Quantitative 4D Transcatheter Intraarterial Perfusion MR Imaging as a Method to Standardize Angiographic Chemoembolization Endpoints

PubMed Central

Jin, Brian; Wang, Dingxin; Lewandowski, Robert J.; Ryu, Robert K.; Sato, Kent T.; Larson, Andrew C.; Salem, Riad; Omary, Reed A.

2011-01-01

PURPOSE We aimed to test the hypothesis that subjective angiographic endpoints during transarterial chemoembolization (TACE) of hepatocellular carcinoma (HCC) exhibit consistency and correlate with objective intraprocedural reductions in tumor perfusion as determined by quantitative four dimensional (4D) transcatheter intraarterial perfusion (TRIP) magnetic resonance (MR) imaging. MATERIALS AND METHODS This prospective study was approved by the institutional review board. Eighteen consecutive patients underwent TACE in a combined MR/interventional radiology (MR-IR) suite. Three board-certified interventional radiologists independently graded the angiographic endpoint of each procedure based on a previously described subjective angiographic chemoembolization endpoint (SACE) scale. A consensus SACE rating was established for each patient. Patients underwent quantitative 4D TRIP-MR imaging immediately before and after TACE, from which mean whole tumor perfusion (Fρ) was calculated. Consistency of SACE ratings between observers was evaluated using the intraclass correlation coefficient (ICC). The relationship between SACE ratings and intraprocedural TRIP-MR imaging perfusion changes was evaluated using Spearman’s rank correlation coefficient. RESULTS The SACE rating scale demonstrated very good consistency among all observers (ICC = 0.80). The consensus SACE rating was significantly correlated with both absolute (r = 0.54, P = 0.022) and percent (r = 0.85, P < 0.001) intraprocedural perfusion reduction. CONCLUSION The SACE rating scale demonstrates very good consistency between raters, and significantly correlates with objectively measured intraprocedural perfusion reductions during TACE. These results support the use of the SACE scale as a standardized alternative method to quantitative 4D TRIP-MR imaging to classify patients based on embolic endpoints of TACE. PMID:22021520

75 FR 68401 - Duncan Smith and Gerald Altizer-Continuance in Control Exemption-Eighteen Thirty Group, LLC and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-05

... Gerald Altizer--Continuance in Control Exemption--Eighteen Thirty Group, LLC and Georges Creek Railway... verified notice of exemption to continue in control of Eighteen Thirty Group, LLC (Eighteen Thirty) and... control any other rail carriers. \\1\\ The remaining 5% interest in Georges Creek is owned by Patrick Stakem...

The C-stem in clinical practice: fifteen-year follow-up of a triple tapered polished cemented stem.

PubMed

Purbach, Bodo; Kay, Peter R; Siney, Paul D; Fleming, Patricia A; Wroblewski, B Michael

2013-09-01

The triple tapered polished cemented stem, C-Stem, introduced in 1993 was based on the original Charnley concept of the "flat back" polished stem. We present our continuing experience with the C-Stem in 621 consecutive primary arthroplasties implanted into 575 patients between 1993 and 1997. Four hundred and eighteen arthroplasties had a clinical and radiological follow-up past 10 years with a mean follow-up of 13 years (10-15). There were no revisions for stem loosening but 2 stems were revised for fracture - both with a defective cement mantle proximally. The stem design and the surgical technique support the original Charnley concept of limited stem subsidence within the cement mantle and the encouraging results continue to stand as a credit to Sir John Charnley's original philosophy. Copyright © 2013 Elsevier Inc. All rights reserved.

Does creating a subperiosteal tunnel influence the periorbital edema and ecchymosis in rhinoplasty?

PubMed

Kara, Cüneyt Orhan; Kara, Inci Gökalan; Topuz, Bülent

2005-08-01

The study goal was to determine whether creating a subperiosteal tunnel before lateral osteotomy had an effect on postoperative periorbital edema, ecchymosis, and subconjunctival ecchymosis. Eighteen consecutive patients who underwent septorhinoplasty were included in the study. In all patients lateral osteotomies were carried out bilaterally, after creating a subperiosteal tunnel on a randomly chosen side and without creating a subperiosteal tunnel on the other side. The patients were seen on the second postoperative day, and a different surgeon who was unaware of the side with the periosteal tunnel determined the side of the face with more edema and ecchymosis. Subconjunctival ecchymosis was evaluated and recorded, as well. Creating subperiosteal tunnels before lateral osteotomy statistically increased periorbital ecchymosis. Although there was no statistically significant difference, creating subperiosteal tunnels also increased development and severity of subconjunctival ecchymosis and edema. We suggest performing lateral osteotomy without creating subperiosteal tunnels.

Oral versus intravenous paracetamol: which is better in closure of patent ductus arteriosus in very low birth weight infants?

PubMed

Sancak, Selim; Gokmen Yildirim, Tulin; Topcuoglu, Sevilay; Yavuz, Taner; Karatekin, Guner; Ovali, Fahri

2016-01-01

To compare the efficacy of oral and intravenous paracetamol for closure of hemodynamically significant patent ductus arteriosus (HSPDA) in very low birth weight (VLBW) preterm infants. Eighteen VLBW infants with HSPDA treated with either intravenous (n = 10) or oral (n = 8) paracetamol at 60 mg/kg/d for three consecutive days were analysed retrospectively. Ductal closure rate and evaluation of liver function tests were the major outcomes. After two courses of treatment, HSPDA closure rate was higher in oral paracetamol group than that in the intravenous paracetamol group (88% versus 70%), but it was not statistically significant (p = 0.588). Liver function tests were normal after the treatment. Although it was not statistically significant, the cumulative closure rates were higher in oral paracetamol group than those in the intravenous group. Larger trials are needed to confirm these data.

Nonlinguistic Learning in Individuals with Aphasia: Effects of Training Method and Stimulus Characteristics

ERIC Educational Resources Information Center

Vallila-Rohter, Sofia; Kiran, Swathi

2013-01-01

Purpose: The purpose of the current study was to explore nonlinguistic learning ability in individuals with aphasia, examining the impact of stimulus typicality and feedback on success with learning. Method: Eighteen individuals with aphasia and 8 nonaphasic controls participated in this study. All participants completed 4 computerized,…

Validation of Personal Digital Photography to Assess Dietary Quality among People with Intellectual Disabilities

ERIC Educational Resources Information Center

Elinder, L. S.; Brunosson, A.; Bergstrom, H.; Hagstromer, M.; Patterson, E.

2012-01-01

Background: Dietary assessment is a challenge in general, and specifically in individuals with intellectual disabilities (ID). This study aimed to evaluate personal digital photography as a method of assessing different aspects of dietary quality in this target group. Method: Eighteen adults with ID were recruited from community residences and…

A Multi-Method Approach to Studying the Relationship between Character Strengths and Vocational Interests in Adolescents

ERIC Educational Resources Information Center

Proyer, Rene T.; Sidler, Nicole; Weber, Marco; Ruch, Willibald

2012-01-01

The relationship between character strengths and vocational interests was tested. In an online study, 197 thirteen to eighteen year-olds completed a questionnaire measuring character strengths and a multi-method measure for interests (questionnaire, nonverbal test, and objective personality tests). The main findings were that intellectual…

Hyperfractionated Radiotherapy with Concurrent Cisplatin/5-Fluorouracil for Locoregional Advanced Head and Neck Cancer: Analysis of 105 Consecutive Patients

PubMed Central

Zaboli, David; Tan, Marietta; Gogineni, Hrishikesh; Lake, Spencer; Fan, Katherine; Zahurak, Marianna L.; Messing, Barbara; Ulmer, Karen; Zinreich, Eva S.; Levine, Marshall A.; Tang, Mei; Pai, Sara I.; Blanco, Ray G.; Saunders, John R.; Best, Simon R.; Califano, Joseph A.; Ha, Patrick K.

2012-01-01

Objective. We reviewed a cohort of patients with previously untreated locoregional advanced head and neck squamous cell carcinoma (HNSCC) who received a uniform chemoradiotherapy regimen. Methods. Retrospective review was performed of 105 patients with stage III or IV HNSCC treated at Greater Baltimore Medical Center from 2000 to 2007. Radiation included 125 cGy twice daily for a total 70 Gy to the primary site. Chemotherapy consisted of cisplatin (12 mg/m2/h) daily for five days and 5-fluorouracil (600 mg/m2/20 h) daily for five days, given with weeks one and six of radiation. All but seven patients with N2 or greater disease received planned neck dissection after chemoradiotherapy. Primary outcomes were overall survival (OS), locoregional control (LRC), and disease-free survival (DFS). Results. Median followup of surviving patients was 57.6 months. Five-year OS was 60%, LRC was 68%, and DFS was 56%. Predictors of increased mortality included age ≥55, female gender, hypopharyngeal primary, and T3/T4 stage. Twelve patients developed locoregional recurrences, and 16 patients developed distant metastases. Eighteen second primary malignancies were diagnosed in 17 patients. Conclusions. The CRT regimen resulted in favorable outcomes. However, locoregional and distant recurrences cause significant mortality and highlight the need for more effective therapies to prevent and manage these events. PMID:22778748

Synovial deposition of wild-type transthyretin-derived amyloid in knee joint osteoarthritis patients.

PubMed

Takanashi, Tetsuo; Matsuda, Masayuki; Yazaki, Masahide; Yamazaki, Hideshi; Nawata, Masashi; Katagiri, Yoshiki; Ikeda, Shu-Ichi

2013-09-01

To investigate histological features of deposited amyloid in the synovial tissue and its clinical significance in knee joint osteoarthritis (OA) patients. We prospectively enrolled 232 consecutive patients who underwent arthroplasty or total replacement of the knee joint for treatment of OA. Congo red staining and immunohistochemistry were performed in the synovial tissue obtained at surgery. When transthyretin (TTR)-derived amyloid was positive, we analyzed all 4 exons of the TTR gene using the direct DNA sequencing method in order to detect mutations. We analyzed 322 specimens in this study. Twenty-six specimens (8.1%) obtained from 21 patients (5 men and 16 women; mean, 79.0 ± 4.6 years) showed deposition of amyloid, which was positively stained with the anti-TTR antibody. Eighteen patients showed inhomogeneous accumulations of amyloid in the loose connective tissue under the synovial epithelia sometimes with nodule formation, while in the remaining three, small vessels in the adipose tissue were involved. Medical records of these patients revealed nothing remarkable in the clinical course, laboratory data or macroscopic intraarticular findings at surgery. No mutations were detectable in the TTR gene analysis. Wild-type TTR-derived amyloid may affect the synovial tissue as a result of long-term mechanical stress or as a part of senile systemic amyloidosis in approximately 8% of knee joint OA patients. No obvious clinical significance was found in synovial deposition of amyloid.

Experiences of informational needs and received information following a prenatal diagnosis of congenital heart defect

PubMed Central

Bergman, Gunnar; Wadensten, Barbro; Mattsson, Elisabet

2016-01-01

Abstract Objective To explore the need for information and what information was actually received following prenatal diagnosis of a congenital heart defect, in a country where termination of pregnancy beyond 22 weeks of gestation is not easily possible because of legal constraints. Methods Twenty‐six Swedish‐speaking pregnant women (n = 14) and partners (n = 12) were consecutively recruited for semi‐structured telephone interviews following the prenatal diagnosis of a congenital heart defect. Data were analyzed using content analysis. Results Although high satisfaction with the specialist information was described, the information was considered overwhelming and complex. Objective, honest, and detailed information about multiple subjects were needed, delivered repeatedly, and supplemented by written information/illustrations. Eighteen respondents had used the Internet to search for information and identified issues involving searching difficulties, low quality, and that it was too complex, insufficient, or unspecific. Those who terminated their pregnancy criticized that there was a lack of information about termination of pregnancy, both from health professionals and online sources, resulting in unanswered questions and unpreparedness. Conclusion Individuals faced with a prenatal diagnosis of a congenital heart defect need individualized and repeated information. These needs are not all adequately met, as individuals are satisfied with the specialist consultation but left with unanswered questions regarding pregnancy termination. © 2016 The Authors. Prenatal Diagnosis published by John Wiley & Sons, Ltd. PMID:26991536

Prophylactic temporary abdominal aorta balloon occlusion in women with placenta previa accretism during late gestation

PubMed Central

Qiu, Zhongyuan; Hu, Jifen; Wu, Jianbo; Chen, Lihong

2017-01-01

Abstract Background: To evaluate the clinical efficacy of prophylactic temporary balloon occlusion of the abdominal aorta in patients with placenta previa accretism during cesarean section. Methods: Twenty-three consecutive patients, prenatally confirmed with placenta previa accretism were retrospectively analyzed in our center from August 2012 to October 2014. All 23 subjects underwent cesarean section with prophylactic balloon occlusion of the abdominal aorta. Results: All of the 23 subjects experienced singleton pregnancies leading to the birth of live infants. Of these subjects, the following problems were diagnosed: placenta accrete (n = 10), placenta increte (n = 10), and placenta precrete (n = 3). Mean intraoperative hemorrhage was 1170.0 mL. Fifteen patients received red blood cell transfusion with a mean transfusion volume of 2.3 units. The incidence of hysterectomy was 21.74% (5/23) with blood loss ranging from 2000 to 5000 mL (mean 3360.0 mL). One complication encountered in this retrospective study was lower extremity arterial thrombosis. Eighteen patients were followed-up by telephone to 14 months following discharge, all babies were noted to be healthy. Conclusion: Prophylactic abdominal aorta balloon occlusion (ABO) was relatively safe in the treatment of patients with placenta previa accretism. This approach could represent a key aspect in a multidisciplinary algorithm in reducing hemorrhage in abnormal placentation. PMID:29145299

Ultrasound-guided central venous catheterization in cancer patients improves the success rate of cannulation and reduces mechanical complications: A prospective observational study of 1,978 consecutive catheterizations

PubMed Central

2010-01-01

Background A central venous catheter (CVC) currently represents the most frequently adopted intravenous line for patients undergoing infusional chemotherapy and/or high-dose chemotherapy with hematopoietic stem-cell transplantation and parenteral nutrition. CVC insertion represents a risk for pneumothorax, nerve or arterial punctures. The aim of this prospective observational study was to explore the safety and efficacy of CVC insertion under ultrasound (US) guidance and to confirm its utility in clinical practice in cancer patients. Methods Consecutive adult patients attending the oncology-hematology department were eligible if they had solid or hematologic malignancies and required CVC insertion. Four types of possible complication were defined a priore: mechanical, thrombotic, infection and malfunctioning. The patient was placed in Trendelenburg's position, a 7.5 MHZ puncturing US probe was placed in the supraclavicular site and a 16-gauge needle was advanced under real-time US guidance into the last portion of internal jugular vein. The Seldinger technique was used to place the catheter, which was advanced into the superior vena cava until insertion into right atrium. Within two hours after each procedure, an upright chest X-ray and ultrasound scanning were carried out to confirm the CVC position and to rule out a pneumotorax. CVC-related infections, symptomatic vein thrombosis and malfunctioning were recorded. Results From December 2000 to January 2009, 1,978 CVC insertional procedures were applied to 1,660 consecutive patients. The procedure was performed 580 times in patients with hematologic malignancies and 1,398 times those with solid tumors. A single-needle puncture of the vein was performed on 1,948 of 1,978 procedures (98.48%); only eighteen attempts among 1,978 failed (0.9%). No pneumotorax, no major bleeding, and no nerve puncture were reported; four cases (0.2%) showed self-limiting hematomas. The mean lifespan of CVC was 189.7 +/- 18.6 days (range 7-701). Symptomatic deep-vein thrombosis of the upper limbs developed in 48 patients (2.42%). Catheter-related infections occurred in 197 (9.96%) of the catheters inserted. They were successfully treated with antibiotics and only in 48 (2.9%) patients definitive CVC removal was required for infection and/or thrombosis or malfunctioning. Conclusions This study represents the largest published series of consecutive patients with cancer undergoing CVC insertion under US guidance; this procedure allowed the completion of the therapeutic program for 1,930/1,978 (97.6%) of the catheters inserted. The absence of pneumotorax and other major complications indicates that US guidance should be mandatory for CVC insertion in patients with cancer. PMID:20958986

Selecting and Using Information Sources: Source Preferences and Information Pathways of Israeli Library and Information Science Students

ERIC Educational Resources Information Center

Bronstein, Jenny

2010-01-01

Introduction: The study investigated the source preference criteria of library and information science students for their academic and personal information needs. Method: The empirical study was based on two methods of data collection. Eighteen participants wrote a personal diary for four months in which they recorded search episodes and answered…

The Measurement of Term Importance in Automatic Indexing.

ERIC Educational Resources Information Center

Salton, G.; And Others

1981-01-01

Reviews major term-weighting theories, presents methods for estimating the relevance properties of terms based on their frequency characteristics in a document collection, and compares weighting systems using term relevance properties with more conventional frequency-based methodologies. Eighteen references are cited. (Author/FM)

Scapular thickness--implications for fracture fixation.

PubMed

Burke, Charity S; Roberts, Craig S; Nyland, John A; Radmacher, Paula G; Acland, Robert D; Voor, Michael J

2006-01-01

The purpose of this study was to measure and map scapula osseous thickness to identify the optimal areas for internal fixation. Eighteen (9 pairs) scapulae from 2 female and 7 male cadavers were used. After harvest and removal of all soft tissues, standardized measurement lines were made based on anatomic landmarks. For consistency among scapulae, measurements were taken at standard percentage intervals along each line approximating the distance between two consecutive reconstruction plate screw holes. Two-mm-diameter drill holes were made at each point, and a standard depth gauge was used to measure thickness. The glenoid fossa (25 mm) displayed the greatest mean osseous thickness, followed by the lateral scapular border (9.7 mm), the scapula spine (8.3 mm), and the central portion of the body of the scapula (3.0 mm). To optimize screw purchase and internal fixation strength, the lateral border, the lateral aspect of the base of the scapula spine, and the scapula spine itself should be used for anatomic sites of internal fixation of scapula fractures.

Oral cryotherapy for the prevention of high-dose melphalan-induced stomatitis in allogeneic hematopoietic stem cell transplant recipients.

PubMed

Aisa, Yoshinobu; Mori, Takehiko; Kudo, Masumi; Yashima, Tomoko; Kondo, Sakiko; Yokoyama, Akihiro; Ikeda, Yasuo; Okamoto, Shinichiro

2005-04-01

The purpose of this study was to evaluate the efficacy of oral cryotherapy to prevent high-dose melphalan-induced stomatitis. Eighteen consecutive recipients of allogeneic hematopoietic stem cell transplant conditioned with high-dose melphalan (140 mg/m2) in combination with fludarabine alone or with fludarabine and additional chemotherapy or radiation were enrolled. The severity of stomatitis was graded according to the National Cancer Institute Common Toxicity Criteria. Patients were kept on oral cryotherapy using ice chips and ice-cold water shortly before, during, and for additional 90 min after completion of melphalan administration. Only two of 18 patients (11.1%) developed grade 2 or 3 stomatitis while six of seven patients in the historical control developed it (85.7%; P=0.001). These results suggested that oral cryotherapy could effectively prevent stomatitis caused by high-dose melphalan, and we recommend that it should be incorporated into the conditioning regimen with high-dose melphalan.

Clinical risk factors to predict deep venous thrombosis post-endovenous laser ablation of saphenous veins.

PubMed

Chi, Y-W; Woods, T C

2014-04-01

Endovenous laser ablation of saphenous veins is an alternative in treating symptomatic varicose veins. Deep venous thrombosis (DVT) has been reported in up to 7.7% of patients undergoing such procedure. We sought to establish clinical risk factors that predict DVT post-endovenous laser ablation. Patients who underwent endovenous laser ablation were prospectively followed. Clinical data and post-interventional duplex ultrasound were analysed. A P value <0.05 was accepted as representing a significant difference. From 2007 to 2008, 360 consecutive patients were followed. Nineteen DVTs were found on follow-up ultrasound. Eighteen cases involved either the saphenofemoral or saphenopopliteal junctions; only one case involved the deep venous system. Age >66 (P = 0.007), female gender (P = 0.048) and prior history of superficial thrombophlebitis (SVT) (P = 0.002) were associated with increased risk of DVT postprocedure. Age >66, female gender and history of SVT were significant predictors of DVT post-endovenous laser ablation of saphenous veins.

Can One Portfolio Measure the Six ACGME General Competencies?

ERIC Educational Resources Information Center

Jarvis, Robert M.; O'Sullivan, Patricia S.; McClain, Tina; Clardy, James A.

2004-01-01

Objective: To determine that portfolios, useable by any program, can provide needed evidence of resident performance within the ACGME general competencies. Methods: Eighteen residents constructed portfolios with selected entries from thirteen psychiatric skills. Two raters assessed whether entries reflected resident performance within the general…

Automatic image fusion of real-time ultrasound with computed tomography images: a prospective comparison between two auto-registration methods.

PubMed

Cha, Dong Ik; Lee, Min Woo; Kim, Ah Yeong; Kang, Tae Wook; Oh, Young-Taek; Jeong, Ja-Yeon; Chang, Jung-Woo; Ryu, Jiwon; Lee, Kyong Joon; Kim, Jaeil; Bang, Won-Chul; Shin, Dong Kuk; Choi, Sung Jin; Koh, Dalkwon; Seo, Bong Koo; Kim, Kyunga

2017-11-01

Background A major drawback of conventional manual image fusion is that the process may be complex, especially for less-experienced operators. Recently, two automatic image fusion techniques called Positioning and Sweeping auto-registration have been developed. Purpose To compare the accuracy and required time for image fusion of real-time ultrasonography (US) and computed tomography (CT) images between Positioning and Sweeping auto-registration. Material and Methods Eighteen consecutive patients referred for planning US for radiofrequency ablation or biopsy for focal hepatic lesions were enrolled. Image fusion using both auto-registration methods was performed for each patient. Registration error, time required for image fusion, and number of point locks used were compared using the Wilcoxon signed rank test. Results Image fusion was successful in all patients. Positioning auto-registration was significantly faster than Sweeping auto-registration for both initial (median, 11 s [range, 3-16 s] vs. 32 s [range, 21-38 s]; P < 0.001] and complete (median, 34.0 s [range, 26-66 s] vs. 47.5 s [range, 32-90]; P = 0.001] image fusion. Registration error of Positioning auto-registration was significantly higher for initial image fusion (median, 38.8 mm [range, 16.0-84.6 mm] vs. 18.2 mm [6.7-73.4 mm]; P = 0.029), but not for complete image fusion (median, 4.75 mm [range, 1.7-9.9 mm] vs. 5.8 mm [range, 2.0-13.0 mm]; P = 0.338]. Number of point locks required to refine the initially fused images was significantly higher with Positioning auto-registration (median, 2 [range, 2-3] vs. 1 [range, 1-2]; P = 0.012]. Conclusion Positioning auto-registration offers faster image fusion between real-time US and pre-procedural CT images than Sweeping auto-registration. The final registration error is similar between the two methods.

Reliability of fitness tests using methods and time periods common in sport and occupational management.

PubMed

Burnstein, Bryan D; Steele, Russell J; Shrier, Ian

2011-01-01

Fitness testing is used frequently in many areas of physical activity, but the reliability of these measurements under real-world, practical conditions is unknown. To evaluate the reliability of specific fitness tests using the methods and time periods used in the context of real-world sport and occupational management. Cohort study. Eighteen different Cirque du Soleil shows. Cirque du Soleil physical performers who completed 4 consecutive tests (6-month intervals) and were free of injury or illness at each session (n = 238 of 701 physical performers). Performers completed 6 fitness tests on each assessment date: dynamic balance, Harvard step test, handgrip, vertical jump, pull-ups, and 60-second jump test. We calculated the intraclass coefficient (ICC) and limits of agreement between baseline and each time point and the ICC over all 4 time points combined. Reliability was acceptable (ICC > 0.6) over an 18-month time period for all pairwise comparisons and all time points together for the handgrip, vertical jump, and pull-up assessments. The Harvard step test and 60-second jump test had poor reliability (ICC < 0.6) between baseline and other time points. When we excluded the baseline data and calculated the ICC for 6-month, 12-month, and 18-month time points, both the Harvard step test and 60-second jump test demonstrated acceptable reliability. Dynamic balance was unreliable in all contexts. Limit-of-agreement analysis demonstrated considerable intraindividual variability for some tests and a learning effect by administrators on others. Five of the 6 tests in this battery had acceptable reliability over an 18-month time frame, but the values for certain individuals may vary considerably from time to time for some tests. Specific tests may require a learning period for administrators.

Gastroesophageal Reflux Disease in Children with Interstitial Lung Disease.

PubMed

Dziekiewicz, M A; Karolewska-Bochenek, K; Dembiński, Ł; Gawronska, A; Krenke, K; Lange, J; Banasiuk, M; Kuchar, E; Kulus, M; Albrecht, P; Banaszkiewicz, A

2016-01-01

Gastroesophageal reflux disease is common in adult patients with interstitial lung disease. However, no data currently exist regarding the prevalence and characteristics of the disease in pediatric patients with interstitial lung disease. The aim of the present study was to prospectively assess the incidence of gastroesophageal reflux disease and characterize its features in children with interstitial lung disease. Gastroesophageal reflux disease was established based on 24 h pH-impedance monitoring (MII-pH). Gastroesophageal reflux episodes (GERs) were classified according to widely recognized criteria as acid, weakly acid, weakly alkaline, or proximal. Eighteen consecutive patients (15 boys, aged 0.2-11.6 years) were enrolled in the study. Gastroesophageal reflux disease was diagnosed in a half (9/18) of children. A thousand GERs were detected by MII-pH (median 53.5; IQR 39.0-75.5). Of these, 585 (58.5 %) episodes were acidic, 407 (40.7 %) were weakly acidic, and eight (0.8 %) were weakly alkaline. There were 637 (63.7 %) proximal GERs. The patients in whom gastroesophageal reflux disease was diagnosed had a significantly higher number of proximal and total GERs. We conclude that the prevalence of gastroesophageal reflux disease in children with interstitial lung disease is high; thus, the disease should be considered regardless of presenting clinical symptoms. A high frequency of non-acid and proximal GERs makes the MII-pH method a preferable choice for the detection of reflux episodes in this patient population.

A Large Outbreak of Hepatitis C Virus Infections in a Hemodialysis Clinic.

PubMed

Nguyen, Duc B; Gutowski, Jennifer; Ghiselli, Margherita; Cheng, Tabitha; Bel Hamdounia, Shadia; Suryaprasad, Anil; Xu, Fujie; Moulton-Meissner, Heather; Hayden, Tonya; Forbi, Joseph C; Xia, Guo-Liang; Arduino, Matthew J; Patel, Ami; Patel, Priti R

2016-02-01

BACKGROUND In November and December 2012, 6 patients at a hemodialysis clinic were given a diagnosis of new hepatitis C virus (HCV) infection. OBJECTIVE To investigate the outbreak to identify risk factors for transmission. METHODS A case patient was defined as a patient who was HCV-antibody negative on clinic admission but subsequently was found to be HCV-antibody positive from January 1, 2008, through April 30, 2013. Patient charts were reviewed to identify and describe case patients. The hypervariable region 1 of HCV from infected patients was tested to assess viral genetic relatedness. Infection control practices were evaluated via observations. A forensic chemiluminescent agent was used to identify blood contamination on environmental surfaces after cleaning. RESULTS Eighteen case patients were identified at the clinic from January 1, 2008, through April 30, 2013, resulting in an estimated 16.7% attack rate. Analysis of HCV quasispecies identified 4 separate clusters of transmission involving 11 case patients. The case patients and previously infected patients in each cluster were treated in neighboring dialysis stations during the same shift, or at the same dialysis station on 2 consecutive shifts. Lapses in infection control were identified. Visible and invisible blood was identified on multiple surfaces at the clinic. CONCLUSIONS Epidemiologic and laboratory data confirmed transmission of HCV among numerous patients at the dialysis clinic over 6 years. Infection control breaches were likely responsible. This outbreak highlights the importance of rigorous adherence to recommended infection control practices in dialysis settings.

A Large Outbreak of Hepatitis C Virus Infections in a Hemodialysis Clinic

PubMed Central

Nguyen, Duc B.; Gutowski, Jennifer; Ghiselli, Margherita; Cheng, Tabitha; Hamdounia, Shadia Bel; Suryaprasad, Anil; Xu, Fujie; Moulton-Meissner, Heather; Hayden, Tonya; Forbi, Joseph C.; Xia, Guo-liang; Arduino, Matthew J.; Patel, Ami; Patel, Priti R.

2016-01-01

BACKGROUND In November and December 2012, 6 patients at a hemodialysis clinic were given a diagnosis of new hepatitis C virus (HCV) infection. OBJECTIVE To investigate the outbreak to identify risk factors for transmission. METHODS A case patient was defined as a patient who was HCV-antibody negative on clinic admission but subsequently was found to be HCV-antibody positive from January 1, 2008, through April 30, 2013. Patient charts were reviewed to identify and describe case patients. The hypervariable region 1 of HCV from infected patients was tested to assess viral genetic relatedness. Infection control practices were evaluated via observations. A forensic chemiluminescent agent was used to identify blood contamination on environmental surfaces after cleaning. RESULTS Eighteen case patients were identified at the clinic from January 1, 2008, through April 30, 2013, resulting in an estimated 16.7% attack rate. Analysis of HCV quasispecies identified 4 separate clusters of transmission involving 11 case patients. The case patients and previously infected patients in each cluster were treated in neighboring dialysis stations during the same shift, or at the same dialysis station on 2 consecutive shifts. Lapses in infection control were identified. Visible and invisible blood was identified on multiple surfaces at the clinic. CONCLUSIONS Epidemiologic and laboratory data confirmed transmission of HCV among numerous patients at the dialysis clinic over 6 years. Infection control breaches were likely responsible. This outbreak highlights the importance of rigorous adherence to recommended infection control practices in dialysis settings. PMID:26573412

Severe Hypertriglyceridemia During Therapy For Childhood Acute Lymphoblastic Leukemia

PubMed Central

Bhojwani, Deepa; Darbandi, Rashid; Pei, Deqing; Ramsey, Laura B.; Chemaitilly, Wassim; Sandlund, John T.; Cheng, Cheng; Pui, Ching-Hon; Relling, Mary V.; Jeha, Sima; Metzger, Monika L.

2014-01-01

Background Asparaginase and steroids can cause hypertriglyceridemia in children with acute lymphoblastic leukemia (ALL). There are no guidelines for screening or management of patients with severe hypertriglyceridemia (>1000 mg/dL) during ALL therapy. Patients and Methods Fasting lipid profiles were obtained prospectively at 4 time-points for 257 children consecutively enrolled on a frontline ALL study. Risk factors were evaluated by the exact chi-square test. Details of adverse events and management of hypertriglyceridemia were extracted retrospectively. Results Eighteen of 257 (7%) patients developed severe hypertriglyceridemia. Older age and treatment with higher doses of asparaginase and steroids on the standard/high-risk arm were significant risk factors. Severe hypertriglyceridemia was not associated with pancreatitis after adjustment for age and treatment arm or with osteonecrosis after adjustment for age. However, patients with severe hypertriglyceridemia had a 2.5 to 3 times higher risk of thrombosis compared to patients without, albeit the difference was not statistical significant. Of the 30 episodes of severe hypertriglyceridemia in 18 patients, 7 were managed conservatively while the others with pharmacotherapy. Seventeen of 18 patients continued to receive asparaginase and steroids. Triglyceride levels normalized after completion of ALL therapy in all 12 patients with available measurements. Conclusion Asparaginase- and steroid-induced transient hypertriglyceridemia can be adequately managed with dietary modifications and close monitoring without altering chemotherapy. Patients with severe hypertriglyceridemia were not at increased risk of adverse events, with a possible exception of thrombosis. The benefit of pharmacotherapy in decreasing symptoms and potential complications requires further investigation. PMID:25087182

The repair of umbilical hernia in cirrhotic patients: 18 consecutive case series in a single institute

PubMed Central

Yu, Byung Chul; Lee, Giljae

2015-01-01

Purpose Traditionally, the surgical repair of umbilical hernia in cirrhotic patients with ascites is avoided because of a significant recurrence rate and perioperative morbidity/mortality. However, recent reports recommend early elective surgery in these patients because surgery-related complications can be reduced with minimally invasive surgery and development of perioperative patient care. The current study was conducted to analyze safety and feasibility of umbilical hernia repairs performed in a single institute. Methods A single center retrospective analysis of patients' data was conducted. Eighteen patients with umbilical hernia accompanied by liver cirrhosis underwent hernia repair in the period between 2005 and 2012. The charts of these patients were reviewed and demographic data, postoperative complications, and recurrence were recorded. Results Eleven males and seven females with a mean age of 62.9 years were analyzed. Two of the patients were classified as Child's class A, 11 as Child's class B, and five as Child's class C. Four patients underwent emergency surgery because of perforations in the hernia sac in two cases and incarcerated hernias in the other two cases. Of the 18 patients who underwent surgery, four (22%) experienced a recurrence, three (17%) developed edema at the surgical sites, one (5%) experienced hepatic coma, and one (5%) showed postoperative variceal hemorrhage. All of these events occurred after emergency surgery. Conclusion In contrast to traditional concepts, early and elective repair of umbilical hernia can be performed easily and safely in cirrhotic patients. PMID:26236698

Attention-Deficit/hyperactivity Disorder and Comorbidities in 18 Paisa Colombian Multigenerational Families.

