-Jung; Bae, Sang-Byung; Kim, Chan-Kyu; Kim, Jung Hoon; Lee, Nam-Su; Lee, Kyu-Taeg; Park, Sung-Kyu; Jin, So-Young; Hong, Dae-Sik; Park, Hee-Sook

    2007-01-01

    Extramedullary plasmacytoma of the liver is a very rare tumor. Although a few cases of extramedullary plasmacytoma of the liver have been reported, we could not find any report on truly localized extramedullary plasmacytoma of the liver in the literature. The patient was a 63-yr-old man who exhibited a solitary liver mass on dynamic computed tomography and magnetic resonance imaging. Histologically, the tumor was composed of mature plasma cells with mild atypia. Immunohistochemistry demonstrated monoclonal IgG and Kappa light chain expression. Bone marrow examination revealed no abnormalities. There was no evidence of a monoclonal protein in the serum and urine, lytic bone lesions, anemia, renal insufficiency, and hypercalcemia. The patient was treated with 5,000 cGy of radiotherapy, and the tumor disappeared 6 months after treatment. PMID:17728524

  5. Diagnostic and Therapeutic Challenges in a Liver Transplant Recipient with Central Nervous System Invasive Aspergillosis

    PubMed Central

    Dionissios, Neofytos; Shmuel, Shoham; Kerry, Dierberg; Katharine, Le; Simon, Dufresne; Sean, Zhang X; Kieren, Marr A

    2012-01-01

    This is a case report of central nervous system (CNS) invasive aspergillosis (IA) in a liver transplant recipient, which illustrates the utility of enzyme-based diagnostic tools for the timely and accurate diagnosis of IA, the treatment challenges and poor outcomes associated with CNS IA in liver transplant recipients. PMID:22676861

  6. Prometheus versus molecular adsorbents recirculating system: comparison of efficiency in two different liver detoxification devices.

    PubMed

    Evenepoel, Pieter; Laleman, Wim; Wilmer, Alexander; Claes, Kathleen; Kuypers, Dirk; Bammens, Bert; Nevens, Frederik; Vanrenterghem, Yves

    2006-04-01

    Albumin dialysis by the molecular adsorbents recirculating system (MARS) and by fractionated plasma separation, adsorption, and dialysis (Prometheus[PROM]) represent novel nonbiological liver support systems specifically designed to remove albumin-bound substances. Preliminary evidence suggests a favorable impact of MARS on the course and outcome of liver failure. This study aimed at comparing the detoxification capacity of both devices. For this purpose, we performed a retrospective analysis on data prospectively collected in patients with acute-on-chronic liver failure treated with either the MARS (n = 9) or the PROM (n = 9) device on 2-5 consecutive days. Each treatment was performed for at least 5 h at identical blood and dialysate flows. Blood clearances were calculated during the first treatment session for urea nitrogen, creatinine, total bilirubin, and bile acids from paired arterial and venous line samples after 1, 4, and 6 h of treatment. Reduction ratios for all single-treatment sessions, and the overall treatment phase, were calculated from pretreatment and post-treatment values. For all markers but bile acids, the single-treatment as well as the overall treatment phase reduction ratios obtained with PROM were significantly higher compared with those obtained with MARS. PROM led at all time points to higher clearances for all evaluated solutes. Blood clearances of protein-bound substances declined over time with MARS, but not with PROM. In conclusion, a significant decline in the serum level of water-soluble and protein-bound toxins was achieved with both devices. PROM produces higher blood clearances for most toxins, which results in higher delivered treatment doses compared with a matching treatment with MARS.

  7. Environmental Control and Life Support System Mockup

    NASA Technical Reports Server (NTRS)

    2001-01-01

    The Environmental Control and Life Support System (ECLSS) Group of the Flight Projects Directorate at the Marshall Space Flight Center in Huntsville, Alabama, is responsible for designing and building the life support systems that will provide the crew of the International Space Station (ISS) a comfortable environment in which to live and work. This photograph shows the mockup of the the ECLSS to be installed in the Node 3 module of the ISS. From left to right, shower rack, waste management rack, Water Recovery System (WRS) Rack #2, WRS Rack #1, and Oxygen Generation System (OGS) rack are shown. The WRS provides clean water through the reclamation of wastewaters and is comprised of a Urine Processor Assembly (UPA) and a Water Processor Assembly (WPA). The UPA accepts and processes pretreated crewmember urine to allow it to be processed along with other wastewaters in the WPA. The WPA removes free gas, organic, and nonorganic constituents before the water goes through a series of multifiltration beds for further purification. The OGS produces oxygen for breathing air for the crew and laboratory animals, as well as for replacing oxygen loss. The OGS is comprised of a cell stack, which electrolyzes (breaks apart the hydrogen and oxygen molecules) some of the clean water provided by the WRS, and the separators that remove the gases from the water after electrolysis.

  8. IGENPRO knowledge-based operator support system.

    SciTech Connect

    Morman, J. A.

    1998-07-01

    Research and development is being performed on the knowledge-based IGENPRO operator support package for plant transient diagnostics and management to provide operator assistance during off-normal plant transient conditions. A generic thermal-hydraulic (T-H) first-principles approach is being implemented using automated reasoning, artificial neural networks and fuzzy logic to produce a generic T-H system-independent/plant-independent package. The IGENPRO package has a modular structure composed of three modules: the transient trend analysis module PROTREN, the process diagnostics module PRODIAG and the process management module PROMANA. Cooperative research and development work has focused on the PRODIAG diagnostic module of the IGENPRO package and the operator training matrix of transients used at the Braidwood Pressurized Water Reactor station. Promising simulator testing results with PRODIAG have been obtained for the Braidwood Chemical and Volume Control System (CVCS), and the Component Cooling Water System. Initial CVCS test results have also been obtained for the PROTREN module. The PROMANA effort also involves the CVCS. Future work will be focused on the long-term, slow and mild degradation transients where diagnoses of incipient T-H component failure prior to forced outage events is required. This will enhance the capability of the IGENPRO system as a predictive maintenance tool for plant staff and operator support.

  9. Environmental Control and Life Support System Mockup

    NASA Technical Reports Server (NTRS)

    2001-01-01

    The Environmental Control and Life Support System (ECLSS) Group of the Flight Projects Directorate at the Marshall Space Flight Center in Huntsville, Alabama, is responsible for designing and building the life support systems that will provide the crew of the International Space Station (ISS) a comfortable environment in which to live and work. This photograph shows the mockup of the the ECLSS to be installed in the Node 3 module of the ISS. From left to right, shower rack, waste management rack, Water Recovery System (WRS) Rack #2, WRS Rack #1, and Oxygen Generation System (OGS) rack are shown. The WRS provides clean water through the reclamation of wastewaters and is comprised of a Urine Processor Assembly (UPA) and a Water Processor Assembly (WPA). The UPA accepts and processes pretreated crewmember urine to allow it to be processed along with other wastewaters in the WPA. The WPA removes free gas, organic, and nonorganic constituents before the water goes through a series of multifiltration beds for further purification. The OGS produces oxygen for breathing air for the crew and laboratory animals, as well as for replacing oxygen loss. The OGS is comprised of a cell stack, which electrolyzes (breaks apart the hydrogen and oxygen molecules) some of the clean water provided by the WRS, and the separators that remove the gases from the water after electrolysis.

  10. Strategy for accurate liver intervention by an optical tracking system

    PubMed Central

    Lin, Qinyong; Yang, Rongqian; Cai, Ken; Guan, Peifeng; Xiao, Weihu; Wu, Xiaoming

    2015-01-01

    Image-guided navigation for radiofrequency ablation of liver tumors requires the accurate guidance of needle insertion into a tumor target. The main challenge of image-guided navigation for radiofrequency ablation of liver tumors is the occurrence of liver deformations caused by respiratory motion. This study reports a strategy of real-time automatic registration to track custom fiducial markers glued onto the surface of a patient’s abdomen to find the respiratory phase, in which the static preoperative CT is performed. Custom fiducial markers are designed. Real-time automatic registration method consists of the automatic localization of custom fiducial markers in the patient and image spaces. The fiducial registration error is calculated in real time and indicates if the current respiratory phase corresponds to the phase of the static preoperative CT. To demonstrate the feasibility of the proposed strategy, a liver simulator is constructed and two volunteers are involved in the preliminary experiments. An ex-vivo porcine liver model is employed to further verify the strategy for liver intervention. Experimental results demonstrate that real-time automatic registration method is rapid, accurate, and feasible for capturing the respiratory phase from which the static preoperative CT anatomical model is generated by tracking the movement of the skin-adhered custom fiducial markers. PMID:26417501

  11. Hail Disrometer Array for Launch Systems Support

    NASA Technical Reports Server (NTRS)

    Lane, John E.; Sharp, David W.; Kasparis, Takis C.; Doesken, Nolan J.

    2008-01-01

    Prior to launch, the space shuttle might be described as a very large thermos bottle containing substantial quantities of cryogenic fuels. Because thermal insulation is a critical design requirement, the external wall of the launch vehicle fuel tank is covered with an insulating foam layer. This foam is fragile and can be damaged by very minor impacts, such as that from small- to medium-size hail, which may go unnoticed. In May 1999, hail damage to the top of the External Tank (ET) of STS-96 required a rollback from the launch pad to the Vehicle Assembly Building (VAB) for repair of the insulating foam. Because of the potential for hail damage to the ET while exposed to the weather, a vigilant hail sentry system using impact transducers was developed as a hail damage warning system and to record and quantify hail events. The Kennedy Space Center (KSC) Hail Monitor System, a joint effort of the NASA and University Affiliated Spaceport Technology Development Contract (USTDC) Physics Labs, was first deployed for operational testing in the fall of 2006. Volunteers from the Community Collaborative Rain. Hail, and Snow Network (CoCoRaHS) in conjunction with Colorado State University were and continue to be active in testing duplicate hail monitor systems at sites in the hail prone high plains of Colorado. The KSC Hail Monitor System (HMS), consisting of three stations positioned approximately 500 ft from the launch pad and forming an approximate equilateral triangle (see Figure 1), was deployed to Pad 39B for support of STS-115. Two months later, the HMS was deployed to Pad 39A for support of STS-116. During support of STS-117 in late February 2007, an unusual hail event occurred in the immediate vicinity of the exposed space shuttle and launch pad. Hail data of this event was collected by the HMS and analyzed. Support of STS-118 revealed another important application of the hail monitor system. Ground Instrumentation personnel check the hail monitors daily when a

  12. A novel mechatronic body weight support system.

    PubMed

    Frey, Martin; Colombo, Gery; Vaglio, Martino; Bucher, Rainer; Jörg, Matthias; Riener, Robert

    2006-09-01

    A novel mechatronic body weight support (BWS) system has been developed to provide precise body weight unloading for patients with neurological or other impairments during treadmill training. The system is composed of a passive elastic spring element to take over the main unloading force and an active closed-loop controlled electric drive to generate the exact desired force. Both force generating units, the passive spring and the active electric drive, act on the patient via a polyester rope connected to a harness worn by the patient. The length of the rope can be adjusted with an electric winch to adapt the system to different patient sizes. The system is fully computer controlled. At unloading loads of up to 60 kg and walking speeds of up to 3.2 km/h, the mean unloading error and the maximum unloading error of the presented BWS system was less than 1 and 3 kg, respectively. The performance was compared with those of two purely passive BWS systems currently being used by most other rehabilitation groups. This comprised counterweight systems and static BWS systems with fixed rope lengths. Counterweight systems reached mean and maximum unloading errors of up to 5.34 and 16.22 kg, respectively. The values for the static BWS were 11.02 kg and 27.67 kg, respectively. The novel mechatronic BWS system presented in this study adjusts desired unloading changes of up to 20 kg within less than 100 ms. Thus, not only constant BWS, but also gait cycle dependent or time variant oscillations of the desired force can be realized with high accuracy. Precise and constant unloading force is believed to be an important prerequisite for BWS gait therapy, where it is important to generate physiologically correct segmental dynamics and ground reaction forces. Thus, the novel BWS system presented in this paper is an important contribution to maximize the therapeutic outcome of human gait rehabilitation.

  13. Opportunities and challenges in the wider adoption of liver and interconnected microphysiological systems.

    PubMed

    Hughes, David J; Kostrzewski, Tomasz; Sceats, Emma L

    2017-01-01

    Liver disease represents a growing global health burden. The development of in vitro liver models which allow the study of disease and the prediction of metabolism and drug-induced liver injury in humans remains a challenge. The maintenance of functional primary hepatocytes cultures, the parenchymal cell of the liver, has historically been difficult with dedifferentiation and the consequent loss of hepatic function limiting utility. The desire for longer term functional liver cultures sparked the development of numerous systems, including collagen sandwiches, spheroids, micropatterned co-cultures and liver microphysiological systems. This review will focus on liver microphysiological systems, often referred to as liver-on-a-chip, and broaden to include platforms with interconnected microphysiological systems or multi-organ-chips. The interconnection of microphysiological systems presents the opportunity to explore system level effects, investigate organ cross talk, and address questions which were previously the preserve of animal experimentation. As a field, microphysiological systems have reached a level of maturity suitable for commercialization and consequent evaluation by a wider community of users, in academia and the pharmaceutical industry. Here scientific, operational, and organizational considerations relevant to the wider adoption of microphysiological systems will be discussed. Applications in which microphysiological systems might offer unique scientific insights or enable studies currently feasible only with animal models are described, and challenges which might be addressed to enable wider adoption of the technologies are highlighted. A path forward which envisions the development of microphysiological systems in partnerships between academia, vendors and industry, is proposed. Impact statement Microphysiological systems are in vitro models of human tissues and organs. These systems have advanced rapidly in recent years and are now being

  14. Cellular Manufacturing Internet Performance Support System

    SciTech Connect

    Bohley, M.C.; Schwartz, M.E.

    1998-03-04

    The objective of this project was to develop an Internet-based electronic performance support system (EPSS) for cellular manufacturing providing hardware/software specifications, process descriptions, estimated cost savings, manufacturing simulations, training information, and service resources for government and industry users of Cincinnati Milacron machine tools and products. AlliedSignal Federal Manufacturing and Technologies (ASFM and T) used expertise in the areas of Internet design and multimedia creation to develop a performance support system (PSS) for the Internet with assistance from CM's subject matter experts from engineering, manufacturing, and technical support. Reference information was both created and re-purposed from other existing formats, then made available on the Internet. On-line references on cellular manufacturing operations include: definitions of cells and cellular manufacturing; illustrations on how cellular manufacturing improves part throughput, resource utilization, part quality, and manufacturing flexibility; illustrations on how cellular manufacturing reduces labor and overhead costs; identification of critical factors driving decisions toward cellular manufacturing; a method for identifying process improvement areas using cellular manufacturing; a method for customizing the size of cells for a specific site; a simulation for making a part using cellular manufacturing technology; and a glossary of terms and concepts.

  15. Decision support system for drinking water management

    NASA Astrophysics Data System (ADS)

    Janža, M.

    2012-04-01

    The problems in drinking water management are complex and often solutions must be reached under strict time constrains. This is especially distinct in case of environmental accidents in the catchment areas of the wells that are used for drinking water supply. The beneficial tools that can help decision makers and make program of activities more efficient are decision support systems (DSS). In general they are defined as computer-based support systems that help decision makers utilize data and models to solve unstructured problems. The presented DSS was developed in the frame of INCOME project which is focused on the long-term stable and safe drinking water supply in Ljubljana. The two main water resources Ljubljana polje and Barje alluvial aquifers are characterized by a strong interconnection of surface and groundwater, high vulnerability, high velocities of groundwater flow and pollutant transport. In case of sudden pollution, reactions should be very fast to avoid serious impact to the water supply. In the area high pressures arising from urbanization, industry, traffic, agriculture and old environmental burdens. The aim of the developed DSS is to optimize the activities in cases of emergency water management and to optimize the administrative work regarding the activities that can improve groundwater quality status. The DSS is an interactive computer system that utilizes data base, hydrological modelling, and experts' and stakeholders' knowledge. It consists of three components, tackling the different abovementioned issues in water management. The first one utilizes the work on identification, cleaning up and restoration of illegal dumpsites that are a serious threat to the qualitative status of groundwater. The other two components utilize the predictive capability of the hydrological model and scenario analysis. The user interacts with the system by a graphical interface that guides the user step-by-step to the recommended remedial measures. Consequently, the

  16. Visual Support System for Report Distinctiveness Evaluation

    NASA Astrophysics Data System (ADS)

    Sunayama, Wataru; Kawaguchi, Toshiaki

    In recent years, as the Internet has grown, electronic reports have come to be used in educational organizations such as universities. Though reports written by hand must be evaluated by hand except for stereotype descriptions or numerical answers, electronic reports can be rated by computer. There are two major criteria in rating reports, correctness and distinctiveness. Correctness is rated by absolute criteria and distinctiveness is rated by relative criteria. Relative evaluation is difficult because raters should memorize all contents of submitted reports to provide objective rates. In addition, electronic data are easily copied or exchanged by students. This paper presents a report evaluation support system with which raters can compare each report and give objective rates for distinctiveness. This system evaluates each report by objective similarity criteria and visualizes them in a two-dimensional interface as the calculated distinctiveness order. Experimental results show the system is valid and effective for estimating associations between reports.

  17. An intelligent ground operator support system

    NASA Technical Reports Server (NTRS)

    Goerlach, Thomas; Ohlendorf, Gerhard; Plassmeier, Frank; Bruege, Uwe

    1994-01-01

    This paper presents first results of the project 'Technologien fuer die intelligente Kontrolle von Raumfahrzeugen' (TIKON). The TIKON objective was the demonstration of feasibility and profit of the application of artificial intelligence in the space business. For that purpose a prototype system has been developed and implemented for the operation support of the Roentgen Satellite (ROSAT), a scientific spacecraft designed to perform the first all-sky survey with a high-resolution X-ray telescope and to investigate the emission of specific celestial sources. The prototype integrates a scheduler and a diagnosis tool both based on artificial intelligence techniques. The user interface is menu driven and provides synoptic displays for the visualization of the system status. The prototype has been used and tested in parallel to an already existing operational system.

  18. Repulsive force support system feasibility study

    NASA Technical Reports Server (NTRS)

    Boom, R. W.; Abdelsalam, M. K.; Eyssa, Y. M.; Mcintosh, G. E.

    1987-01-01

    A new concept in magnetic levitation and control is introduced for levitation above a plane. A set of five vertical solenoid magnets mounted flush below the plane supports and controls the model in five degrees of freedom. The compact system of levitation coils is contained in a space 2.4 m (96 in) diameter by 1 m (40 in) deep with the top of the levitation system 0.9 m (36 in) below the center line of the suspended model. The levitated model has a permanent magnet core held in position by the five parallel superconductive solenoids symmetrically located in a circle. The control and positioning system continuously corrects for model position in five dimensions using computer current pulses superimposed on the levitation coil base currents. The conceptual designs include: superconductive and Nd-Fe-B permanent magnet model cores and levitation solenoids of either superconductive, cryoresistive, or room temperature windings.

  19. Liver Metastasectomy and Systemic Therapy Improve Overall Survival Compared With Surgery Alone After Curative Liver Resection of Colorectal Metastases in a Developing Country (Costa Rica)

    PubMed Central

    Quesada-Soto, Paula; Landaverde, Denis

    2017-01-01

    Background Resection of liver-isolated metastases of colorectal cancer (CRC) offers the greatest likelihood of cure. Nevertheless, recurrence rates after this procedure are high, and chemotherapy is a reasonable choice with inconclusive evidence. We aimed to determine if there is a survival difference between patients receiving systemic therapy with surgery versus surgery alone for resection of liver metastases. Methods From a source population of 170 patients treated in our National Centre (Centro Nacional de Cirugía Hepatobiliar, San José, Costa Rica), with liver metastases from various primary sites, we selected 51 patients with CRC who underwent hepatic resection with curative intent. We categorized patients according to the treatment received (fluoropyrimidine-based chemotherapy plus or minus monoclonal antibody and surgery v surgery alone) and then calculated the overall survival (OS) rate according to the Kaplan-Meier method. A Cox proportional hazard model was used to assess the influence of potential confounding variables on OS. Results After a median follow-up of 41.6 months, OS was significantly better for patients treated with systemic therapy (before and/or after hepatic resection) versus surgery alone (3-year OS: 66.7% v 41.7%; hazard ratio, 0.37; 95% CI, 0.15 to 0.91; log-rank test: P = .025). There were no differences among patients who underwent neoadjuvant (48.7%), perioperative (46.2%), and adjuvant therapy (5.1%). The use of systemic therapy was significantly associated with better OS after adjustment for confounding variables (hazard ratio, 0.23; 95% CI, 0.07 to 0.92; P = .03). Conclusion Our findings support the use of systemic therapy (either perioperative, neoadjuvant, or adjuvant) as part of isolated hepatic metastasectomy from CRC. PMID:28717739

  20. Information Systems to Support Communication for Citizens

    NASA Astrophysics Data System (ADS)

    Nishida, Shogo; Ito, Kyoko; Nakatani, Mie

    Today it is pointed out that social acceptance of new science & technology should be decided not only by the experts but also by citizens, because new science & technology gives great affects on the daily life of citizens. This paper deals with information systems to support communication for citizens. Here the communication for citizens is divided into two aspects of communication, dialogue with citizens and information presentation to citizens. First, the problems of communication for citizens are analyzed and the methods and approaches to cope with the problems are investigated. Then, research projects to enhance this type of communication are introduced concretely. We believe the importance of communication support for citizens will be increased in near future.

  1. Efficacy of fractionated plasma separation and adsorption system (Prometheus) for treatment of liver failure due to mushroom poisoning.

    PubMed

    Vardar, Rukiye; Gunsar, Fulya; Ersoz, Galip; Akarca, Ulus Salih; Karasu, Zeki

    2010-01-01

    Consuming wild mushrooms is an ordinary habit in late summer and autumn in our region. Every year, several cases of hepatic toxicity secondary to mushroom poisoning are observed because of poor identification of the mushrooms. Unfortunately some of them are fatal. Prometheus system is a newly developed extracorporeal liver support device for fractionated plasma separation and adsorption (FPSA) that enables removal of albumin-bound and water-soluble toxins. Therefore, it may be a promising treatment option for patients with liver failure due to mushroom poisoning. We studied 8 patients with mushroom poisoning. All patients underwent 1 to 4 consecutive FPSA (Prometheus)-system in addition to medical and supportive treatment such as fluid replacement, Penicillin G, N-acetylcysteine (NAC) and silymarin. A variety of clinical and biochemical parameters were assessed. We had improvement of the biochemical parameters after first treatment with FPSA-system. Seven of 8 patients survived and were discharged to resume an independent life. One patient who had grade III encephalopathy when admitted to hospital died. No major adverse events were observed during the application of this therapy modality. FPSA-system may be a safe and effective treatment option for patient with mushroom poisoning. Early hospitalization is essential in order to be successful. Controlled studies are needed to evaluate the efficacy of this new treatment choice on survival of patients with acute liver failure (ALF) due to mushroom poisoning.

  2. Controlled Ecological Life Support System: Regenerative Life Support Systems in Space

    NASA Technical Reports Server (NTRS)

    Macelroy, Robert D.; Smernoff, David T.

    1987-01-01

    A wide range of topics related to the extended support of humans in space are covered. Overviews of research conducted in Japan, Europe, and the U.S. are presented. The methods and technologies required to recycle materials, especially respiratory gases, within a closed system are examined. Also presented are issues related to plant and algal productivity, efficiency, and processing methods. Computer simulation of closed systems, discussions of radiation effects on systems stability, and modeling of a computer bioregenerative system are also covered.

  3. Decision support system and medical liability.

    PubMed Central

    Allaërt, F. A.; Dusserre, L.