ERIC Educational Resources Information Center

Palacio, Juan D.; Castellanos, F. Xavier; Pineda, David A.; Lopera, Francisco; Arcos-Burgos, Mauricio; Quiroz, Yakeel T.; Henao, Gloria C.; Puerta, Isabel C.; Ramirez, Dora L.; Rapoport, Judith L.; Bailey-Wilson, Joan; Berg, Kate; Muenke, Maximilian

2004-01-01

Objective: Eighteen extended multigenerational families were recruited from the genetically isolated Paisa community in Colombia to conduct genetic studies of attention-deficit/hyperactivity disorder (ADHD). This report describes the inclusion strategy and clinical features of participants to facilitate comparisons with other data sets. Method:…

Conversations with Professors: An Exploration of Academic Career Success

ERIC Educational Resources Information Center

Gladwin, Maree; McDonald, Gael; McKay, Jade

2014-01-01

What factors contribute most to career success in academia? Using qualitative methods, the study sought information from eighteen full and chaired professors in Australia, New Zealand, USA and Canada. Reflecting on factors that contributed to academic success, participants identified: an "inherent" attraction to academic work; ability to…

AN EXPERIMENTAL EVALUATION OF AUDIO-VISUAL METHODS--CHANGING ATTITUDES TOWARD EDUCATION.

ERIC Educational Resources Information Center

LOWELL, EDGAR L.; AND OTHERS

AUDIOVISUAL PROGRAMS FOR PARENTS OF DEAF CHILDREN WERE DEVELOPED AND EVALUATED. EIGHTEEN SOUND FILMS AND ACCOMPANYING RECORDS PRESENTED INFORMATION ON HEARING, LIPREADING AND SPEECH, AND ATTEMPTED TO CHANGE PARENTAL ATTITUDES TOWARD CHILDREN AND SPOUSES. TWO VERSIONS OF THE FILMS AND RECORDS WERE NARRATED BY (1) "STARS" WHO WERE…

Respiratory and Laryngeal Function during Spontaneous Speaking in Teachers with Voice Disorders

ERIC Educational Resources Information Center

Lowell, Soren Y.; Barkmeier-Kraemer, Julie M.; Hoit, Jeannette D.; Story, Brad H.

2008-01-01

Purpose: To determine if respiratory and laryngeal function during spontaneous speaking were different for teachers with voice disorders compared with teachers without voice problems. Method: Eighteen teachers, 9 with and 9 without voice disorders, were included in this study. Respiratory function was measured with magnetometry, and laryngeal…

Comparison of different force fields for the study of disaccharides

USDA-ARS?s Scientific Manuscript database

Eighteen empirical force fields and the semi-empirical quantum method PM3CARB-1 were compared for studying ß-cellobiose, a-maltose, and a-galabiose [a-D-Galp-(1'4)-a-D-Galp]. For each disaccharide, the energies of 54 conformers with differing hydroxymethyl, hydroxyl and glycosidic linkage orientatio...

First-Hand Participation: Illuminating Teachers' Self-Perceptions of Physical Activity Delivery

ERIC Educational Resources Information Center

Till, Jude; Ferkins, Lesley

2014-01-01

The study examines school-based physical activity in investigating teachers' perceptions of a physical activity-related professional development (PD) intervention in New Zealand primary schools. Eighteen semi-structured interviews with six teachers from two schools was the primary data collection method. Using a selected programme, teachers'…

A query for effective mean particle size of dry and high moisture corns

USDA-ARS?s Scientific Manuscript database

Eighteen dry and high moisture corns submitted to the University of Wisconsin Soil and Forage Analysis Laboratory (Marshfield, WI) for routine analysis were retained for mean particle size (MPS) and chemistry determinations. Mean particle size of corns was determined by the methods of the American S...

The Effect of Patient Choice of Intervention on Health Outcomes

PubMed Central

Clark, Noreen M.; Janz, Nancy K.; Dodge, Julia A.; Mosca, Lori; Lin, Xihong; Long, Qi; Little, Roderick J; Wheeler, John R.C.; Keteyian, Steven; Liang, Jersey

2008-01-01

Background Patient preference may influence intervention effects, but has not been extensively studied. Randomized controlled design (N=1075) assessed outcomes when women (60 years +) were given a choice of two formats of a program to enhance heart disease management. Methods Randomization to "no choice" or "choice" study arms. Further randomization of "no choice” to: 1) Group intervention program format, 2) Self-Directed program format, 3) Control Group. "Choice" arm selected their preferred program format. Baseline, four, twelve, and eighteen month follow-up data collected. Two analyses: health outcomes for choice compared to being randomized; and preference effect on treatment efficacy. Results Women who chose a format compared to being assigned a format had better psychosocial functioning at four months (p=0.02) and tended toward better physical functioning at twelve months (p=0.07). At eighteen months women who chose versus being assigned a format had more symptoms measured as: number (p=0.004), frequency (p=0.006) and bother (p=0.004). At four months women who preferred the Group format had better psychosocial functioning when assigned the Group format than when they were assigned the Self Directed format (p=0.03). At eighteen months women preferring a Group format had more symptoms: number (p=0.001), frequency (p=0.001), bother (p=0.001) when assigned the Group format than when assigned the Self Directed format. Conclusions Choice and preference for the Group format each enhanced psychosocial and physical functioning up to one year. Despite the preference for Group format, over the longer term (eighteen months) cardiac symptoms were fewer when assigned the Self-Directed format. PMID:18515187

Report on Admission of Students under the Age of Eighteen, (A.R.S. 15-1821), FY 1998-1999.

ERIC Educational Resources Information Center

Arizona State Board of Directors for Community Colleges, Phoenix.

This report is the State Board of Directors for Community College of Arizona's 1998-1999 Report on Admission of Students under the Age of Eighteen. This report includes the number of students under the age of eighteen who had not yet attained a high school diploma or high school certificate of equivalency and who are enrolled in a community…

Report on Admission of Students under the Age of Eighteen (A.R.S. 15-1821), FY 1999-2000.

ERIC Educational Resources Information Center

Arizona State Board of Directors for Community Colleges, Phoenix.

This report contains information on the number of students under the age of eighteen and the courses taken by these students at Arizona's community colleges in 1999-2000. It provides information on students under the age of eighteen who had not yet attained a high school diploma or high school certificate of equivalency and who were enrolled in a…

Childhood acute promyelocytic leukemia: no benefit of all-trans-retinoic acid administered in a short-course schedule.

PubMed

Zubizarreta, P A; Rose, A B; Felice, M S; Alfaro, E; Delfino, S; Cygler, A M; Sackmann-Muriel, F

2000-03-01

From January 1990 to August 1997, 29 consecutive patients were treated with newly diagnosed primary acute promyelocytic leukemia (APL) at the authors' Institution. Of these, 27 (16 boys and 11 girls) were evaluable. Median age at diagnosis was 6.3 (range: 1.9-15.7) years. This population was treated with two consecutive protocols: 13 patients were included in the AML-HPG-90 protocol and 14 in the AML-HPG-95. The initial treatment was the same for both protocols: an induction 8-day phase with cytarabine, idarubicin, and etoposide was followed by a consolidation with cyclophosphamide, cytarabine, 6-mercaptopurine, vincristine, doxorubicin, and prednisone. Two courses of intensification with high-dose (HD) cytarabine and etoposide were given in the first study. Only one intensification course was administered in the second study, with HD cytarabine plus idarubicin or etoposide decided by randomization. Complete remission was achieved in 67% (18/27) of cases. Mortality on induction was quite high, 30% (8/27) mainly due to hemorrhages from disseminated intravascular coagulation (DIC). The event-free survival estimate for all patients was 0.47 (SE: 0.1). From April 1994, all-trans-retinoic acid (ATRA) was administered just during the first days of the induction phase (median: 9, range: 2-27) to stop or prevent DIC. Eighteen patients received ATRA and 9 did not. Three patients developed signs of ATRA syndrome during the first days of administration but no one died due to this toxicity. The impact of a short course of ATRA on early control of DIC was studied by analyzing the number of platelet, cryoprecipitate, and fresh frozen plasma transfusions during the induction phase in both groups. No statistical differences in complete remission rate, early mortality, need of transfusion of blood components for DIC, and survival estimates could be established between patients who received ATRA and those who did not. ATRA used in a short-course schedule during induction of APL did not stop early mortality due to DIC. Moreover, survival results did not improve with this method of ATRA usage. Longer periods of ATRA administration during APL therapy are strongly recommended.

Changes in urination according to the sound of running water using a mobile phone application.

PubMed

Kwon, Whi-An; Kim, Sung Han; Kim, Sohee; Joung, Jae Young; Chung, Jinsoo; Lee, Kang Hyun; Lee, Sang-Jin; Seo, Ho Kyung

2015-01-01

The sound of running water (SRW) has been effectively used for toilet training during toddlerhood. However, the effect of SRW on voiding functions in adult males with lower urinary tract symptoms (LUTS) has not been evaluated. To determine the effect of SRW on urination in male patients with LUTS, multiple voiding parameters of uroflowmetry with postvoid residual urine (PVR) were assessed according to the presence of SRW played by a mobile application. Eighteen consecutive male patients with LUTS were prospectively enrolled between March and April 2014. Uroflowmetry with PVR measured by a bladder scan was randomly performed once weekly for two consecutive weeks with and without SRW in a completely sealed room after pre-checked bladder volume was scanned to be more than 150 cc. SRW was played with river water sounds amongst relaxed melodies from a smartphone mobile application. The mean age of enrolled patients and their mean International Prostate Symptom Score (IPSS) were 58.9 ± 7.7 years (range: 46-70) and 13.1 ± 5.9, respectively. All patients had not been prescribed any medications, including alpha-blockers or anti-muscarinic agents, in the last 3 months. There was a significant increase in mean peak flow rate (PFR) with SRW in comparison to without SRW (15.7 mL/s vs. 12.3 mL/s, respectively, p = 0.0125). However, there were no differences in other uroflowmetric parameters, including PVR. The study showed that SRW from a mobile phone application may be helpful in facilitating voiding functions by increasing PFR in male LUTS patients.

Focal vibration of quadriceps muscle enhances leg power and decreases knee joint laxity in female volleyball players.

PubMed

Brunetti, O; Botti, F M; Roscini, M; Brunetti, A; Panichi, R; Filippi, G M; Biscarini, A; Pettorossi, V E

2012-12-01

This double-blind randomized controlled study aims at determining the effect of repeated muscle vibration (rMV) on explosive and reactive leg power and on knee laxity of female volleyball players. Eighteen voluntary volleyball athletes, belonging to the same senior regional level team (age=22.7 ± 3 years, height=180.3 ± 5 cm, mass= 64 ± 4 kg) were assigned to three groups (N.=6) for vibration on contracted quadriceps (VC), vibration on relaxed muscle (VR), and sham vibration (NV), respectively. Intervention consisted in 3 rMV sessions performed in 3 consecutive days. In each session, 100 Hz, 300-500 μm amplitude vibratory stimuli were bilaterally delivered to the quadriceps in three consecutive 10-minutes applications. Explosive and reactive leg power and knee joint laxity were evaluated 1 day before, and 1, 30, and 240 days after intervention. In VC group, explosive and reactive leg power increased respectively by ~16% and ~9% at 1 day, by ~19% and ~11% at 30 days and by ~26% and ~13% at 240 days, concomitantly knee laxity decreased by ~6%, ~15% and ~18% at the same times. These changes were significantly larger than in the other groups, in which leg power increment and knee joint laxity reduction remained close to ~3%, ~5% and ~10% at 1, 30 and 240 days, respectively. Combined bilateral voluntary contraction and rMV of the quadriceps muscles is a short-lasting, non-invasive technique that can significantly and persistently improve muscle performance and knee laxity in volleyball women players.

Infusion phlebitis in post-operative patients: when and why.

PubMed

Monreal, M; Oller, B; Rodriguez, N; Vega, J; Torres, T; Valero, P; Mach, G; Ruiz, A E; Roca, J

1999-01-01

The most common complication of intravenous therapy is infusion phlebitis. This study was done to prospectively assess its frequency in a series of consecutive patients who will undergo surgery, and to identify which variables may predict an increased risk for phlebitis. 400 consecutive patients who will undergo surgery in a general surgery department were included. Only the first catheter, inserted the day before surgery, was taken into account. Eighteen variables (from the infusion, the catheter and from the patient) were prospectively evaluated for their contribution to the occurrence of phlebitis. 60/400 patients (15%) developed phlebitis, and most of them needed insertion of a further catheter. The univariate analysis showed that patients who developed phlebitis were older, and their pre-operative levels of both blood haemoglobin and neutrophil cound were significantly higher than those in patients who did not develop phlebitis. However, the multivariate analysis only confirmed the association with blood haemoglobin levels: the risk of phlebitis sharply increased in the patients with the highest haemoglobin levels. As to the influence of time on phlebitis development, there was a significant decrease in the day-specific risk, from the 5th day on. In our series, blood haemoglobin levels were found to be the only variable associated to a higher risk of phlebitis. Besides, in contrast with the recommendations by the Centers for Disease Control, no significant increase in the day-specific risk of phlebitis was found. Thus, a guideline to select the type of catheter to be inserted in an individual patient is suggested. Copyright 2000 S. Karger AG, Basel

Educators' Year Long Reactions to the Implementation of a Response to Intervention (RTI) Model

ERIC Educational Resources Information Center

Sanger, Dixie; Friedli, Corey; Brunken, Cindy; Snow, Pamela; Ritzman, Mitzi

2012-01-01

Mixed methods were used to explore the reactions of educators before and after implementing the Response to Intervention (RTI) model in secondary settings during a school year. Eighteen participants from six middle schools and four high schools collaborated on interdisciplinary teams that involved classroom teachers, speech-language pathologists…

Toy Talk: Simple Strategies to Create Richer Grammatical Input

ERIC Educational Resources Information Center

Hadley, Pamela A.; Walsh, Kathleen M.

2014-01-01

Purpose: The purpose of this initial feasibility study was to determine whether brief instruction in toy talk would change grammatical properties of adult language, specifically 3rd person lexical noun phrase (NP) subjects. Method: Eighteen college students participated in the study. The use of 3rd person subjects was examined before and after…

Higher Education Faculty Engagement in a Modified Mapmark Standard Setting

ERIC Educational Resources Information Center

Horst, S. Jeanne; DeMars, Christine E.

2016-01-01

The Mapmark standard setting method was adapted to a higher education setting in which faculty leaders were highly involved. Eighteen university faculty members participated in a day-long standard setting for a general education communications test. In Round 1, faculty set initial cut-scores for each of four student learning objectives. In Rounds…

The Effects of Load Carriage and Muscle Fatigue on Lower-Extremity Joint Mechanics

ERIC Educational Resources Information Center

Wang, He; Frame, Jeff; Ozimek, Elicia; Leib, Daniel; Dugan, Eric L.

2013-01-01

Military personnel are commonly afflicted by lower-extremity overuse injuries. Load carriage and muscular fatigue are major stressors during military basic training. Purpose: To examine effects of load carriage and muscular fatigue on lower-extremity joint mechanics during walking. Method: Eighteen men performed the following tasks: unloaded…

Lexicality and Frequency in Specific Language Impairment: Accuracy and Error Data from Two Nonword Repetition Tests

ERIC Educational Resources Information Center

Jones, Gary; Tamburelli, Marco; Watson, Sarah E.; Gobet, Fernand; Pine, Julian M.

2010-01-01

Purpose: Deficits in phonological working memory and deficits in phonological processing have both been considered potential explanatory factors in specific language impairment (SLI). Manipulations of the lexicality and phonotactic frequency of nonwords enable contrasting predictions to be derived from these hypotheses. Method: Eighteen typically…

A Narrative Evaluation of Mandarin-Speaking Children with Language Impairment

ERIC Educational Resources Information Center

Hao, Ying; Sheng, Li; Zhang, Yiwen; Jiang, Fan; de Villiers, Jill; Lee, Wendy; Liu, Xueman Lucy

2018-01-01

Purpose: We aimed to study narrative skills in Mandarin-speaking children with language impairment (LI) to compare with children with LI speaking Indo-European languages. Method: Eighteen Mandarin-speaking children with LI (mean age 6;2 [years;months]) and 18 typically developing (TD) age controls told 3 stories elicited using the Mandarin…

Educating the Isolated Ageing: Improving the Quality of Life of the Housebound Elderly through Educational Teleconferencing.

ERIC Educational Resources Information Center

Swindell, Richard; Mayhew, Claire

1996-01-01

Eighteen homebound frail elderly took part in an eight-week teleconference that provided practical information (nutrition, health, social services) as well as stimulated thinking. Quality of life improvements and further interest in education resulted. Teleconferencing proved a cost-effective method of reaching homebound persons. (SK)

A new method for computing the reliability of consecutive k-out-of-n:F systems

NASA Astrophysics Data System (ADS)

Gökdere, Gökhan; Gürcan, Mehmet; Kılıç, Muhammet Burak

2016-01-01

In many physical systems, reliability evaluation, such as ones encountered in telecommunications, the design of integrated circuits, microwave relay stations, oil pipeline systems, vacuum systems in accelerators, computer ring networks, and spacecraft relay stations, have had applied consecutive k-out-of-n system models. These systems are characterized as logical connections among the components of the systems placed in lines or circles. In literature, a great deal of attention has been paid to the study of the reliability evaluation of consecutive k-out-of-n systems. In this paper, we propose a new method to compute the reliability of consecutive k-out-of-n:F systems, with n linearly and circularly arranged components. The proposed method provides a simple way for determining the system failure probability. Also, we write R-Project codes based on our proposed method to compute the reliability of the linear and circular systems which have a great number of components.

Effects of Masking Noise on Laryngeal Resistance for Breathy, Normal, and Pressed Voice

ERIC Educational Resources Information Center

Grillo, Elizabeth U.; Abbott, Katherine Verdolini; Lee, Timothy D.

2010-01-01

Purpose: The purpose of the present study was to explore the effects of masking noise on laryngeal resistance for breathy, normal, and pressed voice in vocally trained women. Method: Eighteen vocally trained women produced breathy, normal, and pressed voice across 7 fundamental frequencies during a repeated CV utterance of /pi/ under normal and…

An Exploration of the Leadership Style Preferences among African American Women Administrators of the 1890 Cooperative Extension System

ERIC Educational Resources Information Center

Campbell, Shelvy L.

2010-01-01

The purpose of this mixed-methods study was to identify and explore the leadership style preferences among current African American Administrators of the 1890 Land-Grant Cooperative Extension system. The population used in this study was African American women administrators from eighteen mostly southern states. The researcher used a…

Classroom Interaction Strategies Employed by English Teachers at Lower Secondary Schools

ERIC Educational Resources Information Center

Suryati, Nunung

2015-01-01

This article reports a study on teachers' use of interaction strategies in English Language Teaching (ELT) in lower secondary level of education. The study involved eighteen teachers from Lower Secondary Schools in Malang, East Java. Classroom observation was selected as a method in this study by utilizing Self Evaluation Teacher Talk (SETT) as…

Addressing Size Stereotypes: A Weight Bias and Weight-Related Teasing Intervention among Adolescents

ERIC Educational Resources Information Center

Miyairi, Maya; Reel, Justine J.; Próspero, Moisés; Okang, Esther N.

2015-01-01

Purpose: The purpose of this study was to evaluate a weight-related teasing prevention program implemented for both female and male students in a school setting. Methods: Junior High School students (N = 143) in seventh grade were invited to participate in the program. One hundred eighteen participants completed pre- and posttest surveys to assess…

Predicting Response of ADHD Symptoms to Methylphenidate Treatment Based on Comorbid Anxiety

ERIC Educational Resources Information Center

Blouin, Brittany; Maddeaux, Cindy; Stanley Firestone, Jill; van Stralen, Judy

2010-01-01

Objective: In this small pilot study, the association of comorbid anxiety with the treatment of ADHD is studied. Methods: Eighteen volunteers from a pediatric clinic are tested for ADHD and anxiety and assessed for behavioral and cognitive ADHD symptomology. Response to methylphenidate as treatment for ADHD symptoms is measured 2 to 3 weeks, and…

Using Pupillometry to Investigate Sentence Comprehension in Children with and without Specific Language Impairment

ERIC Educational Resources Information Center

Lum, Jarrad A. G.; Youssef, George J.; Clark, Gillian M.

2017-01-01

Purpose: In this study pupillometry was used to investigate the allocation of attentional resources associated with sentence comprehension in children with and without specific language impairment (SLI). Method: Eighteen children with SLI (age: M = 6.4 years) and 18 typically developing (TD) children (age: M = 6.3 years) participated in the study.…

Prevalence of ADHD Diagnosis and Nonmedical Prescription Stimulant Use in Medical Students

ERIC Educational Resources Information Center

Tuttle, Jeffrey P.; Scheurich, Neil E.; Ranseen, John

2010-01-01

Objective: The authors aimed to determine the prevalence of ADHD diagnosis and the prevalence of nonmedical prescription stimulant use among a sample of medical students. Methods: An anonymous survey was administered to 388 medical students (84.0% return rate) across all 4 years of education at a public medical college. Results: Eighteen medical…

Blood Density Is Nearly Equal to Water Density: A Validation Study of the Gravimetric Method of Measuring Intraoperative Blood Loss.

PubMed

Vitello, Dominic J; Ripper, Richard M; Fettiplace, Michael R; Weinberg, Guy L; Vitello, Joseph M

2015-01-01

Purpose. The gravimetric method of weighing surgical sponges is used to quantify intraoperative blood loss. The dry mass minus the wet mass of the gauze equals the volume of blood lost. This method assumes that the density of blood is equivalent to water (1 gm/mL). This study's purpose was to validate the assumption that the density of blood is equivalent to water and to correlate density with hematocrit. Methods. 50 µL of whole blood was weighed from eighteen rats. A distilled water control was weighed for each blood sample. The averages of the blood and water were compared utilizing a Student's unpaired, one-tailed t-test. The masses of the blood samples and the hematocrits were compared using a linear regression. Results. The average mass of the eighteen blood samples was 0.0489 g and that of the distilled water controls was 0.0492 g. The t-test showed P = 0.2269 and R (2) = 0.03154. The hematocrit values ranged from 24% to 48%. The linear regression R (2) value was 0.1767. Conclusions. The R (2) value comparing the blood and distilled water masses suggests high correlation between the two populations. Linear regression showed the hematocrit was not proportional to the mass of the blood. The study confirmed that the measured density of blood is similar to water.

Intra-individual variation in urinary iodine concentration: effect of statistical correction on population distribution using seasonal three-consecutive-day spot urine in children

PubMed Central

Ji, Xiaohong; Liu, Peng; Sun, Zhenqi; Su, Xiaohui; Wang, Wei; Gao, Yanhui; Sun, Dianjun

2016-01-01

Objective To determine the effect of statistical correction for intra-individual variation on estimated urinary iodine concentration (UIC) by sampling on 3 consecutive days in four seasons in children. Setting School-aged children from urban and rural primary schools in Harbin, Heilongjiang, China. Participants 748 and 640 children aged 8–11 years were recruited from urban and rural schools, respectively, in Harbin. Primary and secondary outcome measures The spot urine samples were collected once a day for 3 consecutive days in each season over 1 year. The UIC of the first day was corrected by two statistical correction methods: the average correction method (average of days 1, 2; average of days 1, 2 and 3) and the variance correction method (UIC of day 1 corrected by two replicates and by three replicates). The variance correction method determined the SD between subjects (Sb) and within subjects (Sw), and calculated the correction coefficient (Fi), Fi=Sb/(Sb+Sw/di), where di was the number of observations. The UIC of day 1 was then corrected using the following equation: Results The variance correction methods showed the overall Fi was 0.742 for 2 days’ correction and 0.829 for 3 days’ correction; the values for the seasons spring, summer, autumn and winter were 0.730, 0.684, 0.706 and 0.703 for 2 days’ correction and 0.809, 0.742, 0.796 and 0.804 for 3 days’ correction, respectively. After removal of the individual effect, the correlation coefficient between consecutive days was 0.224, and between non-consecutive days 0.050. Conclusions The variance correction method is effective for correcting intra-individual variation in estimated UIC following sampling on 3 consecutive days in four seasons in children. The method varies little between ages, sexes and urban or rural setting, but does vary between seasons. PMID:26920442

Mixed methods analysis of eighteen worksite policies, programs, and environments for physical activity.

PubMed

Hipp, J Aaron; Dodson, Elizabeth A; Lee, Jung Ae; Marx, Christine M; Yang, Lin; Tabak, Rachel G; Hoehner, Christine; Marquet, Oriol; Brownson, Ross C

2017-06-14

This study examined whether specific worksite supports for physical activity (PA) were associated with total and domain-specific PA. A cross-sectional, telephone-based study was conducted in four Missouri, USA, metropolitan areas in 2012 and 2013. Outcome variables included total PA and sub-domains (leisure, work, travel) measured using the International Physical Activity Questionnaire. Logistic regression determined odds of meeting PA recommendations, given access to and use of 18 unique PA worksite supports. A subsample of 119 participants also wore hip accelerometry for seven consecutive days and maintained a wear-time diary. Access to worksite supports were associated with odds of meeting objective moderate and vigorous (MV) PA above 150 min per week. Among 2013 survey participants, meeting PA recommendations while performing work-related tasks was significantly associated with several supports (e.g., walking maps, stair prompts), as was meeting recommendations during travel (e.g., flextime for PA, incentives for public transportation, walking/bicycling to work). Access to 11 worksite supports increased odds of meeting PA recommendations through leisure-time PA; five supports were associated with total PA. There were significant differences between access to and use of supports. Using objective MVPA, access to worksite challenges and bike storage were significantly associated with five and three times greater odds of meeting 150 min of MVPA per week, respectively. Worksite wellness plans are increasing across the US and employers are eager for evidence-based supports for increasing PA. This study provides insights into the utility of multiple worksite supports for PA to increase odds that employees meet PA recommendations.

Nonoperative management for patients with grade IV blunt hepatic trauma

PubMed Central

2012-01-01

Introduction The treatment of complex liver injuries remains a challenge. Nonoperative treatment for such injuries is increasingly being adopted as the initial management strategy. We reviewed our experience, at a University teaching hospital, in the nonoperative management of grade IV liver injuries with the intent to evaluate failure rates; need for angioembolization and blood transfusions; and in-hospital mortality and complications. Methods This is a retrospective analysis conducted at a single large trauma centre in Brazil. All consecutive, hemodynamically stable, blunt trauma patients with grade IV hepatic injury, between 1996 and 2011, were analyzed. Demographics and baseline characteristics were recorded. Failure of nonoperative management was defined by the need for surgical intervention. Need for angioembolization and transfusions, in-hospital death, and complications were also assessed Results Eighteen patients with grade IV hepatic injury treated nonoperatively during the study period were included. The nonoperative treatment failed in only one patient (5.5%) who had refractory abdominal pain. However, no missed injuries and/or worsening of bleeding were observed during the operation. None of the patients died nor need angioembolization. No complications directly related to the liver were observed. Unrelated complications to the liver occurred in three patients (16.7%); one patient developed a tracheal stenosis (secondary to tracheal intubation); one had pleural effusion; and one developed an abscess in the pleural cavity. The hospital length of stay was on average 11.56 days. Conclusions In our experience, nonoperative management of grade IV liver injury for stable blunt trauma patients is associated with high success rates without significant complications. PMID:23531162

Cerebral Hemodynamics and Systemic Endothelial Function Are Already Impaired in Well-Controlled Type 2 Diabetic Patients, with Short-Term Disease

PubMed Central

Altavilla, Riccardo; Di Flaviani, Alessandra; Giordani, Ilaria; Malandrucco, Ilaria; Picconi, Fabiana; Passarelli, Francesco; Pasqualetti, Patrizio; Ercolani, Matilde; Vernieri, Fabrizio; Frontoni, Simona

2013-01-01

Objective Impaired cerebral vasomotor reactivity (VMR) and flow-mediated dilation (FMD) were found in selected subgroups of type 2 diabetes mellitus (T2DM) patients with long-term disease. Our study aimed to evaluate cerebral hemodynamics, systemic endothelial function and sympatho-vagal balance in a selected population of well-controlled T2DM patients with short-term disease and without cardiac autonomic neuropathy (CAN). Research Design and Methods Twenty-six T2DM patients with short-term (4.40±4.80 years) and well-controlled (HbA1C = 6.71±1.29%) disease, without any complications, treated with diet and/or metformin, were consecutively recruited. Eighteen controls, comparable by sex and age, were enrolled also. Results FMD and shear rate FMD were found to be reduced in T2DM subjects with short-term disease (8.5% SD 3.5 and 2.5 SD 1.3, respectively) compared to controls (15.4% SD 4.1 and 3.5 SD 1.4; p<.001 and p<.05). T2DM patients also displayed reduced VMR values than controls (39.4% SD 12.4 vs 51.7%, SD 15.5; p<.05). Sympatho-vagal balance was not different in T2DM patients compared to healthy subjects. FMD and shear rate FMD did not correlate with VMR in T2DM patients or in controls (p>.05). Conclusions In well-controlled T2DM patients with short-term disease cerebral hemodynamics and systemic endothelial function are altered while autonomic balance appeared to be preserved. PMID:24391751

Two-Port Laparoscopic Cholecystectomy: 18 Patients Human Experience Using the Dynamic Laparoscopic NovaTract Retractor.

PubMed

Sucandy, Iswanto; Nadzam, Geoffrey; Duffy, Andrew J; Roberts, Kurt E

2016-08-01

The concept of reducing the number of transabdominal access ports has been criticized for violating basic tenets of traditional multiport laparoscopy. Potential benefits of reduced port surgery may include decreased pain, improved cosmesis, less hernia formation, and fewer wound complications. However, technical challenges associated with these access methods have not been adequately addressed by advancement in instrumentations. We describe our initial experience with the NovaTract™ Laparoscopic Dynamic Retractor. A retrospective review of all patients who underwent two-port laparoscopic cholecystectomy between 2013 and 2014 using the NovaTract retractor was performed. The patients were equally divided into three groups (Group A, B, C) based on the order of case performed. Eighteen consecutive patients underwent successful two-port laparoscopic cholecystectomy for symptomatic cholelithiasis. Mean age was 39.9 years and mean body mass index was 28.1 kg/m(2) (range 21-39.4). Overall mean operative time was 65 minutes (range 42-105), with Group A of 70 minutes, Group B of 65 minutes, and Group C of 58 minutes (P = .58). All cases were completed laparoscopically using the retraction system, without a need for additional ports or open conversion. No intra- or postoperative complications were seen. All patients were discharged on the same day of surgery. No mortality found in this series. The NovaTract laparoscopic dynamic retractor is safe and easy to use, which is reflected by acceptable operative time for a laparoscopic cholecystectomy using only two ports. The system allows surgical approach to mimic the conventional laparoscopic techniques, while eliminating or reducing the number of retraction ports.

Intrinsic factor antibody negative atrophic gastritis; is it different from pernicious anaemia?

PubMed

Amarapurkar, D N; Amarapurkar, A D

2010-01-01

H. pylori gastritis and autoimmune gastritis are the two main types of chronic atrophic gastritis. Parietal cell antibody (PCA) and intrinsic factor antibody (IFA) are characteristic of autoimmune gastritis, of which IFA is more specific. Patients who are IFA negative are considered under the category of chronic atrophic gastritis. To differentiate IFA positive from IFA negative chronic atrophic gastritis. Fifty consecutive patients of biopsy proven chronic atrophic gastritis were included in this study. All patients underwent haematological and biochemical tests including serum LDH, vitamin B12 and fasting serum gastrin levels. PCA and IFA antibodies were tested in all patients. Multiple gastric biopsies from body and antrum of the stomach were taken and evaluated for presence of intestinal metaplasia, endocrine cell hyperplasia, carcinoid and H. pylori infection. Patients were grouped as group A (IFA positive) and group B (IFA negative). The mean laboratory values and histological parameters were compared between the two groups using appropriate statistical methods. Eighteen patients were in group A (mean age 55.5 +/- 13 years, male: female = 16:2) and thirty-two in group B (mean age 49.7 +/- 13 years, male: female = 25:7). There was no statistically significant difference between median values of haemoglobin, MCV, LDH, Vitamin B12 and serum gastrin in both the groups. None of the histological parameters showed any significant difference. There was no statistically significant difference in haematological, biochemical and histological parameters in IFA positive and negative gastritis. These may be the spectrum of the same disease, where H. pylori may be responsible for initiating the process.

Use of carbonated water in reduction of adjacent gastric activity in 456 consecutive technetium-99m myocardial perfusion imaging studies.

PubMed

Thomas, Dustin M; Lee, Joshua S; Charmforoush, Anthony; Rubal, Bernard J; Rosenblatt, Stephen A; Butler, Joshua T; Clemenshaw, Michael; Cheezum, Michael K; Slim, Ahmad M

2015-12-01

Small, observational trials have suggested a reduction in adjacent gastric activity with ingestion of soda water in myocardial perfusion imaging (MPI). We report our findings prior to and after implementation of soda water in 467 consecutive MPI studies. Consecutive MPI studies performed at a high-volume facility referred for vasodilator (VD) or exercise treadmill testing (ETT) were retrospectively reviewed before and after implementation of the soda water protocol. Patients undergoing the soda water protocol received 100 ml of soda water administered 30 min prior to image acquisition and after stress. Studies were performed using a same day rest/stress protocol. Incidence of adjacent gastric activity, diaphragmatic attenuation, stress and rest perfusion defects, and major adverse cardiovascular events (MACE) outcomes defined as death, myocardial infarction, stroke, reevaluation for chest pain, and late revascularization (>90 days from MPI) were abstracted using International Classification of Diseases, Ninth Revision (ICD-9) search. Two hundred and eighteen studies were performed prior to implementation of the soda water protocol and 249 studies were performed with the use of soda water. Baseline demographic data were equal between the groups with the exception of more patients undergoing VD stress receiving soda water (p < 0.001). Soda water was not associated with a decreased incidence of adjacent gastric activity with stress (54.7% versus 61.9% with no soda water, p = 0.129) or rest (68.6% versus 69.5% with no soda water, p = 0.919) imaging. Less adjacent gastric activity was observed with patients undergoing ETT who received soda water (42.5% versus 56.9% with no soda water, p = 0.031), but no difference was observed between the groups with VD stress (69.0% versus 68.1% with no soda water, p = 1.000). The use of soda water prior to technetium-99m MPI was associated with lower rates of adjacent gastric activity only in patients undergoing ETT stress but not rest or VD stress. This differs from previously published data. © The Author(s), 2015.

Mediating Peer Teaching for Learning Games: An Action Research Intervention across Three Consecutive Sport Education Seasons

ERIC Educational Resources Information Center

Farias, Cláudio; Mesquita, Isabel; Hastie, Peter A.; O'Donovan, Toni

2018-01-01

Purpose: The purpose of this study was to provide an integrated analysis of a teacher's peer-teaching mediation strategies, the student-coaches' instruction, and the students' gameplay development across 3 consecutive seasons of sport education. Method: Twenty-six 7th-grade students participated in 3 consecutive sport education seasons of invasion…

Postpartum Hemorrhage Resulting from Pelvic Pseudoaneurysm: A Retrospective Analysis of 588 Consecutive Cases Treated by Arterial Embolization

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

Dohan, Anthony, E-mail: anthony.dohan@lrb.aphp.fr; Soyer, Philippe, E-mail: philippe.soyer@lrb.aphp.fr; Subhani, Aqeel, E-mail: drsubhani07@gmail.com

Objective: This study was designed to determine the incidence of arterial pseudoaneurysm in patients presenting with postpartum hemorrhage (PPH), to analyze the angiographic characteristics of pseudoaneurysms that cause PPH, and to evaluate the effectiveness of pelvic arterial embolization for the treatment of this condition.Study designEighteen women with pelvic arterial pseudoaneurysm were retrieved from a series of 588 consecutive patients with PPH treated by arterial embolization. Clinical files, angiographic examinations, and procedure details were reviewed. Results: The incidence of pseudoaneurysm was 3.06 % (18/588; 95 % confidence interval (CI): 1.82-4.8 %). A total of 20 pseudoaneurysms were found; 15/20 (75 %)more » were located on the uterine arteries. Angiography revealed extravasation of contrast material from pseudoaneurysm indicating rupture in 9 of 18 (50 %) patients. Arterial embolization was performed using gelatin sponge alone in 12 of 18 (67 %) patients or in association with metallic coils in 5 of 18 (28 %) patients or n-butyl-2-cyanoacrylate in 1 of 18 (6 %) patients. Arterial embolization allowed controlling the bleeding in all patients after one or two embolization sessions in 17 of 18 (94 %) and 1 of 18 patients (6 %) respectively, without complications, obviating the need for further surgery. Conclusions: Pseudoaneurysm is rarely associated with PPH. Arterial embolization is an effective and safe procedure for the treatment of PPH due to uterine or vaginal artery pseudoaneurysm. Our results suggest that gelatin sponge is effective for the treatment of ruptured pseudoaneurysms, although we agree that our series does not contain sufficient material to allow drawing definitive conclusions with respect to the most effective embolic material.« less

Ankle Sprain Injuries: A 2-Year Prospective Cohort Study in Female Greek Professional Basketball Players

PubMed Central

Kofotolis, Nikolaos; Kellis, Eleftherios

2007-01-01

Context: Ankle sprains are a common basketball injury. Therefore, examination of risk factors for injury in female professional basketball players is worthwhile. Objective: To examine rates of ankle sprains, associated time missed from participation, and risk factors for injury during 2 consecutive seasons. Design: Prospective cohort study. Setting: Eighteen professional basketball facilities. Patients or Other Participants: We observed 204 players from 18 female professional basketball teams for 2 consecutive seasons during a 2-year period. Main Outcome Measure(s): Using questionnaires, we recorded the incidence of ankle sprains, participation time missed, and mechanisms of injury in games and practice sessions. Potential risk factors, such as age, body mass, height, training experience, and history of ankle sprain, were examined using multivariate logistic regression. Results: Fifty of the 204 participants sustained ankle injuries; injuries included 32 ankle sprains, which translated to an ankle sprain rate of 1.12 per 1000 hours of exposure to injury. The 32 players missed 224.4 training and game sessions and an average of 7.01 sessions per injury. Most injuries occurred in the key area of the basketball court and were the result of contact. Injury rates during games were higher than injury rates during practice sessions. Centers, followed by guards and forwards, had the highest rate of injury. Players who did not wear an external ankle support had an odds ratio of 2.481 for sustaining an ankle sprain. Conclusions: Female professional basketball athletes who did not wear an external ankle support, who played in the key area, or who functioned as centers had a higher risk for ankle sprain than did other players. PMID:18059995

Repeated transcranial direct current stimulation reduces food craving in Wistar rats.

PubMed

Macedo, I C; de Oliveira, C; Vercelino, R; Souza, A; Laste, G; Medeiros, L F; Scarabelot, V L; Nunes, E A; Kuo, J; Fregni, F; Caumo, W; Torres, I L S

2016-08-01

It has been suggested that food craving-an intense desire to consume a specific food (particularly foods high in sugar and fat)-can lead to obesity. This behavior has also been associated with abuse of other substances, such as drugs. Both drugs and food cause dependence by acting on brain circuitry involved in reward, motivation, and decision-making processes. The dorsolateral prefrontal cortex (DLPFC) can be activated following evocation and is implicated in alterations in food behavior and craving. Transcranial direct current stimulation (tDCS), a noninvasive brain stimulation technique capable of modulates brain activity significantly, has emerged as a promising treatment to inhibit craving. This technique is considered safe and inexpensive; however, there is scant research using animal models. Such studies could help elucidate the behavioral and molecular mechanisms of eating disorders, including food craving. The aim of our study was to evaluate palatable food consumption in rats receiving tDCS treatment (anode right/cathode left). Eighteen adult male Wistar rats were randomized by weight and divided into three groups (n = 6/group): control, with no stimulation; sham, receiving daily 30 s tDCS (500 μA) sessions for 8 consecutive days; and tDCS, receiving daily 20 min tDCS (500 μA) sessions for 8 consecutive days. All rats were evaluated for locomotor activity and anxiety-like behavior. A palatable food consumption test was performed at baseline and on treatment completion (24 h after the last tDCS session) under fasting and feeding conditions and showed that tDCS decreased food craving, thus corroborating human studies. This result confirms the important role of the prefrontal cortex in food behavior, which can be modulated by noninvasive brain stimulation. Copyright © 2016. Published by Elsevier Ltd.

Physiological Adaptations to Resistance Training in Prepubertal Boys

ERIC Educational Resources Information Center

dos Santos Cunha, Giovani; Sant'anna, Marcelo Morganti; Cadore, Eduardo Lusa; de Oliveira, Norton Luis; dos Santos, Cinara Bos; Pinto, Ronei Silveira; Reischak-Oliveira, Alvaro

2015-01-01

Purpose: The purpose of this study was to investigate the physiological adaptations of resistance training (RT) in prepubertal boys. Methods: Eighteen healthy boys were divided into RT (n = 9, M[subscript age] = 10.4 ± 0.5 years) and control (CTR; n = 9, M[subscript age] = 10.9 ± 0.7 years) groups. The RT group underwent a resistance training…

Back to Africa in the 21st Century: The Cultural Reconnection Experiences of African American Women

ERIC Educational Resources Information Center

Arunga, Marcia Tate

2017-01-01

The purpose of this study is to examine the lived experiences of 18 African American women who went to Kenya, East Africa as part of a Cultural Reconnection delegation. A qualitative narrative inquiry method was used for data collection. This was an optimal approach to honoring the authentic voices of African American women. Eighteen African…

Identifying the Barriers and Facilitators to Participation in Physical Activity for Children with Down Syndrome

ERIC Educational Resources Information Center

Barr, M.; Shields, N.

2011-01-01

Background: Many children with Down syndrome do not undertake the recommended amount of daily physical activity. The aim of this study was to explore the barriers and facilitators to physical activity for this group. Methods: Eighteen in-depth interviews were conducted with 20 parents (16 mothers, 4 fathers) of children with Down syndrome aged…

Exemplar Variability Facilitates Retention of Word Learning by Children with Specific Language Impairment

ERIC Educational Resources Information Center

Aguilar, Jessica M.; Plante, Elena; Sandoval, Michelle

2018-01-01

Purpose: Variability in the input plays an important role in language learning. The current study examined the role of object variability for new word learning by preschoolers with specific language impairment (SLI). Method: Eighteen 4- and 5-year-old children with SLI were taught 8 new words in 3 short activities over the course of 3 sessions.…

A Placebo-Controlled, Fixed-Dose Study of Aripiprazole in Children and Adolescents with Irritability Associated with Autistic Disorder

ERIC Educational Resources Information Center

Marcus, Ronald N.; Owen, Randall; Kamen, Lisa; Manos, George; McQuade, Robert D.; Carson, William H.; Aman, Michael G.

2009-01-01

Objective: To evaluate the short-term efficacy and safety of aripiprazole in the treatment of irritability in children and adolescents with autistic disorder. Method: Two hundred eighteen children and adolescents (aged 6-17 years) with a diagnosis of autistic disorder, and with behaviors such as tantrums, aggression, self-injurious behavior, or a…

Investigating the Relationship between Nonword Repetition Performance and Syllabic Structure in Typical and Atypical Language Development

ERIC Educational Resources Information Center

Tamburelli, Marco; Jones, Gary

2013-01-01

Purpose: In this study, the authors examined the role of syllabic structure in nonword repetition performance in typically developing (TD) children and children with specific language impairment (SLI). Method: Eighteen children with SLI (5;7--6;7 [years;months]) and 18 TD children matched for chronological age were tested on their ability to…

Detail view to show one of the eighteen aluminum torcheres ...

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

Detail view to show one of the eighteen aluminum torcheres that surround the building; the torcheres were designed by C. Paul Jennwein - United States Department of Justice, Constitution Avenue between Ninth & Tenth Streets, Northwest, Washington, District of Columbia, DC

Blood Density Is Nearly Equal to Water Density: A Validation Study of the Gravimetric Method of Measuring Intraoperative Blood Loss

PubMed Central

Vitello, Dominic J.; Ripper, Richard M.; Fettiplace, Michael R.; Weinberg, Guy L.; Vitello, Joseph M.

2015-01-01

Purpose. The gravimetric method of weighing surgical sponges is used to quantify intraoperative blood loss. The dry mass minus the wet mass of the gauze equals the volume of blood lost. This method assumes that the density of blood is equivalent to water (1 gm/mL). This study's purpose was to validate the assumption that the density of blood is equivalent to water and to correlate density with hematocrit. Methods. 50 µL of whole blood was weighed from eighteen rats. A distilled water control was weighed for each blood sample. The averages of the blood and water were compared utilizing a Student's unpaired, one-tailed t-test. The masses of the blood samples and the hematocrits were compared using a linear regression. Results. The average mass of the eighteen blood samples was 0.0489 g and that of the distilled water controls was 0.0492 g. The t-test showed P = 0.2269 and R 2 = 0.03154. The hematocrit values ranged from 24% to 48%. The linear regression R 2 value was 0.1767. Conclusions. The R 2 value comparing the blood and distilled water masses suggests high correlation between the two populations. Linear regression showed the hematocrit was not proportional to the mass of the blood. The study confirmed that the measured density of blood is similar to water. PMID:26464949

Predicting Nitrogen Availability to Rice: II. Assessing Available Nitrogen in Silt Loams With Different Previous Year Crop History

Treesearch

J. L. Sims; B. G. Blackmon

1967-01-01

Soil test method s that measure NH4+-N in silt 100ms before and after incubation under waterlogged conditions were evaluated as predictors of N availability to 'Nato' rice (Oriza sativa L.) frown in the greenhouse. Eighteen soils for each of five previous year crop histories were utilized. An soils were from crop rotations containing rice....

Perspectives of Nurses and Patients on Call Light Technology.

PubMed

Galinato, Jose; Montie, Mary; Patak, Lance; Titler, Marita

2015-08-01

Call lights are prevalent in inpatient healthcare facilities across the nation. While call light use directly influences the delivery of nursing care, there remain significant gaps both in research and technology that can affect the quality of care and patient satisfaction. This study examines nurse and patient perceptions of the use of a new call communication solution, Eloquence, in the acute care inpatient setting. Eighteen patients were recruited for the study and participated in individual semistructured interviews during their hospital stay. Eighteen nurses were recruited and participated in focus groups for this study. Qualitative descriptive methods were used to analyze the data. Results revealed themes of usability, improved communication, and suggestions for improvement to the alpha prototype design. After a demonstration of the use and capability of Eloquence, nurse and patient participants found Eloquence as a welcomed advancement in nurse call technology that has the potential to improve workflow and patient outcomes. In addition, the participants also proposed ideas on how to further develop the technology to improve its use.

What are the physical and psychological health effects of suicide bereavement on family members? An observational and interview mixed-methods study in Ireland

PubMed Central

Matvienko-Sikar, Karen; Larkin, Celine; Corcoran, Paul; Arensman, Ella

2018-01-01

Objectives Research focussing on the impact of suicide bereavement on family members’ physical and psychological health is scarce. The aim of this study was to examine how family members have been physically and psychologically affected following suicide bereavement. A secondary objective of the study was to describe the needs of family members bereaved by suicide. Design A mixed-methods study was conducted, using qualitative semistructured interviews and additional quantitative self-report measures of depression, anxiety and stress (DASS-21). Setting Consecutive suicide cases and next-of-kin were identified by examining coroner’s records in Cork City and County, Ireland from October 2014 to May 2016. Participants Eighteen family members bereaved by suicide took part in a qualitative interview. They were recruited from the Suicide Support and Information System: A Case-Control Study (SSIS-ACE), where family members bereaved by suicide (n=33) completed structured measures of their well-being. Results Qualitative findings indicated three superordinate themes in relation to experiences following suicide bereavement: (1) co-occurrence of grief and health reactions; (2) disparity in supports after suicide and (3) reconstructing life after deceased’s suicide. Initial feelings of guilt, blame, shame and anger often manifested in enduring physical, psychological and psychosomatic difficulties. Support needs were diverse and were often related to the availability or absence of informal support by family or friends. Quantitative results indicated that the proportion of respondents above the DASS-21 cut-offs respectively were 24% for depression, 18% for anxiety and 27% for stress. Conclusions Healthcare professionals’ awareness of the adverse physical and psychosomatic health difficulties experienced by family members bereaved by suicide is essential. Proactively facilitating support for this group could help to reduce the negative health sequelae. The effects of suicide bereavement are wide-ranging, including high levels of stress, depression, anxiety and physical health difficulties. PMID:29331974

Xpert MTB/RIF assay for diagnosis of pulmonary tuberculosis in sputum specimens in remote health care facility.

PubMed

Geleta, Dereje Assefa; Megerssa, Yoseph Cherinet; Gudeta, Adugna Negussie; Akalu, Gizachew Taddesse; Debele, Melaku Tesfaye; Tulu, Kassu Desta

2015-10-19

Xpert MTB/RIF assay is considered as a great advance over conventional smear and culture in the diagnosis of TB and MDR-TB by simultaneously detecting M.tuberculosis and rifampicin resistance bacilli. However, very little information regarding the performance characteristics of Xpert MTB/RIF assay is available in Ethiopia. Therefore, the purpose of this study was to evaluate the performance of Xpert MTB/RIF assay compared to conventional sputum smear and culture methods for the diagnosis of pulmonary tuberculosis in remote health care facility. A paired expectorated sputum samples were obtained from 227 consecutively recruited patients with signs and symptoms suggestive of tuberculosis at Karamara hospital during December 2013 to May 2014. One of the sputum specimen was tested directly by Ziehl-Neelsen staining and Xpert MTB/RIF assay without NALC-NaOH decontamination. The other of pair of sputa specimen was cultured for isolation of TB bacilli by conventional methods. Diagnostic performance of Xpert MTB/RIF assay and AFB smear microscopy were calculated against culture as the gold standard. Overall 25.5% (58/227) samples were positive for Mycobacterium tuberculosis complex (MTBC) by MGIT and/or LJ media of which 36.2% (21/58) and 65.5% (35/58) were positive by AFB smear microscopy and Xpert MTB/RIF respectively. The sensitivity, specificity, as well as the positive and negative predictive value of Xpert MTB/RIF assay were 65.5% (95% CI: 53.3-77.7%), 96.3% (95% CI: 93.4-99.2%), 86.4% (95% CI: 76.2-96.5%), and 88.6% (95% CI: 83.9-93.3%) respectively. Eighteen of 58 (31%) cases that were smear microscopy negative, were positive by Xpert MTB/RIF assay. Although Xpert MTB/RIF assay demonstrated high sensitivity in detecting MTBC in sputum specimens compared with conventional AFB smear microscopy, it demonstrated suboptimal sensitivity in smear negative patients compared to conventional culture.

Reliability of Fitness Tests Using Methods and Time Periods Common in Sport and Occupational Management

PubMed Central

Burnstein, Bryan D.; Steele, Russell J.; Shrier, Ian

2011-01-01

Context: Fitness testing is used frequently in many areas of physical activity, but the reliability of these measurements under real-world, practical conditions is unknown. Objective: To evaluate the reliability of specific fitness tests using the methods and time periods used in the context of real-world sport and occupational management. Design: Cohort study. Setting: Eighteen different Cirque du Soleil shows. Patients or Other Participants: Cirque du Soleil physical performers who completed 4 consecutive tests (6-month intervals) and were free of injury or illness at each session (n = 238 of 701 physical performers). Intervention(s): Performers completed 6 fitness tests on each assessment date: dynamic balance, Harvard step test, handgrip, vertical jump, pull-ups, and 60-second jump test. Main Outcome Measure(s): We calculated the intraclass coefficient (ICC) and limits of agreement between baseline and each time point and the ICC over all 4 time points combined. Results: Reliability was acceptable (ICC > 0.6) over an 18-month time period for all pairwise comparisons and all time points together for the handgrip, vertical jump, and pull-up assessments. The Harvard step test and 60-second jump test had poor reliability (ICC < 0.6) between baseline and other time points. When we excluded the baseline data and calculated the ICC for 6-month, 12-month, and 18-month time points, both the Harvard step test and 60-second jump test demonstrated acceptable reliability. Dynamic balance was unreliable in all contexts. Limit-of-agreement analysis demonstrated considerable intraindividual variability for some tests and a learning effect by administrators on others. Conclusions: Five of the 6 tests in this battery had acceptable reliability over an 18-month time frame, but the values for certain individuals may vary considerably from time to time for some tests. Specific tests may require a learning period for administrators. PMID:22488138

Measurement of fatigue in knee flexor and extensor muscles.

PubMed

Kawabata, Y; Senda, M; Oka, T; Yagata, Y; Takahara, Y; Nagashima, H; Inoue, H

2000-04-01

In order to examine fatigue of the knee flexor and extensor muscles and to investigate the characteristics of muscular fatigue in different sports, a Cybex machine was used to measure muscle fatigue and recovery during isokinetic knee flexion and extension. Eighteen baseball players, 12 soccer players and 13 marathon runners were studied. Each subject was tested in the sitting position and made to perform 50 consecutive right knee bends and stretches at maximum strength. This was done 3 times with an interval of 10 min between each series. The peak torque to body weight ratio and the fatigue rate were determined in each case. In all subjects, the peak torque to body weight ratio was higher for extensors than flexors. Over the 3 trials, the fatigue rate of extensors showed little change, while that of flexors had a tendency to increase. In each subject, knee extensors showed a high fatigue rate but a quick recovery, while knee flexors showed a low fatigue rate but a slow recovery. As the marathon runners had the smallest fatigue rates for both flexors and extensors, we concluded that marathon runners had more stamina than baseball players and soccer players.

Selective local anesthetic placement using ultrasound guidance and neurostimulation for infraclavicular brachial plexus block.

PubMed

Bowens, Clifford; Gupta, Rajnish K; O'Byrne, William T; Schildcrout, Jonathan S; Shi, Yaping; Hawkins, Jermel J; Michaels, Damon R; Berry, James M

2010-05-01

In this study, we performed the infraclavicular block with combined ultrasound guidance and neurostimulation to selectively target cords to compare the success rates of placing a single injection of local anesthetic either in a central or peripheral location. Two hundred eighteen patients were enrolled in a consecutive, prospective study. Patients were randomized to injection of local anesthetic either centrally (posterior cord) or peripherally (medial or lateral cord) using ultrasound guidance and neurostimulation. Supervised senior anesthesiology residents or attending anesthesiologists performed the blocks. Both intent-to-treat and treatment-received analyses were used to compare central and peripheral placement efficacy. The overall success rate was significantly higher for the central placements than peripheral placements (96% vs 85%, P = 0.004). Individual cord success rates were as follows: posterior 99%, lateral 92%, and medial 84% (P = 0.001). The central group required attending physician intervention more frequently (27% vs 6%, P < 0.001). Postoperative pain scores of < or =3 were more likely with central placement (100% vs 94%, P = 0.012). Central placement of a single injection of local anesthetic targeted at the posterior cord resulted in a higher success rate for infraclavicular block.

Associations between obesity and physical activity in dogs: a preliminary investigation.

PubMed

Morrison, R; Penpraze, V; Beber, A; Reilly, J J; Yam, P S

2013-11-01

To assess whether obesity has any association with objectively measured physical activity levels in dogs. Thirty-nine dogs wore Actigraph GT3X accelerometers (Actigraph) for 7 consecutive days. Each dog was classified as ideal weight, overweight or obese using the 5-point body condition scoring system. Total volume of physical activity and time spent in sedentary behaviour, light-moderate intensity physical activity and vigorous intensity physical activity were compared between body condition categories. Valid accelerometry data were returned for 35 of 39 dogs recruited. Eighteen dogs were classed as ideal weight, 9 as overweight and the remaining 8 as obese. All dogs spent a significant proportion of the day sedentary and obese dogs spent significantly less time in vigorous intensity physical activity than ideal weight dogs (7 ±3 minute/day versus 21 ±15 minute/day, P=0·01). Obesity is associated with lower vigorous intensity physical activity in dogs, as is also thought to occur in humans. These preliminary findings will help inform a future, larger study and may also improve our understanding of the associations between obesity and physical activity in dogs. © 2013 British Small Animal Veterinary Association.

Surgical management of reflux strictures of the esophagus in childhood.

PubMed Central

O'Neill, J A; Betts, J; Ziegler, M M; Schnaufer, L; Bishop, H C; Templeton, J M

1982-01-01

The etiology of gastroesophageal reflux (GER) in infancy is related to developmental factors, and there is a high incidence of associated conditions such as neurologic syndromes and esophageal atresia (60%). This is different from the situation in adults. Experience with 18 consecutive children with peptic esophageal strictures is reviewed to determine if conservative surgical management is effective. Eighteen children 14 months to 13 years (mean 6.3 years) of age took an average of 3.5 years from the time of onset of symptoms of GER to develop tight strictures diagnosed by esophagography and esophagoscopy. The incidence of stricture in patients with GER was approximately 15%. Preoperative dilation or direct surgical management prior to correction of reflux is ineffective. All 18 children were managed by intraoperative dilatation, Nissen fundoplication, and guided dilatation after operation. More aggressive surgical procedures were not required nor were associated operations such as pyloroplasty; they are rarely necessary. An average three-year follow-up indicates that this conservative surgical approach is effective in the management of peptic esophageal strictures in childhood with relief of symptoms and gratifying improvement in growth. Images Fig. 3. Fig. 4. Fig. 5. PMID:7125730

Modeling the BOD of Danube River in Serbia using spatial, temporal, and input variables optimized artificial neural network models.

PubMed

Šiljić Tomić, Aleksandra N; Antanasijević, Davor Z; Ristić, Mirjana Đ; Perić-Grujić, Aleksandra A; Pocajt, Viktor V

2016-05-01

This paper describes the application of artificial neural network models for the prediction of biological oxygen demand (BOD) levels in the Danube River. Eighteen regularly monitored water quality parameters at 17 stations on the river stretch passing through Serbia were used as input variables. The optimization of the model was performed in three consecutive steps: firstly, the spatial influence of a monitoring station was examined; secondly, the monitoring period necessary to reach satisfactory performance was determined; and lastly, correlation analysis was applied to evaluate the relationship among water quality parameters. Root-mean-square error (RMSE) was used to evaluate model performance in the first two steps, whereas in the last step, multiple statistical indicators of performance were utilized. As a result, two optimized models were developed, a general regression neural network model (labeled GRNN-1) that covers the monitoring stations from the Danube inflow to the city of Novi Sad and a GRNN model (labeled GRNN-2) that covers the stations from the city of Novi Sad to the border with Romania. Both models demonstrated good agreement between the predicted and actually observed BOD values.

Plasma homovanillic acid in adolescents with bulimia nervosa.

PubMed

Castro-Fornieles, Josefina; Deulofeu, Ramón; Martínez-Mallen, Esteve; Baeza, Immaculada; Fernández, Lorena; Lázaro, Luisa; Toro, Josep; Vila, Montserrat; Bernardo, Miquel

2009-12-30

Dopaminergic abnormalities in bulimia nervosa have been reported in some studies, but results are not consistent across studies. In the present study, clinical characteristics, plasma level of homovanillic acid (pHVA) and two scales - the Eating Attitudes Test (EAT) and the Beck Depression Inventory (BDI) - were assessed in 36 adolescent bulimia nervosa patients (mean age16.3 years, S.D. 1.1) who were consecutively seen on an Eating Disorder Unit. Levels of pHVA were also measured in 16 healthy control adolescents from the general population. Patients had significantly higher mean pHVA than controls. Eighteen patients (50%) had a pHVA level equal to or higher than the mean of control subjects plus one standard deviation, and this group of patients had significantly higher mean BDI scores and non-significantly higher mean EAT scores, although they did not differ from the other patients in age, time elapsed since the onset of disorder, body mass index and number of binges or vomits. Moreover, in logistic regression analysis the BDI score proved to be an independent predictor of high pHVA. The level of pHVA is increased in bulimia nervosa patients with high scores on measures of depressive and eating symptomatology.

Permacol™ collagen paste injection for the treatment of complex anal fistula: 1-year follow-up.

PubMed

Fabiani, B; Menconi, C; Martellucci, J; Giani, I; Toniolo, G; Naldini, G

2017-03-01

Optimal surgical treatment for anal fistula should result in healing of the fistula track and preserve anal continence. The aim of this study was to evaluate Permacol™ collagen paste (Covidien plc, Gosport, Hampshire, UK) injection for the treatment of complex anal fistulas, reporting feasibility, safety, outcome and functional results. Between May 2013 and December 2014, 21 consecutive patients underwent Permacol paste injection for complex anal fistula at our institutions. All patients underwent fistulectomy and seton placement 6-8 weeks before Permacol™ paste injection. Follow-up duration was 12 months. Eighteen patients (85.7%) had a high transsphincteric anal fistula, and three female patients (14.3%) had an anterior transsphincteric fistula. Fistulas were recurrent in three patients (14.3%). Seven patients (33%) had a fistula with multiple tracts. After a follow-up of 12 months, ten patients were considered healed (overall success rate 47.6%). The mean preoperative FISI score was 0.33 ± 0.57 and 0.61 ± 1.02 after 12 months. Permacol™ paste injection was safe and effective in some patients with complex anal fistula without compromising continence.

Coping and Sport-Motivation of Adolescent Handballers in Debrecen

ERIC Educational Resources Information Center

Kovács, Karolina-Eszter; Nagy, Beáta-Erika

2016-01-01

The aim of the study was to examine coping and motivation of adolescent handball players in Debrecen. Forty-six male and thirty-one female handball players completed the questionnaires, furthermore eighteen males and eighteen females participated in focus groups. The purpose of this study was to measure gender differences in sport motivation,…

Beyond Brain Growth: Other Factors Affecting Cognitive Development.

ERIC Educational Resources Information Center

Stefanich, Greg; Aldridge, Mary Nan

The intellectual model of Jean Piaget asserts that individuals pass through a series of various intellectual stages as they mature. Human development is categorized into four basic stages: (1) sensory motor stage, which lasts from birth to about eighteen months; (2) preoperational stage, lasting from eighteen months to about seven years; (3)…

Evaluating the Quality of the Interaction between Persons with Profound Intellectual and Multiple Disabilities and Direct Support Staff: A Preliminary Application of Three Observation Scales from Parent-Infant Research

ERIC Educational Resources Information Center

Hostyn, Ine; Petry, Katja; Lambrechts, Greet; Maes, Bea

2011-01-01

Background: Affective and reciprocal interactions with others are essential for persons with profound intellectual and multiple disabilities (PIMD), but it is a challenge to assess their quality. This study aimed to investigate the usefulness of instruments from parent-infant research to evaluate these interactions. Method: Eighteen videotaped…

SELECTIVE DISSEMINATION OF INFORMATION--REVIEW OF SELECTED SYSTEMS AND A DESIGN FOR ARMY TECHNICAL LIBRARIES. FINAL REPORT. ARMY TECHNICAL LIBRARY IMPROVEMENT STUDIES (ATLIS), REPORT NO. 8.