    1992-01-01

    Expert systems, which are going to be an essential tool in Medicine, are evolving in terms of sophistication of both knowledge representation and types of reasoning models used. The more efficient they are, the more often they will be used and professional liability will be involved. So after giving a short survey of configuration and working of expert systems, the authors will study the liabilities of people building and the using expert systems regarding some various dysfunctions. Of course the expert systems have to be considered only for human support and they should not possess any authority themselves, therefore the doctors must keep in mind that it is their own responsibility and as such keep their judgment and criticism. However other professionals could be involved, if they have participated in the building of expert systems. The different liabilities and the burden of proof are discussed according to some possible dysfunctions. In any case the final proof is inside the expert system by itself through re-computation of data. PMID:1482972

  4. Advanced integrated life support system update

    NASA Technical Reports Server (NTRS)

    Whitley, Phillip E.

    1994-01-01

    The Advanced Integrated Life Support System Program (AILSS) is an advanced development effort to integrate the life support and protection requirements using the U.S. Navy's fighter/attack mission as a starting point. The goal of AILSS is to optimally mate protection from altitude, acceleration, chemical/biological agent, thermal environment (hot, cold, and cold water immersion) stress as well as mission enhancement through improved restraint, night vision, and head-mounted reticules and displays to ensure mission capability. The primary emphasis to date has been to establish garment design requirements and tradeoffs for protection. Here the garment and the human interface are treated as a system. Twelve state-off-the-art concepts from government and industry were evaluated for design versus performance. On the basis of a combination of centrifuge, thermal manikin data, thermal modeling, and mobility studies, some key design parameters have been determined. Future efforts will concentrate on the integration of protection through garment design and the use of a single layer, multiple function concept to streamline the garment system.

  5. Advanced integrated life support system update

    NASA Technical Reports Server (NTRS)

    Whitley, Phillip E.

    1994-01-01

    The Advanced Integrated Life Support System Program (AILSS) is an advanced development effort to integrate the life support and protection requirements using the U.S. Navy's fighter/attack mission as a starting point. The goal of AILSS is to optimally mate protection from altitude, acceleration, chemical/biological agent, thermal environment (hot, cold, and cold water immersion) stress as well as mission enhancement through improved restraint, night vision, and head-mounted reticules and displays to ensure mission capability. The primary emphasis to date has been to establish garment design requirements and tradeoffs for protection. Here the garment and the human interface are treated as a system. Twelve state-off-the-art concepts from government and industry were evaluated for design versus performance. On the basis of a combination of centrifuge, thermal manikin data, thermal modeling, and mobility studies, some key design parameters have been determined. Future efforts will concentrate on the integration of protection through garment design and the use of a single layer, multiple function concept to streamline the garment system.

  6. Bone marrow transplantation concurrently reconstitutes donor liver and immune system across host species barrier in mice.

    PubMed

    Qi, Ziping; Li, Lu; Wang, Xuefu; Gao, Xiang; Wang, Xin; Wei, Haiming; Zhang, Jian; Sun, Rui; Tian, Zhigang

    2014-01-01

    Liver immunopathologic mechanisms during hepatotropic infection, malignant transformation, and autoimmunity are still unclear. Establishing a chimeric mouse with a reconstituted liver and immune system derived from a single donor across species is critical to study regional donor immune responses in recipient liver. Using a strain of mice deficient in tyrosine catabolic enzyme fumarylacetoacetate hydrolase (fah-/-) and bone marrow transplantation (BMT), we reconstituted the donor's hepatocytes and immune cells across host species barrier. Syngeneic, allogeneic or even xenogeneic rat BMT rescued most recipient fah-/- mice against liver failure by donor BM-derived FAH+ hepatocytes. Importantly, immune system developed normally in chimeras, and the immune cells together with organ architecture were intact and functional. Thus, donor BM can across host species barrier and concurrently reconstitutes MHC-identical response between immune cells and hepatocytes, giving rise to a new simple and convenient small animal model to study donor's liver immune response in mice.

  7. Bone Marrow Transplantation Concurrently Reconstitutes Donor Liver and Immune System across Host Species Barrier in Mice

    PubMed Central

    Qi, Ziping; Li, Lu; Wang, Xuefu; Gao, Xiang; Wang, Xin; Wei, Haiming; Zhang, Jian; Sun, Rui; Tian, Zhigang

    2014-01-01

    Liver immunopathologic mechanisms during hepatotropic infection, malignant transformation, and autoimmunity are still unclear. Establishing a chimeric mouse with a reconstituted liver and immune system derived from a single donor across species is critical to study regional donor immune responses in recipient liver. Using a strain of mice deficient in tyrosine catabolic enzyme fumarylacetoacetate hydrolase (fah-/-) and bone marrow transplantation (BMT), we reconstituted the donor's hepatocytes and immune cells across host species barrier. Syngeneic, allogeneic or even xenogeneic rat BMT rescued most recipient fah-/- mice against liver failure by donor BM-derived FAH+ hepatocytes. Importantly, immune system developed normally in chimeras, and the immune cells together with organ architecture were intact and functional. Thus, donor BM can across host species barrier and concurrently reconstitutes MHC-identical response between immune cells and hepatocytes, giving rise to a new simple and convenient small animal model to study donor's liver immune response in mice. PMID:25191899

  8. A Flexible Nurse Scheduling Support System

    PubMed Central

    Ozkarahan, Irem

    1987-01-01

    Scheduling nursing personnel in hospitals is very complex because of the variety of conflicting interests and objectives. Also, demand varies 24-hour a day 7-day a week, is skill specific and hard to forecast. In the face of this complexity, the present nurse scheduling models have met with little success. In this paper, we propose a more flexible decision support system that will satisfy the interests of both hospitals and nurses through alternative models that attempt to accommodate flexible work patterns as it integrates time of the day (TOD) and day of the week (DOW) scheduling problems.

  9. Space transportation system biomedical operations support study

    NASA Technical Reports Server (NTRS)

    White, S. C.

    1983-01-01

    The shift of the Space Transportation System (STS) flight tests of the orbiter vehicle to the preparation and flight of the payloads is discussed. Part of this change is the transition of the medical and life sciences aspects of the STS flight operations to reflect the new state. The medical operations, the life sciences flight experiments support requirements and the intramural research program expected to be at KSC during the operational flight period of the STS and a future space station are analyzed. The adequacy of available facilities, plans, and resources against these future needs are compared; revisions and/or alternatives where appropriate are proposed.

  10. Hollow fiber membrane systems for advanced life support systems

    NASA Technical Reports Server (NTRS)

    Roebelen, G. J., Jr.; Lysaght, M. J.

    1976-01-01

    The practicability of utilizing hollow fiber membranes in vehicular and portable life support system applications is described. A preliminary screening of potential advanced life support applications resulted in the selection of five applications for feasibility study and testing. As a result of the feasibility study and testing, three applications, heat rejection, deaeration, and bacteria filtration, were chosen for breadboard development testing; breadboard hardware was manufactured and tested, and the physical properties of the hollow fiber membrane assemblies are characterized.

  11. Development of liver cell-targeted drug delivery systems: experimental approaches

    NASA Astrophysics Data System (ADS)

    Ivanenkov, Ya A.; Maklakova, S. Yu; Beloglazkina, E. K.; Zyk, N. V.; Nazarenko, A. G.; Tonevitsky, A. G.; Kotelianski, V. E.; Majouga, A. G.

    2017-08-01

    The review is devoted to liver cell-targeted drug delivery systems. Primary attention is paid to the therapy of hepatocellular carcinoma, liver fibrosis, liver cirrhosis, viral hepatitis (A-G), cholangiocarcinoma, autoimmune liver diseases and some metabolic disorders. A general overview, modern classification and specific features of drug delivery systems are presented. The key characteristics and parameters of these systems and their advantages and restrictions for clinical applications are discussed. A considerable body of information is presented as summary tables convenient for perception and comparison. The data presented are critically analyzed and an expert evaluation of the therapeutic potential of the drug delivery systems in question is given. Discussion of invasive local delivery approaches, transmembrane systems and implants, as well as prodrugs is beyond the scope of the review, except for a few examples. The bibliography includes 344 references.

  12. The Role of the Apelin/APJ System in the Regulation of Liver Disease

    PubMed Central

    Lv, Xinrui; Kong, Jing; Chen, Wei-Dong; Wang, Yan-Dong

    2017-01-01

    Apelin is an endogenous peptide that is a ligand for the APJ receptor (angiotensin II receptor like-1, AT-1). The apelin/APJ system is distributed in diverse periphery organ tissues. It has been shown that the apelin/APJ system plays various roles in physiology and pathophysiology of many organs. It regulates cardiovascular development or cardiac disease, glycometabolism and fat metabolism as well as metabolic disease. The apelin/APJ system participates in various cell activities such as proliferation, migration, apoptosis or inflammation. However, apelin/APJ function in the liver is still under investigation. In the liver, the apelin-APJ system could play an inhibitory role in liver regeneration and promote Fas-induced apoptosis. It may participate in the formation of hepatic fibrosis or cirrhosis, and even cancer. In this review, we summarize the role of the apelin/APJ system in liver disease. PMID:28484393

  13. The Role of the Apelin/APJ System in the Regulation of Liver Disease.

    PubMed

    Lv, Xinrui; Kong, Jing; Chen, Wei-Dong; Wang, Yan-Dong

    2017-01-01

    Apelin is an endogenous peptide that is a ligand for the APJ receptor (angiotensin II receptor like-1, AT-1). The apelin/APJ system is distributed in diverse periphery organ tissues. It has been shown that the apelin/APJ system plays various roles in physiology and pathophysiology of many organs. It regulates cardiovascular development or cardiac disease, glycometabolism and fat metabolism as well as metabolic disease. The apelin/APJ system participates in various cell activities such as proliferation, migration, apoptosis or inflammation. However, apelin/APJ function in the liver is still under investigation. In the liver, the apelin-APJ system could play an inhibitory role in liver regeneration and promote Fas-induced apoptosis. It may participate in the formation of hepatic fibrosis or cirrhosis, and even cancer. In this review, we summarize the role of the apelin/APJ system in liver disease.

  14. Environmental Control and Life Support System Evolution

    NASA Technical Reports Server (NTRS)

    Wieland, Paul

    1990-01-01

    The Space Station Freedom Environmental Control and Life Support System (ECLSS) will have to accommodate the changes to Freedom as it evolves over the design life of 30 years or more. Requirements will change as pressurized modules are added, crew numbers increase, and as the tasks to be performed change. This evolution will result in different demands on the ECLSS and the ECLSS wilt have to adapt. Technologies other than the baselined ones may be better able to perform the various tasks and technological advances will result in improved life support hardware having better performance, increased reliability, reduced power consumption, weight, and volume, greater autonomy, and fewer resupply requirements. A preliminary study was performed to look at alternative technologies for life support and evaluate them for their integration requirements, focusing on the fluid line interface requirements. (A follow-on study will expand greatly on the scope of this preliminary study.) The integration requirements of the alternative technologies may be different from those of the baselined technologies. If this is the case, then by designing the initial space station to have the necessary fluid lines, etc. required by the selected alternative technologies then the task of replacing the baselined ones will be greatly simplified, thereby reducing the cost in on-orbit time as well as dollars.

  15. Donation After Circulatory Death for Liver Transplantation: A Meta-Analysis on the Location of Life Support Withdrawal Affecting Outcomes.

    PubMed

    Cao, Yiming; Shahrestani, Sara; Chew, Hong Chee; Crawford, Michael; Macdonald, Peter Simon; Laurence, Jerome; Hawthorne, Wayne John; Dhital, Kumud; Pleass, Henry

    2016-07-01

    Liver transplantation using donation after circulatory death (DCD) donors is associated with inferior outcomes compared to donation after brain death (DBD). Prolonged donor warm ischemic time has been identified as the key factor responsible for this difference. Various aspects of the donor life support withdrawal procedure, including location of withdrawal and administration of antemortem heparin, are thought to play important roles in mitigating the effects of warm ischemia. However, a systematic exploration of these factors is important for more confident integration of these practices into a standard DCD protocol. Medline, EMBASE, and Cochrane libraries were systematically searched and 23 relevant studies identified for analysis. Donation after circulatory death recipients were stratified according to location of life support withdrawal (intensive care unit or operating theater) and use of antemortem heparin. Donation after circulatory death recipients had comparable 1-year patient survival to DBD recipients if the location of withdrawal of life support was the operating theater, but not if the location was the intensive care unit. Likewise, the inferior 1-year graft survival and higher incidence of ischemic cholangiopathy of DCD compared with DBD recipients were improved by withdrawal in operating theater, although higher rates of ischemic cholangiopathy and worse graft survival were still observed in DCD recipients. Furthermore, administering heparin before withdrawal of life support reduced the incidence of primary nonfunction of the allograft. Our evidence suggests that withdrawal in the operating theater and premortem heparin administration improve DCD liver transplant outcomes, thus allowing for the most effective usage of these valuable organs.

  16. Comparative effectiveness of plasma prepared with amotosalen-UVA pathogen inactivation and conventional plasma for support of liver transplantation.

    PubMed

    Cinqualbre, Jacques; Kientz, Daniel; Remy, Emilie; Huang, Norman; Corash, Laurence; Cazenave, Jean Pierre

    2015-07-01

    Liver transplant may require large-volume plasma transfusion with increased risk of transfusion-transmitted infection (TTI). Pathogen inactivation of plasma with amotosalen-UVA offers the potential to mitigate TTI risk. A retrospective cohort design was used to compare the therapeutic efficacy and key safety outcomes for liver transplants supported with quarantine plasma (Q-FFP [reference]) or amotosalen-UVA plasma (IBS plasma [test]). The outcomes evaluated were volume of plasma, the numbers of red blood cell (RBC) components, and the total dose of platelets (PLTs) transfused during and 7 days after transplant. The safety outcomes were acute hepatic artery thrombosis (HAT) and mortality. Transplantation and transfusion records for 212 Q-FFP transplants and 215 IBS plasma transplants were reviewed. Not all transplants required plasma; 161 received Q-FFP and 174 received IBS plasma. Among the transplants that required plasma, there were significant differences in median values between cohorts for delay to transplantation (p=0.002), model end-stage liver disease score (p<0.001), pretransplant hematocrit (p=0.006), and graft cold perfusion time (p=0.033). The median volumes of plasma transfused were not different for test and reference (2.160 L vs. 1.969 L, p=0.292). Transplants in the test cohort required a mean of 3.7% more RBC components (p=0.767) and on average a 16.5% increase in total PLT dose (p=0.518). No significant differences were observed for the frequency of acute HAT or mortality. In this retrospective study, IBS plasma provided therapeutic support of liver transplant not different from Q-FFP. © 2015 Cerus Corporation. Transfusion published by Wiley Periodicals, Inc. on behalf of AABB.

  17. Semantic technologies in a decision support system

    NASA Astrophysics Data System (ADS)

    Wasielewska, K.; Ganzha, M.; Paprzycki, M.; Bǎdicǎ, C.; Ivanovic, M.; Lirkov, I.

    2015-10-01

    The aim of our work is to design a decision support system based on ontological representation of domain(s) and semantic technologies. Specifically, we consider the case when Grid / Cloud user describes his/her requirements regarding a "resource" as a class expression from an ontology, while the instances of (the same) ontology represent available resources. The goal is to help the user to find the best option with respect to his/her requirements, while remembering that user's knowledge may be "limited." In this context, we discuss multiple approaches based on semantic data processing, which involve different "forms" of user interaction with the system. Specifically, we consider: (a) ontological matchmaking based on SPARQL queries and class expression, (b) graph-based semantic closeness of instances representing user requirements (constructed from the class expression) and available resources, and (c) multicriterial analysis based on the AHP method, which utilizes expert domain knowledge (also ontologically represented).

  18. A Framework for Classifying Decision Support Systems

    PubMed Central

    Sim, Ida; Berlin, Amy

    2003-01-01

    Background Computer-based clinical decision support systems (CDSSs) vary greatly in design and function. A taxonomy for classifying CDSS structure and function would help efforts to describe and understand the variety of CDSSs in the literature, and to explore predictors of CDSS effectiveness and generalizability. Objective To define and test a taxonomy for characterizing the contextual, technical, and workflow features of CDSSs. Methods We retrieved and analyzed 150 English language articles published between 1975 and 2002 that described computer systems designed to assist physicians and/or patients with clinical decision making. We identified aspects of CDSS structure or function and iterated our taxonomy until additional article reviews did not result in any new descriptors or taxonomic modifications. Results Our taxonomy comprises 95 descriptors along 24 descriptive axes. These axes are in 5 categories: Context, Knowledge and Data Source, Decision Support, Information Delivery, and Workflow. The axes had an average of 3.96 coded choices each. 75% of the descriptors had an inter-rater agreement kappa of greater than 0.6. Conclusions We have defined and tested a comprehensive, multi-faceted taxonomy of CDSSs that shows promising reliability for classifying CDSSs reported in the literature. PMID:14728243

  19. Complexity in electronic negotiation support systems.

    PubMed

    Griessmair, Michele; Strunk, Guido; Vetschera, Rudolf; Koeszegi, Sabine T

    2011-10-01

    It is generally acknowledged that the medium influences the way we communicate and negotiation research directs considerable attention to the impact of different electronic communication modes on the negotiation process and outcomes. Complexity theories offer models and methods that allow the investigation of how pattern and temporal sequences unfold over time in negotiation interactions. By focusing on the dynamic and interactive quality of negotiations as well as the information, choice, and uncertainty contained in the negotiation process, the complexity perspective addresses several issues of central interest in classical negotiation research. In the present study we compare the complexity of the negotiation communication process among synchronous and asynchronous negotiations (IM vs. e-mail) as well as an electronic negotiation support system including a decision support system (DSS). For this purpose, transcripts of 145 negotiations have been coded and analyzed with the Shannon entropy and the grammar complexity. Our results show that negotiating asynchronically via e-mail as well as including a DSS significantly reduces the complexity of the negotiation process. Furthermore, a reduction of the complexity increases the probability of reaching an agreement.

  20. Web Support System for Group Collaborative Decisions

    NASA Astrophysics Data System (ADS)

    Rigopoulos, George; Psarras, John; Askounis, Dimitrios Th.

    In this research, we present a Group Decision Support System (GDSS) based on web technology, which can be used in asynchronous mode from group members. It supports small collaborative groups in classification decisions, implementing a supervised multicriteria methodology. A facilitator, who defines necessary parameters and initiates the procedure, coordinates the entire operation. Next, members evaluate the proposed parameter set and express their preferences in numeric format. Aggregation of individuals` preferences is executed at the parameter level by utilization of OWA operator and a group parameter set is produced which is used as input for the classification algorithm. A multicriteria classification algorithm is used for the classification of actions (people, projects etc.). Finally, group members evaluate results and consensus as well as satisfaction indexes are calculated. In case of low acceptance level, parameters are redefined and aggregation phase is repeated. The system has been utilized effectively to solve group classification problems in business environment. The overall architecture as well the methodology is presented, along with a sample application. Empirical findings from GDSS application and the methodology provide evidence that it is a valid approach for similar decision problems in numerous business environments, including production, human resources and operations.

  1. Infrastructure to Support Hydrologic Research: Information Systems

    NASA Astrophysics Data System (ADS)

    Lall, U.; Duffy, C j

    2001-12-01

    Hydrologic Sciences are inherently interdisciplinary. Consequently, a myriad state variables are of interest to hydrologists. Hydrologic processes transcend many spatial and temporal scales, and their measurements reflect a variety of scales of support. The global water cycle is continuously modified by human activity through changes in land use, alteration of rivers, irrigation and groundwater pumping and through a modification of atmospheric composition. Since water is a solvent and a medium of transport, the water cycle fundamentally influences other material and energy cycles. This metaphor extends to the function that a hydrologic research information system needs to provide, to facilitate discovery in earth systems science, and to improve our capability to manage resources and hazards in a sustainable manner. At present, we have a variety of sources that provide data useful for hydrologic analyses, that range from massive remote sensed data sets, to sparsely sampled historical and paleo data. Consequently, the first objective of the Hydrologic Information Systems (HIS) group is to design a data services system that makes these data accessible in a uniform and useful way for specific, prioritized research goals. The design will include protocols for archiving and disseminating data from the Long Term Hydrologic Observatories (LTHOs), and comprehensive modeling experiments. Hydrology has a rich tradition of mathematical and statistical modeling of processes. However, given limited data and access to it, and a narrow focus that has not exploited connections to climatic and ecologic processes (among others), there have been only a few forays into diagnostic analyses of hydrologic fields, to identify and evaluate spatial and process teleconnections and an appropriate reduced space for modeling and understanding systems. The HIS initiative consequently proposes an investment in research and the provision of toolboxes to facilitate such analyses using the data

  2. Development of coaxial ultrasonic probe for fatty liver diagnostic system using ultrasonic velocity change

    NASA Astrophysics Data System (ADS)

    Hori, Makoto; Yokota, Daiki; Aotani, Yuhei; Kumagai, Yuta; Wada, Kenji; Matsunaka, Toshiyuki; Morikawa, Hiroyasu; Horinaka, Hiromichi

    2017-07-01

    A diagnostic system for fatty liver at an early stage is needed because fatty liver is linked to metabolic syndrome. We have already proposed a fatty liver diagnosis method based on the temperature coefficient of ultrasonic velocity. In this study, we fabricated a coaxial ultrasonic probe by integrating two kinds of transducers for warming and signal detection. The diagnosis system equipped with the coaxial probe was applied to tissue-mimicking phantoms including the fat area. The fat content rates corresponding to the set rates of the phantoms were estimated by the ultrasonic velocity-change method.

  3. Creation of closed life support systems

    NASA Astrophysics Data System (ADS)

    Gitelson, I.

    The 40-year-long experience in devising ecological systems with a significantly closed material cycling (CES), which are intended for human life support outside the Earth's biosphere, allows us to state that this problem has been largely solved technically. To test the terrestrial prototypes of these systems: Bios in Krasnoyarsk, the Terrestrial Ecological System (TES) in Moscow, and Bioplex in Houston, crews of humans stayed inside them over long periods of time. In Bios-3 humans could be fully (100%) provided with regenerated air and water and with a vegetable part (80%) of their diet. One human requires 4.5 kW of light energy, which is equal to the light energy incident on an 8-m2 surface perpendicular to solar rays in the Earth's orbit. The regeneration of air and water can be alternatively performed by a 17-L2 microalgal cultivator with a light-receiving surface of 8 m at 2 kW of light energy or by a conveyer culture of agricultural plants. To regenerate the vegetable part of2 the diet to the full, the area must increase to 31.5 m per person. Similar values have been obtained in the TES and in Bioplex. It can be concluded that the system is ready to be implemented in the engineering-technical designs of specific versions: for orbital flights, for missions to Mars and other planets, and for stations on the Moon and Mars. To improve the CES further, a number of new key problems should be resolved. The first of them are: to robotize the technological processes and to establish an optimized system of the internal control of the CES by the crew working in it; to develop a hybrid physicochemical-biological technology for returning the dead-end products of biosynthesis into the system's cycling; to solve the fundamental problem of regenerating the human ration completely inside the CES by the autotrophic chemo - and photosynthesis. Once this problem is solved, the energy requirements for life support in space will be significantly reduced. This will also considerably

  4. A web-based computer aided system for liver surgery planning: initial implementation on RayPlus

    NASA Astrophysics Data System (ADS)

    Luo, Ming; Yuan, Rong; Sun, Zhi; Li, Tianhong; Xie, Qingguo

    2016-03-01

    At present, computer aided systems for liver surgery design and risk evaluation are widely used in clinical all over the world. However, most systems are local applications that run on high-performance workstations, and the images have to processed offline. Compared with local applications, a web-based system is accessible anywhere and for a range of regardless of relative processing power or operating system. RayPlus (http://rayplus.life.hust.edu.cn), a B/S platform for medical image processing, was developed to give a jump start on web-based medical image processing. In this paper, we implement a computer aided system for liver surgery planning on the architecture of RayPlus. The system consists of a series of processing to CT images including filtering, segmentation, visualization and analyzing. Each processing is packaged into an executable program and runs on the server side. CT images in DICOM format are processed step by to interactive modeling on browser with zero-installation and server-side computing. The system supports users to semi-automatically segment the liver, intrahepatic vessel and tumor from the pre-processed images. Then, surface and volume models are built to analyze the vessel structure and the relative position between adjacent organs. The results show that the initial implementation meets satisfactorily its first-order objectives and provide an accurate 3D delineation of the liver anatomy. Vessel labeling and resection simulation are planned to add in the future. The system is available on Internet at the link mentioned above and an open username for testing is offered.