ERIC Educational Resources Information Center

BIVONA, WILLIAM A.

THIS REPORT PRESENTS AN ANALYSIS OF OVER EIGHTEEN SMALL, INTERMEDIATE, AND LARGE SCALE SYSTEMS FOR THE SELECTIVE DISSEMINATION OF INFORMATION (SDI). SYSTEMS ARE COMPARED AND ANALYZED WITH RESPECT TO DESIGN CRITERIA AND THE FOLLOWING NINE SYSTEM PARAMETERS--(1) INFORMATION INPUT, (2) METHODS OF INDEXING AND ABSTRACTING, (3) USER INTEREST PROFILE…

Development and Reliability of Items Measuring the Nonmedical Use of Prescription Drugs for the Youth Risk Behavior Survey: Results Froman Initial Pilot Test

ERIC Educational Resources Information Center

Howard, Melissa M.; Weiler, Robert M.; Haddox, J. David

2009-01-01

Background: The purpose of this study was to develop and test the reliability of self-report survey items designed to monitor the nonmedical use of prescription drugs among adolescents. Methods: Eighteen nonmedical prescription drug items designed to be congruent with the substance abuse items in the US Centers for Disease Control and Prevention's…

Toxic anterior segment syndrome caused by autoclave reservoir wall biofilms and their residual toxins.

PubMed

Sorenson, Andrew L; Sorenson, Robert L; Evans, David J

2016-11-01

To identify etiology of toxic anterior segment syndrome (TASS) after uneventful phacoemulsification. EyeMD Laser and Surgery Center, Oakland, California. Retrospective case series. Patient charts with TASS were reviewed. Reservoirs of 2 autoclaves associated with these cases were cultured for bacterial contamination. Cultures were performed on 23 other autoclave reservoirs at surgery centers in the local area. The main outcome measures were the incidence of TASS and prevalence of bacterial biofilm contamination of autoclave reservoirs. From 2010 to 2013, 11 935 consecutive cataract surgeries were performed at 1 center by multiple surgeons with no reported TASS. Between January 1, 2014, and January 15, 2015, 10 cases of TASS occurred out of 3003 cataract surgeries; these patients' charts were reviewed. Cultures of 2 Statim autoclave reservoir walls grew Bacillus species, Williamsia species, Mycobacterium mucogenicum, and Candida parapsilosis. Scanning electron microscopy of reservoir wall sections showed prominent biofilm. The 2 autoclaves were replaced in January 2015. Subsequently, 2875 cataract surgeries were performed with no reported TASS (P < .001, χ 2 test). Eighteen of 23 additional regional autoclaves were also contaminated with bacterial biofilms. Toxic anterior segment syndrome was strongly associated with bacterial biofilm contamination of autoclave reservoirs. An etiological mechanism might involve transport of heat-stable bacterial cell antigens in the steam with deposition on surgical instrumentation. Data suggest widespread prevalence of bacterial biofilms on fluid-reservoir walls, despite adherence to manufacturer guidelines for cleaning and maintenance. Prevention or elimination of autoclave fluid-reservoir biofilms might reduce the risk for postoperative TASS. None of the authors has a financial or proprietary interest in any material or method mentioned. Copyright © 2016 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Femtosecond-assisted laser in situ keratomileusis for consecutive hyperopia after radial keratotomy.

PubMed

Leccisotti, Antonio; Fields, Stefania V

2015-08-01

To evaluate femtosecond-assisted laser in situ keratomileusis (LASIK) for the treatment of hyperopic shift after radial keratotomy (RK). Private practice, Siena, Italy. Prospective case series. Eyes with a spherical equivalent (SE) of +1.0 diopters (D) to +4.0 D after RK with 6 or 8 incisions had LASIK. The flap (nominal thickness 130 μm) was created with a femtosecond laser (LDV Z2); the refractive ablation was performed with an excimer laser (217P). The flap was dissected in a centrifugal fashion along previous RK cuts. Eighteen eyes of 10 patients were treated. Preoperatively, the mean defocus equivalent was 3.13 diopters (D) ± 0.71 (SD); the corrected distance visual acuity (CDVA) was 0.09 ± 0.06 logMAR. At 9 months, the mean defocus equivalent was 0.51 ± 0.47 D (P < .05), with 13 eyes (72%) having 0.50 D or less of defocus equivalent and 16 eyes (89%) having 1.0 D or less of defocus equivalent. The mean CDVA was 0.04 ± 0.06 logMAR (P < .05). No lines of logMAR CDVA were lost. The mean uncorrected distance visual acuity was 0.11 ± 0.10 logMAR. The safety index was 1.11; the efficacy index was 0.97. No retreatments were performed. Flap complications were limited to an RK incision opening larger than 2 mm in 3 eyes and 1 case of a small, self-limiting epithelial ingrowth. Laser in situ keratomileusis with a low-energy femtosecond laser was a safe and effective approach to treat post-RK hyperopia, causing no relevant inflammation. Neither author has a financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Effects of Immediate vs. Delayed Massage-like Loading on Skeletal Muscle Viscoelastic Properties Following Eccentric Exercise

PubMed Central

Crawford, Scott K.; Haas, Caroline; Wang, Qian; Zhang, Xiaoli; Zhao, Yi; Best, Thomas M.

2014-01-01

Background This study compared immediate versus delayed massage-like compressive loading on skeletal muscle viscoelastic properties following eccentric exercise. Methods Eighteen rabbits were surgically instrumented with peroneal nerve cuffs for stimulation of the tibialis anterior muscle. Rabbits were randomly assigned to a massage loading protocol applied immediately post exercise (n=6), commencing 48 hours post exercise (n=6), or exercised no-massage control (n=6). Viscoelastic properties were evaluated in vivo by performing a stress-relaxation test pre- and post-exercise and daily pre- and post-massage for four consecutive days of massage loading. A quasi-linear viscoelastic approach modeled the instantaneous elastic response (AG0), fast ( g1p) and slow ( g2p) relaxation coefficients, and the corresponding relaxation time constants τ1 and τ2. Findings Exercise increased AG0 in all groups (P<0.05). After adjusting for the three multiple comparisons, recovery of AG0 was not significant in the immediate (P=0.021) or delayed (P=0.048) groups compared to the control group following four days of massage. However, within-day (pre- to post-massage) analysis revealed a decrease in AG0 in both massage groups. Following exercise, g1p increased and g2p and τ1 decreased for all groups (P<0.05). Exercise had no effect on τ2 (P>0.05). After four days of massage, there was no significant recovery of the relaxation parameters for either massage loading group compared to the control group. Interpretation Our findings suggest that massage loading following eccentric exercise has a greater effect on reducing muscle stiffness, estimated by AG0, within-day rather than affecting recovery over multiple days. Massage loading also has little effect on the relaxation response. PMID:24861827

Identification of Quantitative Trait Loci Controlling Root and Shoot Traits Associated with Drought Tolerance in a Lentil (Lens culinaris Medik.) Recombinant Inbred Line Population

PubMed Central

Idrissi, Omar; Udupa, Sripada M.; De Keyser, Ellen; McGee, Rebecca J.; Coyne, Clarice J.; Saha, Gopesh C.; Muehlbauer, Fred J.; Van Damme, Patrick; De Riek, Jan

2016-01-01

Drought is one of the major abiotic stresses limiting lentil productivity in rainfed production systems. Specific rooting patterns can be associated with drought avoidance mechanisms that can be used in lentil breeding programs. In all, 252 co-dominant and dominant markers were used for Quantitative Trait Loci (QTL) analysis on 132 lentil recombinant inbred lines based on greenhouse experiments for root and shoot traits during two seasons under progressive drought-stressed conditions. Eighteen QTLs controlling a total of 14 root and shoot traits were identified. A QTL-hotspot genomic region related to a number of root and shoot characteristics associated with drought tolerance such as dry root biomass, root surface area, lateral root number, dry shoot biomass and shoot length was identified. Interestingly, a QTL (QRSratioIX-2.30) related to root-shoot ratio, an important trait for drought avoidance, explaining the highest phenotypic variance of 27.6 and 28.9% for the two consecutive seasons, respectively, was detected. This QTL was closed to the co-dominant SNP marker TP6337 and also flanked by the two SNP TP518 and TP1280. An important QTL (QLRNIII-98.64) related to lateral root number was found close to TP3371 and flanked by TP5093 and TP6072 SNP markers. Also, a QTL (QSRLIV-61.63) associated with specific root length was identified close to TP1873 and flanked by F7XEM6b SRAP marker and TP1035 SNP marker. These two QTLs were detected in both seasons. Our results could be used for marker-assisted selection in lentil breeding programs targeting root and shoot characteristics conferring drought avoidance as an efficient alternative to slow and labor-intensive conventional breeding methods. PMID:27602034

The Effect of a Moderately Low and High Carbohydrate Intake on Crossfit Performance

PubMed Central

ESCOBAR, KURT A.; MORALES, JACOBO; VANDUSSELDORP, TRISHA A.

2016-01-01

CrossFit is a metabolically demanding strength and conditioning method which performance may benefit from a carbohydrate (CHO)-rich diet. This study investigated the effect of three consecutive days of high CHO intake on CrossFit performance and corresponding metabolically -related variables in strength trained individuals. Eighteen subjects with a CHO intake of <6 g/kg/day were randomly assigned into a CHO (n = 9) or control (C) group (n =9) and underwent a 9-day training protocol. During days 1, 5, and 9, performance was measured as repetitions completed during a 12 minute CrossFit workout. Oxygen consumption (VO2), respiratory exchange ratio (RER), and blood lactate (BL) were also measured. Days 6–8, the CHO group increased CHO intake from <6 g/kg/day to 6–8 g/kg/day; the C group maintained their current intake of <6 g/kg/day. On days 6 and 7 both groups performed CrossFit workouts followed by a day of rest prior to day 9. There was a significant increase in repetitions completed in both groups in day 9 (vs. means score of day 1 + 5) (p = 0.002), but no differences between C and CHO groups (p = 0.111). However, the CHO group displayed a 15.2 repetition increase (+10.9%) in day 9, compared to 5.7 (+4.2%) by the C group. VO2, RER, and BL were not influenced by the experimental intervention. Our results suggest that the CrossFit-embraced practice of moderately-low CHO diets may be adequate in CHO during short periods of training, however, given the noted trend, extended training periods may be effected. PMID:27766133

The Effect of a Moderately Low and High Carbohydrate Intake on Crossfit Performance.

PubMed

Escobar, Kurt A; Morales, Jacobo; Vandusseldorp, Trisha A

2016-01-01

CrossFit is a metabolically demanding strength and conditioning method which performance may benefit from a carbohydrate (CHO)-rich diet. This study investigated the effect of three consecutive days of high CHO intake on CrossFit performance and corresponding metabolically -related variables in strength trained individuals. Eighteen subjects with a CHO intake of <6 g/kg/day were randomly assigned into a CHO (n = 9) or control (C) group (n =9) and underwent a 9-day training protocol. During days 1, 5, and 9, performance was measured as repetitions completed during a 12 minute CrossFit workout. Oxygen consumption (VO 2 ), respiratory exchange ratio (RER), and blood lactate (BL) were also measured. Days 6-8, the CHO group increased CHO intake from <6 g/kg/day to 6-8 g/kg/day; the C group maintained their current intake of <6 g/kg/day. On days 6 and 7 both groups performed CrossFit workouts followed by a day of rest prior to day 9. There was a significant increase in repetitions completed in both groups in day 9 (vs. means score of day 1 + 5) (p = 0.002), but no differences between C and CHO groups (p = 0.111). However, the CHO group displayed a 15.2 repetition increase (+10.9%) in day 9, compared to 5.7 (+4.2%) by the C group. VO 2 , RER, and BL were not influenced by the experimental intervention. Our results suggest that the CrossFit-embraced practice of moderately-low CHO diets may be adequate in CHO during short periods of training, however, given the noted trend, extended training periods may be effected.

Patients' involvement in decisions about medicines: GPs' perceptions of their preferences

PubMed Central

Cox, Kate; Britten, Nicky; Hooper, Richard; White, Patrick

2007-01-01

Background Patients vary in their desire to be involved in decisions about their care. Aim To assess the accuracy and impact of GPs' perceptions of their patients' desire for involvement. Design of study Consultation-based study. Setting Five primary care centres in south London. Method Consecutive patients completed decision-making preference questionnaires before and after consultation. Eighteen GPs completed a questionnaire at the beginning of the study and reported their perceptions of patients' preferences after each consultation. Patients' satisfaction was assessed using the Medical Interview Satisfaction Scale. Analyses were conducted in 190 patient–GP pairs that identified the same medicine decision about the same main health problem. Results A total of 479 patients participated (75.7% of those approached). Thirty-nine per cent of these patients wanted their GPs to share the decision, 45% wanted the GP to be the main (28%) or only (17%) decision maker regarding their care, and 16% wanted to be the main (14%) or only (2%) decision maker themselves. GPs accurately assessed patients' preferences in 32% of the consultations studied, overestimated patients' preferences for involvement in 45%, and underestimated them in 23% of consultations studied. Factors protective against GPs underestimating patients' preferences were: patients preferring the GP to make the decision (odds ratio [OR] 0.2 per point on the five-point scale; 95% confidence interval [CI] = 0.1 to 0.4), and the patient having discussed their main health problem before (OR 0.3; 95% CI = 0.1 to 0.9). Patients' educational attainment was independently associated with GPs underestimation of preferences. Conclusion GPs' perceptions of their patients' desire to be involved in decisions about medicines are inaccurate in most cases. Doctors are more likely to underestimate patients' preferred level of involvement when patients have not consulted about their condition before. PMID:17925134

Using language for social interaction: Communication mechanisms promote recovery from chronic non-fluent aphasia.

PubMed

Stahl, Benjamin; Mohr, Bettina; Dreyer, Felix R; Lucchese, Guglielmo; Pulvermüller, Friedemann

2016-12-01

Clinical research highlights the importance of massed practice in the rehabilitation of chronic post-stroke aphasia. However, while necessary, massed practice may not be sufficient for ensuring progress in speech-language therapy. Motivated by recent advances in neuroscience, it has been claimed that using language as a tool for communication and social interaction leads to synergistic effects in left perisylvian eloquent areas. Here, we conducted a crossover randomized controlled trial to determine the influence of communicative language function on the outcome of intensive aphasia therapy. Eighteen individuals with left-hemisphere lesions and chronic non-fluent aphasia each received two types of training in counterbalanced order: (i) Intensive Language-Action Therapy (ILAT, an extended form of Constraint-Induced Aphasia Therapy) embedding verbal utterances in the context of communication and social interaction, and (ii) Naming Therapy focusing on speech production per se. Both types of training were delivered with the same high intensity (3.5 h per session) and duration (six consecutive working days), with therapy materials and number of utterances matched between treatment groups. A standardized aphasia test battery revealed significantly improved language performance with ILAT, independent of when this method was administered. In contrast, Naming Therapy tended to benefit language performance only when given at the onset of the treatment, but not when applied after previous intensive training. The current results challenge the notion that massed practice alone promotes recovery from chronic post-stroke aphasia. Instead, our results demonstrate that using language for communication and social interaction increases the efficacy of intensive aphasia therapy. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Improving dementia health literacy using the FLOW mnemonic: pilot findings from the Old SCHOOL hip-hop program.

PubMed

Noble, James M; Hedmann, Monique G; Williams, Olajide

2015-02-01

Dementia health literacy is low among the public and likely poses a significant barrier to Alzheimer's disease (AD) symptom recognition and treatment, particularly among minority populations already facing higher AD burden. We evaluated the pilot phase of a novel AD health education program, Old SCHOOL (Seniors Can Have Optimal Aging and Ongoing Longevity) Hip-Hop (OSHH), which is designed to enable children to be AD health educational conduits in the home ("child-mediated health communication"). OSHH applied our stroke-validated model of engaging, dynamic, and age- and culturally appropriate curriculum delivered to elementary school-age children (fourth/fifth grades, ages 9-11 years). We assessed AD knowledge among the children at baseline, immediately following the intervention (1-hour program delivered daily over 3 consecutive days), and 3 months later. For key AD symptoms, we developed the FLOW mnemonic (forget, lose, overlook, write/wander); students were additionally taught action plans for recognized symptoms. Seventy-five students completed baseline assessments, and 68 completed posttesting. AD symptoms in FLOW were not well known at baseline (individually ranging from 16% to 71% correct) but were highly learned after 3 days (89% to 98% correct) and retained well after 3 months (80% to 95% correct, p ≤ .01 for all comparisons vs. baseline). AD localization, including its effect on memory and the hippocampus, was also highly learned and retained (p < .001). Eighteen students (24%) reported having a close friend/family member with AD. This study suggests our hip-hop health education model may be an effective method to improve AD health literacy. © 2014 Society for Public Health Education.

Access Patterns of ADHD Students Utilizing Campus Disability Services Supports

ERIC Educational Resources Information Center

Jackson, Meribeth L.

2013-01-01

Source of initial access to disability services, accommodations received as supports on campus, and the rate of continuous enrollment data was measured and compared for students diagnosed with ADHD prior to age eighteen and those diagnosed with ADHD after age eighteen. These two groups were compared to analyze the assumption that students who were…

Brick and Click Libraries: Proceedings of an Academic Libraries Symposium (8th, Maryville, Missouri, November 7, 2008)

ERIC Educational Resources Information Center

Baudino, Frank, Ed.; Ury, Connie Jo, Ed.; Park, Sarah G., Ed.

2008-01-01

Eighteen scholarly papers and eighteen abstracts comprise the content of the 8th "Brick and Click Libraries Symposium," held annually at Northwest Missouri State University in Maryville, Missouri. The proceedings, authored by academic librarians and presented at the symposium, portray the contemporary and future face of librarianship. Many of the…

Competent Youth in a "Disorderly World": Findings from an Eighteen-Nation Study

ERIC Educational Resources Information Center

Seiffge-Krenke, Inge

2012-01-01

Social changes in all parts of the world, together with an increasing globalization, may have contributed to high levels of school-related stress and worries about the future. This article focuses on these concerns and the coping styles adolescents from eighteen countries use in dealing with them. This is an important yet understudied research…

The Well of Time. Eighteen Short Stories from Philippine Contemporary Literature.

ERIC Educational Resources Information Center

Laygo, Teresito M., Comp.

A collection of eighteen short stories by Filipino writers is presented. The selections represent a variety of images of Filipino culture, both urban and rural, and life styles in northern and southern Philippines. The aim of the anthology is that the student will learn to empathize with experience rendered in language, appreciate the Filipino…

Sleeping Position and Health Status of Children at Six-, Eighteen- and Thirty-Six-Month Development

ERIC Educational Resources Information Center

Lung, For-Wey; Shu, Bih-Ching

2011-01-01

Using structural equation modeling to investigate the multiple pathways of sleeping position and children's early development at six-, eighteen- and thirty-six-month children, with parental demographics and child health status controlled. The participants consisted of 1783 six-month children, who were assessed using the Taiwan Birth Cohort Study…

Concomitant external pneumatic compression treatment with consecutive days of high intensity interval training reduces markers of proteolysis.

PubMed

Haun, Cody T; Roberts, Michael D; Romero, Matthew A; Osburn, Shelby C; Healy, James C; Moore, Angelique N; Mobley, Christopher B; Roberson, Paul A; Kephart, Wesley C; Mumford, Petey W; Goodlett, Michael D; Pascoe, David D; Martin, Jeffrey S

2017-12-01

To compare the effects of external pneumatic compression (EPC) and sham when used concurrently with high intensity interval training (HIIT) on performance-related outcomes and recovery-related molecular measures. Eighteen recreationally endurance-trained male participants (age: 21.6 ± 2.4 years, BMI: 25.7 ± 0.5 kg/m 2 , VO 2peak : 51.3 ± 0.9 mL/kg/min) were randomized to balanced sham and EPC treatment groups. Three consecutive days of HIIT followed by EPC/sham treatment (Days 2-4) and 3 consecutive days of recovery (Days 5-7) with EPC/sham only on Days 5-6 were employed. Venipuncture, flexibility and pressure-to-pain threshold (PPT) measurements were made throughout. Vastus lateralis muscle was biopsied at PRE (i.e., Day 1), 1-h post-EPC/sham treatment on Day 2 (POST1), and 24-h post-EPC/sham treatment on Day 7 (POST2). 6-km run time trial performance was tested at PRE and POST2. No group × time interaction was observed for flexibility, PPT, or serum measures of creatine kinase (CK), hsCRP, and 8-isoprostane. However, there was a main effect of time for serum CK (p = 0.005). Change from PRE in 6-km run times at POST2 were not significantly different between groups. Significant between-groups differences existed for change from PRE in atrogin-1 mRNA (p = 0.018) at the POST1 time point (EPC: - 19.7 ± 8.1%, sham: + 7.7 ± 5.9%) and atrogin-1 protein concentration (p = 0.013) at the POST2 time point (EPC: - 31.8 ± 7.5%, sham: + 96.0 ± 34.7%). In addition, change from PRE in poly-Ub proteins was significantly different between groups at both the POST1 (EPC: - 26.0 ± 10.3%, sham: + 34.8 ± 28.5%; p = 0.046) and POST2 (EPC: - 33.7 ± 17.2%, sham: + 21.4 ± 14.9%; p = 0.037) time points. EPC when used concurrently with HIIT and in subsequent recovery days reduces skeletal muscle markers of proteolysis.

The effect of family policies and public health initiatives on breastfeeding initiation among 18 high-income countries: a qualitative comparative analysis research design.

PubMed

Lubold, Amanda Marie

2017-01-01

The objective of this study is to examine the effects of macro-level factors - welfare state policies and public health initiatives - on breastfeeding initiation among eighteen high-income countries. This study utilizes fuzzy-set Qualitative Comparative Analysis methods to examine the combinations of conditions leading to both high and low national breastfeeding initiation rates among eighteen high-income countries. The most common pathway leading to high breastfeeding initiation is the combination of conditions including a high percentage of women in parliament, a low national cesarean section rate, and either low family spending, high rates of maternity leave, or high rates of women working part-time. The most common pathway leading to low breastfeeding initiation includes the necessary condition of low national adherence to the Baby-Friendly Hospital Initiative. This research suggests that there is a connection between broad level welfare state polices, public health initiatives, and breastfeeding initiation. Compliance with the WHO/UNICEF initiatives depends on welfare regime policies and overall support for women in both productive and reproductive labor.

Perspectives of Nurses and Patients on Call Light Technology

PubMed Central

Galinato, Jose; Montie, Mary; Patak, Lance; Titler, Marita

2015-01-01

Call lights are prevalent in inpatient healthcare facilities across the nation. While call light use directly influences the delivery of nursing care, there remain significant gaps both in research and technology that can impact the quality of care and patient satisfaction. This study examines the perception of nurses and patients on the use of a new call communication solution, Eloquence™, in the acute care inpatient setting. Eighteen patients were recruited for the study and participated in individual semi-structured interviews during their hospital stay. Eighteen nurses were recruited and participated in focus groups for this study. Qualitative descriptive methods were used to analyze the data. Results revealed themes of usability, improved communication, and suggestions for improvement to the alpha prototype design. After a demonstration of the use and capability of Eloquence™, nurse and patient participants found Eloquence™ as a welcomed advancement in nurse call technology that has the potential to improve workflow and patient outcomes. In addition, the participants also proposed ideas on how to further develop the technology to improve its use. PMID:26176639

Refining pathological evaluation of neoadjuvant therapy for adenocarcinoma of the esophagus

PubMed Central

Noble, Fergus; Nolan, Luke; Bateman, Adrian C; Byrne, James P; Kelly, Jamie J; Bailey, Ian S; Sharland, Donna M; Rees, Charlotte N; Iveson, Timothy J; Underwood, Tim J; Bateman, Andrew R

2013-01-01

AIM: To assess tumour regression grade (TRG) and lymph node downstaging to help define patients who benefit from neoadjuvant chemotherapy. METHODS: Two hundred and eighteen consecutive patients with adenocarcinoma of the esophagus or gastro-esophageal junction treated with surgery alone or neoadjuvant chemotherapy and surgery between 2005 and 2011 at a single institution were reviewed. Triplet neoadjuvant chemotherapy consisting of platinum, fluoropyrimidine and anthracycline was considered for operable patients (World Health Organization performance status ≤ 2) with clinical stage T2-4 N0-1. Response to neoadjuvant chemotherapy (NAC) was assessed using TRG, as described by Mandard et al. In addition lymph node downstaging was also assessed. Lymph node downstaging was defined by cN1 at diagnosis: assessed radiologically (computed tomography, positron emission tomography, endoscopic ultrasonography), then pathologically recorded as N0 after surgery; ypN0 if NAC given prior to surgery, or pN0 if surgery alone. Patients were followed up for 5 years post surgery. Recurrence was defined radiologically, with or without pathological confirmation. An association was examined between t TRG and lymph node downstaging with disease free survival (DFS) and a comprehensive range of clinicopathological characteristics. RESULTS: Two hundred and eighteen patients underwent esophageal resection during the study interval with a mean follow up of 3 years (median follow up: 2.552, 95%CI: 2.022-3.081). There was a 1.8% (n = 4) inpatient mortality rate. One hundred and thirty-six (62.4%) patients received NAC, with 74.3% (n = 101) of patients demonstrating some signs of pathological tumour regression (TRG 1-4) and 5.9% (n = 8) having a complete pathological response. Forty four point one percent (n = 60) had downstaging of their nodal disease (cN1 to ypN0), compared to only 15.9% (n = 13) that underwent surgery alone (pre-operatively overstaged: cN1 to pN0), (P < 0.0001). Response to NAC was associated with significantly increased DFS (mean DFS; TRG 1-2: 5.1 years, 95%CI: 4.6-5.6 vs TRG 3-5: 2.8 years, 95%CI: 2.2-3.3, P < 0.0001). Nodal down-staging conferred a significant DFS advantage for those patients with a poor primary tumour response to NAC (median DFS; TRG 3-5 and nodal down-staging: 5.533 years, 95%CI: 3.558-7.531 vs TRG 3-5 and no nodal down-staging: 1.114 years, 95%CI: 0.961-1.267, P < 0.0001). CONCLUSION: Response to NAC in the primary tumour and in the lymph nodes are both independently associated with improved DFS. PMID:24409055

A new technique of extracapsular restoration with a tie made of ethylene tetrafluoroethylene (ETFE) for rupture of the cranial cruciate ligament in dogs.

PubMed

Yamada, E; Imayama, Y; Katano, S; Nagashima, F; Shibata, T

1996-06-01

A new extracapsular technique for repair of canine cranial cruciate ligament rupture using an ethylene tetrafluoroethylene (ETFE) tie was presented. Eighteen dogs (body weight: 6.0-46 kg) with this problem were used for this study. The advantages of this method were 1) the operation was easily performed. 2) Joint could be stabilized by proper fixation with microadjustment during operation. 3) This method presented less surgical invasion than the intracapsular one, since wide incision was not conducted over peripheral tissue of the stifle joint.

Adaption of the temporal correlation coefficient calculation for temporal networks (applied to a real-world pig trade network).

PubMed

Büttner, Kathrin; Salau, Jennifer; Krieter, Joachim

2016-01-01

The average topological overlap of two graphs of two consecutive time steps measures the amount of changes in the edge configuration between the two snapshots. This value has to be zero if the edge configuration changes completely and one if the two consecutive graphs are identical. Current methods depend on the number of nodes in the network or on the maximal number of connected nodes in the consecutive time steps. In the first case, this methodology breaks down if there are nodes with no edges. In the second case, it fails if the maximal number of active nodes is larger than the maximal number of connected nodes. In the following, an adaption of the calculation of the temporal correlation coefficient and of the topological overlap of the graph between two consecutive time steps is presented, which shows the expected behaviour mentioned above. The newly proposed adaption uses the maximal number of active nodes, i.e. the number of nodes with at least one edge, for the calculation of the topological overlap. The three methods were compared with the help of vivid example networks to reveal the differences between the proposed notations. Furthermore, these three calculation methods were applied to a real-world network of animal movements in order to detect influences of the network structure on the outcome of the different methods.

Radiological features of primitive neuroectodermal tumors in intra-abdominal and retroperitoneal regions: A series of 18 cases

PubMed Central

Zhang, Youming; Xiao, Desheng; Yin, Hongling; Long, Xueying; Li, Li; Zai, Hongyan; Chen, Minfeng; Li, Wenzheng; Sun, Lunquan

2017-01-01

Objectives To characterize the imaging and clinicopathological features of primitive neuroectodermal tumors (PNETs) arising in intra-abdominal and retroperitoneal regions. Methods Eighteen patients with histopathologically proven intra-abdominal and retroperitoneal PNET were enrolled; computed tomography was performed for all cases, and magnetic resonance imaging was performed for a single case. Typical computed tomography and magnetic resonance imaging findings, including morphology, texture and enhancement features, as well as clinicopathological characteristics and prognosis data were retrospectively analyzed. Results Of eighteen PNET patients, fifteen were male and three were female, with a median age of 36 years (range, 2–65 years). The onset of symptoms was most often nonspecific and insidious. The mean tumor diameter was 7.2 cm (range, 3.0–12.1 cm), with necrosis in fifteen cases, cystic changes in eight, partition structure in five, calcification in five, hemorrhage in two, and mural nodules in one. Contrast enhanced computed tomography showed multiple tiny feeding arteries within the masses in six cases, resulting in a crab-like appearance, and mild ring enhancement pattern in five cases. Eleven cases showed surrounding invasion and metastasis. Of the eighteen PNET cases, nine cases showed smooth, well-defined margins, and nine cases had irregular, ill-defined margins. A median survival was 10.0±1.6 months. However, chemotherapy had efficacy on patients even those with advanced disease. Conclusions Primary intra-abdominal and retroperitoneal PNETs are rare, and imaging features documented here may help the diagnosis of this severe disease. Notably, two signs present in retroperitoneal PNET tumors, including a mild ring enhancement pattern and a crab-like appearance of the tiny feeding arteries, may have the potential to help us improve the ability to make a relatively reliable diagnosis. PMID:28319177

77 FR 19642 - Low Enriched Uranium From France: Final Results of Antidumping Duty Changed Circumstances Review

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-02

... in U.S. customs territory, and (ii) are re-exported within eighteen (18) months of entry of the LEU... amend the scope of the order and to extend the deadline for the re-exportation of this sole LEU entry... transporter(s) while in U.S. customs territory, and (ii) are re-exported within eighteen (18) months of entry...

Estimating loop length from CryoEM images at medium resolutions.

PubMed

McKnight, Andrew; Si, Dong; Al Nasr, Kamal; Chernikov, Andrey; Chrisochoides, Nikos; He, Jing

2013-01-01

De novo protein modeling approaches utilize 3-dimensional (3D) images derived from electron cryomicroscopy (CryoEM) experiments. The skeleton connecting two secondary structures such as α-helices represent the loop in the 3D image. The accuracy of the skeleton and of the detected secondary structures are critical in De novo modeling. It is important to measure the length along the skeleton accurately since the length can be used as a constraint in modeling the protein. We have developed a novel computational geometric approach to derive a simplified curve in order to estimate the loop length along the skeleton. The method was tested using fifty simulated density images of helix-loop-helix segments of atomic structures and eighteen experimentally derived density data from Electron Microscopy Data Bank (EMDB). The test using simulated density maps shows that it is possible to estimate within 0.5 Å of the expected length for 48 of the 50 cases. The experiments, involving eighteen experimentally derived CryoEM images, show that twelve cases have error within 2 Å. The tests using both simulated and experimentally derived images show that it is possible for our proposed method to estimate the loop length along the skeleton if the secondary structure elements, such as α-helices, can be detected accurately, and there is a continuous skeleton linking the α-helices.

Consecutive Plate Acoustic Suppressor Apparatus and Methods

NASA Technical Reports Server (NTRS)

Doychak, Joseph (Inventor); Parrott, Tony L. (Inventor)

1993-01-01

An apparatus and method for suppressing acoustic noise utilizes consecutive plates, closely spaced to each other so as to exploit dissipation associated with sound propagation in narrow channels to optimize the acoustic resistance at a liner surface. The closely spaced plates can be utilized as high temperature structural materials for jet engines by constructing the plates from composite materials. Geometries of the plates, such as plate depth, shape, thickness, inter-plate spacing, arrangement, etc., can be selected to achieve bulk material-like behavior.