  5. Engineering functional two- and three-dimensional liver systems in vivo using hepatic tissue sheets.

    PubMed

    Ohashi, Kazuo; Yokoyama, Takashi; Yamato, Masayuki; Kuge, Hiroyuki; Kanehiro, Hiromichi; Tsutsumi, Masahiro; Amanuma, Toshihiro; Iwata, Hiroo; Yang, Joseph; Okano, Teruo; Nakajima, Yoshiyuki

    2007-07-01

    Hepatic tissue engineering using primary hepatocytes has been considered a valuable new therapeutic modality for several classes of liver diseases. Recent progress in the development of clinically feasible liver tissue engineering approaches, however, has been hampered mainly by insufficient cell-to-cell contact of the engrafted hepatocytes. We developed a method to engineer a uniformly continuous sheet of hepatic tissue using isolated primary hepatocytes cultured on temperature-responsive surfaces. Sheets of hepatic tissue transplanted into the subcutaneous space resulted in efficient engraftment to the surrounding cells, with the formation of two-dimensional hepatic tissues that stably persisted for longer than 200 d. The engineered hepatic tissues also showed several characteristics of liver-specific functionality. Additionally, when the hepatic tissue sheets were layered in vivo, three-dimensional miniature liver systems having persistent survivability could be also engineered. This technology for liver tissue engineering is simple, minimally invasive and free of potentially immunogenic biodegradable scaffolds.

  6. Evaluation of a hybrid artificial liver module based on a spheroid culture system of embryonic stem cell-derived hepatic cells.

    PubMed

    Mizumoto, Hiroshi; Hayashi, Shunsuke; Matsumoto, Kinya; Ikeda, Kaoru; Kusumi, Tomoaki; Inamori, Masakazu; Nakazawa, Kohji; Ijima, Hiroyuki; Funatsu, Kazumori; Kajiwara, Toshihisa

    2012-01-01

    Hybrid artificial liver (HAL) is an extracorporeal circulation system comprised of a bioreactor containing immobilized functional liver cells. It is expected to not only serve as a temporary liver function support system, but also to accelerate liver regeneration in recovery from hepatic failure. One of the most difficult problems in developing a hybrid artificial liver is obtaining an adequate cell source. In this study, we attempt to differentiate embryonic stem (ES) cells by hepatic lineage using a polyurethane foam (PUF)/spheroid culture in which the cultured cells spontaneously form spherical multicellular aggregates (spheroids) in the pores of the PUF. We also demonstrate the feasibility of the PUF-HAL system by comparing ES cells to primary hepatocytes in in vitro and ex vivo experiments. Mouse ES cells formed multicellular spheroids in the pores of PUF. ES cells expressed liver-specific functions (ammonia removal and albumin secretion) after treatment with the differentiation-promoting agent, sodium butyrate (SB). We designed a PUF-HAL module comprised of a cylindrical PUF block with many medium-flow capillaries for hepatic differentiation of ES cells. The PUF-HAL module cells expressed ammonia removal and albumin secretion functions after 2 weeks of SB culture. Because of high proliferative activity of ES cells and high cell density, the maximum expression level of albumin secretion function per unit volume of module was comparable to that seen in primary mouse hepatocyte culture. In the animal experiments with rats, the PUF-HAL differentiating ES cells appeared to partially contribute to recovery from liver failure. This outcome indicates that the PUF module containing differentiating ES cells may be a useful biocomponent of a hybrid artificial liver support system.

  7. NASA Advanced Explorations Systems: Advancements in Life Support Systems

    NASA Technical Reports Server (NTRS)

    Shull, Sarah A.; Schneider, Walter F.

    2016-01-01

    The NASA Advanced Exploration Systems (AES) Life Support Systems (LSS) project strives to develop reliable, energy-efficient, and low-mass spacecraft systems to provide environmental control and life support systems (ECLSS) critical to enabling long duration human missions beyond low Earth orbit (LEO). Highly reliable, closed-loop life support systems are among the capabilities required for the longer duration human space exploration missions assessed by NASA's Habitability Architecture Team (HAT). The LSS project is focused on four areas: architecture and systems engineering for life support systems, environmental monitoring, air revitalization, and wastewater processing and water management. Starting with the international space station (ISS) LSS systems as a point of departure (where applicable), the mission of the LSS project is three-fold: 1. Address discrete LSS technology gaps 2. Improve the reliability of LSS systems 3. Advance LSS systems towards integrated testing on the ISS. This paper summarized the work being done in the four areas listed above to meet these objectives. Details will be given on the following focus areas: Systems Engineering and Architecture- With so many complex systems comprising life support in space, it is important to understand the overall system requirements to define life support system architectures for different space mission classes, ensure that all the components integrate well together and verify that testing is as representative of destination environments as possible. Environmental Monitoring- In an enclosed spacecraft that is constantly operating complex machinery for its own basic functionality as well as science experiments and technology demonstrations, it's possible for the environment to become compromised. While current environmental monitors aboard the ISS will alert crew members and mission control if there is an emergency, long-duration environmental monitoring cannot be done in-orbit as current methodologies

  8. Drug-induced Liver Injury

    PubMed Central

    David, Stefan; Hamilton, James P

    2011-01-01

    Drug-induced liver injury (DILI) is common and nearly all classes of medications can cause liver disease. Most cases of DILI are benign, and improve after drug withdrawal. It is important to recognize and remove the offending agent as quickly as possible to prevent the progression to chronic liver disease and/or acute liver failure. There are no definite risk factors for DILI, but pre-existing liver disease and genetic susceptibility may predispose certain individuals. Although most patients have clinical symptoms that are identical to other liver diseases, some patients may present with symptoms of systemic hypersensitivity. Treatment of drug and herbal-induced liver injury consists of rapid drug discontinuation and supportive care targeted to alleviate unwanted symptoms. PMID:21874146

  9. Does rooibos tea (Aspalathus linearis) support regeneration of rat liver after intoxication by carbon tetrachloride?

    PubMed

    Ulicná, O; Vancová, O; Waczulíková, I; Bozek, P; Janega, P; Babál, P; Lísková, S; Greksák, M

    2008-09-01

    This study evaluates the effect of rooibos tea (RT, Aspalathus linearis) on biochemical and histological parameters during rat liver regeneration after intoxication by carbon tetrachloride (CCl4). From the 10th week, when the administration of CCl4 was terminated, the liver tissue began to regenerate. Seven days later in the regeneration phase, the animals treated by RT during whole period of the experiment, and those which drunk RT only during the regeneration period, exhibited a trend for decrease in the activity of alanine aminotransferase and significant decrease in the activity of aspartate aminotransferase and in total bilirubin content when compared with the water-drinking group. At the same time, the concentration of plasma albumin was elevated and that of tissue malondialdehyde decreased in the both groups drinking RT. After 42 days of regeneration, all biochemical parameters in all three groups reached the level of control healthy animals. In both groups treated with RT, the extent of fibrotic tissue was lower than in the group which received water. We conclude that RT can be recommended not only for the prevention but also as a co-adjuvant for the therapy of liver diseases.

  10. ESRP2 controls an adult splicing programme in hepatocytes to support postnatal liver maturation

    PubMed Central

    Bhate, Amruta; Parker, Darren J.; Bebee, Thomas W.; Ahn, Jaegyoon; Arif, Waqar; Rashan, Edrees H.; Chorghade, Sandip; Chau, Anthony; Lee, Jae-Hyung; Anakk, Sayeepriyadarshini; Carstens, Russ P.; Xiao, Xinshu; Kalsotra, Auinash

    2015-01-01

    Although major genetic networks controlling early liver specification and morphogenesis are known, the mechanisms responsible for postnatal hepatic maturation are poorly understood. Here we employ global analyses of the mouse liver transcriptome to demonstrate that postnatal remodelling of the liver is accompanied by large-scale transcriptional and post-transcriptional transitions that are cell-type-specific and temporally coordinated. Combining detailed expression analyses with gain- and loss-of-function studies, we identify epithelial splicing regulatory protein 2 (ESRP2) as a conserved regulatory factor that controls the neonatal-to-adult switch of ∼20% of splice isoforms in mouse and human hepatocytes. The normal shift in splicing coincides tightly with dramatic postnatal induction of ESRP2 in hepatocytes. We further demonstrate that forced expression of ESRP2 in immature mouse and human hepatocytes is sufficient to drive a reciprocal shift in splicing and causes various physiological abnormalities. These findings define a direct role for ESRP2 in the generation of conserved repertoires of adult splice isoforms that facilitate terminal differentiation and maturation of hepatocytes. PMID:26531099

  11. The use Prometheus FPSA system in the treatment of acute liver failure: preliminary results.

    PubMed

    Skwarek, A; Grodzicki, M; Nyckowski, P; Kotulski, M; Zieniewicz, K; Michalowicz, B; Patkowski, W; Grzelak, I; Paczkowska, A; Giercuszkiewicz, D; Sańko-Resmer, J; Paczek, L; Krawczyk, M

    2006-01-01

    The preliminary outcomes of patients with acute liver failure treated with the Prometheus Fractionated Plasma Separation and Absorption (FPSA) system are presented herein. The procedures were performed in 13 patients (4, intoxication by Amanita phalloides; 4, unknown reason; 3, acetaminophen intoxication; 1, Wilson disease, and 1, liver insufficiency after hemihepatectomy owing to metastases of colon adenocarcinoma). The patients were qualified for the procedure according to the King's College Hospital criteria. The patients' general status was assessed on basic of GCS, UNOS, and the 4-grade encephalopathy classifications. The procedures were performed with the Prometheus 4008H Fresenius Medical Care unit. The 29 procedures were of mean duration 6.5 hours. There were statistically significant reductions in total bilirubin, ammonia, and aminotransferase levels. In addition, the procedures corrected water, mineral, and carbohydrate disorders. One patient did not require liver transplantation. Seven patients received liver transplants: three patients with positive outcomes; two died due to septicemia within 30 days perioperatively, one died at 6 months after OLT owing to respiratory failure; and one, owing to hemorrhagic diathesis. Four patients did not receive a liver transplant because of lack of a organ, no consent for the surgery, or neoplastic disease with metastases. The Prometheus FPSA-System was an effective detoxication method for patients with acute liver failure. The system was useful as a symptomatic treatment before liver transplantation allowing a longer wait for a graft.

  12. Launch Processing System - A system to support the Space Shuttle

    NASA Technical Reports Server (NTRS)

    Paul, H. C.

    1975-01-01

    Kennedy Space Center (KSC) is designing and acquiring a Launch Processing System (LPS), an important part of Ground Support Equipment (GSE), to Support launch site operations in a more efficient way than was done on previous programs. LPS will provide (1) automatic control of GSE and Shuttle systems for test and operations, (2) real time data analysis and information display, and (3) efficient recall of test data and engineering files to support Shuttle ground operations. Modern automation techniques, off-the-shelf components, and modular design are being employed to the maximum to achieve these goals. The cost of acquisition, operations, and maintenance of LPS is of great importance and is considered with each engineering trade.

  13. Knowledge-based systems and NASA's software support environment

    NASA Technical Reports Server (NTRS)

    Dugan, Tim; Carmody, Cora; Lennington, Kent; Nelson, Bob

    1990-01-01

    A proposed role for knowledge-based systems within NASA's Software Support Environment (SSE) is described. The SSE is chartered to support all software development for the Space Station Freedom Program (SSFP). This includes support for development of knowledge-based systems and the integration of these systems with conventional software systems. In addition to the support of development of knowledge-based systems, various software development functions provided by the SSE will utilize knowledge-based systems technology.

  14. Development of Reliable Life Support Systems

    NASA Technical Reports Server (NTRS)

    Carter, Layne

    2017-01-01

    The life support systems on the International Space Station (ISS) are the culmination of an extensive effort encompassing development, design, and test to provide the highest possible confidence in their operation on ISS. Many years of development testing are initially performed to identify the optimum technology and the optimum operational approach. The success of this development program depends on the accuracy of the system interfaces. The critical interfaces include the specific operational environment, the composition of the waste stream to be processed and the quality of the product. Once the development program is complete, a detailed system schematic is built based on the specific design requirements, followed by component procurement, assembly, and acceptance testing. A successful acceptance test again depends on accurately simulating the anticipated environment on ISS. The ISS Water Recovery System (WRS) provides an excellent example of where this process worked, as well as lessons learned that can be applied to the success of future missions. More importantly, ISS has provided a test bed to identify these design issues. Mechanical design issues have included an unreliable harmonic drive train in the Urine Processor's fluids pump, and seals in the Water Processor's Catalytic Reactor with insufficient life at the operational temperature. Systems issues have included elevated calcium in crew urine (due to microgravity effect) that resulted in precipitation at the desired water recovery rate, and the presence of an organosilicon compound (dimethylsilanediol) in the condensate that is not well removed by the water treatment process. Modifications to the WRS to address these issues are either complete (and now being evaluated on ISS) or are currently in work to insure the WRS has the required reliability before embarking on a mission to Mars.

  15. Embedded systems for supporting computer accessibility.

    PubMed

    Mulfari, Davide; Celesti, Antonio; Fazio, Maria; Villari, Massimo; Puliafito, Antonio

    2015-01-01

    Nowadays, customized AT software solutions allow their users to interact with various kinds of computer systems. Such tools are generally available on personal devices (e.g., smartphones, laptops and so on) commonly used by a person with a disability. In this paper, we investigate a way of using the aforementioned AT equipments in order to access many different devices without assistive preferences. The solution takes advantage of open source hardware and its core component consists of an affordable Linux embedded system: it grabs data coming from the assistive software, which runs on the user's personal device, then, after processing, it generates native keyboard and mouse HID commands for the target computing device controlled by the end user. This process supports any operating system available on the target machine and it requires no specialized software installation; therefore the user with a disability can rely on a single assistive tool to control a wide range of computing platforms, including conventional computers and many kinds of mobile devices, which receive input commands through the USB HID protocol.

  16. Suspension system for gimbal supported scanning payloads

    NASA Technical Reports Server (NTRS)

    Polites, Michael E. (Inventor)

    1995-01-01

    Gimballed scanning devices or instruments are the subject of this invention. Scanning is an important aspect of space science. To achieve a scan pattern some means must be provided which impart to the payload an oscillatory motion. Various forms of machines have been employed for controllably conferring on scanning instruments predetermined scan patterns. They include control moment gyroscopes, reaction wheels, torque motors, reaction control systems, and the like. But rotating unbalanced mass (RUM) devices are a new and efficient way to generate scans in gimballed payloads. RUM devices are superior to previous scanning apparatus, but they require power consuming and frequently complex auxiliary control systems to position and reposition the particular scan pattern relative to a target or a number of targets. Herein the control system is simplified. The most frequently employed method for achieving the various scan patterns is to gimbal the scanning device. Gimbals are suspended in such a way that they can be activated to generate the scan pattern. The suspension means described is for payloads supported in gimbals wherein the payload rotation is restricted by a flex pivot so that the payload oscillates, thereby moving in a scan pattern.

  17. Suspension system for gimbal supported scanning payloads

    NASA Astrophysics Data System (ADS)

    Polites, Michael E.

    1995-03-01

    Gimballed scanning devices or instruments are the subject of this invention. Scanning is an important aspect of space science. To achieve a scan pattern some means must be provided which impart to the payload an oscillatory motion. Various forms of machines have been employed for controllably conferring on scanning instruments predetermined scan patterns. They include control moment gyroscopes, reaction wheels, torque motors, reaction control systems, and the like. But rotating unbalanced mass (RUM) devices are a new and efficient way to generate scans in gimballed payloads. RUM devices are superior to previous scanning apparatus, but they require power consuming and frequently complex auxiliary control systems to position and reposition the particular scan pattern relative to a target or a number of targets. Herein the control system is simplified. The most frequently employed method for achieving the various scan patterns is to gimbal the scanning device. Gimbals are suspended in such a way that they can be activated to generate the scan pattern. The suspension means described is for payloads supported in gimbals wherein the payload rotation is restricted by a flex pivot so that the payload oscillates, thereby moving in a scan pattern.

  18. Optimization of life support systems and their systems reliability

    NASA Technical Reports Server (NTRS)

    Fan, L. T.; Hwang, C. L.; Erickson, L. E.

    1971-01-01

    The identification, analysis, and optimization of life support systems and subsystems have been investigated. For each system or subsystem that has been considered, the procedure involves the establishment of a set of system equations (or mathematical model) based on theory and experimental evidences; the analysis and simulation of the model; the optimization of the operation, control, and reliability; analysis of sensitivity of the system based on the model; and, if possible, experimental verification of the theoretical and computational results. Research activities include: (1) modeling of air flow in a confined space; (2) review of several different gas-liquid contactors utilizing centrifugal force: (3) review of carbon dioxide reduction contactors in space vehicles and other enclosed structures: (4) application of modern optimal control theory to environmental control of confined spaces; (5) optimal control of class of nonlinear diffusional distributed parameter systems: (6) optimization of system reliability of life support systems and sub-systems: (7) modeling, simulation and optimal control of the human thermal system: and (8) analysis and optimization of the water-vapor eletrolysis cell.

  19. Continuous reporting of new cases in Spain supports the relationship between Herbalife® products and liver injury.

    PubMed

    Manso, Gloria; López-Rivas, Laureano; Salgueiro, M Esther; Duque, Jose M; Jimeno, Francisco J; Andrade, Raúl J; Lucena, M Isabel

    2011-10-01

    Previous publications have linked Herbalife® products to hepatotoxicity. The identification of earlier cases in which the culprit agent could not be established raised the hypothesis of a possible contamination of some specific batches of Herbalife products. We searched the Spanish Pharmacovigilance Centres' database of adverse reactions for reports of liver injury associated with the use of Herbalife products from 2003, when the first case was submitted, through September 2010. The search resulted in 20 reports of liver damage (mean age, 49 years; 16 women), with 12 patients (60%) requiring hospitalization. Hepatocellular damage predominated, and nine (53%) of the hepatocellular cases with bilirubin values were jaundiced, fulfilling the Hy's law criteria, which increases the risk for serious outcomes. Two patients experienced a positive rechallenge. One patient developed cirrhosis, whereas all the others recovered. Causality assessment by the Karch and Lasagna modified algorithm showed a category of definite in 1 case, probable in 14, and possible in 5. Analysis of the different Herbalife products that each patient had taken did not enable us to identify any commonly known hepatotoxic ingredient. Our results support the relationship between the consumption of Herbalife products and hepatotoxicity, underscore the concern regarding the liver-related safety of this dietary supplement, and emphasize the need to establish further regulatory measures. Copyright © 2011 John Wiley & Sons, Ltd.

  20. Composting in advanced life support systems.

    PubMed

    Atkinson, C F; Sager, J C; Alazraki, M; Loader, C

    1998-01-01

    Space missions of extended duration are currently hampered by the prohibitive costs of external resupply. To reduce the need for resupply, the National Aeronautics and Space Administration (NASA) is currently testing methods to recycle solid wastes, water, and air. Composting can be an integral part of a biologically based waste treatment/recycling system. Results indicate that leachate from composted plant wastes is not inhibitory to seed germination and contains sufficient inorganic minerals to support plant growth. Other solid wastes, for example kitchen (food) wastes and human solid wastes, can be composted with inedible plant residues to safely reduce the volume of the wastes and levels of microorganisms potentially pathogenic to humans. Finished compost could serve as a medium for plant growth or mushroom production.

  1. Composting in advanced life support systems

    NASA Technical Reports Server (NTRS)

    Atkinson, C. F.; Sager, J. C.; Alazraki, M.; Loader, C.

    1998-01-01

    Space missions of extended duration are currently hampered by the prohibitive costs of external resupply. To reduce the need for resupply, the National Aeronautics and Space Administration (NASA) is currently testing methods to recycle solid wastes, water, and air. Composting can be an integral part of a biologically based waste treatment/recycling system. Results indicate that leachate from composted plant wastes is not inhibitory to seed germination and contains sufficient inorganic minerals to support plant growth. Other solid wastes, for example kitchen (food) wastes and human solid wastes, can be composted with inedible plant residues to safely reduce the volume of the wastes and levels of microorganisms potentially pathogenic to humans. Finished compost could serve as a medium for plant growth or mushroom production.

  2. Technological Support for Logistics Transportation Systems

    NASA Astrophysics Data System (ADS)

    Bujak, Andrzej; Śliwa, Zdzisław; Gębczyńska, Alicja

    The modern world is changing introducing robots, remotely controlled vehicles and other crewless means of transportation to reduce people's mistakes, as the main cause of incidents and crashes during traffic. New technologies are supporting operators and drivers, and according to some studies they can even replace them. Such programs as: AHS, UAH, IVBSS or MTVR are under development to improve traffic flow and its safety, to reduce traffic hazards and crashes. It is necessary to analyze such concepts and implement them boldly, including Polish logistics' companies, new programs, highways' system etc., as they will be applied in the future, so it is necessary to prepare logistics infrastructure ahead of time in order to capitalize on these improvements. The problem is quite urgent as transportation in the country must not be outdated to meet clients' expectations and to keep pace with competing foreign companies.

  3. Composting in advanced life support systems

    NASA Technical Reports Server (NTRS)

    Atkinson, C. F.; Sager, J. C.; Alazraki, M.; Loader, C.

    1998-01-01

    Space missions of extended duration are currently hampered by the prohibitive costs of external resupply. To reduce the need for resupply, the National Aeronautics and Space Administration (NASA) is currently testing methods to recycle solid wastes, water, and air. Composting can be an integral part of a biologically based waste treatment/recycling system. Results indicate that leachate from composted plant wastes is not inhibitory to seed germination and contains sufficient inorganic minerals to support plant growth. Other solid wastes, for example kitchen (food) wastes and human solid wastes, can be composted with inedible plant residues to safely reduce the volume of the wastes and levels of microorganisms potentially pathogenic to humans. Finished compost could serve as a medium for plant growth or mushroom production.

  4. Supporting Space Systems Design via Systems Dependency Analysis Methodology

    NASA Astrophysics Data System (ADS)

    Guariniello, Cesare

    assess the behavior of each system based on its internal status and on the topology of its dependencies on systems connected to it. Designers and decision makers can therefore quickly analyze and explore the behavior of complex systems and evaluate different architectures under various working conditions. The methods support educated decision making both in the design and in the update process of systems architecture, reducing the need to execute extensive simulations. In particular, in the phase of concept generation and selection, the information given by the methods can be used to identify promising architectures to be further tested and improved, while discarding architectures that do not show the required level of global features. The methods, when used in conjunction with appropriate metrics, also allow for improved reliability and risk analysis, as well as for automatic scheduling and re-scheduling based on the features of the dependencies and on the accepted level of risk. This dissertation illustrates the use of the two methods in sample aerospace applications, both in the operational and in the developmental domain. The applications show how to use the developed methodology to evaluate the impact of failures, assess the criticality of systems, quantify metrics of interest, quantify the impact of delays, support informed decision making when scheduling the development of systems and evaluate the achievement of partial capabilities. A larger, well-framed case study illustrates how the Systems Operational Dependency Analysis method and the Systems Developmental Dependency Analysis method can support analysis and decision making, at the mid and high level, in the design process of architectures for the exploration of Mars. The case study also shows how the methods do not replace the classical systems engineering methodologies, but support and improve them.

  5. Diagnostic library support system for medical practice.

    PubMed

    Grams, R R; Massey, J K; Hickey, S; Jin, Z M

    1985-12-01

    Here is a tragic case where the diagnosis was missed on three separate occasions over a 19-month period. Both terminal conditions are treatable and potentially separable if discovered and aggressively managed. It is not the intent of this presentation to criticize the evaluation of this patient, but rather to point out the need and, also, the potential benefits of an alternate approach, which could have significantly changed the course of this particular patient's evaluation. We have conducted similar analyses with other CPC cases with almost equivalent specificity. These same evaluations have been performed in a real clinical setting with live patient data. What we have learned so far we think will be extremely helpful in extending the potential application of this technology: A text-based decision support tool is only as good as its practitioner. It takes practice and training to learn to use this system effectively. There are many traps in logic, and the use of words and terms within the text must be understood to effectively utilize this tool. There are shortcuts in logical analysis which we mentally use all the time but which cannot be accepted using this system (e.g., you must not rely on your memory or any specific associations to circumvent the system). The system will only become clinically relevant when the entire field of medicine is included in the data base. This is one of our current limitations with only two-thirds of the Merck medical text available for reference. This makes it difficult to apply to a general medical problem since we are not sure which direction the case might take, and often these are multisystem diseases or problems that put us at a severe disadvantage if we don't have the necessary data base. The structure and integrity of the data base are critical to the success of the system. Since numbers are ubiquitous, these cannot be used for key word elements. Techniques must be introduced to create word-oriented numbers that can be

  6. Application of postoperative Model for End-Stage Liver Disease scoring system for evaluating liver graft function after living donor liver transplantation.

    PubMed

    Toshima, T; Ikegami, T; Kimura, K; Harimoto, N; Yamashita, Y; Yoshizumi, T; Soejima, Y; Ikeda, T; Shirabe, K; Maehara, Y

    2014-01-01

    The Model for End-Stage Liver Disease (MELD) score has been validated to predict the mortality rate of patients with various chronic liver diseases on the waiting list for liver transplantation (LT). The aim of this study was to assess the value of the postoperative MELD scoring system as an early postoperative predictor of outcome in patients undergoing living donor LT (LDLT). A retrospective analysis of 217 adult-to-adult LDLT patients was performed. The values of the MELD score on various postoperative days (PODs) as predictors of graft loss within 6 months after LDLT were examined by calculating the areas under the receiver operating characteristic (AUROC) curves. The 6-months graft survival rates were compared between patients with (n = 22) and without (n = 195) graft loss. Univariate and multivariate analyses were performed to identify the factors associated with mortality. The MELD score on POD2 was a predictor of graft loss, with an AUROC c-statistic of 0.779, a specificity of 79.5%, and a sensitivity of 68.2% at optimal cutoff, whereas the preoperative MELD score c-statistic was 0.605 with 44.6% sensitivity. Multivariate analyses for postoperative mortality revealed MELD-POD2 ≥19 (odds ratio, 5.601; 95% confidence interval [CI], 1.395-4.508; P = .0009) as an independent predictor of short-term graft loss following LDLT, in addition to preoperative hospitalization status. Later MELD POD scores were also predictive of graft loss. The early postoperative MELD scoring system is feasible as an index for prediction of postoperative mortality following LDLT. Published by Elsevier Inc.

  7. Differences in Redox Regulatory Systems in Human Lung and Liver Tumors Suggest Different Avenues for Therapy

    PubMed Central

    Tobe, Ryuta; Carlson, Bradley A.; Tsuji, Petra A.; Lee, Byeong Jae; Gladyshev, Vadim N.; Hatfield, Dolph L.

    2015-01-01

    A common characteristic of many cancer cells is that they suffer from oxidative stress. They, therefore, require effective redox regulatory systems to combat the higher levels of reactive oxygen species that accompany accelerated growth compared to the normal cells of origin. An elevated dependence on these systems in cancers suggests that targeting these systems may provide an avenue for retarding the malignancy process. Herein, we examined the redox regulatory systems in human liver and lung cancers by comparing human lung adenocarcinoma and liver carcinoma to their respective surrounding normal tissues. Significant differences were found in the two major redox systems, the thioredoxin and glutathione systems. Thioredoxin reductase 1 levels were elevated in both malignancies, but thioredoxin was highly upregulated in lung tumor and only slightly upregulated in liver tumor, while peroxiredoxin 1 was highly elevated in lung tumor, but downregulated in liver tumor. There were also major differences within the glutathione system between the malignancies and their normal tissues. The data suggest a greater dependence of liver on either the thioredoxin or glutathione system to drive the malignancy, while lung cancer appeared to depend primarily on the thioredoxin system. PMID:26569310

  8. Influence of Fasciola hepatica on Serum Biochemical Parameters and Vascular and Biliary System of Sheep Liver

    PubMed Central

    Hodžić, A; Zuko, A; Avdić, R; Alić, A; Omeragić, J; Jažić, A

    2013-01-01

    Background The aim of this study was to evaluate the functional capacity of the liver based on the activity of specific enzymes and bilirubin in serum and also to investigate the influence of mechanical and toxic effects of Fasciola hepatica on the structures of the blood vessels and biliary tract in the sheep liver. Methods Blood samples and liver of 63 indigenous sheep of Pramenka breed, slaughtered in the period from March to December 2009 were used. Based on parasitological findings in the liver, all animals were divided into two groups: control (n = 34) and infected group (n = 29). For investigation and description of pathological changes in sheep liver, naturally infected with F. hepatica, corrosion cast technique was used. Results Biochemical analysis of tested parameters showed a significant elevation (P≤0.05) of serum gamma-glutamyl transferase (GGT), total bilirubin (TBIL) and direct bilirubin (DBIL) in infected sheep group comparing with the control group. No significant differences were observed for activity of aspartate aminotranferase (AST) between groups. Vascular and biliary systems of the liver were found to be affected. Conclusion Results of biochemical analysis are consistent with pathological findings and measuring of tested parameters could be used in early diagnosis of sheep fasciolosis and to test the effectiveness of anthelmintic therapy. Corrosion cast technique is very useful for investigation of pathological changes and neoangiogenesis of vascular and biliary system in sheep liver, caused by mechanical and toxic effects of F. hepatica. PMID:23682266

  9. A systems biology approach for understanding the collagen regulatory network in alcoholic liver disease.

    PubMed

    Nieto, Natalia

    2012-02-01

    Among the pathogenesis and risk factors of alcoholic liver disease (ALD) are the source of dietary fat, obesity, insulin resistance, adipokines and acetaldehyde. Translocation of Gram-negative bacteria from the gut, the subsequent effects mediated by endotoxin, and the increased production of matricellular proteins, cytokines, chemokines and growth factors, actively participate in the progression of liver injury. In addition, generation of reactive oxygen and nitrogen species and the activation of non-parenchymal cells also contribute to the pathophysiology of ALD. A key event leading to liver damage is the transition of quiescent hepatic stellate cells into activated myofibroblasts, with the consequent deposition of fibrillar collagen I resulting in significant scarring. Thus, it is becoming clearer that matricellular proteins are critical players in the pathophysiology of liver disease; however, additional mechanistic insight is needed to understand the signalling pathways involved in the up-regulation of collagen I protein. At present, systems biology approaches are helping to answer the many unresolved questions in this field and are allowing to more comprehensively identify protein networks regulating pathological collagen I deposition in hopes of determining how to prevent the onset of liver fibrosis and/or to slow disease progression. Thus, this review article provides a snapshot on current efforts for identifying pathological protein regulatory networks in the liver using systems biology tools. These approaches hold great promise for future research in liver disease.

  10. Nuclear accumulation of seven in absentia homologue-2 supports motility and proliferation of liver cancer cells.

    PubMed

    Malz, Mona; Aulmann, Antje; Samarin, Jana; Bissinger, Michaela; Longerich, Thomas; Schmitt, Sabrina; Schirmacher, Peter; Breuhahn, Kai

    2012-11-01

    Stability of many tumor-relevant proteins is partly mediated by E3 ligases, which determine substrate specificity within the ubiquitin system. Recent data demonstrated that increased nuclear expression of the E3 ligase seven in absentia homologue (SIAH)-1 in human hepatocarcinogenesis supports tumor cell proliferation and migration. To define whether closely related SIAH-2 synergizes with protumorigenic SIAH-1, we systematically analyzed expression, localization and functional relevance of SIAH-2 in human hepatocellular carcinoma (HCC). Nuclear accumulation of SIAH-2 is detectable in more than 60% of all HCCs and correlates with tumor progression, cell proliferation and distant metastasis. An inverse correlation between nuclear SIAH-1 and SIAH-2 was detected, suggesting independent mechanisms for nuclear enrichment. Inhibition of nuclear SIAH-2 by RNAi in HCC cell lines reduced proliferation as well as lateral tumor cell motility and transmigration; however, combined knock down of both SIAH-1 and SIAH-2 did not further amplify biological effects compared to single gene inhibition. Reduction of SIAH-2 expression sensitizes HCC cells to the treatment with different cytostatic drugs, demonstrating that SIAH-2-targeting approaches may increase the response of HCC cells to conventional chemotherapy. Together, these data show that SIAH-2--as described for SIAH-1--accumulates in nuclei of HCC cells where it supports tumor growth and tumor cell dissemination. Because the nuclear pattern of SIAH-2 differs in HCC tissues from the SIAH-1 pattern and because the inactivation of SIAH-2 is not compensated by SIAH-1, the specific inhibition of SIAH-2 (especially in combination with other drugs) represents a promising therapeutic strategy for HCC.

  11. Changes in the renin angiotensin system during the development of colorectal cancer liver metastases

    PubMed Central

    2010-01-01

    Background Blockade of the renin angiotensin system (RAS) via angiotensin I converting enzyme (ACE) inhibition reduces growth of colorectal cancer (CRC) liver metastases in a mouse model. In this work we defined the expression of the various components of the RAS in both tumor and liver during the progression of this disease. Methods Immunohistochemistry and quantitative RT-PCR was used to examine RAS expression in a mouse CRC liver metastases model. CRC metastases and liver tissue was assessed separately at key stages of CRC liver metastases development in untreated (control) mice and in mice treated with the ACE inhibitor captopril (750 mg/kg/day). Non-tumor induced (sham) mice indicated the effect of tumors on normal liver RAS. The statistical significance of multiple comparisons was determined using one-way analysis of variance followed by Bonferroni adjustment with SAS/STAT software. Results Reduced volume of CRC liver metastases with captopril treatment was evident. Local RAS of CRC metastases differed from the surrounding liver, with lower angiotensin II type 1 receptor (AT1R) expression but increased ANG-(1-7) receptor (MasR) compared to the liver. The AT1R localised to cancer and stromal infiltrating cells, while other RAS receptors were detected in cancer cells only. Tumor induction led to an initial increase in AT1R and ACE expression while captopril treatment significantly increased ACE expression in the final stages of tumor growth. Conversely, captopril treatment decreased expression of AT1R and angiotensinogen. Conclusions These results demonstrate significant changes in RAS expression in the tumor-bearing captopril treated liver and in CRC metastases. The data suggests the existence of a tumor-specific RAS that can be independently targeted by RAS blockade. PMID:20380732

  12. In vitro metabolism of hyperforin in rat liver microsomal systems.

    PubMed

    Cui, Yanyan; Ang, Catharina Y W; Beger, Richard D; Heinze, Thomas M; Hu, Lihong; Leakey, Julian

    2004-01-01

    Hyperforin is an important active component of St. John's wort (Hypericum perforatum) that has been suggested to be responsible for the St. John's wort antidepressive effects and herbal-drug interactions. In this study, the in vitro metabolism profile of hyperforin was investigated using liver microsomes from male and female Sprague-Dawley rats, with or without induction by phenobarbital or dexamethasone. Four major Phase I metabolites, named 19-hydroxyhyperforin, 24-hydroxyhyperforin, 29-hydroxyhyperforin, and 34-hydroxyhyperforin, were isolated by high performance liquid chromatography and identified by mass spectrometry and NMR. Results suggest that hydroxylation is a major biotransformation of the hyperforin pathway in rat liver and that inducible cytochrome P450 3A (CYP450 3A) and/or CYP2B may be the major cytochrome P450 isoforms catalyzing these hydroxylation reactions.

  13. A Support Database System for Integrated System Health Management (ISHM)

    NASA Technical Reports Server (NTRS)

    Schmalzel, John; Figueroa, Jorge F.; Turowski, Mark; Morris, John

    2007-01-01

    The development, deployment, operation and maintenance of Integrated Systems Health Management (ISHM) applications require the storage and processing of tremendous amounts of low-level data. This data must be shared in a secure and cost-effective manner between developers, and processed within several heterogeneous architectures. Modern database technology allows this data to be organized efficiently, while ensuring the integrity and security of the data. The extensibility and interoperability of the current database technologies also allows for the creation of an associated support database system. A support database system provides additional capabilities by building applications on top of the database structure. These applications can then be used to support the various technologies in an ISHM architecture. This presentation and paper propose a detailed structure and application description for a support database system, called the Health Assessment Database System (HADS). The HADS provides a shared context for organizing and distributing data as well as a definition of the applications that provide the required data-driven support to ISHM. This approach provides another powerful tool for ISHM developers, while also enabling novel functionality. This functionality includes: automated firmware updating and deployment, algorithm development assistance and electronic datasheet generation. The architecture for the HADS has been developed as part of the ISHM toolset at Stennis Space Center for rocket engine testing. A detailed implementation has begun for the Methane Thruster Testbed Project (MTTP) in order to assist in developing health assessment and anomaly detection algorithms for ISHM. The structure of this implementation is shown in Figure 1. The database structure consists of three primary components: the system hierarchy model, the historical data archive and the firmware codebase. The system hierarchy model replicates the physical relationships between

  14. Life support systems for lunar missions

    NASA Astrophysics Data System (ADS)

    Tamponnet, C.

    Future Lunar missions envision three successive scenarios: (i) robotic preparatory missions, (ii) Lunar outpost (man-tended), and (iii) a permanently inhabited Lunar base. As soon as man appears as a key element (i.e. the second and third scenario), development and building of adequate Life Support Systems (LSS) become mandatory. Life Support covers basically all the techniques that enable the crew of the Lunar outpost or base to survive in this hostile environment. The internal structures of these LSS are highly dependent upon the type of missions. Indeed, there are three non-exclusive ways to ensure the autonomy of man on the Moon: (i) provide all the required consumables (oxygen, water, food) at the start of the mission or replenish them during the mission, (ii) regenerate these consumables from waste during the mission, or (iii) use Lunar resources. Man-tended Lunar missions will require Shuttle-like or International Space Station-like types of LSS although continuosly inhabited Lunar bases will require an autonomous (i.e. totally regenerative) type of LSS. Therefore, first manned Lunar missions will use non-regenerative LSS. These LSS will progressively evolve towards a total regeneration of materials using in a first step purely physico-chemical technologies, then using more and more biologically-based technologies and relying more and more on Lunar resources. Moreover, first Lunar outposts and Lunar bases will serve as testbed for the development of the LSS of respectively the future Lunar bases and the future Mars (or other planetary) bases.

  15. Stability of therapeutic albumin solutions used for molecular adsorbent recirculating system-based liver dialysis.

    PubMed

    De Bruyn, Tom; Meijers, Björn; Evenepoel, Pieter; Laub, Ruth; Willems, Ludo; Augustijns, Patrick; Annaert, Pieter

    2012-01-01

    Mounting evidence suggests beneficial effects of albumin dialysis-based liver support in patients suffering from acute-on-chronic liver failure. Molecular adsorbent recirculating system (MARS) is a nonbiological liver support device, based on the exchange of albumin-bound toxins between the patient's blood and a 20% human serum albumin solution in a secondary circuit. Bound toxins are continuously removed from the circulating albumin by exposure to activated charcoal and an ion-exchange resin. The aim of the present in vitro study was to determine the impact of exposure to charcoal and resin on the ligand binding properties of albumins, containing various levels of stabilizers and obtained from different suppliers (Baxter, CAF-DCF [Red Cross], and Sigma-Aldrich). Albumin binding properties were assessed by measuring equilibrium binding properties of warfarin, diazepam, and salicylate before and after incubation (for up to 7 h) with adsorbing materials; albumin-associated esterase-like activities were also determined. Notable changes in albumin binding upon incubation with adsorbing materials were only observed when using warfarin as a ligand. Affinity of warfarin for the Baxter and Sigma albumins showed a pronounced decrease (higher K(d) ) after the 1-7-h exposure to charcoal or resin. In the absence of adsorbing materials, similar effects were found, indicating that incubation time per se affects albumin binding properties. Following exposure to resin, Baxter albumin binding capacity (B(max)) increased about twofold. For albumin obtained from CAF-DCF, binding affinity and capacity for warfarin were constant under all conditions tested. Esterase-like activities associated with these albumins were either maintained or enhanced (up to 2.5-fold in case of Sigma albumin) following 7-h incubations with adsorbing materials. Our data suggest limited direct influence of the presence of stabilizers in therapeutic albumin solutions on baseline binding properties of human

  16. Systemic chemotherapy as a main strategy for liver metastases from gastric cancer.

    PubMed

    Zhang, W; Yu, Y; Fang, Y; Wang, Y; Cui, Y; Shen, K; Liu, T

    2015-11-01

    Liver metastasis is associated with poor prognosis in gastric cancer. Surgical resection and systemic chemotherapy have been reported to be effective in gastric cancer with liver metastasis (GCLM). However, the best strategy for GCLM has not been established. From May 2009 to July 2014, a consecutive series of GCLM patients in Zhongshan Hospital of Fudan University were studied. Treatment strategies were evaluated with regard to different extents of metastases. A total of 163 patients were included. The overall survival was 10.1 months. Active treatment significantly prolongs the survival of GCLM patients. The overall survival time for patients with liver-limited metastases and extra-hepatic liver metastases was 11.6 mo and 8.7 mo, respectively (P = 0.012). The median survival time for liver-limited disease of H1, H2 and H3 was 14.2, 15.8, and 8.5 months, respectively (H3 vs H2, P = 0.001; H3 vs H1, P = 0.000; H1 vs H2, P = 0.900). Systemic chemotherapy was chosen as the main strategy for the 'extensive' patients with extra-hepatic metastases and H3 type liver-limited metastases. Patients' survival was benefited by multi-line chemotherapy. No differences were shown between systemic chemotherapy and curative resection or palliative resection in H1 and H2 liver-limited metastases (16.0 mo vs 12.0 mo, P = 0.711; 16.0 vs 18.8 months, P = 0.654). Systemic chemotherapy was the main treatment for gastric cancer patients with liver metastases. Curative resection could be considered for highly selected patients.

  17. Matched-Pair Comparison of Radioembolization Plus Best Supportive Care Versus Best Supportive Care Alone for Chemotherapy Refractory Liver-Dominant Colorectal Metastases

    SciTech Connect

    Seidensticker, Ricarda; Denecke, Timm; Kraus, Patrick; Seidensticker, Max; Mohnike, Konrad; Fahlke, Joerg; Kettner, Erika; Dudeck, Oliver; Pech, Maciej; Amthauer, Holger; Ricke, Jens

    2012-10-15

    Purpose: This study was designed to evaluate overall survival after radioembolization or best supportive care (BSC) in patients with chemotherapy-refractory liver-dominant metastatic colorectal cancer (mCRC). Methods: This was a matched-pair comparison of patients who received radioembolization plus BSC or BSC alone for extensive liver disease. Twenty-nine patients who received radioembolization were retrospectively matched with a contemporary cohort of >500 patients who received BSC from 3 centers in Germany. Using clinical databases, patients were initially matched for prior treatments and tumor burden and then 29 patients were consecutively identified with two or more of four matching criteria: synchronous/metachronous metastases, tumor burden, increased ALP, and/or CEA >200 U/ml. Survival was calculated from date of progression before radioembolization or BSC by using Kaplan-Meier analysis. Results: Of 29 patients in each study arm, 16 pairs (55.2%) matched for all four criteria, and 11 pairs (37.9%) matched three criteria. Patients in both groups had a similar performance status (Karnofsky index, median 80% [range, 60-100%]). Compared with BSC alone, radioembolization prolonged survival (median, 8.3 vs. 3.5 months; P < 0.001) with a hazard ratio of 0.3 (95% confidence interval, 0.16-0.55; P < 0.001) in a multivariate Cox proportional hazard model. Treatment-related adverse events following radioembolization included: grade 1-2 fatigue (n = 20, 69%), grade 1 abdominal pain/nausea (n = 14, 48.3%), and grade 2 gastrointestinal ulceration (n = 3, 10.3%). Three cases of grade 3 radiation-induced liver disease were symptomatically managed. Conclusions: Radioembolization offers a promising addition to BSC in treatment-refractory patients for whom there are limited options. Survival was prolonged and adverse events were generally mild-to-moderate in nature and manageable.

  18. Creating clinical decision support systems for respiratory medicine.

    PubMed

    Tams, Carl G; Euliano, Neil R

    2015-01-01

    Clinical decision support systems are vital for advances in improving patient therapeutic care. We share lessons learned from creating two respiratory clinical decisions support systems for ventilating patients in a critical care setting.

  19. Diagnostic efficiency of Mueller-matrix polarization reconstruction system of the phase structure of liver tissue

    NASA Astrophysics Data System (ADS)

    Zabolotna, Natalia I.; Pavlov, Sergii V.; Radchenko, Kostiantyn O.; Stasenko, Vladyslav A.; Wójcik, Waldemar; Kussambayeva, Nazym

    2015-12-01

    The application field of using the Mueller-matrix polarizing reconstruction system of phase structure of biological layer for optical-anisotropic parameters differentiation of histological sections of healthy and rat's liver with hepatitis were investigated. Comparison of system informativity with known systems on indexes of sensitivity, specificity and balanced accuracy were performed.

  20. The Controlled Ecological Life Support Systems (CELSS) research program

    NASA Technical Reports Server (NTRS)

    Macelroy, Robert D.

    1990-01-01

    The goal of the Controlled Ecological Life Support Systems (CELSS) program is to develop systems composed of biological, chemical and physical components for purposes of human life support in space. The research activities supported by the program are diverse, but are focused on the growth of higher plants, food and waste processing, and systems control. Current concepts associated with the development and operation of a bioregenerative life support system will be discussed in this paper.

  1. Environmental Control and Life Support System, Oxygen Generation System

    NASA Technical Reports Server (NTRS)

    2000-01-01

    The Environmental Control and Life Support System (ECLSS) Group of the Flight Projects Directorate at the Marshall Space Flight Center (MSFC) in Huntsville, Alabama, is responsible for designing and building the life support systems that will provide the crew of the International Space Station (ISS) a comfortable environment in which to live and work. This is a close-up view of ECLSS Oxygen Generation System (OGS) rack. The ECLSS Group at the MSFC oversees the development of the OGS, which produces oxygen for breathing air for the crew and laboratory animals, as well as for replacing oxygen lost due to experiment use, airlock depressurization, module leakage, and carbon dioxide venting. The OGS consists primarily of the Oxygen Generator Assembly (OGA), provided by the prime contractor, the Hamilton Sundstrand Space Systems, International (HSSSI) in Windsor Locks, Cornecticut and a Power Supply Module (PSM), supplied by the MSFC. The OGA is comprised of a cell stack that electrolyzes (breaks apart the hydrogen and oxygen molecules) some of the clean water provided by the Water Recovery System and the separators that remove the gases from water after electrolysis. The PSM provides the high power to the OGA needed to electrolyze the water.

  2. Environmental Control and Life Support System, Oxygen Generation System

    NASA Technical Reports Server (NTRS)

    2000-01-01

    The Environmental Control and Life Support System (ECLSS) Group of the Flight Projects Directorate at the Marshall Space Flight Center (MSFC) in Huntsville, Alabama, is responsible for designing and building the life support systems that will provide the crew of the International Space Station (ISS) a comfortable environment in which to live and work. This is a close-up view of ECLSS Oxygen Generation System (OGS) rack. The ECLSS Group at the MSFC oversees the development of the OGS, which produces oxygen for breathing air for the crew and laboratory animals, as well as for replacing oxygen lost due to experiment use, airlock depressurization, module leakage, and carbon dioxide venting. The OGS consists primarily of the Oxygen Generator Assembly (OGA), provided by the prime contractor, the Hamilton Sundstrand Space Systems, International (HSSSI) in Windsor Locks, Cornecticut and a Power Supply Module (PSM), supplied by the MSFC. The OGA is comprised of a cell stack that electrolyzes (breaks apart the hydrogen and oxygen molecules) some of the clean water provided by the Water Recovery System and the separators that remove the gases from water after electrolysis. The PSM provides the high power to the OGA needed to electrolyze the water.