Effectiveness of a five-step method for teaching clinical skills to students in a dental college in India.

PubMed

Virdi, Mandeep S; Sood, Meenakshi

2011-11-01

This study conducted at the PDM Dental College and Research Institute, Haryana, India, had the purpose of developing a teaching method based upon a five-step method for teaching clinical skills to students proposed by the American College of Surgeons. This five-step teaching method was used to place fissure sealants as an initial procedure by dental students in clinics. The sealant retention was used as an objective evaluation of the skill learnt by the students. The sealant retention was 92 percent at six- and twelve-month evaluations and 90 percent at the eighteen-month evaluation. These results indicate that simple methods can be devised for teaching clinical skills and achieve high success rates in clinical procedures requiring multiple steps.

Measurement of self-esteem in repeat assault victims.

PubMed Central

Conti, C. T.; Moncure, M.; Hines, J.; Clack, Z.; Smith, T.; Simpkins, C. O.

1998-01-01

Background characterization of assault-related injuries have demonstrated that lifestyle, substance abuse, education, employment, mental illness, and high-risk behavior contribute to low self-esteem in repeat assault victims. Recurrent-assault patients have never been studied with respect to self-esteem. This study evaluated self-esteem and assault-related injury in 28 consecutive male assault patients (11 first-assault and 17 recurrent-assault patients) and 19 controls with no previous assault history. Study participants were administered the Walmyr Assessment Scales Index of Self-Esteem (WASISE) as part of a three-item survey to determine the relationship between self-esteem and assault-related injury. No demographic differences were found between the groups. The mean (+/- standard error) WASISE score for recurrent-assault patients (34.9 +/- 3.4) was significantly higher than mean scores for no-assault and first-time assault-injured patients (14.7 +/- 1.4 and 15.0 +/- 2.3, respectively). The recurrent-assault patients had a lower mean education level than both no-assault and first-time assault-injured patients (2.1 +/- 0.26 and 1.9 +/- 0.57, respectively). Eighteen (2%) first-time assault-injured and 11 (7%) recurrent-assault patients were employed. These data suggest that self-esteem, education, and employment history need to be considered when evaluating and developing interventions for repeat-assault patients. PMID:9549981

Extending the use of the pacing pulmonary artery catheter for safe minimally invasive cardiac surgery.

PubMed

Levin, Ricardo; Leacche, Marzia; Petracek, Michael R; Deegan, Robert J; Eagle, Susan S; Thompson, Annemarie; Pretorius, Mias; Solenkova, Nataliya V; Umakanthan, Ramanan; Brewer, Zachary E; Byrne, John G

2010-08-01

In this study, the therapeutic use of pacing pulmonary artery catheters in association with minimally invasive cardiac surgery was evaluated. A retrospective study. A single institutional university hospital. Two hundred twenty-four consecutive patients undergoing minimally invasive cardiac surgery through a small (5-cm) right anterolateral thoracotomy using fibrillatory arrest without aortic cross-clamping. Two hundred eighteen patients underwent mitral valve surgery (97%) alone or in combination with other procedures. Six patients underwent other cardiac operations. In all patients, the pacing pulmonary artery catheter was used intraoperatively to induce ventricular fibrillation during the cooling period, and in the postoperative period it also was used in 37 (17%) patients who needed to be paced, mainly for bradyarrhythmias (51%). There were no complications related to the insertion of the catheters. Six (3%) patients experienced a loss of pacing capture, and 2 (1%) experienced another complication requiring the surgical removal of the catheter. Seven (3%) patients needed postoperative implantation of a permanent pacemaker. In combination with minimally invasive cardiac surgery, pacing pulmonary artery catheters were therapeutically useful to induce ventricular fibrillatory arrest intraoperatively and for obtaining pacing capability in the postoperative period. Their use was associated with a low number of complications. Copyright 2010 Elsevier Inc. All rights reserved.

Sentinel lymph node detection in patients with endometrial cancer.

PubMed

Niikura, Hitoshi; Okamura, Chikako; Utsunomiya, Hiroki; Yoshinaga, Kosuke; Akahira, Junichi; Ito, Kiyoshi; Yaegashi, Nobuo

2004-02-01

The purpose of this study was to examine the feasibility of sentinel lymph node (SLN) detection in patients with endometrial cancer using preoperative lymphoscintigraphy and an intraoperative gamma probe. Between June 2001 and January 2003, 28 consecutive patients with endometrial cancer who were scheduled for total abdominal hysterectomy, bilateral salpingo-oophorectomy, total pelvic lymphadenectomy, and paraaortic lymphadenectomy at Tohoku University School of Medicine underwent sentinel lymph node detection. On the day before surgery, preoperative lymphoscintigraphy was performed by injection of 99m-Technetium ((99m)Tc)-labeled phytate into the endometrium during hysteroscopy. At the time of surgery, a gamma-detecting probe was used to locate radioactive lymph nodes. At least one sentinel node was detected in each of 23 of the 28 patients (82%). The mean number of sentinel nodes detected was 3.1 (range, 1-9). Sentinel nodes could be identified in 21 of 22 patients (95%) whose tumor did not invade more than halfway into the myometrium. Eighteen patients had radioactive nodes in the paraaortic area. Most patients had a sentinel node in one of the following three sites: paraaortic, external iliac, and obturator. The sensitivity and specificity for detecting lymph node metastases were both 100%. The combination of preoperative lymphoscintigraphy with intraoperative gamma probe detection may be useful in identifying sentinel nodes in early-stage endometrial cancer.

Repeated Acute Oral Exposure to Cannabis sativa Impaired Neurocognitive Behaviours and Cortico-hippocampal Architectonics in Wistar Rats.

PubMed

Imam, A; Ajao, M S; Akinola, O B; Ajibola, M I; Ibrahim, A; Amin, A; Abdulmajeed, W I; Lawal, Z A; Ali-Oluwafuyi, A

2017-03-06

The most abused illicit drug in both the developing and the developed world is Cannabis disposing users to varying forms of personality disorders. However, the effects of cannabis on cortico-hippocampal architecture and cognitive behaviours still remain elusive.  The present study investigated the neuro-cognitive implications of oral cannabis use in rats. Eighteen adult Wistar rats were randomly grouped to three. Saline was administered to the control rats, cannabis (20 mg/kg) to the experimental group I, while Scopolamine (1 mg/kg. ip) was administered to the last group as a standard measure for the cannabis induced cognitive impairment. All treatments lasted for seven consecutive days. Open Field Test (OFT) was used to assess locomotor activities, Elevated Plus Maze (EPM) for anxiety-like behaviour, and Y maze paradigm for spatial memory and data subjected to ANOVA and T test respectively. Thereafter, rats were sacrificed and brains removed for histopathological studies. Cannabis significantly reduced rearing frequencies in the OFT and EPM, and increased freezing period in the OFT. It also reduced percentage alternation similar to scopolamine in the Y maze, and these effects were coupled with alterations in the cortico-hippocampal neuronal architectures. These results point to the detrimental impacts of cannabis on cortico-hippocampal neuronal architecture and morphology, and consequently cognitive deficits.

Immune globulins are effective in severe pediatric Guillain-Barré syndrome.

PubMed

Shahar, E; Shorer, Z; Roifman, C M; Levi, Y; Brand, N; Ravid, S; Murphy, E G

1997-01-01

The effect of high-dose intravenous immune globulins was evaluated in an open prospective multicenter study of 26 children with severe Guillain-Barré syndrome. They presented with mild to moderate flaccid weakness of extremities, with cranial nerve involvement (20) and sensory impairment (22). All children rapidly deteriorated in 2-16 days (mean 6) to become bedridden, and 2 children also developed respiratory failure requiring artificial ventilation (Disability Grading Scale 4-5). Immune globulins were then administered at a total dose of 2 gm/kg, on 2 consecutive days, without adverse effects requiring discontinuation of therapy. Marked and rapid improvement was noted in 25 children, who improved by 1 to 2 Disability Grade Scales < or = 2 weeks after the infusion. Twenty were able to walk independently by 1 week, and 1 could be weaned off a ventilator. Eighteen children recovered by 2 weeks. The rest recuperated in a period of four months, including a child who was artificially ventilated for 4 weeks. The uniform rapid improvement and recovery associated with immune globulins contrasts with the slow recovery course in severe natural cases. We conclude that immune globulins are effective and safe in severe childhood-onset Guillain-Barré syndrome and therefore may serve as the initial treatment of choice.

Genetic heterogeneity in primary and relapsed mantle cell lymphomas: Impact of recurrent CARD11 mutations.

PubMed

Wu, Chenglin; de Miranda, Noel Fcc; Chen, Longyun; Wasik, Agata M; Mansouri, Larry; Jurczak, Wojciech; Galazka, Krystyna; Dlugosz-Danecka, Monika; Machaczka, Maciej; Zhang, Huilai; Peng, Roujun; Morin, Ryan D; Rosenquist, Richard; Sander, Birgitta; Pan-Hammarström, Qiang

2016-06-21

The genetic mechanisms underlying disease progression, relapse and therapy resistance in mantle cell lymphoma (MCL) remain largely unknown. Whole-exome sequencing was performed in 27 MCL samples from 13 patients, representing the largest analyzed series of consecutive biopsies obtained at diagnosis and/or relapse for this type of lymphoma. Eighteen genes were found to be recurrently mutated in these samples, including known (ATM, MEF2B and MLL2) and novel mutation targets (S1PR1 and CARD11). CARD11, a scaffold protein required for B-cell receptor (BCR)-induced NF-κB activation, was subsequently screened in an additional 173 MCL samples and mutations were observed in 5.5% of cases. Based on in vitro cell line-based experiments, overexpression of CARD11 mutants were demonstrated to confer resistance to the BCR-inhibitor ibrutinib and NF-κB-inhibitor lenalidomide. Genetic alterations acquired in the relapse samples were found to be largely non-recurrent, in line with the branched evolutionary pattern of clonal evolution observed in most cases. In summary, this study highlights the genetic heterogeneity in MCL, in particular at relapse, and provides for the first time genetic evidence of BCR/NF-κB activation in a subset of MCL.

Reducing adolescent clients' anger in a residential substance abuse treatment facility.

PubMed

Adelman, Robert; McGee, Patricia; Power, Robert; Hanson, Cathy

2005-06-01

Sundown Ranch, a residential behavioral health care treatment facility for adolescents, tracked the progress and results of treatment by selecting performance measures from a psychosocial screening inventory. The temper scale was one of the two highest scales at admission and the highest scale at discharge. A clinical performance improvement (PI) project was conducted to assess improvements in clients' ability to manage anger after the incorporation of Rational Emotive Behavior Therapy (REBT) into treatment. Eighteen months of baseline data (July 1, 1999 - February 1, 2001) were collected, and 20 months of data (May 1, 2001 - December 31, 2002) were collected after the introduction of the PI activity. In all, data were collected for 541 consecutive admissions. A comparison of five successive quarterly reviews indicated average scores of 1.4 standard deviations (SDs) above the mean on the temper scale before the PI activity and .45 SD above the mean after. The performance threshold of reduction of the average temper scale score to < or =1 SD was met for 17 of 20 months. The fact that the PI activity reduced the temper scale elevations by almost one full SD is highly suggestive of the efficacy of REBT with the treatment population. After the project was completed, REBT was promoted as an additional therapeutic modality within the treatment program.

Subtotal pancreatectomy for cancer: closure of the pancreatic remnant with staplers.

PubMed

Ahrén, B; Tranberg, K G; Andrén-Sandberg, A; Bengmark, S

1990-03-01

This paper presents a 2-year series of 26 consecutive pancreatectomies for periampullary cancer where the pancreatic tail was closed with a stapler in order to avoid complications related to a pancreatico-digestive anastomosis. The follow-up period was 14 months or more. Seven patients developed operative complications. Pancreatic fistulas developed in 3 patients. The fistulas closed spontaneously in 2 of the patients after 2-4 months. Intraabdominal abscesses developed in 4 patients and required surgical drainage. In 1 of these patients, the abscess eroded a large vessel with a fatal outcome resulting in an operative mortality rate of 3.8%. A transient postoperative gastric stasis was observed in seven patients. Postoperative hospital median stay was 27 days (range 10-83 days). Eighteen patients have died after 4-30 months in recurrent disease and seven patients are alive after a follow-up period of 15-29 months. Pancreatic endocrine function seemed well preserved; diabetes mellitus has developed in only one patient. In conclusion, it appears that subtotal pancreatectomy with closure of the pancreatic remnant with staples gives a low morbidity and mortality. Although the conclusion should be tempered by the small number of patients, the results justify continued evaluation of this technique with long-term follow-up.

Short-term music-induced hearing loss after sound exposure to discotheque music: the effectiveness of a break in reducing temporary threshold shift.

PubMed

Helleman, Hiske W; Dreschler, Wouter A

2015-02-01

To investigate the effect of a break in music exposure on temporary threshold shifts. A cross-over design where subjects are exposed to dance music for either two hours consecutively, or exposed to two hours of dance music with a one-hour break in between. Outcome measure was the change in hearing threshold, measured in 1-dB steps at different time points after ending the music. Eighteen normal-hearing subjects participated in this study. Changes in pure-tone threshold were observed in both conditions and were similar, regardless of the break. Threshold shifts could be averaged for 1000, 2000, and 4000 Hz. The shift immediately after the ending of the music was 1.7 dB for right ears, and 3.4 dB for left ears. The difference between left and right ears was significant. One hour after the exposure, right ears were recovered to baseline conditions whereas left ears showed a small but clinically irrelevant remaining shift of approximately 1 dB. The advice to use chill-out zones is still valid, because this helps to reduce the duration to the exposure. This study does not provide evidence that a rest period gives an additional reduction of temporary threshold shifts.

Diagnosis of co-morbid axis-I psychiatric disorders among women with newly diagnosed, untreated endocrine disorders.

PubMed

Fornaro, Michele; Iovieno, Nadia; Clementi, Nicoletta; Boscaro, Marco; Paggi, Francesca; Balercia, Giancarlo; Fava, Maurizio; Papakostas, George I

2010-12-01

To determine the prevalence of major depressive disorder (MDD) and other selected axis-I disorders among women with newly diagnosed, untreated endocrine disorders. Two hundred and eighteen consecutive women, aged 18-65, with newly diagnosed, untreated endocrine disorders were referred for potential diagnosis of co-morbid axis-I disorders with the use of the Structured Clinical Interview for Axis I-Patient Edition (SCID-P). The SCID-P was re-administered after 12 weeks. At baseline, 64 (29.3%) women met criteria for at least one axis-I disorder. Women who were diagnosed with hyperthyroidism were more likely to meet criteria for generalized anxiety disorder and panic disorder than women without hyperthyroidism. Nine of 154 (5.8 %) women who did not meet criteria for an axis-I disorder at baseline met criteria for at least one axis-I disorder during follow-up. Among them, the presence of diabetes mellitus was statistically correlated with a higher probability of developing major depressive disorder at follow-up. Although preliminary, our findings are consistent with previous studies and suggest an increased prevalence of MDD and other axis-I disorders among women with newly diagnosed endocrine disorders, providing further evidence suggesting that women with endocrine abnormalities may be at increased risk of depression and/or anxiety disorders.

Prophylactic temporary abdominal aorta balloon occlusion in women with placenta previa accretism during late gestation.

PubMed

Qiu, Zhongyuan; Hu, Jifen; Wu, Jianbo; Chen, Lihong

2017-11-01

To evaluate the clinical efficacy of prophylactic temporary balloon occlusion of the abdominal aorta in patients with placenta previa accretism during cesarean section. Twenty-three consecutive patients, prenatally confirmed with placenta previa accretism were retrospectively analyzed in our center from August 2012 to October 2014. All 23 subjects underwent cesarean section with prophylactic balloon occlusion of the abdominal aorta. All of the 23 subjects experienced singleton pregnancies leading to the birth of live infants. Of these subjects, the following problems were diagnosed: placenta accrete (n = 10), placenta increte (n = 10), and placenta precrete (n = 3). Mean intraoperative hemorrhage was 1170.0 mL. Fifteen patients received red blood cell transfusion with a mean transfusion volume of 2.3 units. The incidence of hysterectomy was 21.74% (5/23) with blood loss ranging from 2000 to 5000 mL (mean 3360.0 mL). One complication encountered in this retrospective study was lower extremity arterial thrombosis. Eighteen patients were followed-up by telephone to 14 months following discharge, all babies were noted to be healthy. Prophylactic abdominal aorta balloon occlusion (ABO) was relatively safe in the treatment of patients with placenta previa accretism. This approach could represent a key aspect in a multidisciplinary algorithm in reducing hemorrhage in abnormal placentation.

Evaluation of a visual layering methodology for colour coding control room displays.

PubMed

Van Laar, Darren; Deshe, Ofer

2002-07-01

Eighteen people participated in an experiment in which they were asked to search for targets on control room like displays which had been produced using three different coding methods. The monochrome coding method displayed the information in black and white only, the maximally discriminable method contained colours chosen for their high perceptual discriminability, the visual layers method contained colours developed from psychological and cartographic principles which grouped information into a perceptual hierarchy. The visual layers method produced significantly faster search times than the other two coding methods which did not differ significantly from each other. Search time also differed significantly for presentation order and for the method x order interaction. There was no significant difference between the methods in the number of errors made. Participants clearly preferred the visual layers coding method. Proposals are made for the design of experiments to further test and develop the visual layers colour coding methodology.

Computerized Analysis of Digital Photographs for Evaluation of Tooth Movement.

PubMed

Toodehzaeim, Mohammad Hossein; Karandish, Maryam; Karandish, Mohammad Nabi

2015-03-01

Various methods have been introduced for evaluation of tooth movement in orthodontics. The challenge is to adopt the most accurate and most beneficial method for patients. This study was designed to introduce analysis of digital photographs with AutoCAD software as a method to evaluate tooth movement and assess the reliability of this method. Eighteen patients were evaluated in this study. Three intraoral digital images from the buccal view were captured from each patient in half an hour interval. All the photos were sent to AutoCAD software 2011, calibrated and the distance between canine and molar hooks were measured. The data was analyzed using intraclass correlation coefficient. Photographs were found to have high reliability coefficient (P > 0.05). The introduced method is an accurate, efficient and reliable method for evaluation of tooth movement.

Corporal and capital punishment of juveniles.

PubMed

Frazier, H C

1990-01-01

There is a previously unobserved connection between corporal punishment of public school children and capital punishment of juveniles. Both are barometers of acceptable levels of violent punishment and their elimination is a hallmark of a maturing and decent society. Within a majority of the eighteen states where school authorities most frequently strike children are housed 25 of the nation's 28 juvenile death row inmates. On average, the homicide rates of these jurisdictions are two and a half times greater than those that have abolished both state-sanctioned corporal and capital punishment or limit death sentences to those age eighteen and older at the time of their crime(s). Most of the eighteen state abolitions of corporal punishment occurred in the 1980's. The US Supreme Court has ruled both corporal and capital punishment of juveniles constitutional. Additional state legislative abolition of both is anticipated in the 1990s.

Eastern equine encephalitis cases among horses in Brazil between 2005 and 2009.

PubMed

de Novaes Oliveira, Rafael; Iamamoto, Keila; Silva, Maria Luana Cristiny Rodrigues; Achkar, Samira Maria; Castilho, Juliana Galera; Ono, Ekaterina Durymanova; Lobo, Renata Spinelli Vaz; Brandão, Paulo Eduardo; Carnieli, Pedro; Carrieri, Maria Luiza; Kotait, Ivanete; Macedo, Carla Isabel

2014-10-01

Eastern equine encephalitis is a viral zoonosis that exhibits complex distribution and epidemiology, and greater importance should be given to this disease by the public-health authorities. In Brazil, although eastern equine encephalitis virus (EEEV) has been identified in vectors and antibodies are sometimes detected in horses and humans, there have been no records of equine encephalitis in horses caused by this virus during the last 24 years. This study describes eighteen cases of eastern equine encephalomyelitis that occurred in six Brazilian states between 2005 and 2009. Viral RNA was identified using semi-nested RT-PCR to detect members of the genus Alphavirus, and by genetic sequencing. The gene encoding NSP1 was partially amplified, and after genetic sequencing, eighteen sequences were generated. All eighteen strains were classified as belonging to lineage III of American EEEV. These findings could be an indication of the importance of this virus in animal and human public health.

Nonparametric methods for analyzing recurrent gap time data with application to infections after hematopoietic cell transplant.

PubMed

Lee, Chi Hyun; Luo, Xianghua; Huang, Chiung-Yu; DeFor, Todd E; Brunstein, Claudio G; Weisdorf, Daniel J

2016-06-01

Infection is one of the most common complications after hematopoietic cell transplantation. Many patients experience infectious complications repeatedly after transplant. Existing statistical methods for recurrent gap time data typically assume that patients are enrolled due to the occurrence of an event of interest, and subsequently experience recurrent events of the same type; moreover, for one-sample estimation, the gap times between consecutive events are usually assumed to be identically distributed. Applying these methods to analyze the post-transplant infection data will inevitably lead to incorrect inferential results because the time from transplant to the first infection has a different biological meaning than the gap times between consecutive recurrent infections. Some unbiased yet inefficient methods include univariate survival analysis methods based on data from the first infection or bivariate serial event data methods based on the first and second infections. In this article, we propose a nonparametric estimator of the joint distribution of time from transplant to the first infection and the gap times between consecutive infections. The proposed estimator takes into account the potentially different distributions of the two types of gap times and better uses the recurrent infection data. Asymptotic properties of the proposed estimators are established. © 2015, The International Biometric Society.

Nonparametric methods for analyzing recurrent gap time data with application to infections after hematopoietic cell transplant

PubMed Central

Lee, Chi Hyun; Huang, Chiung-Yu; DeFor, Todd E.; Brunstein, Claudio G.; Weisdorf, Daniel J.

2015-01-01

Summary Infection is one of the most common complications after hematopoietic cell transplantation. Many patients experience infectious complications repeatedly after transplant. Existing statistical methods for recurrent gap time data typically assume that patients are enrolled due to the occurrence of an event of interest, and subsequently experience recurrent events of the same type; moreover, for one-sample estimation, the gap times between consecutive events are usually assumed to be identically distributed. Applying these methods to analyze the post-transplant infection data will inevitably lead to incorrect inferential results because the time from transplant to the first infection has a different biological meaning than the gap times between consecutive recurrent infections. Some unbiased yet inefficient methods include univariate survival analysis methods based on data from the first infection or bivariate serial event data methods based on the first and second infections. In this paper, we propose a nonparametric estimator of the joint distribution of time from transplant to the first infection and the gap times between consecutive infections. The proposed estimator takes into account the potentially different distributions of the two types of gap times and better uses the recurrent infection data. Asymptotic properties of the proposed estimators are established. PMID:26575402

Computerized Analysis of Digital Photographs for Evaluation of Tooth Movement

PubMed Central

Toodehzaeim, Mohammad Hossein; Karandish, Maryam; Karandish, Mohammad Nabi

2015-01-01

Objectives: Various methods have been introduced for evaluation of tooth movement in orthodontics. The challenge is to adopt the most accurate and most beneficial method for patients. This study was designed to introduce analysis of digital photographs with AutoCAD software as a method to evaluate tooth movement and assess the reliability of this method. Materials and Methods: Eighteen patients were evaluated in this study. Three intraoral digital images from the buccal view were captured from each patient in half an hour interval. All the photos were sent to AutoCAD software 2011, calibrated and the distance between canine and molar hooks were measured. The data was analyzed using intraclass correlation coefficient. Results: Photographs were found to have high reliability coefficient (P > 0.05). Conclusion: The introduced method is an accurate, efficient and reliable method for evaluation of tooth movement. PMID:26622272

Eighteen microsatellite loci in Salix arbutifolia (Salicaceae) and cross-species amplification in Salix and Populus species.

PubMed

Hoshikawa, Takeshi; Kikuchi, Satoshi; Nagamitsu, Teruyoshi; Tomaru, Nobuhiro

2009-07-01

Salix arbutifolia is a riparian dioecious tree species that is of conservation concern in Japan because of its highly restricted distribution. Eighteen polymorphic loci of dinucleotide microsatellites were isolated and characterized. Among these, estimates of the expected heterozygosity ranged from 0.350 to 0.879. Cross-species amplification was successful at 9-13 loci among six Salix species and at three loci in one Populus species. © 2009 Blackwell Publishing Ltd.

Simultaneous determination of 18 tetrahydrocorticosteroid sulfates in human urine by liquid chromatography/electrospray ionization-tandem mass spectrometry.

PubMed

Mitamura, Kuniko; Satoh née Okihara, Rika; Kamibayashi, Mami; Sato, Kanta; Iida, Takashi; Ikegawa, Shigeo

2014-07-01

A liquid chromatography (LC)/electrospray ionization (ESI)-mass spectrometry (MS) method for the direct determination of eighteen tetrahydrocorticosteroid sulfates in human urine has been developed. The analytes were 3- and 21-monosulfates and 3,21-disulfates of tetrahydrocortisol (THF), tetrahydrocortisone (THE), tetrahydro-11-deoxycortisol (THS), and their corresponding 5α-H stereoisomers. The mass spectrometric behavior of these sulfates in negative-ion ESI-MS/MS revealed the production of intense structure specific product ions within the same group of sulfates and permitted distinction between regioisomeric sulfates by collision-induced fragmentation with the MS/MS technique using a linear ion-trap instrument. For the quantitative analysis, selected reaction monitoring analysis in the negative-ion detection mode using triple-stage quadrupole mass spectrometer was performed by monitoring transitions from [M-H](-) to the most abundant product ion of each tetrahydrocorticosteroid sulfate. After addition of 3- and 21-monosulfates of [2,2,3β,4,4-d5]-THF, -THE, and -THS as internal standards, urine sample was applied to a solid phase extraction using a lipophilic-weak anion exchange cartridge column, and then analyzed by LC/ESI-MS/MS. The method had satisfactory performance in terms of intra- and inter-assay precision (less than 9.7% and 9.6%, respectively), and accuracy (91.2-108.2%). The limit of quantification was lower than 2.5 ng/mL for all sulfates examined. We applied this method to determine the concentration of eighteen tetrahydrocorticosteroid sulfates in the urine of healthy subjects. Thus, we have developed a sensitive, precise and accurate assay for urinary tetrahydrocorticosteroid sulfates that should be useful for clinical and biological studies. Copyright © 2014 Elsevier Inc. All rights reserved.

Effect of cultural factors on outcome of Ponseti treatment of clubfeet in rural America.

PubMed

Avilucea, Frank R; Szalay, Elizabeth A; Bosch, Patrick P; Sweet, Katherine R; Schwend, Richard M

2009-03-01

Nonoperative management of clubfoot with the Ponseti method has proven to be effective, and it is the accepted initial form of treatment. Although several studies have shown that problems with compliance with the brace protocol are principally responsible for recurrence, no distinction has been made with regard to whether the distance from the site of care affects the early recurrence rate. We compared early recurrence after Ponseti treatment between rural and urban ethnically diverse North American populations to analyze whether distance from the site of care affects compliance and whether certain patient demographic characteristics predict recurrence. One hundred consecutive infants with a total of 138 clubfeet treated with the Ponseti method were followed prospectively for at least two years from the beginning of treatment. Early recurrence, defined as the need for subsequent cast treatment or surgical treatment, and compliance, defined as strict adherence to the brace protocol described by Ponseti, were analyzed with respect to the distance from the site of care, age at presentation, number of casts needed for the initial correction, need for tenotomy, and family demographic variables. Of eighteen infants from a rural area who had early recurrence, fourteen were Native American. The families of these children, like those of all of the children with early recurrence, discontinued orthotic use earlier than was recommended by the physician. Discontinuation of orthotic use was related to recurrence, with an odds ratio of 120 (p < 0.0001), in patients living in a rural area. Native American ethnicity, unmarried parents, public or no insurance, parental education at the high-school level or less, and a family income of less than $20,000 were also significant risk factors for recurrence in patients living in a rural area. Intrinsic factors of the clubfoot deformity were not correlated with recurrence or discontinuation of bracing. Compliance with the orthotic regimen after cast treatment is imperative for the Ponseti method to succeed. The striking difference in outcome in rural Native American patients as compared with the outcomes in urban Native American patients and children of other ethnicities suggests particular problems in communicating to families in this subpopulation the importance of bracing to maintain correction. An examination of communication styles suggested that these communication failures may be culturally related.

Plastic-Film Mulching for Enhanced Water-Use Efficiency and Economic Returns from Maize Fields in Semiarid China.

PubMed

Zhang, Peng; Wei, Ting; Cai, Tie; Ali, Shahzad; Han, Qingfang; Ren, Xiaolong; Jia, Zhikuan

2017-01-01

Film mulch has gradually been popularized to increase water availability to crops for improving and stabilizing agricultural production in the semiarid areas of Northwest China. To find more sustainable and economic film mulch methods for alleviating drought stress in semiarid region, it is necessary to test optimum planting methods in same cultivation conditions. A field experiment was conducted during 2013 and 2014 to evaluate the effects of different plastic film mulch methods on soil water, soil temperature, water use efficiency (WUE), yield and revenue. The treatments included: (i) the control, conventional flat planting without plastic film mulch (CK); (ii) flat planting with maize rows (60 cm spacing) on plastic film mulch (70 cm wide); (iii) furrow planting of maize (60 cm spacing), separated by consecutive plastic film-mulched ridges (each 50 cm wide and 15 cm tall); (iv) furrow planting of maize (60 cm spacing), separated by alternating large and small plastic film-mulched ridges (large ridges: 70 cm wide and 15 cm tall, small ridges 50 cm wide and 10 cm tall); and (v) furrow-flat planting of maize (60 cm spacing) with a large plastic film-mulched ridge (60 cm wide and 15 cm tall) alternating with a flat without plastic film-mulched space (60 cm wide). Topsoil temperature (5-25 cm) was significantly ( p < 0.05) higher in field plots with plastic film mulch than the control (CK), and resulted in greater soil water storage (0-200 cm) up to 40 days after planting. Maize grain yield and WUE were significantly ( p < 0.05) higher with the furrow planting methods (consecutive film-mulched ridges and alternating film-mulched ridges) than the check in both years. Maize yield was, on average, 29% ( p < 0.05) greater and 28% ( p < 0.05) greater with these furrow planting methods, while the average WUE increased by 22.8% ( p < 0.05) with consecutive film-mulched ridges and 21.1% ( p < 0.05) with alternating film-mulched ridges. The 2-year average net income increased by 1559, 528, and 350 Chinese Yuan (CNY) ha -1 with the consecutive film-mulched ridges, furrow-flat planting and alternating film-mulched ridges, respectively, compared with the control (CK). We conclude that the consecutive film-mulched ridge method was the most productive and profitable for maize in this semi-arid area with limited and erratic precipitation.

Stroke mimics under the drip-and-ship paradigm.

PubMed

Mehta, Sonal; Vora, Nirav; Edgell, Randall C; Allam, Hesham; Alawi, Aws; Koehne, Jennifer; Kumar, Abhay; Feen, Eliahu; Cruz-Flores, Salvador; Alshekhlee, Amer

2014-01-01

Recent reports suggested better outcomes associated with the drip-and-ship paradigm for acute ischemic stroke (AIS) treated with thrombolysis. We hypothesized that a higher rate of stroke mimics (SM) among AIS treated in nonspecialized stroke centers that are transferred to comprehensive centers is responsible for such outcomes. Consecutive patients treated with thrombolysis according to the admission criteria were reviewed in a single comprehensive stroke center over 1 academic year (July 1, 2011 to June 30, 2012). Information on the basic demographic, hospital complications, psychiatric diagnoses, and discharge disposition was collected. We identified those patients who were treated at a facility and then transferred to the tertiary center (ie, drip-and-ship paradigm). In addition to comparative and adjusted analysis to identify predictors for SM, a stratified analysis by the drip-and-ship status was performed. One hundred twenty patients were treated with thrombolysis for AIS included in this analysis; 20 (16.7%) were discharged with the final diagnosis of SM; 14 of those had conversion syndrome and 6 patients had other syndromes (seizures, migraine, and hypoglycemia). Patients with SM were younger (55.6 ± 15.0 versus 69.4 ± 14.9, P = .0003) and more likely to harbor psychiatric diagnoses (45% versus 9%; P ≤ .0001). Eighteen of 20 SM patients (90%) had the drip-and-ship treatment paradigm compared with 65% of those with AIS (P = .02). None of the SM had hemorrhagic complications, and all were discharged to home. Predictors of SM on adjusted analysis included the drip-and-ship paradigm (odds ratio [OR] 12.8, 95% confidence interval [CI] 1.78, 92.1) and history of any psychiatric illness (OR 12.08; 95% CI 3.14, 46.4). Eighteen of 83 drip-and-ship patients (21.7%) were diagnosed with SM compared with 2 of 37 patients (5.4%) presented directly to the hub hospital (P = .02). The drip-and-ship paradigm and any psychiatric history predict the diagnosis of SM. None of the SM had thrombolysis-related complications, and all were discharged to home. These findings may explain the superior outcomes associated with the drip-and-ship paradigm in the treatment for AIS. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

A polymorphism at the 3'-UTR region of the aromatase gene defines a subgroup of postmenopausal breast cancer patients with poor response to neoadjuvant letrozole

PubMed Central

2010-01-01

Background Aromatase (CYP19A1) regulates estrogen biosynthesis. Polymorphisms in CYP19A1 have been related to the pathogenesis of breast cancer (BC). Inhibition of aromatase with letrozole constitutes the best option for treating estrogen-dependent BC in postmenopausal women. We evaluate a series of polymorphisms of CYP19A1 and their effect on response to neoadjuvant letrozole in early BC. Methods We analyzed 95 consecutive postmenopausal women with stage II-III ER/PgR [+] BC treated with neoadjuvant letrozole. Response to treatment was measured by radiology at 4th month by World Health Organization (WHO) criteria. Three polymorphisms of CYP19A1, one in exon 7 (rs700519) and two in the 3'-UTR region (rs10046 and rs4646) were evaluated on DNA obtained from peripheral blood. Results Thirty-five women (36.8%) achieved a radiological response to letrozole. The histopathological and immunohistochemical parameters, including hormonal receptor status, were not associated with the response to letrozole. Only the genetic variants (AC/AA) of the rs4646 polymorphism were associated with poor response to letrozole (p = 0.03). Eighteen patients (18.9%) reported a progression of the disease. Those patients carrying the genetic variants (AC/AA) of rs4646 presented a lower progression-free survival than the patients homozygous for the reference variant (p = 0.0686). This effect was especially significant in the group of elderly patients not operated after letrozole induction (p = 0.009). Conclusions Our study reveals that the rs4646 polymorphism identifies a subgroup of stage II-III ER/PgR [+] BC patients with poor response to neoadjuvant letrozole and poor prognosis. Testing for the rs4646 polymorphism could be a useful tool in order to orientate the treatment in elderly BC patients. PMID:20144226

Anesthetic Efficacy of a Combination of 4% Prilocaine/2% Lidocaine with Epinephrine for the Inferior Alveolar Nerve Block: A Prospective, Randomized, Double-blind Study.

PubMed

Cook, Olivia; Nusstein, John; Drum, Melissa; Fowler, Sara; Reader, Al; Draper, John

2018-05-01

Prilocaine plain has a high pH and concentration (4%), which could decrease the pain of injection and increase success. The purpose of this study was to compare pain associated with anesthetic solution deposition and the degree of pulpal anesthesia obtained with the combination of prilocaine and lidocaine versus a lidocaine and lidocaine combination when used for inferior alveolar nerve blocks (IANBs). One hundred eighteen asymptomatic subjects were randomly given a combination of 1 cartridge of 4% prilocaine plain plus 1 cartridge of 2% lidocaine with 1:100,000 epinephrine or a combination of 2 cartridges of 2% lidocaine with 1:100,000 epinephrine for the IANB at 2 separate appointments. Subjects rated the pain associated with anesthetic solution deposition of injection. Mandibular teeth were tested with an electric pulp tester every 4 minutes for 57 minutes. Anesthesia was considered successful when 2 consecutive 80 readings were obtained within 17 minutes and the 80 reading was continuously sustained for 57 minutes. Comparisons for anesthetic success were analyzed using the exact McNemar test, and pain ratings associated with anesthetic solution deposition were analyzed using multiple Wilcoxon matched pairs signed rank tests; both were adjusted using the step-down Bonferroni method of Holm. Four percent prilocaine plain was significantly less painful upon anesthetic solution deposition. Pulpal anesthetic success was not significantly different between the 2 combinations. The combination of 4% prilocaine plain plus 2% lidocaine with 1:100,000 epinephrine did not increase pulpal anesthetic success for IANBs compared with a combination of 2 cartridges of 2% lidocaine with 1:100,000 epinephrine. Pain associated with anesthetic solution deposition from the first cartridge of 4% prilocaine plain was significantly less when compared with the first cartridge of 2% lidocaine with 1:100,000 epinephrine. Copyright © 2018 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Coenzyme Q10 supplementation downregulates the increase of monocytes expressing toll-like receptor 4 in response to 6-day intensive training in kendo athletes.

PubMed

Shimizu, Kazuhiro; Kon, Michihiro; Tanimura, Yuko; Hanaoka, Yukichi; Kimura, Fuminori; Akama, Takao; Kono, Ichiro

2015-06-01

This study examined changes in toll-like receptor 4 (TLR-4)-expressing monocytes and lymphocyte subpopulations in response to continuous intensive exercise training in athletes, as well as the effect of coenzyme Q10 (CoQ10) supplementation on these changes. Eighteen male elite kendo athletes in Japan were randomly assigned to a CoQ10-supplementation group (n = 9) or a placebo-supplementation group (n = 9) using a double-blind method. Subjects in the CoQ10 group took 300 mg CoQ10 per day for 20 days. Subjects in the placebo group took the same dosage of placebo. All subjects practiced kendo 5.5 h per day for 6 consecutive days during the study period. Blood samples were collected 2 weeks before training, on the first day (day 1), third day (day 3), and fifth day of training (day 5), and 1 week after the training period (post-training) to ascertain TLR-4(+)/CD14(+) monocyte and lymphocyte subpopulations (CD3(+), CD4(+), CD8(+), CD28(+)/CD4(+), CD28(+)/CD8(+), and CD56(+)/CD3(-) cells) using flow cytometry analysis. The group × time interaction for TLR-4(+)/CD14(+) cells did not reach significance (p = 0.08). Within the CoQ10 group, the absolute number of TLR-4(+)/CD14(+) cells was significantly higher only at day 5. The placebo group showed a significant increase in the absolute number of TLR-4(+)/CD14(+) cells at day 3, day 5, and post-training (p < 0.05). There was no significant group × time interaction for any lymphocyte subpopulation. CD3(+), CD8(+), and CD56(+)/CD3(-) cells were significantly reduced at day 3 in both groups (p < 0.05). In conclusion, CoQ10 supplementation might downregulate the increase of TLR-4-expressing monocytes in response to continuous strenuous exercise training in kendo athletes.

Protocol for diagnostic test accuracy study: the efficacy of screening for common dental diseases by Dental Care Professionals

PubMed Central

2013-01-01

Background The bulk of service delivery in dentistry is delivered by general dental practitioners, when a large proportion of patients who attend regularly are asymptomatic and do not require treatment. This represents a substantial and unnecessary cost, given that it is possible to delegate a range of tasks to dental care professionals, who are a less expensive resource. Screening for the common dental diseases by dental care professionals has the potential to release general dental practitioner’s time and increase the capacity to care for those who don't currently access services. The aim of this study is to compare the diagnostic test accuracy of dental care professionals when screening for dental caries and periodontal disease in asymptomatic adults aged eighteen years of age. Methods/design Ten dental practices across the North-West of England will take part in a diagnostic test accuracy study with 200 consecutive patients in each practice. The dental care professionals will act as the index test and the general dental practitioner will act as the reference test. Consenting asymptomatic patients will enter the study and see either the dental care professionals or general dental practitioner first to remove order effects. Both sets of clinicians will make an assessment of dental caries and periodontal disease and enter their decisions on a record sheet for each participant. The primary outcome measure is the diagnostic test accuracy of the dental care professionals and sensitivity, specificity, positive predictive value and negative predictive values will be reported. A number of clinical factors will be assessed for confounding. Discussion The results of this study will determine whether dental care professionals can screen for the two most prevalent oral diseases. This will inform the literature and is apposite given the recent policy change in the United Kingdom towards direct access. PMID:24053760

Relationship between ventral hernia defect area and intra-abdominal pressure: dynamic in vivo measurement.

PubMed

Qandeel, Haitham; O'Dwyer, Patrick J

2016-04-01

It is an acceptable concept that the ventral hernia defect area will increase with a rise in intra-abdominal pressure (IAP). The literature lacks the evidence about how much this increase is in vivo. The aim of this study was to objectively measure the change in the ventral hernia defect area with increasing intra-abdominal pressure. In a prospective study of laparoscopic ventral hernia repair, the area of hernia defect was measured from inside the abdomen using a sterile paper ruler. The horizontal (width) and vertical (length) measurements of the defect were taken at two pressure points: (IAP = 8 mmHg) and (IAP = 15 mmHg). The hernia defect area was calculated as an oval shape using a standard formula. Eighteen consecutive patients with a ventral hernia were included in this study (8 males: 10 females). Median age was 60 years (30-81), body mass index (BMI) was 29.9 (22.6-37.6). Changing the IAP significantly, (P < 0.001) changed the values of horizontal and vertical measurements, and the calculated area of the ventral hernia defect. The median calculated defect area, as an oval shape, was 5.6 cm(2) (Q1-Q3 = 3.5-15.5) and 6.9 cm(2) (Q1-Q3 = 4.5-18.7) at 8 and 15 mmHg IAP, respectively. The calculated area of mesh required to cover the defect with a 5 cm overlap increased by a median of 5% (Q1-Q3 = 3-6%). The change in defect area did not differ significantly between obese and non-obese patients (P = 0.5). Dynamic, rather than static, measurements of ventral hernia area during laparoscopy provide a simple way of in vivo objective measurement that helps the surgeon choose the appropriate area of mesh. When choosing mesh area, we support the trend toward a larger overlap of at least 5 cm if less precise methods of measuring defect area are been used.

A dose-finding, cross-over study to evaluate the effect of a Nestorone®/Estradiol transdermal gel delivery on ovulation suppression in normal ovulating women.

PubMed

Brache, Vivian; Merkatz, Ruth; Kumar, Narender; Jesam, Cristian; Sussman, Heather; Hoskin, Elena; Roberts, Kevin; Alami, Mohcine; Taylor, Deshawn; Jorge, Aidelis; Croxatto, Horacio; Lorange, Ellen; Mishell, Daniel R; Sitruk-Ware, Regine

2015-10-01

This study aims to determine the lowest effective of three Nestorone (NES)/estradiol (E2) transdermal gel doses to ensure ovulation suppression in 90-95% of cycles. This was a randomized, open-label, three-treatment-period cross-over study to evaluate the effects of NES/E2 transdermal gel on ovulation inhibition, suppression of follicular growth and pharmacokinetic parameters. The doses were low (1.5 mg NES/0.5 mg E2), medium (3.0 mg NES/1.0 mg E2) and high (4.5 mg NES/1.5 mg E2). Participants applied gel daily to a fixed area on the abdomen for 21 consecutive days. They were interviewed regarding their experiences using the gel. Eighteen participants were randomized; 16 completed the study. Median NES C(max) values for low, medium and high dose groups at day 21 were 318.6 pmol/L, 783.0 pmol/L and 1063.8 pmol/L, respectively. Median maximum follicular diameter was higher with the lowest dose with 16.2 mm versus 10.0 and 10.4 mm with the medium and high doses, respectively. Among adherent participants, ovulation was inhibited in all dose groups, except for one participant in the medium dose (6.7%) that had luteal activity and an ultrasound image suggestive of a luteinized unruptured follicle. There were few reports of unscheduled bleeding, with more episodes reported for the lower dose. Adverse events were mild, and no skin irritation was reported from gel application. While all three doses blocked ovulation effectively and were evaluated as safe and acceptable, the medium dose was considered the lowest effective dose based on a more adequate suppression of follicular development. Further development of this novel contraceptive delivering NES and E2 is warranted and has potential for improved safety compared to ethinyl-estradiol-based methods. Copyright © 2015 Elsevier Inc. All rights reserved.

Locomotor-respiratory coupling during axillary crutch ambulation.

PubMed

Hurst, C A; Kirby, R L; MacLeod, D A

2001-11-01

To test the hypotheses that locomotor-respiratory coupling occurs in humans using axillary crutches in a swing-through ambulation pattern and that expiration occurs during crutch-stance phase during locomotor-respiratory coupling. Eighteen able-bodied persons were trained in one-footed swing-through gait with axillary crutches. Then, as subjects walked at "somewhat hard" speeds (Borg) on a motorized treadmill for 5 min, we recorded signals from a crutch pressure switch and a mouthpiece-mounted thermocouple. Coupling was defined as being present when the onset of inspiration varied by < or = 5% with respect to the onset of the crutch gait cycle for a minimum of 10 consecutive gait cycles and when there was no drift on a raster plot of the respiratory phases relative to the onset of the gait cycle. Ten (56%) of the 18 subjects exhibited locomotor-respiratory coupling on 1-4 occasions each, with episodes lasting 11.3-148 sec. In 17 (89%) of the 19 episodes of 1:1 locomotor-respiratory coupling, expiration occurred during the crutch-stance phase of the gait cycle and inspiration occurred during crutch swing. Transient 1:1 locomotor-respiratory coupling occurs in many able-bodied subjects ambulating with axillary crutches and a swing-through gait. Expiration is most often associated with the crutch-stance phase of the gait cycle. This study may have implications for training axillary crutch users.

Reliability of the identification of the systemic inflammatory response syndrome in critically ill infants and children.

PubMed

Juskewitch, Justin E; Prasad, Swati; Salas, Carlos F Santillan; Huskins, W Charles

2012-01-01

To assess interobserver reliability of the identification of episodes of the systemic inflammatory response syndrome in critically ill hospitalized infants and children. Retrospective, cross-sectional study of the application of the 2005 consensus definition of systemic inflammatory response syndrome in infants and children by two independent, trained reviewers using information in the electronic medical record. Eighteen-bed pediatric multidisciplinary medical/surgical pediatric intensive care unit. A randomly selected sample of children admitted consecutively to the pediatric intensive care unit between May 1 and September 30, 2009. None. Sixty infants and children were selected from a total of 343 admitted patients. Their median age was 3.9 yrs (interquartile range, 1.5-12.7), 57% were female, and 68% were Caucasian. Nineteen (32%) children were identified by both reviewers as having an episode of systemic inflammatory response syndrome (88% agreement, 95% confidence interval 78-94; κ = 0.75, 95% confidence interval 0.59-0.92). Among these 19 children, agreement between the reviewers for individual systemic inflammatory response syndrome criteria was: temperature (84%, 95% confidence interval 60-97); white blood cell count (89%, 95% confidence interval 67-99); respiratory rate (84%, 95% confidence interval 60-97); and heart rate (68%, 95% confidence interval 33-87). Episodes of systemic inflammatory response syndrome in critically ill infants and children can be identified reproducibly using the consensus definition.

Does C₁ fracture displacement correlate with transverse ligament integrity?

PubMed

Radcliff, Kristen E; Sonagli, Marcos A; Rodrigues, Luciano M; Sidhu, Gursukhman S; Albert, Todd J; Vaccaro, Alexander R

2013-05-01

The Rule of Spence states that displacement of the C₁ lateral masses by >6.9-8.1 mm suggests loss of transverse ligament integrity. The purpose of this study was to establish the thresholds of C₁ displacement on CT scans that correspond to transverse ligament disruption. Over four years, consecutive patients with acute C₁ fractures with at least three fracture lines were analyzed. CT measurements and MRI were assessed by blinded observers for bony displacement in the axial (internal and external lateral mass separation), coronal and sagittal planes and transverse ligament integrity. Eighteen patients were studied. Mean CT bony measurements were as follows: internal border lateral mass separation (ILM) 23.3 ± 3.4 mm, external border lateral mass separation (ELM) 50.3 ± 4.3 mm, total C₁ lateral mass overhang over the C₂ superior process (LMO) 5.4 ± 1.3 mm. Twelve patients were identified as having intact transverse ligament and six had transverse ligament disruption. There was no difference in mean normalized ILM, ELM, or LMO between patients with or without transverse ligament integrity (P > 0.05). There was no correlation between bony displacement and transverse ligament integrity. CT scans post-injury may not show the position of maximal displacement. If there is clinical concern about a possible transverse ligament injury, MRI should be performed. © 2013 Chinese Orthopaedic Association and Wiley Publishing Asia Pty Ltd.

Mandibular reconstruction after cancer: an in-house approach to manufacturing cutting guides.

PubMed

Bosc, R; Hersant, B; Carloni, R; Niddam, J; Bouhassira, J; De Kermadec, H; Bequignon, E; Wojcik, T; Julieron, M; Meningaud, J-P

2017-01-01

The restoration of mandibular bone defects after cancer can be facilitated by computer-assisted preoperative planning. The aim of this study was to assess an in-house manufacturing approach to customized cutting guides for use in the reconstruction of the mandible with osteocutaneous free flaps. A retrospective cohort study was performed, involving 18 patients who underwent mandibular reconstruction with a fibula free flap at three institutions during the period July 2012 to March 2015. A single surgeon designed and manufactured fibula and mandible cutting guides using a computer-aided design process and three-dimensional (3D) printing technology. The oncological outcomes, production parameters, and quality of the reconstructions performed for each patient were recorded. Computed tomography scans were acquired after surgery, and these were compared with the preoperative 3D models. Eighteen consecutive patients with squamous cell carcinoma underwent surgery and then reconstruction using this customized in-house surgical approach. The lengths of the fibula bone segments and the angle measurements in the simulations were similar to those of the postoperative volume rendering (P=0.61). The ease of access to 3D printing technology has enabled the computer-aided design and manufacturing of customized cutting guides for oral cancer treatment without the need for input from external laboratories. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Change of the human taste bud volume over time.

PubMed

Srur, Ehab; Stachs, Oliver; Guthoff, Rudolf; Witt, Martin; Pau, Hans Wilhelm; Just, Tino

2010-08-01

The specific aim of this study is to measure the taste volume in healthy human subjects over a 2.5-month period and to demonstrate morphological changes of the peripheral taste organs. Eighteen human taste buds in four fungiform papillae (fPap) were examined over a 10-week period. The fungiform papillae investigated were selected based on the form of the papillae or the arrangement of surface taste pores. Measurements were performed over 10 consecutive weeks, with five scans in a day once a week. The following parameters were measured: height and diameter of the taste bud, diameter of the fungiform papilla and diameter of the taste pore. The findings of this exploratory study indicated that (1) taste bud volumes changed over a 10-week period, (2) the interval between two volume maxima within the 10-week period was 3-5 weeks, and (3) the diameter of the fPap did not correlate with the volume of a single taste bud or with the volume of all taste buds in the fPap within the 10-week period. This exploratory in vivo study revealed changes in taste bud volumes in healthy humans with age-related gustatory sensitivity. These findings need to be considered when studying the effect of denervation of fungiform papillae in vivo using confocal microscopy. Crown Copyright 2009. Published by Elsevier Ireland Ltd. All rights reserved.

Remote limb ischemic conditioning enhances motor learning in healthy humans

PubMed Central

Cherry-Allen, Kendra M.; Gidday, Jeff M.; Lee, Jin-Moo; Hershey, Tamara

2015-01-01

Brief bouts of sublethal ischemia have been shown to protect exposed tissue (ischemic conditioning) and tissues at remote sites (remote ischemic conditioning) against subsequent ischemic challenges. Given that the mechanisms of this protective phenomenon are multifactorial and epigenetic, we postulated that remote limb ischemic conditioning (RLIC) might enhance mechanisms responsible for neural plasticity, and thereby facilitate learning. Specifically, we hypothesized that conditioning of the nervous system with RLIC, achieved through brief repetitive limb ischemia prior to training, would facilitate the neurophysiological processes of learning, thus making training more effective and more long-lasting. Eighteen healthy adults participated in this study; nine were randomly allocated to RLIC and nine to sham conditioning. All subjects underwent seven consecutive weekday sessions and 2-wk and 4-wk follow-up sessions. We found that RLIC resulted in significantly greater motor learning and longer retention of motor performance gains in healthy adults. Changes in motor performance do not appear to be due to a generalized increase in muscle activation or muscle strength and were not associated with changes in serum brain-derived neurotrophic factor (BDNF) concentration. Of note, RLIC did not enhance cognitive learning on a hippocampus-dependent task. While future research is needed to establish optimal conditioning and training parameters, this inexpensive, clinically feasible paradigm might ultimately be implemented to enhance motor learning in individuals undergoing neuromuscular rehabilitation for brain injury and other pathological conditions. PMID:25867743

Long-term follow-up after surgery in localized laryngeal amyloidosis.

PubMed

Hazenberg, Aldert J C; Hazenberg, Bouke P C; Dikkers, Frederik G

2016-09-01

To study effectiveness of surgery and watchful waiting in localized laryngeal amyloidosis, retrospective case series. This retrospective study comprises all consecutive patients with localized laryngeal amyloidosis surgically treated in a tertiary hospital between 1994 and February 2016. Recurrence rate, revision surgery, progression to systemic amyloidosis, and changes in voice were monitored yearly. Eighteen patients were included. Seven women and eleven men had a median age 50 years (range 21-77 years) and median follow-up 6.4 years (2.4-17 years). Amyloid was located in subglottis (5), glottis (8), false vocal folds (8) and other supraglottic areas (5), in more than one laryngeal region (13) and bilaterally (12). Cold steel excision was used at the glottis; CO2 laser excision, sometimes assisted by microdebrider, at other laryngeal areas. Eleven patients needed revision surgery, ten within the first 4 years after surgical treatment. One patient needed his first revision surgery after 11 years. Five patients needed a second revision within 6 years after initial diagnosis. Two patients needed a third revision. Indications for first revision surgery were progression (8) with dysphonia (7), dyspnea (2), dysphagia (1), exclusion of malignancy (1), and aphonia (1). No patient developed systemic amyloidosis during follow-up. Although local progression of amyloid necessitates revision surgery once or twice in the first 4-6 years, progression slows down thereafter. Late progression, however, remains possible.

Experiences of informational needs and received information following a prenatal diagnosis of congenital heart defect.

PubMed

Carlsson, Tommy; Bergman, Gunnar; Wadensten, Barbro; Mattsson, Elisabet

2016-06-01

To explore the need for information and what information was actually received following prenatal diagnosis of a congenital heart defect, in a country where termination of pregnancy beyond 22 weeks of gestation is not easily possible because of legal constraints. Twenty-six Swedish-speaking pregnant women (n = 14) and partners (n = 12) were consecutively recruited for semi-structured telephone interviews following the prenatal diagnosis of a congenital heart defect. Data were analyzed using content analysis. Although high satisfaction with the specialist information was described, the information was considered overwhelming and complex. Objective, honest, and detailed information about multiple subjects were needed, delivered repeatedly, and supplemented by written information/illustrations. Eighteen respondents had used the Internet to search for information and identified issues involving searching difficulties, low quality, and that it was too complex, insufficient, or unspecific. Those who terminated their pregnancy criticized that there was a lack of information about termination of pregnancy, both from health professionals and online sources, resulting in unanswered questions and unpreparedness. Individuals faced with a prenatal diagnosis of a congenital heart defect need individualized and repeated information. These needs are not all adequately met, as individuals are satisfied with the specialist consultation but left with unanswered questions regarding pregnancy termination. © 2016 John Wiley & Sons, Ltd. © 2016 John Wiley & Sons, Ltd.

Etiology and microbial patterns of pulmonary infiltrates in patients with orthotopic liver transplantation.

PubMed

Torres, A; Ewig, S; Insausti, J; Guergué, J M; Xaubet, A; Mas, A; Salmeron, J M

2000-02-01

To evaluate the etiology and microbial patterns of pulmonary infiltrates in liver transplant patients using a bronchoscopic diagnostic approach and the impact of diagnostic results on antimicrobial treatment decisions. A prospective cohort study. A 1,000-bed tertiary-care university hospital. Fifty consecutive liver transplant patients with 60 episodes of pulmonary infiltrates (33 episodes during mechanical ventilation) were studied using flexible bronchoscopy with protected specimen brush (PSB) and BAL. A definite infectious etiology was confirmed in 29 episodes (48%). Eighteen episodes corresponded to probable pneumonia (30%), 10 episodes had noninfectious etiologies (17%), and 3 remained undetermined (5%). Opportunistic infections were the most frequent etiology (16/29, 55%, including 1 mixed etiology). Bacterial infections (mainly Gram-negative) accounted for 14 of 29 episodes (48%), including 1 of mixed etiology. The majority of bacterial pneumonia episodes (n = 10, 71%) occurred in period 1 (1 to 28 days posttransplant) during mechanical ventilation, whereas opportunistic episodes were predominant in periods 2 and 3 (29 to 180 days and > 180 days posttransplant, respectively; n = 14, 82%). Microbial treatment was changed according to diagnostic results in 21 episodes (35%). Microbial patterns in liver transplant patients with pulmonary infiltrates corresponded to nosocomial, mainly Gram-negative bacterial pneumonia in period 1, and to opportunistic infections in period 2 and, to a lesser extent, period 3. A comprehensive diagnostic evaluation including PSB and BAL fluid examination frequently guided specific antimicrobial therapy.

Use of bioluminescence mutant screening for identification of Edwardsiella ictaluri genes involved in channel catfish (Ictalurus punctatus) skin colonization.

PubMed

Menanteau-Ledouble, Simon; Lawrence, Mark L

2013-03-23

Initial invasion of the host is the first and vital part of any infection process. We have demonstrated that Edwardsiella ictaluri is capable of colonizing and penetrating catfish skin. Therefore, a mutant library was constructed by random insertion of the Mar2xT7 transposon into the chromosome of E. ictaluri harboring the bioluminescence plasmid pAKgfplux1. This library was then screened through a series of three consecutive challenges for mutants showing a decreased ability to colonize the catfish epithelium. Eighteen mutants were identified that have decreased adhesion and virulence. Mutated genes encoded one sensor protein, two transport proteins, five enzymes, two regulatory proteins, and five hypothetical proteins. Among the mutated genes, the first one identified was a gene encoding for RstA/B, which is known to play a role in regulating the expression of invasion genes in Salmonella enterica Typhimurium. Another mutant was lacking a putative ribonuclease similar to a Shigella protein that regulates the expression of adhesin. A third mutant was defective in a protein similar to a Brucella protein that was initially identified as a transporter, but actually is a member of a newly discovered adhesin family. Results from this study could enable development of a new strategy for blocking E. ictaluri invasion at the initial adherence stage. Copyright © 2012 Elsevier B.V. All rights reserved.

Current characteristics and management of congenital esophageal stenosis: 40 consecutive cases from a multicenter study in the Kyushu area of Japan.

PubMed

Suzuhigashi, Masaya; Kaji, Tatsuru; Noguchi, Hiroyuki; Muto, Mitsuru; Goto, Michiko; Mukai, Motoi; Nakame, Kazuhiko; Kawano, Takafumi; Yamada, Waka; Yamada, Koji; Onishi, Shun; Ieiri, Satoshi

2017-10-01

Congenital esophageal stenosis (CES) is rare, and the available clinical data are limited. We explored the current diagnosis, treatment and outcomes of CES. A questionnaire survey was performed using medical records at pediatric surgical centers in the Kyushu area. Over 10 years, 40 patients (24 males) had CES. The incidence of associated anomalies was 52.5% (21/40), and that of esophageal atresia was 20.0% (8/40). The mean age at the diagnosis was 12.0 months (range, 1 day-8.8 years). Seven (17.5%) patients were diagnosed in the neonatal period. Ten (25.0%) developed CES due to tracheobronchial remnants, 27 (67.5%) due to fibromuscular stenosis (FMS) and 1 (2.5%) due to membranous stenosis + FMS. Thirty-six (90.0%) were treated by balloon dilatation (mean, 3 times; range, 1-20). Perforation at dilatation occurred in 7 (17.5%) patients, and all were diagnosed with FMS. Eighteen (45.0%) patients underwent radical operation (3 primary, 15 secondary to dilatation). Our study clarified the characteristics and outcomes of CES, including neonatal diagnoses. CES occurred in 1 in every 33,000 births in the Kyushu area. Careful attention should be paid, even in cases of dilatation for FMS. CES requires long-term follow-up for symptom persistence after adequate and repeated treatment.

Patch testing with hydroxyisohexyl 3-cyclohexene carboxaldehyde (HICC) - a multicentre study of the Swedish Contact Dermatitis Research Group.

PubMed

Engfeldt, Malin; Hagvall, Lina; Isaksson, Marléne; Matura, Mihály; Mowitz, Martin; Ryberg, Kristina; Stenberg, Berndt; Svedman, Cecilia; Bruze, Magnus

2017-01-01

In 2014, the fragrance hydroxyisohexyl 3-cyclohexene carboxaldehyde (HICC) was excluded from the Swedish baseline series. To study (i) whether fragrance mix (FM) II with 5% HICC detects more positive reactions than usual FM II with 2.5% HICC, and (ii) the reproducibility of patch testing with HICC. Two thousand one hundred and eighteen dermatitis patients at five Swedish dermatology departments were consecutively tested with FM II 14% pet., FM II 16.5% pet., and duplicate preparations of HICC 5% pet. Of the patients, 3.2% reacted to FM II 14%, and 1.5% reacted to HICC. Separate testing with HICC detected 0.3% reactions without concomitant reactivity to FM II. FM II with 5% HICC did not give rise to more irritant reactions or signs of active sensitization than FM II with 2.5% HICC. Patch testing with duplicate applications of HICC increased the overall prevalence of HICC contact allergy to 1.9%. FM II with 5% HICC does not detect more positive reactions than FM II with 2.5% HICC. Separate testing with HICC does not detect a sufficient proportion of patients who react only to HICC, without concomitant reactions to FM II, to warrant its inclusion in a baseline series. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

[On the partition of acupuncture academic schools].

PubMed

Yang, Pengyan; Luo, Xi; Xia, Youbing

2016-05-01

Nowadays extensive attention has been paid on the research of acupuncture academic schools, however, a widely accepted method of partition of acupuncture academic schools is still in need. In this paper, the methods of partition of acupuncture academic schools in the history have been arranged, and three typical methods of"partition of five schools" "partition of eighteen schools" and "two-stage based partition" are summarized. After adeep analysis on the disadvantages and advantages of these three methods, a new method of partition of acupuncture academic schools that is called "three-stage based partition" is proposed. In this method, after the overall acupuncture academic schools are divided into an ancient stage, a modern stage and a contemporary stage, each schoolis divided into its sub-school category. It is believed that this method of partition can remedy the weaknesses ofcurrent methods, but also explore a new model of inheritance and development under a different aspect through thedifferentiation and interaction of acupuncture academic schools at three stages.

Robert E. Slaughter Research Award Studies 1975. Research Report. Number 3. Effectiveness of Model Office, Cooperative Office Education, and Office Procedures Courses Based on Employee Satisfaction and Satisfactoriness Eighteen Months after Graduation. [AND] A Study of the Content in Selected Textbooks for the Commonly Offered Basic Business Courses in Secondary Schools.

ERIC Educational Resources Information Center

McLean, Gary N.; Jones, L. Eugene

The two studies which received the 1975 Robert E. Slaughter Research Award in Business and Office Education are summarized in the document. The first paper, entitled "Effectiveness of Model Office, Cooperative Office Education, and Office Procedures Courses Based on Employee Satisfaction and Satisfactoriness Eighteen Months After…

Diverse Lifestyles and Strategies of Plant Pathogenesis Encoded in the Genomes of Eighteen Dothideomycetes

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

Ohm, Robin A.; Feau, Nicolas; Henrissat, Bernard

2013-03-05

The class of Dothideomycetes is one of the largest and most diverse groups of fungi. Many are plant pathogens and pose a serious threat to agricultural crops that are grown for biofuel, food or feed. Most Dothideomycetes have only a single host plant, and related species can have very diverse hosts. Eighteen genomes of Dothideomycetes have currently been sequenced by the Joint Genome Institute and other sequencing centers. Here we describe the results of comparative analyses of the fungi in this group.