  3. COMBINATION OF MOLECULAR ADSORBENT RECIRCULATING SYSTEM AND RADIOIODINE FOR THE TREATMENT OF CONCURRENT HYPERTHYROIDISM AND SEVERE LIVER DYSFUNCTION: A RETROSPECTIVE COHORT STUDY.

    PubMed

    Zhang, Qing; Guan, Yanxing; Xiang, Tianxin; Liu, Shaozheng; Chen, Qingjie; Zhang, Qing

    2017-02-01

    The treatment of hyperthyroidism associated with severe liver dysfunction (LD) is a clinical challenge, and there has been no unified examination of this problem. The objective of this study was to assess the efficacy and safety of radioiodine ((131)I) in combination with a molecular adsorbent recirculating system (MARS) for the treatment of hyperthyroidism complicated by severe liver LD. A total of 116 hyperthyroidism patients with concomitant LD who received MARS treatment were studied retrospectively. The patients were grouped according to whether or not they also received (131)I treatment: Group 1 (59 patients) received (131)I following MARS treatment, while Group 2 (57 cases) received only MARS. Clinical outcomes, including thyroid hormone levels, liver function parameters, and therapeutic efficacy were calculated. The overall response rate was significantly greater in Group 1 than in Group 2 (P<.01). The clinical indicators improved significantly in both groups 3 months after treatment compared with before treatment (P<.05), but Group 1 showed a greater improvement. Compared with Group 1, patients in Group 2 had a longer stay in hospital (P<.05), and received more frequent MARS treatments (P<.05). The combination of MARS and (131)I for the treatment of hyperthyroidism complicated by severe LD was effective and safe. The use of this system could rapidly improve liver function and metabolism, allowing (131)I therapy to be applied as early as possible with a shortened recovery time of liver function. ALSS = artificial liver support system ALT = alanine transaminase AST = aspartate transaminase ATD = antithyroid drugs DBil = direct bilirubin FT3 = free tri-iodothyronine FT4 = free thyroxine (131)I = radioiodine INR = international normalized ratio LD = liver dysfunction MARS = molecular adsorbent recirculating system MELD = model for end-stage liver disease PT = prothrombin time TBil = total bilirubin TSH = thyroid-stimulating hormone.

  4. 30 CFR 75.817 - Cable handling and support systems.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Cable handling and support systems. 75.817... High-Voltage Longwalls § 75.817 Cable handling and support systems. Longwall mining equipment must be provided with cable-handling and support systems that are constructed, installed and maintained to minimize...

  5. 30 CFR 75.817 - Cable handling and support systems.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Cable handling and support systems. 75.817... High-Voltage Longwalls § 75.817 Cable handling and support systems. Longwall mining equipment must be provided with cable-handling and support systems that are constructed, installed and maintained to minimize...

  6. 30 CFR 75.817 - Cable handling and support systems.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Cable handling and support systems. 75.817... High-Voltage Longwalls § 75.817 Cable handling and support systems. Longwall mining equipment must be provided with cable-handling and support systems that are constructed, installed and maintained to minimize...

  7. 30 CFR 75.817 - Cable handling and support systems.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Cable handling and support systems. 75.817... High-Voltage Longwalls § 75.817 Cable handling and support systems. Longwall mining equipment must be provided with cable-handling and support systems that are constructed, installed and maintained to minimize...

  8. 30 CFR 75.817 - Cable handling and support systems.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Cable handling and support systems. 75.817... High-Voltage Longwalls § 75.817 Cable handling and support systems. Longwall mining equipment must be provided with cable-handling and support systems that are constructed, installed and maintained to minimize...

  9. 45 CFR 307.5 - Mandatory computerized support enforcement systems.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... hardware, operational system software, and electronic linkages with the separate components of an... 45 Public Welfare 2 2012-10-01 2012-10-01 false Mandatory computerized support enforcement systems... HEALTH AND HUMAN SERVICES COMPUTERIZED SUPPORT ENFORCEMENT SYSTEMS § 307.5 Mandatory computerized support...

  10. 45 CFR 307.5 - Mandatory computerized support enforcement systems.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... hardware, operational system software, and electronic linkages with the separate components of an... 45 Public Welfare 2 2013-10-01 2012-10-01 true Mandatory computerized support enforcement systems... HEALTH AND HUMAN SERVICES COMPUTERIZED SUPPORT ENFORCEMENT SYSTEMS § 307.5 Mandatory computerized support...

  11. A Computuerized Operator Support System Prototype

    SciTech Connect

    Ken Thomas; Ronald Boring; Roger Lew; Tom Ulrich; Richard Villim

    2013-08-01

    A report was published by the Idaho National Laboratory in September of 2012, entitled Design to Achieve Fault Tolerance and Resilience, which described the benefits of automating operator actions for transients. The report identified situations in which providing additional automation in lieu of operator actions would be advantageous. It recognized that managing certain plant upsets is sometimes limited by the operator’s ability to quickly diagnose the fault and to take the needed actions in the time available. Undoubtedly, technology is underutilized in the nuclear power industry for operator assistance during plant faults and operating transients. In contrast, other industry sectors have amply demonstrated that various forms of operator advisory systems can enhance operator performance while maintaining the role and responsibility of the operator as the independent and ultimate decision-maker. A computerized operator support system (COSS) is proposed for use in nuclear power plants to assist control room operators in addressing time-critical plant upsets. A COSS is a collection of technologies to assist operators in monitoring overall plant performance and making timely, informed decisions on appropriate control actions for the projected plant condition. The COSS does not supplant the role of the operator, but rather provides rapid assessments, computations, and recommendations to reduce workload and augment operator judgment and decision-making during fast-moving, complex events. This project proposes a general model for a control room COSS that addresses a sequence of general tasks required to manage any plant upset: detection, validation, diagnosis, recommendation, monitoring, and recovery. The model serves as a framework for assembling a set of technologies that can be interrelated to assist with each of these tasks. A prototype COSS has been developed in order to demonstrate the concept and provide a test bed for further research. The prototype is based

  12. A Computuerized Operator Support System Prototype

    SciTech Connect

    Ken Thomas; Ronald Boring; Roger Lew; Tom Ulrich; Richard Villim

    2013-11-01

    A report was published by the Idaho National Laboratory in September of 2012, entitled Design to Achieve Fault Tolerance and Resilience, which described the benefits of automating operator actions for transients. The report identified situations in which providing additional automation in lieu of operator actions would be advantageous. It recognized that managing certain plant upsets is sometimes limited by the operator’s ability to quickly diagnose the fault and to take the needed actions in the time available. Undoubtedly, technology is underutilized in the nuclear power industry for operator assistance during plant faults and operating transients. In contrast, other industry sectors have amply demonstrated that various forms of operator advisory systems can enhance operator performance while maintaining the role and responsibility of the operator as the independent and ultimate decision-maker. A computerized operator support system (COSS) is proposed for use in nuclear power plants to assist control room operators in addressing time-critical plant upsets. A COSS is a collection of technologies to assist operators in monitoring overall plant performance and making timely, informed decisions on appropriate control actions for the projected plant condition. The COSS does not supplant the role of the operator, but rather provides rapid assessments, computations, and recommendations to reduce workload and augment operator judgment and decision-making during fast-moving, complex events. This project proposes a general model for a control room COSS that addresses a sequence of general tasks required to manage any plant upset: detection, validation, diagnosis, recommendation, monitoring, and recovery. The model serves as a framework for assembling a set of technologies that can be interrelated to assist with each of these tasks. A prototype COSS has been developed in order to demonstrate the concept and provide a test bed for further research. The prototype is based

  13. Superstoichiometric Ca2+ uptake supported by hydrolysis of endogenous ATP in rat liver mitochondria.

    PubMed

    Brand, M D; Lehninger, A L

    1975-10-10

    The nature of the energy store causing rapid superstoichiometric leads to H+/2e minus ejection and leads to Ca2+/2e minus uptake ratios in rat liver mitochondria pulsed with Ca2+ has been investigated. The extent and the rate of the initial fast superstoichiometric phase of H plus ejection were greatly reduced by oligomycin and other ATPase inhibitors; the subsequent shoichiometric phase was unaffected. No such inhibition was seen with atractyloside. Similarly, the initial fast phase of Ca2+ uptake was reduced in extent by oligomycin, whereas the slower stoichiometric phase was unaffected. Moreover, the ATP content of mitochondria previously incubated with succinate decreased by about 80% within 5 s after pulsing with Ca2+. The energy store for superstoichiometric Ca2+ uptake and H plus injection is thus identified as endogenous ATP.

  14. Route-dependent effect of nutritional support on liver glucose uptake.

    PubMed

    Chen, Sheng-Song; Torres-Sanchez, Carlos J; Hosein, Nadeen; Zhang, Yiqun; Lacy, D Brooks; Chang, Chris; McGuinness, Owen P

    2005-11-01

    The liver is a major site of glucose disposal during chronic (5 day) total parenteral (TPN) and enteral (TEN) nutrition. Net hepatic glucose uptake (NHGU) is dependent on the route of delivery when only glucose is delivered acutely; however, the hepatic response to chronic TPN and TEN is very similar. We aimed to determine whether the route of nutrient delivery altered the acute (first 8 h) response of the liver and whether chronic enteral delivery of glucose alone could augment the adaptive response to TPN. Chronically catheterized conscious dogs received either TPN or TEN containing glucose, Intralipid, and Travasol for either 8 h or 5 days. Another group received TPN for 5 days, but approximately 50% of the glucose in the nutrition was given via the enteral route (TPN+EG). Hepatic metabolism was assessed with tracer and arteriovenous difference techniques. In the presence of similar arterial plasma glucose levels (approximately 6 mM), NHGU and net hepatic lactate release increased approximately twofold between 8 h and 5 days in TPN and TEN. NHGU (26 +/- 1 vs. 23 +/- 3 micromol.kg(-1).min(-1)) and net hepatic lactate release (44 +/- 1 vs. 34 +/- 6 micromol.kg(-1).min(-1)) in TPN+EG were similar to results for TPN, despite lower insulin levels (96 +/- 6 vs. 58 +/- 16 pM, TPN vs. TPN+EG). TEN does not acutely enhance NHGU or disposition above that seen with TPN. However, partial delivery of enteral glucose is effective in decreasing the insulin requirement during chronic TPN.

  15. Using systems thinking to support clinical system transformation.

    PubMed

    Best, Allan; Berland, Alex; Herbert, Carol; Bitz, Jennifer; van Dijk, Marlies W; Krause, Christina; Cochrane, Douglas; Noel, Kevin; Marsden, Julian; McKeown, Shari; Millar, John

    2016-05-16

    Purpose - The British Columbia Ministry of Health's Clinical Care Management initiative was used as a case study to better understand large-scale change (LSC) within BC's health system. Using a complex system framework, the purpose of this paper is to examine mechanisms that enable and constrain the implementation of clinical guidelines across various clinical settings. Design/methodology/approach - Researchers applied a general model of complex adaptive systems plus two specific conceptual frameworks (realist evaluation and system dynamics mapping) to define and study enablers and constraints. Focus group sessions and interviews with clinicians, executives, managers and board members were validated through an online survey. Findings - The functional themes for managing large-scale clinical change included: creating a context to prepare clinicians for health system transformation initiatives; promoting shared clinical leadership; strengthening knowledge management, strategic communications and opportunities for networking; and clearing pathways through the complexity of a multilevel, dynamic system. Research limitations/implications - The action research methodology was designed to guide continuing improvement of implementation. A sample of initiatives was selected; it was not intended to compare and contrast facilitators and barriers across all initiatives and regions. Similarly, evaluating the results or process of guideline implementation was outside the scope; the methods were designed to enable conversations at multiple levels - policy, management and practice - about how to improve implementation. The study is best seen as a case study of LSC, offering a possible model for replication by others and a tool to shape further dialogue. Practical implications - Recommended action-oriented strategies included engaging local champions; supporting local adaptation for implementation of clinical guidelines; strengthening local teams to guide implementation; reducing

  16. Environmental Control and Life Support System, Water Recovery System

    NASA Technical Reports Server (NTRS)

    2000-01-01

    The Environmental Control and Life Support System (ECLSS) Group of the Flight Projects Directorate at the Marshall Space Flight Center (MSFC) is responsible for designing and building the life support systems that will provide the crew of the International Space Station (ISS) a comfortable environment in which to live and work. This is a close-up view of ECLSS Water Recovery System (WRS) racks. The MSFC's ECLSS Group overseas much of the development of the hardware that will allow a constant supply of clean water for four to six crewmembers aboard the ISS. The WRS provides clean water through the reclamation of wastewaters, including water obtained from the Space Shuttle's fuel cells, crewmember urine, used shower, handwash and oral hygiene water cabin humidity condensate, and Extravehicular Activity (EVA) wastes. The WRS is comprised of a Urine Processor Assembly (UPA), and a Water Processor Assembly (WPA). The UPA accepts and processes pretreated crewmember urine to allow it to be processed along with other wastewaters in the WPA, which removes free gas, organic, and nonorganic constituents before the water goes through a series of multifiltration beds for further purification. Product water quality is monitored primarily through conductivity measurements. Unacceptable water is sent back through the WPA for reprocessing. Clean water is sent to a storage tank. The water must meet stringent purity standards before consumption by the crew. The UPA provided by the MSFC and the WRA is provided by the prime contractor, Hamilton Sundstrand Space Systems, International (HSSSI) from Cornecticut.

  17. Environmental Control and Life Support System, Water Recovery System

    NASA Technical Reports Server (NTRS)

    2000-01-01

    The Environmental Control and Life Support System (ECLSS) Group of the Flight Projects Directorate at the Marshall Space Flight Center (MSFC) is responsible for designing and building the life support systems that will provide the crew of the International Space Station (ISS) a comfortable environment in which to live and work. This is a close-up view of ECLSS Water Recovery System (WRS) racks. The MSFC's ECLSS Group overseas much of the development of the hardware that will allow a constant supply of clean water for four to six crewmembers aboard the ISS. The WRS provides clean water through the reclamation of wastewaters, including water obtained from the Space Shuttle's fuel cells, crewmember urine, used shower, handwash and oral hygiene water cabin humidity condensate, and Extravehicular Activity (EVA) wastes. The WRS is comprised of a Urine Processor Assembly (UPA), and a Water Processor Assembly (WPA). The UPA accepts and processes pretreated crewmember urine to allow it to be processed along with other wastewaters in the WPA, which removes free gas, organic, and nonorganic constituents before the water goes through a series of multifiltration beds for further purification. Product water quality is monitored primarily through conductivity measurements. Unacceptable water is sent back through the WPA for reprocessing. Clean water is sent to a storage tank. The water must meet stringent purity standards before consumption by the crew. The UPA provided by the MSFC and the WRA is provided by the prime contractor, Hamilton Sundstrand Space Systems, International (HSSSI) from Cornecticut.

  18. [Role of the endocrine system in the pathogenesis of non-alcoholic fatty liver disease].

    PubMed

    Hagymási, Krisztina; Reismann, Péter; Rácz, Károly; Tulassay, Zsolt

    2009-11-29

    The most frequent liver disorder in metabolic syndrome is the nonalcoholic fatty liver disease. Its pathogenesis is a complex, multifactorial process, characterized by insulin resistance and involvement of the endocrine system. Hypothyroidism may lead to nonalcoholic steatohepatitis via hyperlipidemia and obesity. Adult patients with growth hormone deficiency have a metabolic syndrome-like phenotype with obesity and many characteristic metabolic alterations. The chronic activation of the hypothalamic-pituitary-adrenal axis results in metabolic syndrome as well. Cushing's syndrome has also features of metabolic syndrome. Mild elevation of transaminase activities is commonly seen in patients with adrenal failure. Non-alcoholic steatosis is twice as common in postmenopusal as in premenopausal women and hormonal replacement therapy decreases the risk of steatosis. Insulin resistance, diabetes mellitus type 2, sleeping apnoe syndrome, cardiovascular disorders and non-alcoholic fatty liver disease are more frequent in polycystic ovary syndrome. Hypoandrogenism in males and hyperandrogenism in females may lead to fatty liver via obesity and insulin resistance. Adipokines (leptin, acylation stimulating protein, adiponectin) have a potential role in the pathogenesis of nonalcoholic fatty liver. The alterations of endocrine system must be considered in the background of cryptogenic liver diseases. The endocrine perspective may help the therapeutic approaches in the future.

  19. Nutritional support in patients with systemic sclerosis.

    PubMed

    Ortiz-Santamaria, Vera; Puig, Celia; Soldevillla, Cristina; Barata, Anna; Cuquet, Jordi; Recasens, Asunción

    2014-01-01

    Systemic sclerosis (SSc) is a chronic multisystem autoimmune disease which involves the gastrointestinal tract in about 90% of cases. It may contribute to nutritional deterioration. To assess whether the application of a nutritional support protocol to these patients could improve their nutritional status and quality of life. Single center prospective study, performed on an outpatient basis, in a county hospital. The Malnutrition Universal Screening Tool (MUST) was used to screen risk for malnutrition. Health questionnaire SF-36 and the Hospital Anxiety and Depression Scale were used to assess quality of life and psychopathology respectively. Weight, height, energy and protein requirements, macronutrient intake and nutritional biochemical parameters were evaluated. Nutritional intervention was performed in patients at risk for malnutrition. Of the 72 patients, 12.5% were at risk for malnutrition. Iron deficiency anemia (18.35%) and vitamin D deficiency (54%) were the most frequently observed nutritional deficits. The questionnaires on psychopathology and quality of life showed a high prevalence of anxiety and depression, and lower level poor quality of life in the physical and mental component. No significant improvements were observed in the weight, food intake, nutritional biochemical parameters, psychopathology and quality of life follow-up. Dietary intervention was able to maintain body weight and food intake. Iron deficiency anemia and vitamin D deficiency improved with iron and vitamine D supplements. No deterioration was observed in psychological assessment or quality of life. Studies with larger numbers of patients are needed to assess the efficacy of this intervention. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

  20. Clinical Decision Support Systems and Prevention

    PubMed Central

    Njie, Gibril J.; Proia, Krista K.; Thota, Anilkrishna B.; Finnie, Ramona K.C.; Hopkins, David P.; Banks, Starr M.; Callahan, David B.; Pronk, Nicolaas P.; Rask, Kimberly J.; Lackland, Daniel T.; Kottke, Thomas E.

    2016-01-01

    Context Clinical decision support systems (CDSSs) can help clinicians assess cardiovascular disease (CVD) risk and manage CVD risk factors by providing tailored assessments and treatment recommendations based on individual patient data. The goal of this systematic review was to examine the effectiveness of CDSSs in improving screening for CVD risk factors, practices for CVD-related preventive care services such as clinical tests and prescribed treatments, and management of CVD risk factors. Evidence acquisition An existing systematic review (search period, January 1975–January 2011) of CDSSs for any condition was initially identified. Studies of CDSSs that focused on CVD prevention in that review were combined with studies identified through an updated search (January 2011–October 2012). Data analysis was conducted in 2013. Evidence synthesis A total of 45 studies qualified for inclusion in the review. Improvements were seen for recommended screening and other preventive care services completed by clinicians, recommended clinical tests completed by clinicians, and recommended treatments prescribed by clinicians (median increases of 3.8, 4.0, and 2.0 percentage points, respectively). Results were inconsistent for changes in CVD risk factors such as systolic and diastolic blood pressure, total and low-density lipoprotein cholesterol, and hemoglobin A1C levels. Conclusions CDSSs are effective in improving clinician practices related to screening and other preventive care services, clinical tests, and treatments. However, more evidence is needed from implementation of CDSSs within the broad context of comprehensive service delivery aimed at reducing CVD risk and CVD-related morbidity and mortality. PMID:26477805

  1. A knowledge-based decision support system for payload scheduling

    NASA Technical Reports Server (NTRS)

    Floyd, Stephen; Ford, Donnie

    1988-01-01

    The role that artificial intelligence/expert systems technologies play in the development and implementation of effective decision support systems is illustrated. A recently developed prototype system for supporting the scheduling of subsystems and payloads/experiments for NASA's Space Station program is presented and serves to highlight various concepts. The potential integration of knowledge based systems and decision support systems which has been proposed in several recent articles and presentations is illustrated.

  2. Novel polymer blends for the preparation of membranes for biohybrid liver systems.

    PubMed

    Kostadinova, Aneliya; Seifert, Barbara; Albrecht, Wolfgang; Malsch, Guenter; Groth, Thomas; Lendlein, Andreas; Altankov, George

    2009-01-01

    It was found previously that membranes based on co-polymers of acrylonitrile (AN) and 2-acrylamido-2-methyl-propansulfonic acid (AMPS) greatly stimulated the functionality and survival of primary hepatocytes. In those studies, however, the pure AN-AMPS co-polymer had poor membrane-forming properties, resulting in quite dense rubber-like membranes. Hence, membranes with required permeability and optimal biocompatibility were obtained by blending the AN-AMPS co-polymer with poly(acrylonitrile) homopolymer (PAN). The amount of PAN (P) and AN-AMPS (A) in the blend was varied from pure PAN (P/A-100/0) over P/A-75/25 and P/A-50/50 to pure AN-AMPS co-polymer (P/A-0/100). A gradual decrease of molecular cut-off of membranes with increase of AMPS concentration was found, which allows tailoring membrane permeability as necessary. C3A hepatoblastoma cells were applied as a widely accepted cellular model for assessment of hepatocyte behaviour by attachment, viability, growth and metabolic activity. It was found that the blend P/A-50/50, which possessed an optimal permeability for biohybrid liver systems, supported also the attachment, growth and function of C3A cells in terms of fibronectin synthesis and P-450 isoenzyme activity. Hence, blend membranes based on a one to one mixture of PAN and AN-AMPS combine sufficient permeability with the desired cellular compatibility for application in bioreactors for liver replacement.

  3. Nuclear reactor heat transport system component low friction support system

    DOEpatents

    Wade, Elman E.

    1980-01-01

    A support column for a heavy component of a liquid metal fast breeder reactor heat transport system which will deflect when the pipes leading coolant to and from the heavy component expand or contract due to temperature changes includes a vertically disposed pipe, the pipe being connected to the heavy component by two longitudinally spaced cycloidal dovetail joints wherein the distal end of each of the dovetails constitutes a part of the surface of a large diameter cylinder and the centerlines of these large diameter cylinders intersect at right angles and the pipe being supported through two longitudinally spaced cycloidal dovetail joints wherein the distal end of each of the dovetails constitutes a part of the surface of a large diameter cylinder and the centerlines of these large diameter cylinders intersect at right angles, each of the cylindrical surfaces bearing on a flat and horizontal surface.

  4. Considerations for a successful clinical decision support system.

    PubMed

    Castillo, Ranielle S; Kelemen, Arpad

    2013-07-01

    Clinical decision support systems have the potential to improve patient care in a multitude of ways. Clinical decision support systems can aid in the reduction of medical errors and reduction in adverse drug events, ensure comprehensive treatment of patient illnesses and conditions, encourage the adherence to guidelines, shorten patient length of stay, and decrease expenses over time. A clinical decision support system is one of the key components for reaching compliance for Meaningful Use. In this article, the advantages, potential drawbacks, and clinical decision support system adoption barriers are discussed, followed by an in-depth review of the characteristics that make a clinical decision support system successful. The legal and ethical issues that come with the implementation of a clinical decision support system within an organization and the future expectations of clinical decision support system are reviewed.