A survey of major east coast snowstorms, 1960-1983. Part 2: Case studies of eighteen storms

NASA Technical Reports Server (NTRS)

Kocin, P. J.; Uccellini, L. W.

1985-01-01

Snowfall, surface and upper air charts, and available satellite images are presented for eighteen major East Coast snowstorms that occurred between 1960 and 1983. The charts and descriptions of key fields are provided so that students, weather forecasters, and researchers alike can visualize how a large sample of major winter cyclones form and intensify. Although there are noted similarities in certain aspects of the surface and upper tropospheric development of the storms, significant case-to-case variability precludes the ability to effectively composite these weather systems.

Maternal Feeding Styles and Food Parenting Practices as Predictors of Longitudinal Changes in Weight Status in Hispanic Preschoolers from Low-Income Families

PubMed Central

O'Connor, Teresia M.; Orlet Fisher, Jennifer

2016-01-01

Objective. The aim was to investigate the influence of feeding styles and food parenting practices on low-income children's weight status over time. Method. Participants were 129 Latina parents and their Head Start children participating in a longitudinal study. Children were assessed at baseline (4 to 5 years old) and again eighteen months later. At each time point, parents completed questionnaires and height and weight measures were taken on the child. Results. The indulgent feeding style (parent-report at baseline) was associated with increased child BMI z-score eighteen months later compared to other feeding styles. Authoritative, authoritarian, and uninvolved feeding styles were not significantly associated with increased child BMI z-score. Child BMI z-score at Time 1 (strongest) and maternal acculturation were positive predictors of child BMI z-score at Time 2. Maternal use of restriction positively predicted and maternal monitoring negatively predicted Time 2 BMI z-score, but only when accounting for feeding styles. Conclusion. This is the first study to investigate the impact of feeding styles on child weight status over time. Results suggest that indulgent feeding predicts later increases in children's weight status. The interplay between feeding styles and food parenting practices in influencing child weight status needs to be further explored. PMID:27429801

Not all stories of professional identity formation are equal: An analysis of formation narratives of highly humanistic physicians.

PubMed

Branch, William T; Frankel, Richard

2016-08-01

We sought to identify and define "highly humanistic" formation narratives, and understand how these events described, together with a reflective learning process, the professional development of physicians in a longitudinal faculty development program. Qualitative analysis of twenty highly humanistic appreciative inquiry narratives selected from a total of 124 written by faculty members at the beginning and end of an eighteen month program at eight medical schools. [9,10] We employed the immersion/crystallization method of Borkan [20] to capture the rich meanings and emotional depth of the twenty narratives. Highly humanistic formation narratives described emotionally charged events in which the faculty writers provided humanistic care that went beyond what they had previously thought themselves capable of; benefited the patient, family or faculty member to a major extent; and reaffirmed or strengthened their professional values. Highly humanistic formation narratives were clustered at the end of our eighteen month curriculum. Participation in faculty development for humanism may have increased the numbers of highly humanistic events by sensitizing and motivating faculty members to meet their patients' emotional needs. Our paper describes a process whereby faculty members may achieve growth in their capacities to meet patients' needs. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Maternal Feeding Styles and Food Parenting Practices as Predictors of Longitudinal Changes in Weight Status in Hispanic Preschoolers from Low-Income Families.

PubMed

Hughes, Sheryl O; Power, Thomas G; O'Connor, Teresia M; Orlet Fisher, Jennifer; Chen, Tzu-An

2016-01-01

Objective. The aim was to investigate the influence of feeding styles and food parenting practices on low-income children's weight status over time. Method. Participants were 129 Latina parents and their Head Start children participating in a longitudinal study. Children were assessed at baseline (4 to 5 years old) and again eighteen months later. At each time point, parents completed questionnaires and height and weight measures were taken on the child. Results. The indulgent feeding style (parent-report at baseline) was associated with increased child BMI z-score eighteen months later compared to other feeding styles. Authoritative, authoritarian, and uninvolved feeding styles were not significantly associated with increased child BMI z-score. Child BMI z-score at Time 1 (strongest) and maternal acculturation were positive predictors of child BMI z-score at Time 2. Maternal use of restriction positively predicted and maternal monitoring negatively predicted Time 2 BMI z-score, but only when accounting for feeding styles. Conclusion. This is the first study to investigate the impact of feeding styles on child weight status over time. Results suggest that indulgent feeding predicts later increases in children's weight status. The interplay between feeding styles and food parenting practices in influencing child weight status needs to be further explored.

Increased fMRI Sensitivity at Equal Data Burden Using Averaged Shifted Echo Acquisition

PubMed Central

Witt, Suzanne T.; Warntjes, Marcel; Engström, Maria

2016-01-01

There is growing evidence as to the benefits of collecting BOLD fMRI data with increased sampling rates. However, many of the newly developed acquisition techniques developed to collect BOLD data with ultra-short TRs require hardware, software, and non-standard analytic pipelines that may not be accessible to all researchers. We propose to incorporate the method of shifted echo into a standard multi-slice, gradient echo EPI sequence to achieve a higher sampling rate with a TR of <1 s with acceptable spatial resolution. We further propose to incorporate temporal averaging of consecutively acquired EPI volumes to both ameliorate the reduced temporal signal-to-noise inherent in ultra-fast EPI sequences and reduce the data burden. BOLD data were collected from 11 healthy subjects performing a simple, event-related visual-motor task with four different EPI sequences: (1) reference EPI sequence with TR = 1440 ms, (2) shifted echo EPI sequence with TR = 700 ms, (3) shifted echo EPI sequence with every two consecutively acquired EPI volumes averaged and effective TR = 1400 ms, and (4) shifted echo EPI sequence with every four consecutively acquired EPI volumes averaged and effective TR = 2800 ms. Both the temporally averaged sequences exhibited increased temporal signal-to-noise over the shifted echo EPI sequence. The shifted echo sequence with every two EPI volumes averaged also had significantly increased BOLD signal change compared with the other three sequences, while the shifted echo sequence with every four EPI volumes averaged had significantly decreased BOLD signal change compared with the other three sequences. The results indicated that incorporating the method of shifted echo into a standard multi-slice EPI sequence is a viable method for achieving increased sampling rate for collecting event-related BOLD data. Further, consecutively averaging every two consecutively acquired EPI volumes significantly increased the measured BOLD signal change and the subsequently calculated activation map statistics. PMID:27932947

Field soil aggregate stability kit for soil quality and rangeland health evaluations

USGS Publications Warehouse

Herrick, J.E.; Whitford, W.G.; de Soyza, A. G.; Van Zee, J. W.; Havstad, K.M.; Seybold, C.A.; Walton, M.

2001-01-01

Soil aggregate stability is widely recognized as a key indicator of soil quality and rangeland health. However, few standard methods exist for quantifying soil stability in the field. A stability kit is described which can be inexpensively and easily assembled with minimal tools. It permits up to 18 samples to be evaluated in less than 10 min and eliminates the need for transportation, minimizing damage to soil structure. The kit consists of two 21??10.5??3.5 cm plastic boxes divided into eighteen 3.5??3.5 cm sections, eighteen 2.5-cm diameter sieves with 1.5-mm distance openings and a small spatula used for soil sampling. Soil samples are rated on a scale from one to six based on a combination of ocular observations of slaking during the first 5 min following immersion in distilled water, and the percent remaining on a 1.5-mm sieve after five dipping cycles at the end of the 5-min period. A laboratory comparison yielded a correlation between the stability class and percent aggregate stability based on oven dry weight remaining after treatment using a mechanical sieve. We have applied the method in a wide variety of agricultural and natural ecosystems throughout western North America, including northern Mexico, and have found that it is highly sensitive to differences in management and plant community composition. Although the field kit cannot replace the careful laboratory-based measurements of soil aggregate stability, it can clearly provide valuable information when these more intensive procedures are not possible.

New accelerometric method to discriminate between asymptomatic subjects and patients with medial knee osteoarthritis during 3-d gait.

PubMed

Turcot, Katia; Aissaoui, Rachid; Boivin, Karine; Pelletier, Michel; Hagemeister, Nicola; de Guise, Jacques A

2008-04-01

This study presents a new method to estimate 3-D linear accelerations at tibial and femoral functional coordinate systems. The method combines the use of 3-D accelerometers, 3-D gyroscopes and reflective markers rigidly fixed on an exoskeleton and, a functional postural calibration method. Marker positions were tracked by a six-camera optoelectronic system (VICON 460, Oxford Metrics). The purpose of this study was to determine if this method could discriminate between medial osteoarthritic and asymptomatic knees during gait. Nine patients with osteoarthritic knees and nine asymptomatic control subjects were included in this study. Eighteen parameters representing maximal, minimal, and range of acceleration values were extracted during the loading and preswing to mid-swing phase periods, and were compared in both groups. Results show good discriminative capacity of the new method. Eight parameters were significantly different between both groups. The proposed method has the potential to be used in comprehending and monitoring gait strategy in patients with osteoarthritic knee.

Evaluation of three sampling methods to monitor outcomes of antiretroviral treatment programmes in low- and middle-income countries.

PubMed

Tassie, Jean-Michel; Malateste, Karen; Pujades-Rodríguez, Mar; Poulet, Elisabeth; Bennett, Diane; Harries, Anthony; Mahy, Mary; Schechter, Mauro; Souteyrand, Yves; Dabis, François

2010-11-10

Retention of patients on antiretroviral therapy (ART) over time is a proxy for quality of care and an outcome indicator to monitor ART programs. Using existing databases (Antiretroviral in Lower Income Countries of the International Databases to Evaluate AIDS and Médecins Sans Frontières), we evaluated three sampling approaches to simplify the generation of outcome indicators. We used individual patient data from 27 ART sites and included 27,201 ART-naive adults (≥15 years) who initiated ART in 2005. For each site, we generated two outcome indicators at 12 months, retention on ART and proportion of patients lost to follow-up (LFU), first using all patient data and then within a smaller group of patients selected using three sampling methods (random, systematic and consecutive sampling). For each method and each site, 500 samples were generated, and the average result was compared with the unsampled value. The 95% sampling distribution (SD) was expressed as the 2.5(th) and 97.5(th) percentile values from the 500 samples. Overall, retention on ART was 76.5% (range 58.9-88.6) and the proportion of patients LFU, 13.5% (range 0.8-31.9). Estimates of retention from sampling (n = 5696) were 76.5% (SD 75.4-77.7) for random, 76.5% (75.3-77.5) for systematic and 76.0% (74.1-78.2) for the consecutive method. Estimates for the proportion of patients LFU were 13.5% (12.6-14.5), 13.5% (12.6-14.3) and 14.0% (12.5-15.5), respectively. With consecutive sampling, 50% of sites had SD within ±5% of the unsampled site value. Our results suggest that random, systematic or consecutive sampling methods are feasible for monitoring ART indicators at national level. However, sampling may not produce precise estimates in some sites.

Movements of Two Satellite-tagged Pygmy Killer Whales (Feresa attenuata) Off the Island of Hawaii

DTIC Science & Technology

2011-01-01

ac- cessed January 2009) using two independent methods: distance between consecutive locations, and rate and bearings among consecutive movement...Ross Sea, Antarctica. Polar Biology 31:1461–1468. Andrews, K. R., L. Karczmarski, W. W. L. Au, et al. 2010. Rolling stones and stable homes: Social...variation and evidence for population structure in eastern North Pacific false killer whales (Pseudorca crassidens). Canadian Journal of Zoology 85

Safety and efficacy of minimalist approach in transfemoral transcatheter aortic valve replacement: insights from the Optimized transCathEter vAlvular interventioN-Transcatheter Aortic Valve Implantation (OCEAN-TAVI) registry.

PubMed

Hosoba, Soh; Yamamoto, Masanori; Shioda, Kayoko; Sago, Mitsuru; Koyama, Yutaka; Shimura, Tetsuro; Kagase, Ai; Tada, Norio; Naganuma, Toru; Araki, Motoharu; Yamanaka, Futoshi; Shirai, Shinichi; Watanabe, Yusuke; Hayashida, Kentaro

2018-03-01

Favourable results have been reported for monitored anaesthesia care that includes local anaesthesia and conscious sedation [minimalist approach (MA)] for transfemoral transcatheter aortic valve replacement (TAVR). However, the efficacy of MA is still controversial in Japan. We describe our experience from a Japanese multicentre registry. Between October 2013 and April 2016, 1215 consecutive Japanese patients with symptomatic, severe aortic stenosis undergoing TAVR with self-expandable or balloon-expandable valves were prospectively included in the Optimized transCathEter vAlvular intervention-Transcatheter Aortic Valve Implantation (OCEAN-TAVI) registry. Of these patients, we retrospectively reviewed 921 consecutive patients who underwent elective transfemoral-TAVR. We evaluated the perioperative results of MA-TAVR and non-minimalist approach (NMA) TAVR using propensity score matching analysis. A total of 118 patients underwent MA-TAVR, and 802 patients underwent NMA-TAVR [median age 84 vs 85 years, P = 0.25; Society of Thoracic Surgeons (STS) score 7.6 vs 6.4, P = 0.01]. One hundred eighteen matched pairs were compared after propensity score matching. In-hospital mortality and stroke/transient ischaemic attack were not significantly different between the MA-TAVR and the NMA-TAVR groups (2.5% vs 0.8%, P = 0.3; 1.7% vs 0.8%, P = 0.6, respectively). Major or life-threatening bleeding and the transfusion rate were significantly lower in the MA-TAVR group (3.4% vs 17%, P = 0.003; 6.8% vs 29%, P = 0.0002, respectively). The total intensive care unit days and length of hospital stay were significantly lower in the MA-TAVR group (P ≤ 0.0002). MA-TAVR has similar results to NMA-TAVR in terms of mortality and stroke in this Japanese multicentre registry. Shorter procedure time and hospital stays were seen in the MA-TAVR group. MA-TAVR is as safe and effective as NMA-TAVR. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Geology-based method of assessing sensitivity of streams to acidic deposition in Charles and Anne Arundel Counties, Maryland

USGS Publications Warehouse

Rice, Karen C.; Bricker, Owen P.

1991-01-01

The report describes the results of a study to assess the sensitivity of streams to acidic deposition in Charles and Anne Arundel Counties, Maryland using a geology-based method. Water samples were collected from streams in July and August 1988 when streams were at base-flow conditions. Eighteen water samples collected from streams in Charles County, and 17 water samples from streams in Anne Arundel County were analyzed in the field for pH, specific conductance, and acid-neutralizing capacity (ANC); 8 water samples from streams in Charles County were analyzed in the laboratory for chloride and sulfate concentrations. The assessment revealed that streams in these counties are sensitive to acidification by acidic deposition.

Influences to ADHD Problem Recognition: Mixed-Method Investigation and Recommendations to Reduce Disparities for Latino Youth.

PubMed

Haack, Lauren M; Meza, Jocelyn; Jiang, Yuanyuan; Araujo, Eva Jimenez; Pfiffner, Linda

2018-05-16

ADHD problem recognition serves as the first step of help seeking for ethnic minority families, such as Latinos, who underutilize ADHD services. The current mixed-method study explores underlying factors influencing recognition of ADHD problems in a sample of 159 school-aged youth. Parent-teacher informant discrepancy results suggest that parent ethnicity, problem domain, and child age influence ADHD problem recognition. Emerging themes from semi-structured qualitative interviews/focus groups conducted with eighteen Spanish-speaking Latino parents receiving school-based services for attention and behavior concerns support a range of recognized ADHD problems, beliefs about causes, and reactions to ADHD identification. Findings provide recommendations for reducing disparities in ADHD problem recognition and subsequent help seeking.

Plastic-Film Mulching for Enhanced Water-Use Efficiency and Economic Returns from Maize Fields in Semiarid China

PubMed Central

Zhang, Peng; Wei, Ting; Cai, Tie; Ali, Shahzad; Han, Qingfang; Ren, Xiaolong; Jia, Zhikuan

2017-01-01

Film mulch has gradually been popularized to increase water availability to crops for improving and stabilizing agricultural production in the semiarid areas of Northwest China. To find more sustainable and economic film mulch methods for alleviating drought stress in semiarid region, it is necessary to test optimum planting methods in same cultivation conditions. A field experiment was conducted during 2013 and 2014 to evaluate the effects of different plastic film mulch methods on soil water, soil temperature, water use efficiency (WUE), yield and revenue. The treatments included: (i) the control, conventional flat planting without plastic film mulch (CK); (ii) flat planting with maize rows (60 cm spacing) on plastic film mulch (70 cm wide); (iii) furrow planting of maize (60 cm spacing), separated by consecutive plastic film-mulched ridges (each 50 cm wide and 15 cm tall); (iv) furrow planting of maize (60 cm spacing), separated by alternating large and small plastic film-mulched ridges (large ridges: 70 cm wide and 15 cm tall, small ridges 50 cm wide and 10 cm tall); and (v) furrow-flat planting of maize (60 cm spacing) with a large plastic film-mulched ridge (60 cm wide and 15 cm tall) alternating with a flat without plastic film-mulched space (60 cm wide). Topsoil temperature (5–25 cm) was significantly (p < 0.05) higher in field plots with plastic film mulch than the control (CK), and resulted in greater soil water storage (0–200 cm) up to 40 days after planting. Maize grain yield and WUE were significantly (p < 0.05) higher with the furrow planting methods (consecutive film-mulched ridges and alternating film-mulched ridges) than the check in both years. Maize yield was, on average, 29% (p < 0.05) greater and 28% (p < 0.05) greater with these furrow planting methods, while the average WUE increased by 22.8% (p < 0.05) with consecutive film-mulched ridges and 21.1% (p < 0.05) with alternating film-mulched ridges. The 2-year average net income increased by 1559, 528, and 350 Chinese Yuan (CNY) ha−1 with the consecutive film-mulched ridges, furrow-flat planting and alternating film-mulched ridges, respectively, compared with the control (CK). We conclude that the consecutive film-mulched ridge method was the most productive and profitable for maize in this semi-arid area with limited and erratic precipitation. PMID:28428798

A new sclerosant therapy for testicular hydrocele with aspiration and injection of OK-432.

PubMed

Yamamoto, M; Hibi, H; Miyake, K

1994-01-01

Twenty patients with testicular hydrocele were treated with a new sclerosing therapy consisting of intrascrotal injection of OK-432 (group A Streptococcus pyogenes of human origin). The median observation period after treatment was 6 months (range 2-13 months). Eighteen patients required only one treatment. Two patients had recurrences and received repeat injection. There have been no serious side effects except for fever of 2-3 days' duration and local inflammatory reaction. Sclerotherapy with OK-432 is an efficient and easy method which can be recommended as a primary treatment for hydrocele.

Internalized Homonegativity: A Systematic Mapping Review of Empirical Research

PubMed Central

Berg, Rigmor C.; Munthe-Kaas, Heather M.; Ross, Michael W.

2016-01-01

ABSTRACT Internalized homonegativity (IH) is an important variable affecting the wellbeing of lesbian, gay, and bisexual (LGB) persons. We included 201 studies in a systematic mapping review of IH. Most studies were conducted in North America and examined IH as a predictor of poor health. The primary focus of 14 studies was IH scale measurement, and, in total, these studies detailed nine distinct scales. Eighteen studies compared levels of IH in LGB populations, four described prevention programs, and one investigated IH using qualitative methods. Our review indicates that further research is needed, particularly qualitative research and ways to ameliorate IH. PMID:26436322

Full field study of strain distribution near the crack tip in the fracture of solid propellants via large strain digital image correlation and optical microscopy

NASA Astrophysics Data System (ADS)

Gonzalez, Javier

A full field method for visualizing deformation around the crack tip in a fracture process with large strains is developed. A digital image correlation program (DIC) is used to incrementally compute strains and displacements between two consecutive images of a deformation process. Values of strain and displacements for consecutive deformations are added, this way solving convergence problems in the DIC algorithm when large deformations are investigated. The method developed is used to investigate the strain distribution within 1 mm of the crack tip in a particulate composite solid (propellant) using microscopic visualization of the deformation process.

A new serial pooling method of shifted tree ring blocks to construct millennia long tree ring isotope chronologies with annual resolution.

PubMed

Boettger, Tatjana; Friedrich, Michael

2009-03-01

The study presents a new serial pooling method of shifted tree ring blocks for the building of isotope chronologies. This method combines the advantages of traditional 'serial' and 'intertree' pooling, and can be recommended for the construction of sub-regional long isotope chronologies with sufficient replication, and on annual resolution, especially for the case of extremely narrow tree rings. For Scots pines (Pinus sylvestris L., Khibiny Low Mountains, NW Russia) and Silver firs (Abies alba Mill., Franconia, Southern Germany), serial pooling of five consecutive tree rings seems appropriate because the species- and site-specific particularities lead to blurs of climate linkages in their tree rings for the period up to ca. five years back. An equivalent to a five-year running means that curve gained on the base annual data sets of single trees can be derived from the analysis of yearly shifted five-year blocks of consecutive tree rings, and therefore, with approximately 20% of the expense. Good coherence of delta(13)C- and delta(18)O-values between calculated means of annual total rings or late wood data and means of five-year blocks of consecutive total tree rings analysed experimentally on most similar material confirms this assumption.

Comparison of Floseal(r) and electrocautery in hemostasis after total knee arthroplasty

PubMed Central

Helito, Camilo Partezani; Gobbi, Riccardo Gomes; Castrillon, Lucas Machado; Hinkel, Betina Bremer; Pécora, José Ricardo; Camanho, Gilberto Luis

2013-01-01

Objective To evaluate whether hemostasis with eletrocauterization in comparison with Floseal(r) leads to different bleeding rates during total knee arthroplasty. Methods A comparative study was performed between two groups: group with ten consecutive total knee arthroplasties with Floseal(r) used as hemostatic method and control group with ten consecutive total knee arthroplasties with eletrocauterization as hemostatic method. Bleeding parameters such as debit of the drain, liquid infusion and blood transfusion rate were recorded. Results Floseal(r) group received less blood transfusion, less liquid infusion and lower drainage in absolute numbers compared to the control group. However, no parameter was statistically significant. Conclusion Hemostasis with Floseal(r) is as effective as hemostasis with eletrocauterization, what makes it a viable alternative to patients with contraindication to electric scalpel use. Level of Evidence II, Prospective Comparative Study. PMID:24453689

Supportive interventions for enhancing dietary intake in malnourished or nutritionally at-risk adults: a systematic review of nonrandomised studies.

PubMed

Kimber, K; Gibbs, M; Weekes, C E; Baldwin, C

2015-12-01

Supportive interventions for enhancing dietary intake in malnourished or nutritionally at risk adults are frequently recommended. A recent systematic review of randomised controlled trials identified limited and poor quality evidence to support their use. Observational studies have been shown to compliment and extend their evidence. This review aimed to synthesise evidence from nonrandomised studies aiming to improve nutritional intake in nutritionally vulnerable individuals and to describe their effects on cost, nutritional, clinical and patient centred outcomes. Systematic searches of 10 electronic databases were undertaken to May 2013. Reference lists of identified studies and systematic reviews were scrutinised and hand searching of relevant meeting abstracts was undertaken. Titles and abstracts were reviewed, data extracted by two research-ers working independently and summarised using a structured narrative format. Forty-one studies (n = 3751 participants) were identified for inclusion. Interventions identified included changes to the organisation of nutritional care (n = 15), changes to the feeding environment (n = 11), modification to meals (n = 6), supplementation of meals (n = 7) and recipients of home delivered meals (n = 2). Eighteen of 23 studies reported improvements in nutritional intake; however, effects on nutritional status, clinical outcomes and costs were reported in few studies and findings were inconsistent. Eighteen studies reported patient experience, highlighting benefits to nutritional status most commonly as judged by the carers but the methods used lacked rigour. This systematic review describes a range of interventions that may be implemented in clinical practice. A limited range of outcomes are reported and it is difficult to draw any meaningful conclusions on the effect of the different methods. © 2015 The British Dietetic Association Ltd.

Application of fault detection techniques to spiral bevel gear fatigue data

NASA Technical Reports Server (NTRS)

Zakrajsek, James J.; Handschuh, Robert F.; Decker, Harry J.

1994-01-01

Results of applying a variety of gear fault detection techniques to experimental data is presented. A spiral bevel gear fatigue rig was used to initiate a naturally occurring fault and propagate the fault to a near catastrophic condition of the test gear pair. The spiral bevel gear fatigue test lasted a total of eighteen hours. At approximately five and a half hours into the test, the rig was stopped to inspect the gears for damage, at which time a small pit was identified on a tooth of the pinion. The test was then stopped an additional seven times throughout the rest of the test in order to observe and document the growth and propagation of the fault. The test was ended when a major portion of a pinion tooth broke off. A personal computer based diagnostic system was developed to obtain vibration data from the test rig, and to perform the on-line gear condition monitoring. A number of gear fault detection techniques, which use the signal average in both the time and frequency domain, were applied to the experimental data. Among the techniques investigated, two of the recently developed methods appeared to be the first to react to the start of tooth damage. These methods continued to react to the damage as the pitted area grew in size to cover approximately 75% of the face width of the pinion tooth. In addition, information gathered from one of the newer methods was found to be a good accumulative damage indicator. An unexpected result of the test showed that although the speed of the rig was held to within a band of six percent of the nominal speed, and the load within eighteen percent of nominal, the resulting speed and load variations substantially affected the performance of all of the gear fault detection techniques investigated.

Palyno-morphological characteristics of gymnosperm flora of pakistan and its taxonomic implications with LM and SEM methods.

PubMed

Khan, Raees; Ul Abidin, Sheikh Zain; Ahmad, Mushtaq; Zafar, Muhammad; Liu, Jie; Amina, Hafiza

2018-01-01

The present study is intended to assess gymnosperms pollen flora of Pakistan using Light Microscope (LM) and Scanning Electron Microscopy (SEM) for its taxonomic significance in identification of gymnosperms. Pollens of 35 gymnosperm species (12 genera and five families) were collected from its various distributional sites of gymnosperms in Pakistan. LM and SEM were used to investigate different palyno-morphological characteristics. Five pollen types (i.e., Inaperturate, Monolete, Monoporate, Vesiculate-bisaccate and Polyplicate) were observed. Six In equatorial view seven types of pollens were observed, in which ten species were sub-angular, nine species were Traingular, six species were Perprolate, three species were Rhomboidal, three species were semi-angular, two species were rectangular and two species were prolate. While five types of pollen were observed in polar view, in which ten species were Spheroidal, nine species were Angular, eight were Interlobate, six species were Circular, two species were Elliptic. Eighteen species has rugulate and 17 species has faveolate ornamentation. Eighteen species has verrucate and 17 have gemmate type sculpturing. The data was analysed through cluster analysis. The study showed that these palyno-morphological features have significance value in classification and identification of gymnosperms. Based on these different palyno-morphological features, a taxonomic key was proposed for the accurate and fast identifications of gymnosperms from Pakistan. © 2017 Wiley Periodicals, Inc.

The Stability of DSM Personality Disorders over Twelve to Eighteen Years

PubMed Central

Nestadt, Gerald; Di, Chongzhi; Samuels, J F; Bienvenu, O J; Reti, I M; Costa, P; Eaton, William W; Bandeen-Roche, Karen

2009-01-01

Background Stability of personality disorders is assumed in most nomenclatures; however, the evidence for this is limited and inconsistent. The aim of this study is to investigate the stability of DSM-III personality disorders in a community sample of eastern Baltimore residents unselected for treatment. Methods Two hundred ninety four participants were examined on two occasions by psychiatrists using the same standardized examination twelve to eighteen years apart. All the DSM-III criteria for personality disorders were assessed. Item-response analysis was adapted into two approaches to assess the agreement between the personality measures on the two occasions. The first approach estimated stability in the underlying disorder, correcting for error in trait measurement, and the second approach estimated stability in the measured disorder, without correcting for item unreliability. Results Five of the ten personality disorders exhibited moderate stability in individuals: antisocial, avoidant, borderline, histrionic, and schizotypal. Associated estimated ICCs for stability of underlying disorder over time ranged between approximately 0.4 and 0.7–0.8. A sixth disorder, OCPD, exhibited appreciable stability with estimated ICC of approximately 0.2–0.3. Dependent, narcissistic, paranoid, and schizoid disorders were not demonstrably stable. Conclusions The findings suggest that six of the DSM personality disorder constructs themselves are stable, but that specific traits within the DSM categories are both of lesser importance than the constructs themselves and require additional specification. PMID:19656527

[Effects of different amendments on contents of phenolic acids and specific microbes in rhizosphere of Pseudostellaria heterophylla.

PubMed

Wu, Lin Kun; Wu, Hong Miao; Zhu, Quan; Chen, Jun; Wang, Juan Ying; Wu, Yan Hong; Lin, Sheng; Lin, Wen Xiong

2016-11-18

Pseudostellaria heterophylla is a perennial herbaceous plant in the family Caryophyllaceae. The tuberous roots of P. heterophylla are highly valued in traditional Chinese medicine and have a high market demand. However, extended monoculture of P. heterophylla results in a significant decline in the biomass and quality, and escalates disease and pest problems. Therefore, it is important to understand the underlying mechanism and biocontrol methods for consecutive monoculture problems. With "Zheshen 2" as an experimental material, the changes in the contents of main nutrients in soil, phenolic acids and specific microbes under monoculture and different amendments were analyzed by using high performance liquid chromatography (HPLC) and qPCR. The results showed that consecutive monoculture of P. heterophylla led to a decrease in yield by 43.5% while the microbial fertilizer treatment and the paddy-upland rotation could relieve the consecutive monoculture problems. Available nitrogen, available phosphorus, available potassium and total potassium were significantly higher in the consecutively monocultured soils than in the newly planted soils. But consecutive monoculture resulted in soil acidification. HPLC analysis showed that conse-cutive monoculture of this plant did not lead to a consistent accumulation of soil phenolic acids. At middle stage of root expansion and at harvest stage, most of phenolic acids were even higher in the newly planted soils than in the consecutively monocultured soils. Furthermore, qPCR analysis showed that the amounts of three specific pathogens identified previously (i.e. Fusarium oxysporum, Talaromyces helicus, Kosakonia sacchari) were significantly higher in the consecutively monocultured soils than in the newly planted soils. However, the microbial fertilizer treatment and the paddy-upland rotation resulted in a significant decline in the population of these specific pathogens and improved the soil environment. In conclusion, the consecutive monoculture problems of P. heterophylla may be due to the rapid proliferation of host-specific pathogens, rather than the deficiency of soil nutrients and the autotoxicity of allelochemicals in root exudates. The results in this study could provide the theoretical basis to explore the underlying mechanism of replanting disease of P. heterophylla and its biocontrol strategies.

Inheritance of congenital cataracts and microphthalmia in the Miniature Schnauzer.

PubMed

Gelatt, K N; Samuelson, D A; Bauer, J E; Das, N D; Wolf, E D; Barrie, K P; Andresen, T L

1983-06-01

Congenital cataracts and microphthalmia in the Miniature Schnauzer were inherited as an autosomal recessive trait. Eighteen matings of affected X affected Miniature Schnauzers resulted in 87 offspring with congenital cataracts and microphthalmia (49 males/38 females). Two matings of congenital cataractous and microphthalmic Miniature Schnauzers (2 females) X a normal Miniature Schnauzer (1 male) yielded 11 clinically normal Miniature Schnauzers (7 males/4 females). Eighteen matings of congenital cataractous and microphthalmic Miniature Schnauzers (6 males) X carrier Miniature Schnauzers (9 females) produced 81 offspring; 39 exhibited congenital cataracts and microphthalmia (20 males/19 females) and 42 had clinically normal eyes (17 males/25 females).

Repair of long-bone fractures in cats and small dogs with the Unilock mandible locking plate system.