  5. Alcohol-Related Liver Disease

    MedlinePlus

    ... events. Please support us. Donate | Volunteer Alcohol-Related Liver Disease Discussion on Inspire Support Community Join the ... Disease Information > Alcohol-Related Liver Disease Alcohol-Related Liver Disease Explore this section to learn more about ...

  6. Analysis Support for Space Systems Area

    DTIC Science & Technology

    1991-02-01

    Cryotronics, Inc. Modular Test Dewar for mechanical , electrical, and environmental support. The dewar provides a rigid mechanical support and radiation...baffled isolation to physically position and mechanically stabilize the FPA’s location while being tested. The dewar assembly provides the necessary...target discrimination , multi-target tracking, etc. The DWSG methodology, in contrast to the ’~lackbody" methods described previously, uses infrared laser

  7. Comparison of five incubation systems for rat liver slices using functional and viability parameters.

    PubMed

    Olinga, P; Groen, K; Hof, I H; De Kanter, R; Koster, H J; Leeman, W R; Rutten, A A; Van Twillert, K; Groothuis, G M

    1997-10-01

    Precision-cut liver slices are presently used for various research objects, e.g. to study metabolism, transport, and toxicity of xenobiotics. Various incubation systems are presently employed, but a systematic comparison between these incubation systems with respect to preservation of slice function has not been performed yet. Therefore, we started a comparative study to evaluate five of these systems: the shaken flask (an Erlenmeyer in a shaking water bath), the stirred-well (24-well culture plate equipped with grids and magnetic stirrers), rocker platform (6-well culture plate with Netwell insert rocked on a platform), the roller system (dynamic organ culture rolled on an insert in a glass vial), and the 6-well shaker (6-well culture plate in a shaking water bath). The liver slices were incubated in these incubation systems for 0.5, 1.5, and 24.5 h and subsequently subjected to viability and metabolic function tests. The viability of the incubated liver slices was evaluated by: potassium content, MTT assay, energy charge, histomorphology, and LDH leakage. Their metabolic functions were studied by determination of the metabolism of lidocaine, testosterone, and antipyrine. Up to 1.5 h of incubation all five incubation systems gave similar results with respect to viability and metabolic function of the liver slices. However, after 24 h, the shaken flask, the rocker platform, and the 6-well shaker incubation systems appeared to be superior to the stirred well and the roller incubation systems.

  8. Evolutionary-driven support vector machines for determining the degree of liver fibrosis in chronic hepatitis C.

    PubMed

    Stoean, Ruxandra; Stoean, Catalin; Lupsor, Monica; Stefanescu, Horia; Badea, Radu

    2011-01-01

    Hepatic fibrosis, the principal pointer to the development of a liver disease within chronic hepatitis C, can be measured through several stages. The correct evaluation of its degree, based on recent different non-invasive procedures, is of current major concern. The latest methodology for assessing it is the Fibroscan and the effect of its employment is impressive. However, the complex interaction between its stiffness indicator and the other biochemical and clinical examinations towards a respective degree of liver fibrosis is hard to be manually discovered. In this respect, the novel, well-performing evolutionary-powered support vector machines are proposed towards an automated learning of the relationship between medical attributes and fibrosis levels. The traditional support vector machines have been an often choice for addressing hepatic fibrosis, while the evolutionary option has been validated on many real-world tasks and proven flexibility and good performance. The evolutionary approach is simple and direct, resulting from the hybridization of the learning component within support vector machines and the optimization engine of evolutionary algorithms. It discovers the optimal coefficients of surfaces that separate instances of distinct classes. Apart from a detached manner of establishing the fibrosis degree for new cases, a resulting formula also offers insight upon the correspondence between the medical factors and the respective outcome. What is more, a feature selection genetic algorithm can be further embedded into the method structure, in order to dynamically concentrate search only on the most relevant attributes. The data set refers 722 patients with chronic hepatitis C infection and 24 indicators. The five possible degrees of fibrosis range from F0 (no fibrosis) to F4 (cirrhosis). Since the standard support vector machines are among the most frequently used methods in recent artificial intelligence studies for hepatic fibrosis staging, the

  9. Intraoperative circulatory management using the FloTrac™ system in laparoscopic liver resection.

    PubMed

    Kitaguchi, Kazuhiko; Gotohda, Naoto; Yamamoto, Hiroyuki; Kato, Yuichiro; Takahashi, Shinichiro; Konishi, Masaru; Hayashi, Ryuichi

    2015-05-01

    Several studies have shown that maintenance of the central venous pressure at a low level during liver surgery is effective for intraoperative management. However, others have suggested that stroke volume variation (SVV) may be a better predictor of fluid responsiveness than central venous pressure. The purpose of this study is to conduct a new type of circulatory management using the FloTrac(TM) system in laparoscopic liver resection and to evaluate specific fluctuations in SVV. Of the laparoscopic liver resections that we performed between March 2012 and December 2013, we used the FloTrac system for intraoperative circulatory management in 21 cases. We analyzed the data, mainly the average value of SVV. The average SVV value during liver transection was 5.2%-24.6% (mean, 17.0%), and 18 cases (86%) exceeded the conventional cut-off value (13%). The average SVV value was 4.3%-18.2% (mean, 9.7%) when pneumoperitoneum was not in effect, whereas it was 7.3% greater on average during liver transection (mean, 17.0%). No perioperative complications developed. The average SVV value during laparoscopic liver transection (mean, 17.0%) exceeded the conventional cut-off value, but in this study, no perioperative complications developed, which enabled safe management. We might be able to manage appropriate fluid control using FloTrac system in patients with laparoscopic liver resection. Therefore, it is necessary to set the target SVV and conduct prospective trials to verify the safety margin for intraoperative management in the future. © 2014 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and Wiley Publishing Asia Pty Ltd.

  10. Efficient and Targeted Transduction of Nonhuman Primate Liver With Systemically Delivered Optimized AAV3B Vectors.

    PubMed

    Li, Shaoyong; Ling, Chen; Zhong, Li; Li, Mengxin; Su, Qin; He, Ran; Tang, Qiushi; Greiner, Dale L; Shultz, Leonard D; Brehm, Michael A; Flotte, Terence R; Mueller, Christian; Srivastava, Arun; Gao, Guangping

    2015-12-01

    Recombinant adeno-associated virus serotype 3B (rAAV3B) can transduce cultured human liver cancer cells and primary human hepatocytes efficiently. Serine (S)- and threonine (T)-directed capsid modifications further augment its transduction efficiency. Systemically delivered capsid-optimized rAAV3B vectors can specifically target cancer cells in a human liver cancer xenograft model, suggesting their potential use for human liver-directed gene therapy. Here, we compared transduction efficiencies of AAV3B and AAV8 vectors in cultured primary human hepatocytes and cancer cells as well as in human and mouse hepatocytes in a human liver xenograft NSG-PiZ mouse model. We also examined the safety and transduction efficacy of wild-type (WT) and capsid-optimized rAAV3B in the livers of nonhuman primates (NHPs). Intravenously delivered S663V+T492V (ST)-modified self-complementary (sc) AAV3B-EGFP vectors led to liver-targeted robust enhanced green fluorescence protein (EGFP) expression in NHPs without apparent hepatotoxicity. Intravenous injections of both WT and ST-modified rAAV3B.ST-rhCG vectors also generated stable super-physiological levels of rhesus chorionic gonadotropin (rhCG) in NHPs. The vector genome predominantly targeted the liver. Clinical chemistry and histopathology examinations showed no apparent vector-related toxicity. Our studies should be important and informative for clinical development of optimized AAV3B vectors for human liver-directed gene therapy.

  11. Features of computerized clinical decision support systems supportive of nursing practice: a literature review.

    PubMed

    Lee, Seonah

    2013-10-01

    This study aimed to organize the system features of decision support technologies targeted at nursing practice into assessment, problem identification, care plans, implementation, and outcome evaluation. It also aimed to identify the range of the five stage-related sequential decision supports that computerized clinical decision support systems provided. MEDLINE, CINAHL, and EMBASE were searched. A total of 27 studies were reviewed. The system features collected represented the characteristics of each category from patient assessment to outcome evaluation. Several features were common across the reviewed systems. For the sequential decision support, all of the reviewed systems provided decision support in sequence for patient assessment and care plans. Fewer than half of the systems included problem identification. There were only three systems operating in an implementation stage and four systems in outcome evaluation. Consequently, the key steps for sequential decision support functions were initial patient assessment, problem identification, care plan, and outcome evaluation. Providing decision support in such a full scope will effectively help nurses' clinical decision making. By organizing the system features, a comprehensive picture of nursing practice-oriented computerized decision support systems was obtained; however, the development of a guideline for better systems should go beyond the scope of a literature review.

  12. A portable life support system for use in mines

    NASA Technical Reports Server (NTRS)

    Zeller, S. S.

    1972-01-01

    The portable life support system described in this paper represents a potential increase in the probability of survival for miners who are trapped underground by a fire or explosion. The habitability and life support capability of the prototype shelter have proved excellent. Development of survival chamber life support systems for wide use in coal mines is definitely within the capabilities of current technology.

  13. Management Decision Support Systems: From Theory to Practice.

    ERIC Educational Resources Information Center

    Wong, Simon C. H.

    1995-01-01

    A decision support system integrates individuals' intellectual resources with computer capabilities to improve decision-making quality. This paper presents the theoretical aspects of decision making and decision support and shows how the theories can be applied in developing an operational management decision-making support system for room booking…

  14. Electronic Performance Support Systems (EPSS): Making the Transition.

    ERIC Educational Resources Information Center

    Des Jardins, Susan; Davis, Harry, Jr.

    An electronic performance support system (EPSS) is a computerized system designed to increase productivity by supporting the performance of the worker on demand at the time of need. This way, workers are allowed to perform with a minimum of intervention from others. Popular examples of performance support tools, or partially implemented EPSSs,…

  15. Analysis of a Ubiquitous Performance Support System for Teachers

    ERIC Educational Resources Information Center

    Chen, Chao-Hsiu; Hwang, Gwo-Jen; Yang, Tzu-Chi; Chen, Shih-Hsuan; Huang, Shen-Yu

    2009-01-01

    This paper describes a Ubiquitous Performance Support System for Teachers (UPSST) and its implementation model. Personal Digital Assistants (PDAs) were used as the platform to support high-school teachers. Based on concepts of Electronic Performance Support Systems and design-based research, the authors conducted an iterative process of analysis,…

  16. Space Launch System Vibration Analysis Support

    NASA Technical Reports Server (NTRS)

    Johnson, Katie

    2016-01-01

    The ultimate goal for my efforts during this internship was to help prepare for the Space Launch System (SLS) integrated modal test (IMT) with Rodney Rocha. In 2018, the Structural Engineering Loads and Dynamics Team will have 10 days to perform the IMT on the SLS Integrated Launch Vehicle. After that 10 day period, we will have about two months to analyze the test data and determine whether the integrated vehicle modes/frequencies are adequate for launching the vehicle. Because of the time constraints, NASA must have newly developed post-test analysis methods proven well and with technical confidence before testing. NASA civil servants along with help from rotational interns are working with novel techniques developed and applied external to Johnson Space Center (JSC) to uncover issues in applying this technique to much larger scales than ever before. We intend to use modal decoupling methods to separate the entangled vibrations coming from the SLS and its support structure during the IMT. This new approach is still under development. The primary goal of my internship was to learn the basics of structural dynamics and physical vibrations. I was able to accomplish this by working on two experimental test set ups, the Simple Beam and TAURUS-T, and by doing some light analytical and post-processing work. Within the Simple Beam project, my role involves changing the data acquisition system, reconfiguration of the test set up, transducer calibration, data collection, data file recovery, and post-processing analysis. Within the TAURUS-T project, my duties included cataloging and removing the 30+ triaxial accelerometers, coordinating the removal of the structure from the current rolling cart to a sturdy billet for further testing, preparing the accelerometers for remounting, accurately calibrating, mounting, and mapping of all accelerometer channels, and some testing. Hammer and shaker tests will be performed to easily visualize mode shapes at low frequencies. Short

  17. Desicion Support System For Natural Hazards

    NASA Astrophysics Data System (ADS)

    Vyazilov, E.

    2009-04-01

    recommendations should be reasonable. To resolve the above problems or to make them less significant it is necessary to develop decision support systems (DSS). DMs need not tables with initial data, analytical, forecasting and climatic information, but messages containing warnings on critical value accidence, information on probability of hazards, information on potential losses, and information on hazardous impacts and recommendations on decision making. DSS can do the following: take into account impacts on specific points and on the total area under consideration; allow for the effects of the environment on economic entities (objects) in any geographical region to be analyzed; distinguish impacts and changes caused both by different phenomena and by their combination; signal when objects are or can be in adverse environmental conditions, e.g. in the area affected by fog, storm, tropical cyclone or in the area where the probability of hazardous ice events is very high, etc. The main component of DSS is a knowledge base based on the following concept: if we know environmental conditions it is possible to predict potential impacts on the economy; if we know impacts it is possible to give a set of recommendations on how to prevent (reduce) losses or how to use natural resources most efficiently. Decision making criteria are safety of people and property, reduction of losses, increase of profit, materials saving, etc. Knowledge base is a set of rules formulated in a formalized way using if, that, else. If "Water level in S.-Petersburg >150 cm" that "To give out warning information "Hazards for building on coastal river Neva is possible" and recommendations "The valuable goods carry out in second floor" else "To switch another rule". To have a knowledge base in place it is necessary to: develop tools of identifying and getting knowledge from experts; arrange the information flow from available information systems (operational data, analyses, forecasts, climatic information) through

  18. Activation of the hepatic endothelin-system in rats with biliary liver fibrosis.

    PubMed

    Rothermund, L; Cho, J J; Leggewie, S; Schwarz, A; Bauer, C; Paul, M; Neumayer, H H; Schuppan, D; Hocher, B

    2000-11-01

    Circulating plasma endothelin-1 (ET-1) is elevated in liver cirrhosis, in a disease-stage-dependent manner. However, ET-1 exerts its effects mainly via paracrine and autocrine pathways. Therefore, the aim of the present study was to analyze the hepatic endothelin (ET) system in liver cirrhosis resulting from bile duct obstruction (BDO). Wistar rats were subjected for 6 weeks to either sham operation (control) or BDO. Thereafter, hepatic ET-1 concentrations were elevated 7.2-fold in BDO compared to control (p <0.001), whereas big ET-1 was unchanged. The density of both ET receptor subtypes was upregulated in BDO (ETA: 7.4-fold and ETB: 4.9-fold vs control, p < 0.001, respectively). The affinity of both receptor subtypes was significantly reduced in BDO. In conclusion, our data demonstrated for the first time that the hepatic ET system in liver cirrhosis is characterized by a simultaneous upregulation of both ET-1 tissue concentration as well as the density of hepatic ETA- and ETB-receptors, suggesting a synergistic activation of the hepatic ET system in rats with BDO. The increased ET-1 tissue concentration is not a result of an altered big ET-1 synthesis in biliary liver fibrosis, suggesting an increased activity of endothelin-converting enzyme (ECE) in liver cirrhosis.

  19. Effect of human patient plasma ex vivo treatment on gene expression and progenitor cell activation of primary human liver cells in multi-compartment 3D perfusion bioreactors for extra-corporeal liver support.

    PubMed

    Schmelzer, Eva; Mutig, Kerim; Schrade, Petra; Bachmann, Sebastian; Gerlach, Jörg C; Zeilinger, Katrin

    2009-07-01

    Cultivation of primary human liver cells in innovative 3D perfusion multi-compartment capillary membrane bioreactors using decentralized mass exchange and integral oxygenation provides in vitro conditions close to the physiologic environment in vivo. While a few scale-up bioreactors were used clinically, inoculated liver progenitors in these bioreactors were not investigated. Therefore, we characterized regenerative processes and expression patterns of auto- and paracrine mediators involved in liver regeneration in bioreactors after patient treatment. Primary human liver cells containing parenchymal and non-parenchymal cells co-cultivated in bioreactors were used for clinical extra-corporeal liver support to bridge to liver transplantation. 3D tissue re-structuring in bioreactors was studied; expression of proteins and genes related to regenerative processes and hepatic progenitors was analyzed. Formation of multiple bile ductular networks and colonies of putative progenitors were observed within parenchymal cell aggregates. HGF was detected in scattered cells located close to vascular-like structures, expression of HGFA and c-Met was assigned to biliary cells and hepatocytes. Increased expression of genes associated to hepatic progenitors was detected following clinical application. The results confirm auto- and paracrine interactions between co-cultured cells in the bioreactor. The 3D bioreactor provides a valuable tool to study mechanisms of progenitor activation and hepatic regeneration ex vivo under patient plasma treatment. (c) 2009 Wiley Periodicals, Inc.

  20. Progress in bioreactors of bioartificial livers.

    PubMed

    Yu, Cheng-Bo; Pan, Xiao-Ping; Li, Lan-Juan

    2009-04-01

    Bioartificial liver support systems are becoming an effective therapy for hepatic failure. Bioreactors, as key devices in these systems, can provide a favorable growth and metabolic environment, mass exchange, and immunological isolation as a platform. Currently, stagnancy in bioreactor research is the main factor restricting the development of bioartificial liver support systems. A PubMed database search of English-language literature was performed to identify relevant articles using the keywords "bioreactor", "bioartificial liver", "hepatocyte", and "liver failure". More than 40 articles related to the bioreactors of bioartificial livers were reviewed. Some progress has been made in the improvement of structures, functions, and modified macromolecular materials related to bioreactors in recent years. The current data on the improvement of bioreactor configurations for bioartificial livers or on the potential of the use of certain scaffold materials in bioreactors, combined with the clinical efficacy and safety evaluation of cultured hepatocytes in vitro, indicate that the AMC (Academic Medical Center) BAL bioreactor and MELS (modular extracorporeal liver support) BAL bioreactor system can partly replace the synthetic and metabolic functions of the liver in phase I clinical studies. In addition, it has been indicated that the microfluidic PDMS (polydimethylsiloxane) bioreactor, or SlideBioreactor, and the microfabricated grooved bioreactor are appropriate for hepatocyte culture, which is also promising for bioartificial livers. Similarly, modified scaffolds can promote the adhesion, growth, and function of hepatocytes, and provide reliable materials for bioreactors. Bioreactors, as key devices in bioartificial livers, play an important role in the therapy for liver failure both now and in the future. Bioreactor configurations are indispensable for the development of bioartificial livers used for liver failure, just as the modified scaffold materials available for

  1. Support Afferentation as the System of Proprioreception

    NASA Astrophysics Data System (ADS)

    Kozlovskaya, I.; Grigoriev, A.; Shenkman, B.

    2008-06-01

    Results of studies of phenomenology and nature of the hypogravitational motor syndrome, provided at the Institute of Biomedical Problems of the RAS, point out to important role in its development of the withdrawal of the support and, accordingly the decrease of the intensity of the support afferentation activities that provokes a decline of the muscle tone in the first phase and the development of atrophic processes in slow fibers of antigravitational muscles in the second one. The subjects exposed to the pure dry immersion (DI) environment revealed after exposition a significant decline of the transverse stiffness and of the maximal isokinetic force of the leg postural muscles, a significant decrease of the absolute force of m.soleus single skinned fibers evoked by Ca++, and an obvious decline of their transverse cross-sectional areas. Mechanical stimulation of the soles support zones eliminated all the above effects.

  2. A liver microphysiological system of tumor cell dormancy and inflammatory responsiveness is affected by scaffold properties.

    PubMed

    Clark, A M; Wheeler, S E; Young, C L; Stockdale, L; Shepard Neiman, J; Zhao, W; Stolz, D B; Venkataramanan, R; Lauffenburger, D; Griffith, L; Wells, A

    2016-12-20

    Distant metastasis is the major cause of breast cancer-related mortality, commonly emerging clinically after 5 or more years of seeming 'cure' of the primary tumor, indicating a quiescent dormancy. The lack of relevant accessible model systems for metastasis that recreate this latent stage has hindered our understanding of the molecular basis and the development of therapies against these lethal outgrowths. We previously reported on the development of an all-human 3D ex vivo hepatic microphysiological system that reproduces several features of liver physiology and enables spontaneous dormancy in a subpopulation of breast cancer cells. However, we observed that the dormant cells were localized primarily within the 3D tissue, while the proliferative cells were in contact with the polystyrene scaffold. As matrix stiffness is known to drive inflammatory and malignant behaviors, we explored the occurrence of spontaneous tumor dormancy and inflammatory phenotype. The microphysiological system was retrofitted with PEGDa-SynKRGD hydrogel scaffolding, which is softer and differs in the interface with the tissue. The microphysiological system incorporated donor-matched primary human hepatocytes and non-parenchymal cells (NPCs), with MDA-MB-231 breast cancer cells. Hepatic tissue in hydrogel scaffolds secreted lower levels of pro-inflammatory analytes, and was more responsive to inflammatory stimuli. The proportion of tumor cells entering dormancy was markedly increased in the hydrogel-supported tissue compared to polystyrene. Interestingly, an unexpected differential response of dormant cells to varying chemotherapeutic doses was identified, which if reflective of patient pathophysiology, has important implications for patient dosing regimens. These findings highlight the metastatic microphysiological system fitted with hydrogel scaffolds as a critical tool in the assessment and development of therapeutic strategies to target dormant metastatic breast cancer.

  3. Update on the Liver Imaging Reporting and Data System: What the Pathologist Needs to Know.

    PubMed

    Tang, An; Valasek, Mark A; Sirlin, Claude B

    2015-09-01

    Hepatocellular carcinoma (HCC) is frequently diagnosed noninvasively with imaging techniques. Computed tomography and magnetic resonance imaging play critical roles in the detection, diagnosis, and staging of HCC. Standardization in the interpretation and reporting of imaging modalities has not existed until recently. In 2008, the American College of Radiology supported the development of the Liver Imaging Reporting and Data System (LI-RADS) for standardized terminology, interpretation, and reporting of imaging examinations for the diagnosis of HCC inpatients at risk for HCC. This article reviews the basic concepts of LI-RADS, emphasizing aspects that are most relevant to pathologists, including the categories, diagnostic algorithm, major features, and ancillary features for the diagnosis of HCC. The similarities and differences between LI-RADS and other major radiology-based diagnostic systems in terms of target population, intended users, categorization of observations, and imaging methods are addressed. Importantly, LI-RADS and other systems are designed to diagnose progressed HCC with high specificity and modest sensitivity. LI-RADS and other systems are not designed to detect early HCC and so have limited sensitivity for such lesions. Moreover, despite continuous advances in imaging technology, imaging detection and characterization of small (<1 cm) nodules remains limited; in addition, colocalization of small nodules and pathology is difficult. For these reasons LI-RADS and most other systems require lesions to be 1 cm or greater for the noninvasive diagnosis of HCC. As LI-RADS evolves, it is critical that stakeholders, including pathologists, provide expert input to help standardize and enhance reporting of radiologic findings.

  4. Validation of the BARD scoring system in Polish patients with nonalcoholic fatty liver disease (NAFLD)

    PubMed Central

    2010-01-01

    Abtract Background Nonalcoholic fatty liver disease (NAFLD) includes a wide spectrum of liver diseases, ranging from pure steatosis to nonalcoholic steatohepatitis (NASH), and eventually to liver cirrhosis with its complications. Identifying advanced fibrosis in patients is crucial to evaluating prognosis and possible therapeutic intervention. A novel, simple, and highly accurate scoring system called BARD, which identifies patients with NAFLD and without significant fibrosis, has been recently introduced and validated in North America..The aim of this study is to validate the BARD scoring system in a Polish cohort with NAFLD. Methods A group of 104 Caucasians with biopsy-proven NAFLD were included in this study. Fibrosis in liver biopsies was evaluated according to the Histological Scoring System for Nonalcoholic Fatty Liver Disease. The BARD scoring system was assessed according to Harrison et al.: BMI ≥ 28 = 1 point, AST/ALT ratio (AAR) ≥ 0.8 = 2 points, type 2 diabetes mellitus = 1point. Results Age over 50 and AAR over 0.8 showed, respectively, a moderate and strong association with advanced fibrosis. A BARD score of 2-4 points was associated with F3 or F4 stages of fibrosis with an odds ratio of 17.333 (95% Cl; 3,639 - 82.558) and negative predictive value of 97%. Conclusion Our results demonstrate that the BARD scoring system has value in the non-invasive diagnosis of advanced fibrosis in NAFLD patients. The vast majority of patients with NAFLD would avoid liver biopsy if BARD was broadly introduced into the clinic. PMID:20584330

  5. Using Word Processing to Implement an Effective Administrative Support System

    ERIC Educational Resources Information Center

    Taylor, Wendy

    1978-01-01

    Describes the steps taken to reorganize the Administrative Support System of Houston Independent School District, to make it more efficient. A more flexible multi-function support team replaced the traditional private secretaries arrangement. (GA)

  6. An Intergenerational Support System for Child Welfare Families.

    ERIC Educational Resources Information Center

    Harnett, Joan

    1989-01-01

    Describes a program developed by the Children's Aid Society of Montgomery County, Pennsylvania, called Intergenerational Support System (ISS), in which senior volunteers serve as support persons for problem families. (SAK)

  7. 14 CFR 417.307 - Support systems.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... control centers and any down-range tracking and command transmitter sites. The system must provide for... motion signals; (2) Synchronize flight safety system instrumentation, including countdown clocks; and (3...

  8. Naval Aviation Maintenance Decision Support System

    DTIC Science & Technology

    1989-03-01

    Processing FCF Functional Check Flight 99 FMC Fully Mission Capable JCN Job Control Number MCC Maintenance Contorl Chief MESM Mission Essential Support...DESIGN, EVALUATION AND EVOLUTION........................6 A. DECISION MAKING THEORY...............6 1. The Decision Making Process ...........7 2...87 2. Prototyping and Adaptive Design ...... 88 V. CONCLUSIONS AND RECOMMENDATIONS ... .......... 91 A. CONCLUSIONS

  9. Support Systems and Women of the Diaspora

    ERIC Educational Resources Information Center

    Ojo, Elizabeth D.

    2009-01-01

    Humans are social beings endowed with intrinsic and extrinsic capabilities and a desire to seek and receive social support from one another. The extent to which this action takes place varies as people move farther away from their familiar environment to new locations. Many immigrant women have traveled far and wide in search of "better…

  10. Liver metastases

    MedlinePlus

    Metastases to the liver; Metastatic liver cancer; Liver cancer - metastatic; Colorectal cancer - liver metastases; Colon cancer - liver metastases; Esophageal cancer - liver metastases; Lung cancer - liver metastases; Melanoma - liver metastases

  11. Columbus system support for telescience operations

    NASA Technical Reports Server (NTRS)

    Lytton, David W.; Schulze, Rolf

    1993-01-01

    With the given constraints of the space environment, the telescience concept aims at providing a space mission user with optimum flexibility and responsiveness for spaceborne investigations. The concept includes automated system management functions, which allocate and monitor planned resources and time windows, within which the investigator can perform his science interactively responding 'on-line' to experimental data. During the telescience operation, the user is given the capability to send telecommands to the payload from the User Home Base with transparency to the rest of the system. Any violation of the 'booked' time and resources will be detected by the system and reported back to the user for appropriate action. Ultimately, the system will react to maintain the integrity of the system and its payload. Upon completion of the telescience session, the system management function reverses the system configuration and deallocates resources automatically.

  12. Betulinic acid prevents alcohol-induced liver damage by improving the antioxidant system in mice

    PubMed Central

    Xia, Wei; Wu, Jianping; Yuan, Liyun; Wu, Jing; Tu, Di; Fang, Jun

    2014-01-01

    Betulinic acid (BA), a pentacyclic lupane-type triterpene, has a wide range of bioactivities. The main objective of this work was to evaluate the hepatoprotective activity of BA and the potential mechanism underlying the ability of this compound to prevent liver damage induced by alcohol in vivo. Mice were given oral doses of BA (0.25, 0.5, and 1.0 mg/kg) daily for 14 days, and induced liver injury by feeding 50% alcohol orally at the dosage of 10 ml/kg after 1 h last administration of BA. BA pretreatment significantly reduced the serum levels of alanine transaminase, aspartate transaminase, total cholesterol, and triacylglycerides in a dose-dependent manner in the mice administered alcohol. Hepatic levels of glutathione, superoxide dismutase, glutathione peroxidase, and catalase were remarkably increased, while malondialdehyde contents and microvesicular steatosis in the liver were decreased by BA in a dose-dependent manner after alcohol-induced liver injury. These findings suggest that the mechanism underlying the hepatoprotective effects of BA might be due to increased antioxidant capacity, mainly through improvement of the tissue redox system, maintenance of the antioxidant system, and decreased lipid peroxidation in the liver. PMID:24378582

  13. Metabolic phenotyping and systems biology approaches to understanding metabolic syndrome and fatty liver disease.

    PubMed

    Dumas, Marc-Emmanuel; Kinross, James; Nicholson, Jeremy K

    2014-01-01

    Metabolic syndrome, a cluster of risk factors for type 2 diabetes mellitus and cardiovascular disease, is becoming an increasing global health concern. Insulin resistance is often associated with metabolic syndrome and also typical hepatic manifestations such as nonalcoholic fatty liver disease. Profiling of metabolic products (metabolic phenotyping or metabotyping) has provided new insights into metabolic syndrome and nonalcoholic fatty liver disease. Data from nuclear magnetic resonance spectroscopy and mass spectrometry combined with statistical modeling and top-down systems biology have allowed us to analyze and interpret metabolic signatures in terms of metabolic pathways and protein interaction networks and to identify the genomic and metagenomic determinants of metabolism. For example, metabolic phenotyping has shown that relationships between host cells and the microbiome affect development of the metabolic syndrome and fatty liver disease. We review recent developments in metabolic phenotyping and systems biology technologies and how these methodologies have provided insights into the mechanisms of metabolic syndrome and nonalcoholic fatty liver disease. We discuss emerging areas of research in this field and outline our vision for how metabolic phenotyping could be used to study metabolic syndrome and fatty liver disease. Copyright © 2014 AGA Institute. Published by Elsevier Inc. All rights reserved.

  14. 46 CFR 56.50-110 - Diving support systems.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 2 2010-10-01 2010-10-01 false Diving support systems. 56.50-110 Section 56.50-110... APPURTENANCES Design Requirements Pertaining to Specific Systems § 56.50-110 Diving support systems. (a) In addition to the requirements of this part, piping for diving installations which is permanently...

  15. 45 CFR 307.5 - Mandatory computerized support enforcement systems.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... plans to use and how they will interface with the base system; (3) Provide documentation that the... 45 Public Welfare 2 2014-10-01 2012-10-01 true Mandatory computerized support enforcement systems... HEALTH AND HUMAN SERVICES COMPUTERIZED SUPPORT ENFORCEMENT SYSTEMS § 307.5 Mandatory computerized...

  16. 45 CFR 307.5 - Mandatory computerized support enforcement systems.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... plans to use and how they will interface with the base system; (3) Provide documentation that the... 45 Public Welfare 2 2011-10-01 2011-10-01 false Mandatory computerized support enforcement systems... HEALTH AND HUMAN SERVICES COMPUTERIZED SUPPORT ENFORCEMENT SYSTEMS § 307.5 Mandatory computerized...

  17. System Engineering and Evolution Decision Support

    DTIC Science & Technology

    2007-11-02

    invoked the applet. 5. LANGUAGE SUPPORT FOR INTELLIGENT SOFTWARE DECOYS We believe that Eiffel is a natural choice of programming languages for...implementing intelligent software decoys, at least for the purposes of initial experimentation with such decoys. In contrast to Ada, for example, Eiffel ...operations ensure postconditions invariant invariants end Moreover, Eiffel provides for inheritance of the assertions from ancestor classes by a descendant

  18. Structural analysis of FAST reflector supporting system

    NASA Astrophysics Data System (ADS)

    Luo, Y. F.; Deng, C. G.; Li, G. Q.; He, Y. M.

    According to the deformation and movement requirements of the FAST reflector, a multi-purpose analysis, including the load-bearing behavior, deformation, construction costs of the reflector supporting structure and its model, is presented in this paper. The advantages and disadvantages of steel and aluminum alloy structures are also discussed and compared through detailed design calculations under load-bearing capacity and normal working conditions.

  19. Knowledge systems support for mission operations automation

    NASA Astrophysics Data System (ADS)

    Atkinson, David J.

    1990-10-01

    A knowledge system which utilizes artificial intelligence technology to automate a subset of real time mission operations functions is described. An overview of spacecraft telecommunications operations at the Jet Propulsion Laboratories (JPL) highlights requirements for automation. The knowledge system, called the Spacecraft Health Automated Reasoning Prototype (SHARP), developed to explore methods for automated health and status analysis is outlined. The advantages of the system were demonstrated during the spacecraft's encounter with the planet Neptune. The design of the fault detection and diagnosis portions of SHARP is discussed. The performance of SHARP during the encounter is discussed along with issues and benefits arising from application of knowledge system to mission operations automation.

  20. Performance status in patients with hepatocellular carcinoma: determinants, prognostic impact, and ability to improve the Barcelona Clinic Liver Cancer system.

    PubMed

    Hsu, Chia-Yang; Lee, Yun-Hsuan; Hsia, Cheng-Yuan; Huang, Yi-Hsiang; Su, Chien-Wei; Lin, Han-Chieh; Lee, Rheun-Chuan; Chiou, Yi-You; Lee, Fa-Yauh; Huo, Teh-Ia

    2013-01-01

    Performance status is included in the Barcelona Clinic Liver Cancer (BCLC) system for hepatocellular carcinoma (HCC). Few studies specifically evaluated the role of performance status in patients with HCC. This study investigated its distribution, determinants, and prognostic impact, aiming to improve the performance of the BCLC system. A total of 2,381 HCC patients were enrolled. Performance status was determined according to the Eastern Cooperative Oncology Group scale. The prognostic ability of the original and three modified BCLC systems in HCC patients was compared by the Akaike information criterion (AIC). There were 60, 17, 11, 8, and 4% of patients who were classified as performance status 0, 1, 2, 3, and 4, respectively. A worse performance status significantly correlated with age, alcoholism, hypoalbuminemia, hyperbilirubinemia, renal insufficiency, hyponatremia, and prothrombin time prolongation (all P < 0.001). Larger tumor burden, poorer residual liver function, more frequent vascular invasion, and diabetes mellitus were also observed in patients with worse performance status (all P < 0.001). Patients with poorer performance status more often received best supportive care (P < 0.001). In the Cox proportional hazards model, performance status was an independent prognostic predictor and the long-term survival tended to be worse in patients with progressively poor performance status (all P < 0.05). Reassigning patients with performance status 0 or 1 to stage B provided the lowest AIC among the four BCLC-based staging systems. Performance status is strongly associated with both tumoral and cirrhotic factors and accurately predicts long-term survival in HCC patients. Modification of the BCLC system based on performance status may further enhance its prognostic ability in patients with early to advanced cancer stage. Copyright © 2012 American Association for the Study of Liver Diseases.

  1. Contrast-Enhanced Three Dimensional Ultrasonography supporting HIFU treatment of Small Liver Cancer

    NASA Astrophysics Data System (ADS)

    Ohto, Masao; Fukuda, Hiroyuki; Ito, Ryu; Shinohara, Yasushi; Sakamoto, Akio; Karasawa, Eii

    2009-04-01

    HIFU was carried out in the 12 patients with small hepatocellular carcinoma (small HCC) as a extracorporeal ablation therapy, and clinical availability was studied from the results. In carrying out the HIFU therapy, contrast enhanced (CE) three dimensional (3D) ultrasound imaging played an important role to clarify the tumor nature , to monitor the sonication procedure and to assess the tumor ablation and was almost indispensable for the treatment. All the patient had no serious side effects and they are all alive with no local tumor progression for 3 to 14 months after the treatment. Ultrasound supporting HIFU therapy could be usefully available for the treatment of small HCC.

  2. Reduced liver apoptosis after venous systemic oxygen persufflation in non-heart-beating donors.

    PubMed

    Tolba, R H; Schildberg, F A; Schnurr, C; Glatzel, U; Decker, D; Minor, T

    2006-01-01

    Graft injury caused by warm ischemia in livers from non-heart-beating donors (NHBDs) strongly affects posttransplantation outcome and is associated with liver apoptosis, which is mediated by death receptors, such as Fas, a surface receptor of the tumor necrosis factor (TNF)-alpha family. The aim of this study was to test the ability of venous systemic oxygen persufflation (VSOP) to reduce apoptotic changes and Fas activation in the liver after warm ischemic insult in vivo. Livers of male Wistar rats were harvested 30 min after cardiac arrest from non-heart-beating donors (NHBD) with (NHBD + O2) or without (NHBD) application of gaseous oxygen during the cold storage period via the suprahepatic caval vein. After 24 h of storage in University of Wisconsin solution at 4 degrees C, viability of the livers was assessed upon isolated reperfusion in vitro. Conventional signs of tissue damage like enzyme release and bile production showed a significantly elevated nonspecific cell injury in the NHBD group. TUNEL staining revealed increased DNA fragmentation of sinusoidal endothelial cells in the NHBD group and more apoptotic hepatocytes than in the control group. All these alterations could be almost abrogated by the use of VSOP in the NHBD + O2 group. The immunohistochemical staining of Fas antigen expression showed a significantly elevated Fas receptor expression in the NHBD and NHBD + O2 groups, in accord with an eightfold increase of Fas receptor mRNA detected by real-time reverse-transcription polymerase chain reaction (RT-PCR). These results demonstrate that the postischemic apoptotic rate of sinusoidal endothelial cells in NHBD livers can be reduced by the use of VSOP. A significant improvement in liver integrity and viability was obtained with this technique, without influencing the expression of Fas expression.

  3. The renin angiotensin system regulates Kupffer cells in colorectal liver metastases

    PubMed Central

    Wen, Shu Wen; Ager, Eleanor I; Neo, Jaclyn; Christophi, Christopher

    2013-01-01

    Blockade of the renin angiotensin system (RAS) can inhibit tumor growth and this may be mediated via undefined immunomodulatory actions. This study investigated the effects of RAS blockade on liver macrophages (Kupffer cells; KCs) in an orthotopic murine model of colorectal cancer (CRC) liver metastases. Here we showed that pharmacological targeting of the RAS [ANG II (31.25 µg/kg/h i.p.), ANG-(1–7) (24 µg/kg/h i.p.) or the ACE inhibitor; captopril (750 mg/kg/d i.p.)] altered endogenous KC numbers in the tumor-bearing liver throughout metastatic growth. Captopril, and to a lesser extent ANG-(1–7), increased KC numbers in the liver but not tumor. KCs were found to express the key RAS components: ACE and AT1R. Treatment with captopril and ANG II increased the number of AT1R-expressing KCs, although total KC numbers were not affected by ANG II. Captopril (0.1 µM) also increased macrophage invasion in vitro. Additionally, captopril was administered with KC depletion before tumor induction (day 0) or at established metastatic growth (day 18) using gadolinium chloride (GdCl3; 20 mg/kg). Livers were collected at day 21 and quantitative stereology used as a measure of tumor burden. Captopril reduced growth of CRC liver metastases. However, when captopril was combined with early KC depletion (day 0) tumor growth was significantly increased compared with captopril alone. In contrast, late KC depletion (day 18) failed to influence the anti-tumor effects of captopril. The result of these studies suggests that manipulation of the RAS can alter KC numbers and may subsequently influence progression of CRC liver metastases. PMID:23792575

  4. The Groningen hypothermic liver perfusion pump: functional evaluation of a new machine perfusion system.

    PubMed

    van der Plaats, A; Maathuis, M H J; 'T Hart, N A; Bellekom, A A; Hofker, H S; van der Houwen, E B; Verkerke, G J; Leuvenink, H G D; Verdonck, P; Ploeg, R J; Rakhorst, G

    2006-12-01

    To improve preservation of donor livers, we have developed a portable hypothermic machine perfusion (HMP) system as an alternative for static cold storage. A prototype of the system was built and evaluated on functionality. Evaluation criteria included 24 h of adequate pressure controlled perfusion, sufficient oxygenation, a maintained 0-4 degrees C temperature and sterile conditions. Porcine livers were perfused with pump pressures that were set at 4 mmHg (continuous, portal vein) and 30/20 mmHg, at 60 BPM (pulsatile, hepatic artery). Control livers were preserved using the clinical golden standard: static cold storage. In the HMP group, pressure, flow and temperature were continuously monitored for 24 h. At time-points t = 0, 2, 4, 8, 12, and 24 h samples of University of Wisconsin machine preservation solution were taken for measurement of partial oxygen pressure (pO(2)) and lacto-dehydrogenase. Biopsies in every lobe were taken for histology and electron microscopy; samples of ice, preservation solution, liver surface, and bile were taken and cultured to determine sterility. Results showed that temperature was maintained at 0-4 degrees C; perfusion pressure was maintained at 4 mmHg and 30/20 mmHg for portal vein and hepatic artery, respectively. Flow was approximately 350 and 80 ml/min, respectively, but decreased in the portal vein, probably due to edema formation. Arterial pO(2) was kept at 100 kPa. Histology showed complete perfusion of the liver with no major damage to hepatocytes, bile ducts, and non-parenchymal cells compared to control livers. The machine perfusion system complied to the design criteria and will have to demonstrate the superiority of machine perfusion over cold storage in transplant experiments.

  5. 7. VIEW NORTHWEST, DETAIL VERTICAL SUPPORT SYSTEM, STRINGER, CONNECTIONS AND ...

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

    7. VIEW NORTHWEST, DETAIL VERTICAL SUPPORT SYSTEM, STRINGER, CONNECTIONS AND TRAFFIC DECK - Hagerstown Road Bridge, Spanning Little Cotoctin Creek at Old Hagerstown Road, Middletown, Frederick County, MD

  6. Efficacy and safety of anticoagulation with heparin versus heparin plus epoprostenol in patients undergoing extracorporeal liver support with Prometheus.

    PubMed

    Krisper, Peter; Tiran, Beate; Fliser, Danilo; Haditsch, Bernd; Stadlbauer, Vanessa; Otto, Ronald; Ernst, Thomas; Kretschmer, Ulrich; Stauber, Rudolf E; Haller, Hermann; Holzer, Herwig; Manns, Michael P; Rifai, Kinan

    2010-01-01

    Anticoagulation for extracorporeal liver support is delicate due to underlying coagulation disorders in patients with liver failure and to the associated elevated bleeding risk. To date, there has been no detailed report on anticoagulation issues in patients treated with Prometheus, a device based on the principle of fractionated plasma separation and adsorption. We studied 17 patients from two centers treated with Prometheus, comparing standard anticoagulation with heparin (15 treatments) and a combination of heparin and the synthetic prostacyclin epoprostenol (22 treatments). Standard coagulation tests, proteins C and S, and thrombin-antithrombin (TAT) complex were determined, and adverse events were recorded. All but two treatments could be completed as scheduled, although filter exchange due to filter clotting was required in 24% of the treatments. Three out of 17 patients developed severe bleeding complications within 24 h of treatment. There were no overt thrombotic events. Addition of epoprostenol neither reduced coagulation-related adverse events nor improved standard coagulation parameters. Protein C, but not protein S, showed a significant reduction (23 +/- 18%) after Prometheus treatments, but levels rebounded to baseline within 18 h. TAT levels--a measure for activation of coagulation--were only altered by Prometheus in patients where TAT was already elevated before treatment. In conclusion, anticoagulation of Prometheus with heparin is feasible but still associated with a relatively high frequency of filter clotting and a considerable risk of severe bleeding in this high-risk patient population. As addition of epoprostenol did not prove beneficial, other strategies, such as regional anticoagulation with citrate, should be further evaluated.

  7. Influence of G-forces and hypodynamia on the portal system of the liver

    NASA Technical Reports Server (NTRS)

    Drozdova, A. V.

    1975-01-01

    Longitudinally and transversely applied g-forces as intolerable levels cause damage to the interlobular veins of the liver, with maximum damage caused by dorso-ventral g-force application. The portal vein system is more resilient with respect to g-forces at the limit of tolerance.

  8. Dual-row needle arrays under an electromagnetic thermotherapy system for bloodless liver resection surgery.

    PubMed

    Huang, Sheng Chieh; Chang, Yi Yuan; Chao, Ying Jui; Shan, Yan Shen; Lin, Xi Zhang; Lee, Gwo Bin

    2012-03-01

    Electromagnetic thermotherapy has been extensively investigated recently and may become a new surgical modality for a variety of medical applications. It applies a high-frequency alternating magnetic field to heat up magnetic materials inserted within the human body to generate tissue coagulation or cell apoptosis. Using a new procedure with dual-row needle arrays under an electromagnetic thermotherapy system with a feedback temperature control system, this study demonstrates bloodless porcine liver resection, which is challenging using existing methods. In vitro experiments showed that hollowed, stainless-steel needles could be heated up to more than 300 °C within 30 s when centered under the induction coils of the electromagnetic thermotherapy system. In order to generate a wide ablation zone and to prevent the dual-row needle arrays from sticking to the tissue after heating, a constant temperature of 120 °C was applied using a specific treatment protocol. The temperature distribution in the porcine livers was also measured to explore the effective coagulation area. Liver resection was then performed in Lan-Yu pigs. Experimental results showed that seven pigs underwent liver resection without bleeding during surgery and no complications afterward. The dual-row needle arrays combined with the electromagnetic thermotherapy system are thus shown to be promising for bloodless tissue resection.

  9. Influence of G-forces and hypodynamia on the portal system of the liver

    NASA Technical Reports Server (NTRS)

    Drozdova, A. V.

    1975-01-01

    Longitudinally and transversely applied g-forces as intolerable levels cause damage to the interlobular veins of the liver, with maximum damage caused by dorso-ventral g-force application. The portal vein system is more resilient with respect to g-forces at the limit of tolerance.

  10. The role of endocannabinoids system in fatty liver disease and therapeutic potentials.

    PubMed

    Alswat, Khalid A

    2013-01-01

    Non-alcoholic fatty liver disease (NAFLD) is a major cause of liver morbidity and mortality with no proven effective therapy as of yet. Its prevalence is increasing globally in parallel with obesity and metabolic syndrome pandemic. The endocannabinoid (EC) system has been implicated in the pathogenesis of several diseases, including fatty liver diseases. This system refers to the cannabinoid receptors type 1 (CB1) and type 2 (CB2), with both their endogenous ligands and machinery dedicated to EC synthesis and degradation. There is accumulating evidence on the role CB1 as a key mediator of insulin resistance and liver lipogenesis in both animals and humans. On the other hand, CB2 receptors have been shown to promote inflammation with anti-fibrogenic properties. The pharmacological modulation of the EC system activity for the treatment of metabolic syndrome and NAFLD are promising yet premature. The initial limited success due to deleterious central nervous system side-effects are likely to be bypassed with the use of peripherally restricted drugs.

  11. Analysis of the HI-6, HS-3 and HS-6, Influence on the Liver Methabolizing Enzyme Systems

    DTIC Science & Technology

    2001-09-01

    ON THE LIVER METHABOLIZING ENZIME SYSTEMS Christophor Dishovsky, Maria Kadiiska*, Petko Alov* Military Medical Academy, 1606, Sofia, Bulgaria...reactivators of ChE, liver, methabolizing enzime systems FIGURES AND TABLES Table 1. Effect of reactivators of ChE HS-3, HS-6, HI-6 on the hexobarbital

  12. A survey of life support system automation and control

    NASA Technical Reports Server (NTRS)

    Finn, Cory K.

    1993-01-01

    The level of automation and control necessary to support advanced life support systems for use in the manned space program is steadily increasing. As the length and complexity of manned missions increase, life support systems must be able to meet new space challenges. Longer, more complex missions create new demands for increased automation, improved sensors, and improved control systems. It is imperative that research in these key areas keep pace with current and future developments in regenerative life support technology. This paper provides an overview of past and present research in the areas of sensor development, automation, and control of life support systems for the manned space program, and it discusses the impact continued research in several key areas will have on the feasibility, operation, and design of future life support systems.

  13. Control Systems Cyber Security Standards Support Activities

    SciTech Connect

    Robert Evans

    2009-01-01

    The Department of Homeland Security’s Control Systems Security Program (CSSP) is working with industry to secure critical infrastructure sectors from cyber intrusions that could compromise control systems. This document describes CSSP’s current activities with industry organizations in developing cyber security standards for control systems. In addition, it summarizes the standards work being conducted by organizations within the sector and provides a brief listing of sector meetings and conferences that might be of interest for each sector. Control systems cyber security standards are part of a rapidly changing environment. The participation of CSSP in the development effort for these standards has provided consistency in the technical content of the standards while ensuring that information developed by CSSP is included.

  14. Environmental Control and Life Support Systems

    NASA Technical Reports Server (NTRS)

    Engel, Joshua Allen

    2017-01-01

    The Environmental Control System provides a controlled air purge to Orion and SLS. The ECS performs this function by processing 100% ambient air while simultaneously controlling temperature, pressure, humidity, cleanliness and purge distribution.

  15. Evaluating Detection and Diagnostic Decision Support Systems for Bioterrorism Response

    PubMed Central

    Sundaram, Vandana; McDonald, Kathryn M.; Smith, Wendy M.; Szeto, Herbert; Schleinitz, Mark D.; Owens, Douglas K.

    2004-01-01

    We evaluated the usefulness of detection systems and diagnostic decision support systems for bioterrorism response. We performed a systematic review by searching relevant databases (e.g., MEDLINE) and Web sites for reports of detection systems and diagnostic decision support systems that could be used during bioterrorism responses. We reviewed over 24,000 citations and identified 55 detection systems and 23 diagnostic decision support systems. Only 35 systems have been evaluated: 4 reported both sensitivity and specificity, 13 were compared to a reference standard, and 31 were evaluated for their timeliness. Most evaluations of detection systems and some evaluations of diagnostic systems for bioterrorism responses are critically deficient. Because false-positive and false-negative rates are unknown for most systems, decision making on the basis of these systems is seriously compromised. We describe a framework for the design of future evaluations of such systems. PMID:15078604

  16. Stability design considerations for mirror support systems in ICF lasers

    SciTech Connect

    Tietbohl, G.L.; Sommer, S.C.

    1996-10-01

    Some of the major components of laser systems used for Inertial Confinement Fusion (ICF) are the large aperture mirrors which direct the path of the laser. These mirrors are typically supported by systems which consist of mirror mounts, mirror enclosures, superstructures, and foundations. Stability design considerations for the support systems of large aperture mirrors have been developed based on the experience of designing and evaluating similar systems at the Lawrence Livermore National Laboratory (LLNL). Examples of the systems developed at LLNL include Nova, the Petawatt laser, Beamlet, and the National Ignition Facility (NIF). The structural design of support systems of large aperture mirrors has typically been controlled by stability considerations in order for the large laser system to meet its performance requirements for alignment and positioning. This paper will discuss the influence of stability considerations and will provide guidance on the structural design and evaluation of mirror support systems in ICF lasers so that this information can be used on similar systems.

  17. Brief Survey of Operational Decision Support Systems

    DTIC Science & Technology

    1979-02-01

    aroumi the investigation of the life cycle evolution of the four specified experimental or operational DSS in terms of their operational...provided a rich source of raw- questionaire type data which reflects the opinions of individual users, technicians and managers (1). Further, a growing...four mature and widely publicized DSS over their individual system life cycles. This ap- - 10 - proach was adopted because the four systems of

  18. 2013 Robotics Science & Systems Conference Travel Support

    DTIC Science & Technology

    2015-01-21

    SECURITY CLASSIFICATION OF: The 2013 Robotics : Science and Systems Conference will bring together researchers working on algorithmic or mathematical...foundations of robotics , robotics applications, and analysis of robotic systems. High quality, original papers are solicited in all areas of robotics ...conference will be single track to allow attendees an opportunity to experience the best research in all areas of robotics . The program will include

  19. Long term perfusion system supporting adipogenesis

    PubMed Central

    Abbott, Rosalyn D.; Raja, Waseem K.; Wang, Rebecca Y.; Stinson, Jordan A.; Glettig, Dean L.; Burke, Kelly A.; Kaplan, David L.

    2015-01-01

    Adipose tissue engineered models are needed to enhance our understanding of disease mechanisms and for soft tissue regenerative strategies. Perfusion systems generate more physiologically relevant and sustainable adipose tissue models, however adipocytes have unique properties that make culturing them in a perfusion environment challenging. In this paper we describe the methods involved in the development of two perfusion culture systems (2D and 3D) to test their applicability for long term in vitro adipogenic cultures. It was hypothesized that a silk protein biomaterial scaffold would provide a 3D framework, in combination with perfusion flow, to generate a more physiologically relevant sustainable adipose tissue engineered model than 2D cell culture. Consistent with other studies evaluating 2D and 3D culture systems for adipogenesis we found that both systems successfully model adipogensis, however 3D culture systems were more robust, providing the mechanical structure required to contain the large, fragile adipocytes that were lost in 2D perfused culture systems. 3D perfusion also stimulated greater lipogenesis and lipolysis and resulted in decreased secretion of LDH compared to 2D perfusion. Regardless of culture configuration (2D or 3D) greater glycerol was secreted with the increased nutritional supply provided by perfusion of fresh media. These results are promising for adipose tissue engineering applications including long term cultures for studying disease mechanisms and regenerative approaches, where both acute (days to weeks) and chronic (weeks to months) cultivation are critical for useful insight. PMID:25843606

  20. EPICS : operating system independent device/driver support.

    SciTech Connect

    Kraimer, M. R.; Accelerator Systems Division

    2003-01-01

    Originally EPICS input/output controllers (IOCs) were only supported on VME-based systems running the vxWorks operating system. Now IOCs are supported on many systems: vxWorks, RTEMS, Solaris, HPUX, Linux, WIN32, and Darwin. A challenge is to provide operating-system-independent device and driver support. This paper presents some techniques for providing such support. EPICS (Experimental Physics and Industrial Control System) is a set of software tools, libraries, and applications developed collaboratively and used worldwide to create distributed, real-time control systems for scientific instruments such as particle accelerators, telescopes, and other large scientific experiments. An important component of all EPICS-based control systems is a collection of input/output controllers (IOCs). An IOC has three primary components: (1) a real-time database; (2) channel access, which provides network access to the database; and (3) device/driver support for interfacing to equipment. This paper describes some projects related to providing device/driver support on non-vxWorks systems. In order to support IOCs on platforms other than vxWorks, operating-system-independent (OSI) application program interfaces (APIs) were defined for threads, semaphores, timers, etc. Providing support for a new platform consists of providing an operating-system-dependent implementation of the OSI APIs.

  1. Developing the U.S. Wildland Fire Decision Support System

    Treesearch

    Erin Noonan-Wright; Tonja S. Opperman; Mark A. Finney; Tom Zimmerman; Robert C. Seli; Lisa M. Elenz; David E. Calkin; John R. Fiedler

    2011-01-01

    A new decision support tool, the Wildland Fire Decision Support System (WFDSS) has been developed to support risk-informed decision-making for individual fires in the United States. WFDSS accesses national weather data and forecasts, fire behavior prediction, economic assessment, smoke management assessment, and landscape databases to efficiently formulate and apply...

  2. Supporting Technology Integration within a Teacher Education System

    ERIC Educational Resources Information Center

    Schaffer, Scott P.; Richardson, Jennifer C.

    2004-01-01

    The purpose of this case study was to examine a teacher education system relative to the degree of performance support for the use of technology to support learning. Performance support was measured by the presence of factors such as clear expectations, feedback, tools, rewards, incentives, motivation, capacity, skills, and knowledge within the…

  3. A support architecture for reliable distributed computing systems

    NASA Technical Reports Server (NTRS)

    Dasgupta, Partha; Leblanc, Richard J., Jr.

    1988-01-01

    The Clouds project is well underway to its goal of building a unified distributed operating system supporting the object model. The operating system design uses the object concept of structuring software at all levels of the system. The basic operating system was developed and work is under progress to build a usable system.

  4. Development of a portable life support system and emergency life support pack

    NASA Technical Reports Server (NTRS)

    1970-01-01

    The design, development, and fabrication of a feasibility model of a breathing bag life support system for extravehicular activity are discussed. The breathing vest and back pack portable life support system contains connectors which allow external water and gas supply. At a metabolic rate of 2000 BTU per hour, the two low pressure bottles provide 27 minutes of breathing gas for a total filled system weight of 30.5 pounds.

  5. Enhanced gene expression of systemically administered plasmid DNA in the liver with therapeutic ultrasound and microbubbles.

    PubMed

    Raju, Balasundar I; Leyvi, Evgeniy; Seip, Ralf; Sethuraman, Shriram; Luo, Xiaoyan; Bird, Andrew; Li, Songtao; Koeberl, Dwight

    2013-01-01

    Ultrasound-mediated delivery (USMD) of novel therapeutic agents in the presence of microbubbles is a potentially safe and effective method for gene therapy offering many desired characteristics, such as low toxicity, potential for repeated treatment, and organ specificity. In this study, we tested the capability of USMD to improve gene expression in mice livers using glycogen storage disease Type Ia as a model disease under systemic administration of naked plasmid DNA. Image-guided therapeutic ultrasound was used in two studies to provide therapeutic ultrasound to mice livers. In the first study, involving wild-type mice, control animals received naked plasmid DNA (pG6Pase 150 μg) via the tail vein, followed by an infusion of microbubbles; the treated animals additionally received therapeutic ultrasound (1 MHz). Following the procedure, the animals were left to recover and were subsequently euthanized after 2 d and liver samples were extracted. Reverse transcription polymerase chain reaction (RT-PCR) assays were performed on the samples to quantify mRNA expression. In addition, Western blot assays of FLAG-tagged glucose-6-phosphatase (G6Pase) were performed to evaluate protein expression. Ultrasound-exposed animals showed a 4-fold increase in G6Pase RNA in the liver, in comparison with control animals. Furthermore, results from Western blot analysis demonstrated a 2-fold increased protein expression in ultrasound-exposed animals after two days ( p < 0.05). A second pilot study was performed with G6Pase knockout mice, and the animals were monitored for correction of hypoglycemia over a period of 3 weeks before tissue analysis. The RT-PCR assays of samples from these animals demonstrated increased G6Pase RNA in the liver following ultrasound treatment. These results demonstrate that USMD can increase gene expression of systemically injected naked pDNA in the liver and also provide insight into the development of realistic approaches that can be translated into

  6. Development and characterization of sorafenib-loaded PLGA nanoparticles for the systemic treatment of liver fibrosis.

    PubMed

    Lin, Ts-Ting; Gao, Dong-Yu; Liu, Ya-Chi; Sung, Yun-Chieh; Wan, Dehui; Liu, Jia-Yu; Chiang, Tsaiyu; Wang, Liying; Chen, Yunching

    2016-01-10

    Sorafenib is a tyrosine kinase inhibitor that has recently been shown to be a potential antifibrotic agent. However, a narrow therapeutic window limits the clinical use and therapeutic efficacy of sorafenib. Herein, we have developed and optimized nanoparticle (NP) formulations prepared from a mixture of poly(ethylene glycol)-b-poly(lactic-co-glycolic acid) (PEG-PLGA) copolymers with poly(lactic-co-glycolic acid) (PLGA) for the systemic delivery of sorafenib into the fibrotic livers of CCl4-induced fibrosis mouse models. We characterized and compared the pharmaceutical and biological properties of two different PLGA nanoparticles (NPs)--PEG-PLGA NPs (PEG-PLGA/PLGA=10/0) and PEG-PLGA/PLGA NPs (PEG-PLGA/PLGA=5/5). Increasing the PLGA content in the PEG-PLGA/PLGA mixture led to increases in the particle size and drug encapsulation efficacy and a decrease in the drug release rate. Both PEG-PLGA and PEG-PLGA/PLGA NPs significantly prolonged the blood circulation of the cargo and increased the uptake by the fibrotic livers. The systemic administration of PEG-PLGA or PEG-PLGA/PLGA NPs containing sorafenib twice per week for a period of 4 weeks efficiently ameliorated liver fibrosis, as indicated by decreased α-smooth muscle actin (α-SMA) content and collagen production in the livers of CCl4-treated mice. Furthermore, sorafenib-loaded PLGA NPs significantly shrank the abnormal blood vessels and decreased microvascular density (MVD), leading to vessel normalization in the fibrotic livers. In conclusion, our results reflect the clinical potential of sorafenib-loaded PLGA NPs for the prevention and treatment of liver fibrosis. Copyright © 2015 Elsevier B.V. All rights reserved.

  7. Advanced systems engineering and network planning support

    NASA Technical Reports Server (NTRS)

    Walters, David H.; Barrett, Larry K.; Boyd, Ronald; Bazaj, Suresh; Mitchell, Lionel; Brosi, Fred

    1990-01-01

    The objective of this task was to take a fresh look at the NASA Space Network Control (SNC) element for the Advanced Tracking and Data Relay Satellite System (ATDRSS) such that it can be made more efficient and responsive to the user by introducing new concepts and technologies appropriate for the 1997 timeframe. In particular, it was desired to investigate the technologies and concepts employed in similar systems that may be applicable to the SNC. The recommendations resulting from this study include resource partitioning, on-line access to subsets of the SN schedule, fluid scheduling, increased use of demand access on the MA service, automating Inter-System Control functions using monitor by exception, increase automation for distributed data management and distributed work management, viewing SN operational control in terms of the OSI Management framework, and the introduction of automated interface management.

  8. Using Visualization in Cockpit Decision Support Systems

    SciTech Connect

    Aragon, Cecilia R.

    2005-07-01

    Beamline 7.2 of the Advanced Light Source (ALS) at the Lawrence Berkeley National Laboratory (LBNL) is a beam diagnostics system that uses the synchrotron radiation emitted by a dipole magnet. It consists of two branches; in the first one the x-ray portion of the radiation is used in a pinhole camera system for measuring the transverse profile of the beam. The second branch is equipped with an x-ray beam position monitor (BPM) and with a multipurpose port where the visible and the far-infrared part of the radiation can be used for various applications such as bunch length measurements and IR coherent synchrotron radiation experiments. The pinhole system has been operating successfully since the end of 2003. The installation of the second branch has been completed recently and the results of its commissioning are presented in this paper together with examples of beam measurements performed at BL 7.2.

  9. Social Network Supported Process Recommender System

    PubMed Central

    Ye, Yanming; Yin, Jianwei; Xu, Yueshen

    2014-01-01

    Process recommendation technologies have gained more and more attention in the field of intelligent business process modeling to assist the process modeling. However, most of the existing technologies only use the process structure analysis and do not take the social features of processes into account, while the process modeling is complex and comprehensive in most situations. This paper studies the feasibility of social network research technologies on process recommendation and builds a social network system of processes based on the features similarities. Then, three process matching degree measurements are presented and the system implementation is discussed subsequently. Finally, experimental evaluations and future works are introduced. PMID:24672309

  10. Social network supported process recommender system.

    PubMed

    Ye, Yanming; Yin, Jianwei; Xu, Yueshen

    2014-01-01

    Process recommendation technologies have gained more and more attention in the field of intelligent business process modeling to assist the process modeling. However, most of the existing technologies only use the process structure analysis and do not take the social features of processes into account, while the process modeling is complex and comprehensive in most situations. This paper studies the feasibility of social network research technologies on process recommendation and builds a social network system of processes based on the features similarities. Then, three process matching degree measurements are presented and the system implementation is discussed subsequently. Finally, experimental evaluations and future works are introduced.

  11. Liver suction-mediated transfection in mice using a pressure-controlled computer system.

    PubMed

    Shimizu, Kazunori; Zhang, Guangyuan; Kawakami, Shigeru; Taniguchi, Yota; Hayashi, Kouji; Hashida, Mitsuru; Konishi, Satoshi

    2014-01-01

    We previously developed an in vivo tissue suction-mediated transfection method (denoted as the tissue suction method) for naked nucleic acids, such as plasmid DNA (pDNA) and small interfering RNA (siRNA), in mice. However, it remains unclear whether the suction pressure conditions affect the results of this method. Therefore, in the present study, we assembled a computer system to control the suction pressure and investigate the effects of the suction pressure conditions on the efficiency of the liver suction transfection of naked pDNA that encodes luciferase in mice. Using the developed system, we examined the effects of the minimum magnitude of the suction pressure, suction pressure waveform, and suction times of the luciferase expression level in mice livers. We determined that the liver suction method at 5 kPa was not only effective but also caused the lowest hepatic toxicity in mice. Additionally, the results indicated that the suction pressure waveform affects the luciferase expression levels, and a single period of suction on the targeted portion of the liver is sufficient for transfection. Thus, the developed system is useful for performing the tissue suction method with high accuracy and safety.

  12. Portal-systemic encephalopathy in two patients without liver cirrhosis and portal hypertension.

    PubMed

    K C, Sudhamshu; Matsutani, Shoichi; Maruyama, Hitoshi; Fukamachi, Tadahiro; Nomoto, Hiromasa; Akiike, Taro; Ebara, Masaaki; Saisho, Hiromitsu

    2002-06-01

    The portal-systemic venous shunt is uncommon in patients without portal hypertension. We present two cases of portal-systemic encephalopathy due to extrahepatic shunt without liver cirrhosis and portal hypertension. Two women in their seventies were admitted to our hospital because of recurrent episodes of altered sensorium, drowsiness, slurred speech, disorientation, asterexis and high blood ammonia levels. There was no history of abdominal surgery or abdominal trauma. Clinical examination revealed no signs of portal hypertension or stigmata of chronic liver diseases. Brain CT and MRI scanning were unremarkable except for a high intensity signal in the basal ganglia on T1 weighted MRI images. Laboratory tests were almost normal except for the hyperammonemia occurring on several occasions. There was no evidence of liver cirrhosis by imaging. However, color Doppler showed an extra-hepatic shunt in both patients and pulsed Doppler showed decreased velocity and volume of the portal venous flow. These sonographic findings were confirmed during percutaneous transhepatic portography (PTP). Portal pressures measured during PTP were 9 and 11 mmHg. Needle biopsy ruled out idiopathic portal hypertension and liver cirrhosis. The diagnosis was portal systemic encephalopathy due to extra-hepatic portosystemic venous shunting. Both patients were treated by embolization of the shunting vessel with metallic coils.

  13. The endocannabinoid system in advanced liver cirrhosis: pathophysiological implication and future perspectives.

    PubMed

    Baldassarre, Maurizio; Giannone, Ferdinando A; Napoli, Lucia; Tovoli, Alessandra; Ricci, Carmen S; Tufoni, Manuel; Caraceni, Paolo

    2013-10-01

    Endogenous cannabinoids (EC) are ubiquitous lipid signalling molecules providing different central and peripheral effects that are mediated mostly by the specific receptors CB1 and CB2. The EC system is highly upregulated during chronic liver disease and consistent experimental and clinical findings indicate that it plays a role in the pathogenesis of liver fibrosis and fatty liver disease associated with obesity, alcohol abuse and hepatitis C. Furthermore, a considerable number of studies have shown that EC and their receptors contribute to the pathogenesis of the cardio-circulatory disturbances occurring in advanced cirrhosis, such as portal hypertension, hyperdynamic circulatory syndrome and cirrhotic cardiomyopathy. More recently, the EC system has been implicated in the development of ascites, hepatic encephalopathy and the inflammatory response related to bacterial infection. Rimonabant, a selective CB1 antagonist, was the first drug acting on the EC system approved for the treatment of obesity. Unfortunately, it has been withdrawn from the market because of its neuropsychiatric side effects. Compounds able to target selectively the peripheral CB1 receptors are under evaluation. In addition, molecules stimulating CB2 receptor or modulating the activity of enzymes implicated in EC metabolism are promising areas of pharmacological research. Liver cirrhosis and the related complications represent an important target for the clinical application of these compounds.

  14. The Organizational Impact of a Decision Support System.

    ERIC Educational Resources Information Center

    Pope, James A.; Cross, Edward M.

    1984-01-01

    The results of a follow-up evaluation of a decision support system installed 5 years ago at Guilford College are reported. Changes in the system, resulting procedures, and the organization are described. (Author/MLW)

  15. Computer-Based Administrative Support Systems: The Stanford Experience.

    ERIC Educational Resources Information Center

    Massy, William F.

    1983-01-01

    Computer-based administrative support tools are having a profound effect on the management of colleges and universities. Several such systems at Stanford University are discussed, including modeling, database management systems, networking, and electronic mail. (JN)

  16. Mars Rover system loopwheel definition support

    NASA Technical Reports Server (NTRS)

    Trautwein, W.

    1977-01-01

    The feasibility of the loopwheel suspension system for use on a Mars roving vehicle was analyzed. Various steering concepts were evaluated and an optimum concept was identified on the basis of maximum probability of mission success. In the structural analysis of the loopwheel core and tread as the major fatigue critical components, important technology areas were identified.

  17. Supporting Continuous Improvement in California's Education System

    ERIC Educational Resources Information Center

    Darling-Hammond, Linda; Plank, David N.

    2015-01-01

    California's new accountability system originated in the radical decentralization of power and authority from Sacramento to local schools and their communities brought about by the Legislature's adoption of the Local Control Funding Formula (LCFF) in 2013. Under California's previous accountability policies and the federal "No Child Left…

  18. Air Systems Provide Life Support to Miners

    NASA Technical Reports Server (NTRS)

    2014-01-01

    Through a Space Act Agreement with Johnson Space Center, Paragon Space Development Corporation, of Tucson, Arizona, developed the Commercial Crew Transport-Air Revitalization System, designed to provide clean air for crewmembers on short-duration space flights. The technology is now being used to help save miners' lives in the event of an underground disaster.

  19. Support system considerations for STS biological investigations

    NASA Technical Reports Server (NTRS)

    Bowman, G. H.; Sebesta, P. D.

    1978-01-01

    Equipment required for Space Transportation System biological experiments is considered, and environmental factors and operational constraints affecting the performance of experiments are examined. Specimen housing is discussed, problems associated with telemetry procedures are characterized, and attention is directed to the problems of handling hazardous fixatives, radioisotopes, and chemicals.

  20. Statistical modeling to support power system planning

    NASA Astrophysics Data System (ADS)

    Staid, Andrea

    This dissertation focuses on data-analytic approaches that improve our understanding of power system applications to promote better decision-making. It tackles issues of risk analysis, uncertainty management, resource estimation, and the impacts of climate change. Tools of data mining and statistical modeling are used to bring new insight to a variety of complex problems facing today's power system. The overarching goal of this research is to improve the understanding of the power system risk environment for improved operation, investment, and planning decisions. The first chapter introduces some challenges faced in planning for a sustainable power system. Chapter 2 analyzes the driving factors behind the disparity in wind energy investments among states with a goal of determining the impact that state-level policies have on incentivizing wind energy. Findings show that policy differences do not explain the disparities; physical and geographical factors are more important. Chapter 3 extends conventional wind forecasting to a risk-based focus of predicting maximum wind speeds, which are dangerous for offshore operations. Statistical models are presented that issue probabilistic predictions for the highest wind speed expected in a three-hour interval. These models achieve a high degree of accuracy and their use can improve safety and reliability in practice. Chapter 4 examines the challenges of wind power estimation for onshore wind farms. Several methods for wind power resource assessment are compared, and the weaknesses of the Jensen model are demonstrated. For two onshore farms, statistical models outperform other methods, even when very little information is known about the wind farm. Lastly, chapter 5 focuses on the power system more broadly in the context of the risks expected from tropical cyclones in a changing climate. Risks to U.S. power system infrastructure are simulated under different scenarios of tropical cyclone behavior that may result from climate