PubMed

Voss, K; Kull, M; Hässig, M; Montavon, P

2009-01-01

To retrospectively evaluate stabilisation of long-bone fractures in cats and small dogs using the Unilock system. Medical histories and radiographs of consecutive patients with long-bone fractures stabilised with the Unilock system were reviewed. Cases with follow-up radiographs taken at least four weeks postoperatively were included. Signalment of the patient, fracture localisation and type, primary fracture repair or revision surgery, single or double plating, and complications for each patient were noted. Additionally, implant size, number of screws, number of cortices engaged with screws, and number of empty holes across the fracture were evaluated in fractures where a single plate had been applied. Eighteen humeral, 18 radial, 20 femoral, and 10 tibial fractures were treated. The Unilock system was used for primary repair in 44 fractures and for revision surgery in 22 fractures. Two plates were applied in 17 fractures, and a single plate was applied in 49 fractures. Follow-up radiographs were taken four to 109 weeks postoperatively. Complications were seen in 12 animals and 13 fractures (19.7%). Fixation failure occurred in seven fractures (10.6%). Cases with a single plate that suffered fixation failure had thinner screws in relation to bone diameter than cases with double plates, and more screws in a main fragment than those without fixation failure. The Unilock system is a suitable implant for fracture fixation of long bones in cats and small dogs.

Three nights leg thermal therapy could improve sleep quality in patients with chronic heart failure.

PubMed

Sawatari, Hiroyuki; Nishizaka, Mari K; Miyazono, Mami; Ando, Shin-Ichi; Inoue, Shujiro; Takemoto, Masao; Sakamoto, Takafumi; Goto, Daisuke; Furumoto, Tomoo; Kinugawa, Shintaro; Hashiguchi, Nobuko; Rahmawati, Anita; Chishaki, Hiroaki; Ohkusa, Tomoko; Magota, Chie; Tsutsui, Hiroyuki; Chishaki, Akiko

2018-02-01

Sleep quality is often impaired in patients with chronic heart failure (HF), which may worsen their quality of life and even prognosis. Leg thermal therapy (LTT), topical leg warming, has been shown to improve endothelial function, oxidative stress, and cardiac function in patients with HF. However, its short-term influence to sleep quality has not been evaluated in HF patients. Eighteen of 23 patients with stable HF received LTT (15 min of warming at 45 °C and 30 min of insulation) at bedtime for 3 consecutive nights and 5 patients served as control. Subjective sleep quality was evaluated by St. Mary's Hospital Sleep Questionnaire, Oguri-Shirakawa-Azumi Sleep Inventory, and Epworth sleepiness scale, and also objectively evaluated by polysomnography. LTT significantly improved subjective sleep quality indicated by depth of sleep (p < 0.01), sleep duration (p < 0.05), number of awaking (p < 0.01), nap duration (p < 0.01), sleep quality (p < 0.05), and sleep satisfaction (p < 0.05). It was also objectively affirmed by a slight but significant decrease of sleep stage N1 (p < 0.01), and increase in sleep stage N2 (p < 0.05). No significant changes occurred in the controls. Hence, the short-term LTT could improve subjective and objective sleep quality in patients with HF. LTT can be a complimentary therapy to improve sleep quality in these patients.

The pathophysiological mechanism of fluid retention in advanced cancer patients treated with docetaxel, but not receiving corticosteroid comedication.

PubMed

Béhar, A; Pujade-Lauraine, E; Maurel, A; Brun, M D; Chauvin, F F; Feuilhade de Chauvin, F; Oulid-Aissa, D; Hille, D

1997-06-01

Fluid retention is a phenomenon associated with taxoids. The principal objective of this study was to investigate the pathophysiological mechanism of docetaxel-induced fluid retention in advanced cancer patients. Docetaxel was administered as a 1 h intravenous infusion every 3 weeks, for at least 4-6 consecutive cycles, to patients with advanced breast (n = 21) or ovarian (n = 3) carcinoma, who had received previous chemotherapy, 21 for advanced disease. Phase II clinical trials have shown that 5 day corticosteroid comedication, starting 1 day before docetaxel infusion, significantly reduces the incidence and severity of fluid retention. This prophylactic corticosteroid regimen is currently recommended for patients receiving docetaxel but was not permitted in this study because of its possible interference with the underlying pathophysiology of the fluid retention. Fluid retention occurred in 21 of the 24 patients but was mainly mild to moderate, with only five patients experiencing severe fluid retention. Eighteen patients received symptomatic flavonoid treatment, commonly prescribed after the last cycle. Specific investigations for fluid retention confirmed a relationship between cumulative docetaxel dose and development of fluid retention. Capillary filtration test analysis showed a two-step process for fluid retention generation, with progressive congestion of the interstitial space by proteins and water starting between the second and the fourth cycle, followed by insufficient lymphatic drainage. A vascular protector such as micronized diosmine hesperidine with recommended corticosteroid premedication and benzopyrones may be useful in preventing and treating docetaxel-induced fluid retention.

Twice-Daily versus Once-Daily Pramipexole Extended Release Dosage Regimens in Parkinson's Disease.

PubMed

Yun, Ji Young; Kim, Young Eun; Yang, Hui-Jun; Kim, Han-Joon; Jeon, Beomseok

2017-01-01

This open-label study aimed to compare once-daily and twice-daily pramipexole extended release (PER) treatment in Parkinson's disease (PD). PD patients on dopamine agonist therapy, but with unsatisfactory control, were enrolled. Existing agonist doses were switched into equivalent PER doses. Subjects were consecutively enrolled into either once-daily-first or twice-daily-first groups and received the prescribed amount in one or two, respectively, daily doses for 8 weeks. For the second period, subjects switched regimens in a crossover manner. The forty-four patients completed a questionnaire requesting preference during their last visit. We measured the UPDRS-III, Hoehn and Yahr stages (H&Y) in medication-on state, Parkinson's disease sleep scale (PDSS), and Epworth Sleepiness Scale. Eighteen patients preferred a twice-daily regimen, 12 preferred a once-daily regimen, and 14 had no preference. After the trial, 14 subjects wanted to be on a once-daily regimen, 25 chose a twice-daily regimen, and 5 wanted to maintain the prestudy regimen. Main reasons for choosing the twice-daily regimen were decreased off-duration, more tolerable off-symptoms, and psychological stability. The mean UPDRS-III, H&Y, and PDSS were not different. Daytime sleepiness was significantly high in the once-daily regimen, whereas nocturnal hallucinations were more common in the twice-daily. Multiple dosing should be considered if once-daily dosing is unsatisfactory. This study is registered as NCT01515774 at ClinicalTrials.gov.

The prevalence of fibromyalgia and its relation with headache characteristics in episodic migraine.

PubMed

Küçükşen, Sami; Genç, Emine; Yılmaz, Halim; Sallı, Ali; Gezer, İlknur Albayrak; Karahan, Ali Yavuz; Salbaş, Ender; Cingöz, Havva Turaç; Nas, Ömer; Uğurlu, Hatice

2013-07-01

The objective of this study was to assess the prevalence of fibromyalgia (FM) in patients with episodic migraine and to evaluate the relationship between migraine characteristics and FM. One hundred and eighteen consecutive patients (mean age = 38 years, 75% women) fulfilling the International Classification of Headache Disorders-II criteria for migraine with (n = 22) and without (n = 96) aura from an outpatient headache clinic of a university hospital were evaluated. The diagnosis of FM was made based on the 1990 American College of Rheumatology classification criteria. Participants completed some self-administered questionnaires ascertaining sociodemographics, headache severity, frequency and duration, headache-related disability (Headache Impact Test [HIT-6]) and Migraine Disability Assessment Scale, widespread musculoskeletal pain (visual analog scale), depression (Beck depression inventory), anxiety (Beck anxiety inventory), sleep quality (Pittsburgh Sleep Quality Index), fatigue (Multidimensional Assessment of Fatigue), and quality of life (Short Form-36 Health Survey [SF-36]). In patients with FM, the tender point count and the Fibromyalgia Impact Questionnaire were employed. FM was diagnosed in 37 (31.4%) of the patients. FM comorbidity was equally distributed across patients with and without aura. Severity of migraine headache, HIT-6, and anxiety were especially associated with FM comorbidity. Patients suffering from migraine plus FM reported lower scores on all items of the SF-36. This study indicates that the assessment and management of coexisting FM should be taken into account in the assessment and management of migraine, particularly when headache is severe or patients suffer from widespread musculoskeletal pain.

In Situ Venous Bypass for Chronic Hand Ischemia: A Review of 25 Cases in 23 Patients.

PubMed

Cornejo, Agustin; Neaman, Keith C; Srinivasan, Ramesh C; Mithani, Suhail K; Pederson, William C

2016-06-01

Chronic ischemia of the hand in the setting of atherosclerotic disease is a challenging problem that leads to serial amputations and significant morbidity. Salvage using an in situ venous bypass has been described. In selected cases, leaving the vein in situ for bypass allows a good size match for anastomosis at the wrist or palmar arch. Due to the rarity of the condition, there is a paucity of data regarding the efficacy of this technique. Outcomes in 23 consecutive patients that underwent a total of 25 in situ vein grafts over a 16-year period were retrospectively reviewed. Eighteen were men and 5 were women with a mean age of 61 years. Target vessels at the wrist or palmar arch were identified on preoperative vascular imaging. The cephalic vein (n = 19, 76%) was most commonly used followed by the basilic vein (n = 6, 24%). Overall patency rate at a mean follow-up period of 12.1 months was 92%. Success as determined by both symptomatic improvement and resolution of the ischemic changes or toleration of revision amputation was achieved in 16 (64%) cases. Postoperative complications occurred in ten cases (40 %). Progression of ischemia occurred in 7 cases (28 %) and 3 (12 %) of these cases required a hand amputation. In situ vein grafts in the upper extremity offer good short-term patency rates and can be used for salvage of chronic hand ischemia.

Electrolyzed Saline Irrigation for Elimination of Bacterial Colonization in the Empyema Space.

PubMed

Nakamoto, Kembu; Takeshige, Motohiro; Fujii, Toshiyuki; Hashiyada, Hiroshi; Yoshida, Kazuya; Kawamoto, Sadahiro

2016-12-01

The empyema space is refractory to elimination of bacterial colonization. Electrolyzed saline (ES) was used as intra-pleural irrigation for rapid disinfection of the empyema space. Twenty consecutive patients with para-pneumonic empyema were reviewed in this study from 2007 to 2015. The empyema space was irrigated by miniaturized thoracoscopic surgery (mini VATS), and the efficacy and safety of the use of ES were evaluated. Sixteen patients were male and four were female, with a mean age of 66.5 ± 9.5 y (27-90 y). Bacterial cultures of the purulent effusions from all 20 patients had positive results. Seventeen patients subsequently underwent continuous catheter irrigation and drainage. No patient had chest pain during ES irrigation. Fever duration after mini VATS was 2.8 ± 1.8 d (0-5 d). Catheter indwelling time was 10.3 ± 7.2 d (3-33 d). Inflammatory markers significantly improved (p < 0.05) within a week after mini VATS. Eighteen patients achieved pleural disinfection, and two patients had residual pathogens, one of whom later died of lung abscess. Space closure was successful in 14 patients. No patient underwent subsequent open drainage. Nineteen (95%) patients were discharged from the hospital. This treatment was successful in 18 (90%) patients, and one (5.6%) patient experienced recurrence. The ES irrigation facilitates the rapid disinfection and closure of the empyema space.

Nonoperative management for patients with grade IV blunt hepatic trauma.

PubMed

Zago, Thiago Messias; Tavares Pereira, Bruno Monteiro; Araujo Calderan, Thiago Rodrigues; Godinho, Mauricio; Nascimento, Bartolomeu; Fraga, Gustavo Pereira

2012-08-22

The treatment of complex liver injuries remains a challenge. Nonoperative treatment for such injuries is increasingly being adopted as the initial management strategy. We reviewed our experience, at a University teaching hospital, in the nonoperative management of grade IV liver injuries with the intent to evaluate failure rates; need for angioembolization and blood transfusions; and in-hospital mortality and complications. This is a retrospective analysis conducted at a single large trauma centre in Brazil. All consecutive, hemodynamically stable, blunt trauma patients with grade IV hepatic injury, between 1996 and 2011, were analyzed. Demographics and baseline characteristics were recorded. Failure of nonoperative management was defined by the need for surgical intervention. Need for angioembolization and transfusions, in-hospital death, and complications were also assessed Eighteen patients with grade IV hepatic injury treated nonoperatively during the study period were included. The nonoperative treatment failed in only one patient (5.5%) who had refractory abdominal pain. However, no missed injuries and/or worsening of bleeding were observed during the operation. None of the patients died nor need angioembolization. No complications directly related to the liver were observed. Unrelated complications to the liver occurred in three patients (16.7%); one patient developed a tracheal stenosis (secondary to tracheal intubation); one had pleural effusion; and one developed an abscess in the pleural cavity. The hospital length of stay was on average 11.56 days. In our experience, nonoperative management of grade IV liver injury for stable blunt trauma patients is associated with high success rates without significant complications.

Rate of recurrence in Indian patients presenting with acute pancreatitis and identification of chronicity on follow up: Possible risk factors for progression.

PubMed

Kalaria, Rishikesh; Abraham, Philip; Desai, Devendra C; Joshi, Anand; Gupta, Tarun

2018-03-01

To study the profile and long-term outcome of Indian patients presenting with acute pancreatitis and the possible risk factors for progression. Consecutive patients with acute or recurrent acute pancreatitis seen in our department during July 2013 to December 2014 were included. Details of past episodes were collected and patients were followed up till March 2015. In the 97 patients included (mean age 47.2 [SD 16.9] years; 74 men), gallstones (37 [38.1%]) and alcohol (19 [19.6%]) were the major identified etiologies; the idiopathic (31 [32%]) group constituted a third of patients. Recurrences were more common with idiopathic etiology (14 patients out of 30 had recurrences [46.7%]) as compared to alcoholic (5 out of 19 [26.3%]) and biliary (4 out of 37 [10.8%]) pancreatitis and with mild index episode. Following the episode of acute pancreatitis, identification of chronic pancreatitis was more common with alcoholic (6 out of 18 [33%]) and idiopathic (9 out of 30 [30%]) etiology as compared to other etiologies. Longer duration of follow up, but not number of recurrent episodes, was associated with identification of chronicity in patients presenting as acute pancreatitis. Out of 97 patients with acute pancreatitis, 27 (27.8%) developed recurrences with risk factors being idiopathic etiology and mild index episode. Eighteen of 97 (18.6%) patients had evidence of chronic pancreatitis on follow up, risk factors being the alcoholic and idiopathic varieties, and longer duration of follow up.

Anal cytology and p16 immunostaining for screening anal intraepithelial neoplasia in HIV-positive and HIV-negative men who have sex with men: a cross-sectional study.

PubMed

Arora, Rahul; Pandhi, Deepika; Mishra, Kiran; Bhattacharya, Sambit N; Yhome, Vizodilhou A

2014-09-01

Summary Akin to cervical cancer in sexually-active women, men who have sex with men (MSM) are predisposed to anal cancers, especially those with HIV co-infection. This cross-sectional study endeavored to assess the prevalence of anal dysplasia using Pap smears and p16 immunostaining amongst Indian MSM. A total of 31 consecutive HIV-positive and 34 HIV-negative MSM, from a cohort of sexually transmitted infection clinic attendees, underwent anal cytological evaluation with Pap smear and p16 staining. Chi square test and coefficient of correlation were used for comparison. Eighteen (27.7%) had abnormal anal cytology; increased in HIV-positive as compared to HIV-negative men (35% versus 20%, p = 0.180). Similarly, both low-grade (25.8% versus 17.6%) and high-grade lesions (8.3% versus 4.8%) were comparable in HIV-positive and HIV-negative group. Thirteen (20%) smears were p16-positive with a sensitivity and specificity for anal dysplasia of 72.3% and 100%, respectively. Anal cytology may be used to screen for anal dysplasia in MSM irrespective of HIV status. Furthermore, the addition of p16, with greater specificity for high-grade lesions, may improve diagnostic accuracy especially for high-grade lesions. A larger study to further corroborate these observations is warranted. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Management of acute bursitis: outcome study of a structured approach.

PubMed Central

Stell, I M

1999-01-01

In patients with septic bursitis the indications for admission and surgical intervention remain unclear, and practice has varied widely. The effectiveness of a conservative outpatient based approach was assessed by an outcome study in a prospective case series. Consecutive patients attending an emergency department with acute swelling of the olecranon or prepatellar bursa were managed according to a structured approach, subjective and objective outcomes being assessed after two to three days, and subsequently as required until clinical discharge. Long-term outcomes were assessed by telephone follow-up for up to eighteen months. 47 patients were included in the study: 22 had septic bursitis, 15 of the olecranon bursa and 7 of the prepatellar bursa. The mean visual analogue pain scores of those with septic bursitis improved from 4.8 at presentation to 1.7 at first follow-up for olecranon bursitis, and from 3.8 to 2.7 for prepatellar bursitis. Symptoms improved more slowly for patients with non-septic bursitis. No patients were admitted initially, but 2 were admitted (two days each) after the first follow-up appointment. One patient had incision and drainage on the third attendance, and 3 patients developed discharging sinuses, which all healed spontaneously. All patients made a good long-term symptomatic recovery and all could lean on the elbow or kneel by the end of the follow-up period. The management protocol, with specific criteria for admission and surgical intervention, thus produced good results with little need for operation or admission. PMID:10692903

Coracoclavicular stabilization using a suture button device for Neer type IIB lateral clavicle fractures.

PubMed

Cho, Chul-Hyun; Jung, Jae-Hoon; Kim, Beom-Soo

2017-05-01

The purpose of this study was to evaluate the radiologic and clinical outcomes of coracoclavicular (CC) stabilization using a suture button device for Neer type IIB lateral clavicle fractures. Eighteen consecutive patients with Neer type IIB fractures were treated with CC stabilization using a TightRope device (Arthrex, Naples, FL, USA). The mean follow-up period was 46.6 months (range, 24-75 months). Radiologic outcomes were assessed using serial plain radiographs. Clinical outcomes were evaluated using the visual analog scale pain score; University of California, Los Angeles score; American Shoulder and Elbow Surgeons score; and subjective shoulder value. Intraoperative and postoperative complications were also evaluated. Of the 18 cases, 17 (94.4%) showed complete bony union. The mean final visual analog scale pain score was 1.1; University of California, Los Angeles score, 31.3; American Shoulder and Elbow Surgeons score, 88.6; and subjective shoulder value, 88.5%. Four complications were observed: (1) intraoperative coracoid process fracture, (2) nonunion, (3) delayed union, and (4) shoulder stiffness. The case with a coracoid process fracture during coracoid tunnel generation was converted to the K-wire tension band technique. CC stabilization using a suture button device for Neer type IIB lateral clavicle fractures yielded satisfactory radiologic and clinical outcomes. The major advantage of this technique is that implant removal is not required. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Severe hypertriglyceridaemia during therapy for childhood acute lymphoblastic leukaemia.

PubMed

Bhojwani, Deepa; Darbandi, Rashid; Pei, Deqing; Ramsey, Laura B; Chemaitilly, Wassim; Sandlund, John T; Cheng, Cheng; Pui, Ching-Hon; Relling, Mary V; Jeha, Sima; Metzger, Monika L

2014-10-01

Asparaginase and steroids can cause hypertriglyceridaemia in children with acute lymphoblastic leukaemia (ALL). There are no guidelines for screening or management of patients with severe hypertriglyceridaemia (>1000mg/dL) during ALL therapy. Fasting lipid profiles were obtained prospectively at four time-points for 257 children consecutively enrolled on a frontline ALL study. Risk factors were evaluated by the exact chi-square test. Details of adverse events and management of hypertriglyceridaemia were extracted retrospectively. Eighteen of 257 (7%) patients developed severe hypertriglyceridaemia. Older age and treatment with higher doses of asparaginase and steroids on the standard/high-risk arm were significant risk factors. Severe hypertriglyceridaemia was not associated with pancreatitis after adjustment for age and treatment arm or with osteonecrosis after adjustment for age. However, patients with severe hypertriglyceridaemia had a 2.5-3 times higher risk of thrombosis compared to patients without, albeit the difference was not statistically significant. Of the 30 episodes of severe hypertriglyceridaemia in 18 patients, seven were managed conservatively while the others with pharmacotherapy. Seventeen of 18 patients continued to receive asparaginase and steroids. Triglyceride levels normalised after completion of ALL therapy in all 12 patients with available measurements. Asparaginase- and steroid-induced transient hypertriglyceridaemia can be adequately managed with dietary modifications and close monitoring without altering chemotherapy. Patients with severe hypertriglyceridaemia were not at increased risk of adverse events, with a possible exception of thrombosis. The benefit of pharmacotherapy in decreasing symptoms and potential complications requires further investigation. Copyright © 2014 Elsevier Ltd. All rights reserved.

Outcomes of Hematopoietic Stem Cell Transplantation at a Limited-Resource Center in Mexico Are Comparable to Those in Developed Countries.

PubMed

Leon Rodriguez, Eucario; Rivera Franco, Monica M

2017-11-01

The first hematopoietic stem cell transplantation (HSCT) in Mexico was performed at our institution in 1980. Eighteen years later, our HSCT program was restructured to reduce transplantation-related mortality (TRM) and improve overall survival (OS). The aim of this study was to describe outcomes of HSCT at our institution despite limited resources. Consecutive patients undergoing HSCT, from November 1998 to February 2017, were retrospectively analyzed at the National Institute of Medical Sciences and Nutrition Salvador Zubiran in Mexico City. Three hundred nine HSCT (59% autologous) were performed in 275 patients. From 114 patients (41%) undergoing an allogeneic HSCT, acute and chronic graft-versus-host disease developed in 21% and 33%, respectively. From the entire cohort, 98 patients relapsed after HSCT and at the last follow-up, 183 (67%) patients were alive. The 100-day TRM rates were 1.9% and 6.1% for autologous and allogeneic HSCT, respectively. Ten-year relapse/progression-free survival were 54% and 65%, for autologous and allogeneic HSCT, respectively. Ten-year OS rates in autologous and allogeneic HSCT were 61% and 57%, respectively. We highlight that HSCT is feasible in developing countries, despite financial and infrastructure limitations, and conclude that our results are comparable to international literature and probably better in terms of TRM and cost-effectiveness. Copyright © 2017 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

The repair of umbilical hernia in cirrhotic patients: 18 consecutive case series in a single institute.

PubMed

Yu, Byung Chul; Chung, Min; Lee, Giljae

2015-08-01

Traditionally, the surgical repair of umbilical hernia in cirrhotic patients with ascites is avoided because of a significant recurrence rate and perioperative morbidity/mortality. However, recent reports recommend early elective surgery in these patients because surgery-related complications can be reduced with minimally invasive surgery and development of perioperative patient care. The current study was conducted to analyze safety and feasibility of umbilical hernia repairs performed in a single institute. A single center retrospective analysis of patients' data was conducted. Eighteen patients with umbilical hernia accompanied by liver cirrhosis underwent hernia repair in the period between 2005 and 2012. The charts of these patients were reviewed and demographic data, postoperative complications, and recurrence were recorded. Eleven males and seven females with a mean age of 62.9 years were analyzed. Two of the patients were classified as Child's class A, 11 as Child's class B, and five as Child's class C. Four patients underwent emergency surgery because of perforations in the hernia sac in two cases and incarcerated hernias in the other two cases. Of the 18 patients who underwent surgery, four (22%) experienced a recurrence, three (17%) developed edema at the surgical sites, one (5%) experienced hepatic coma, and one (5%) showed postoperative variceal hemorrhage. All of these events occurred after emergency surgery. In contrast to traditional concepts, early and elective repair of umbilical hernia can be performed easily and safely in cirrhotic patients.

40 CFR 63.11517 - What are my monitoring requirements?

Code of Federal Regulations, 2010 CFR

2010-07-01

...) of this section. (1) Daily Method 9 testing for welding, Tier 2 or 3. Perform visual determination of... to the requirements of paragraph (d)(1) of this section. (3) Monthly Method 9 testing for welding... Method 22 testing for welding, Tier 2 or 3. If, after two consecutive months of testing, the average of...

Method of Breast Reconstruction Determines Venous Thromboembolism Risk Better Than Current Prediction Models

PubMed Central

Patel, Niyant V.; Wagner, Douglas S.

2015-01-01

Background: Venous thromboembolism (VTE) risk models including the Davison risk score and the 2005 Caprini risk assessment model have been validated in plastic surgery patients. However, their utility and predictive value in breast reconstruction has not been well described. We sought to determine the utility of current VTE risk models in this population and the VTE rate observed in various methods of breast reconstruction. Methods: A retrospective review of breast reconstructions by a single surgeon was performed. One hundred consecutive transverse rectus abdominis myocutaneous (TRAM) patients, 100 consecutive implant patients, and 100 consecutive latissimus dorsi patients were identified over a 10-year period. Patient demographics and presence of symptomatic VTE were collected. 2005 Caprini risk scores and Davison risk scores were calculated for each patient. Results: The TRAM reconstruction group was found to have a higher VTE rate (6%) than the implant (0%) and latissimus (0%) reconstruction groups (P < 0.01). Mean Davison risk scores and 2005 Caprini scores were similar across all reconstruction groups (P > 0.1). The vast majority of patients were stratified as high risk (87.3%) by the VTE risk models. However, only TRAM reconstruction patients demonstrated significant VTE risk. Conclusions: TRAM reconstruction appears to have a significantly higher risk of VTE than both implant and latissimus reconstruction. Current risk models do not effectively stratify breast reconstruction patients at risk for VTE. The method of breast reconstruction appears to have a significant role in patients’ VTE risk. PMID:26090287

Impact of States’ Nurse Work Hour Regulations on Overtime Practices and Work Hours among Registered Nurses

PubMed Central

Bae, Sung-Heui; Yoon, Jangho

2014-01-01

Objectives To examine the degree to which states’ work hour regulations for nurses—policies regarding mandatory overtime and consecutive work hours—decrease mandatory overtime practice and hours of work among registered nurses. Methods We analyzed a nationally representative sample of registered nurses from the National Sample Survey of Registered Nurses for years 2004 and 2008. We obtained difference-in-differences estimates of the effect of the nurse work hour policies on the likelihood of working mandatory overtime, working more than 40 hours per week, and working more than 60 hours per week for all staff nurses working in hospitals and nursing homes. Principal Findings The mandatory overtime and consecutive work hour regulations were significantly associated with 3.9 percentage-point decreases in the likelihood of working overtime mandatorily and 11.5 percentage-point decreases in the likelihood of working more than 40 hours per week, respectively. Conclusions State mandatory overtime and consecutive work hour policies are effective in reducing nurse work hours. The consecutive work hour policy appears to be a better regulatory tool for reducing long work hours for nurses. PMID:24779701

Does Insulin Like Growth Factor-1 (IGF-1) Deficiency Have a "Protective" Role in the Development of Diabetic Retinopathy in Thalassamia Major Patients?

PubMed

De Sanctis, Vincenzo; Incorvaia, Carlo; Soliman, Ashraf T; Candini, Giancarlo; Pepe, Alessia; Kattamis, Christos; Soliman, Nada A; Elsedfy, Heba; Kholy, Mohamed El

2015-01-01

Both insulin and IGF-1 have been implicated in the control of retinal endothelial cell growth, neovascularization and diabetic retinopathy. Recent findings have established an essential role for IGF-1 in angiogenesis and demonstrated a new target for control of retinopathy that explains why diabetic retinopathy initially increases with the onset of insulin treatment. This cross-sectional study was designed to give insights into relationship between Insulin-Growth-Factor 1 (IGF-1) levels and diabetic retinopathy (DR) in a sample of thalassemia major (TM) patients with insulin dependent diabetes mellitus (IDDM). This relation was not previously evaluated, despite the fact that both diseases co-exist in the same patient. The study also describes the clinical and biochemical profile of the associated complications in TM patients with and without IDDM. A population-based cross-sectional study. The study includes 19 consecutive TM patients with IDDM and 31 age- and sex-matched TM patients without IDDM who visited our out-patient clinics for an endocrine assessment. An extensive medical history, with data on associated complications and current medications, was obtained. Blood samples were drawn in the morning after an overnight fast to measure the serum concentrations of IGF-1, glucose, fructosamine, free thyroxine (FT4), thyrotropin (TSH) and biochemical analysis. Serologic screening assays for hepatitis C virus seropositivity (HCVab and HCV-RNA) were also evaluated; applying routine laboratory methods. Plasma total IGF-1 was measured by a chemiluminescent immunometric assay (CLIA) method. Ophthalmology evaluation was done by the same researcher using stereoscopic fundus biomicroscopy through dilated pupils. DR was graded using the scale developed by the Global Diabetic Retinopathy Group. Iron stores were assessed by direct and indirect methods. Eighteen TM patients with IDDM (94.7 %) and ten non-diabetic patients (32.2 %) had IGF-1 levels below the 2.5(th) percentile of the normal values for the Italian population. The mean serum IGF-1 concentrations were significantly lower in the diabetic versus the non-diabetic TM groups (p < 0.001). DR was present in 4 (21 %) of 19 TM patients with IDDM and was associated with the main classical risk factors, namely inefficient glycemic control and duration of the disease but not hypertension. Using the scale developed by the Global Diabetic Retinopathy Group, the DR in our patients was classified as non proliferative diabetic retinopathy (NPDR). Only a few numbers of microaneurysms [1-3] were detected. Our data also confirm the strong association of IDDM in TM patients with other endocrine and non-endocrine complications.

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

Rice, K.; Bricker, O.

The report describes the results of a study to assess the sensitivity of streams to acidic deposition in Charles and Anne Arundel Counties, Maryland using a geology-based method. Water samples were collected from streams in July and August 1988 when streams were at base-flow conditions. Eighteen water samples collected from streams in Charles County, and 17 water samples from streams in Anne Arundel County were analyzed in the field for pH, specific conductance, and acid-neutralizing capacity (ANC); 8 water samples from streams in Charles County were analyzed in the laboratory for chloride and sulfate concentrations. The assessment revealed that streamsmore » in these counties are sensitive to acidification by acidic deposition.« less

Method for minimizing the radiation exposure from scoliosis radiographs. [X ray

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

De Smet, A.A.; Fritz, S.L.; Asher, M.A.

1981-01-01

The radiation exposure resulting from standard scoliosis radiographs was determined for eighteen adolescent girls. The risk of inducing breast cancer was estimated from the skin-exposure doses. The average skin exposure to the breasts was 59.6 millirads (0.59 mGy) for the anteroposterior radiograph. Assuming a total of twenty-two anteroposterior radiographs during a course of treatment, the cumulative exposure would result in a 1.35% relative increase in the risk of development of breast cancer. By utilizing collimation of the x-ray beam and proper selection of grids, films, and screens, the radiation risk of scoliosis radiographs is minimized.

Evaluation of the endometriosis treatment success rate by the laparoscopic-pharmacological method

NASA Astrophysics Data System (ADS)

Mutrynowski, Andrzej; Zabielska, Renata; Smolarczyk, Roman

1996-03-01

The study aimed at evaluating the success rate of the operative laparoscopy assisted by electrocoagulation and laser as well as danazol and lynestrenol in the endometriosis treatment. One-hundred-ninety women with the recognized endometriosis were included into the study. In the I degree(s) endometriosis the operative or hormonal therapy was applied, in the II-IV degree(s) the combined therapy was used. The complete cure was achieved in 159 of the patients (84%): 28 women conceived, in 131 of the cases remission was recognized during the second laparoscopy. Eighteen women found improvement (9%) while 13 women (7%) reported the lack of improvement.

A joint sparse representation-based method for double-trial evoked potentials estimation.

PubMed

Yu, Nannan; Liu, Haikuan; Wang, Xiaoyan; Lu, Hanbing

2013-12-01

In this paper, we present a novel approach to solving an evoked potentials estimating problem. Generally, the evoked potentials in two consecutive trials obtained by repeated identical stimuli of the nerves are extremely similar. In order to trace evoked potentials, we propose a joint sparse representation-based double-trial evoked potentials estimation method, taking full advantage of this similarity. The estimation process is performed in three stages: first, according to the similarity of evoked potentials and the randomness of a spontaneous electroencephalogram, the two consecutive observations of evoked potentials are considered as superpositions of the common component and the unique components; second, making use of their characteristics, the two sparse dictionaries are constructed; and finally, we apply the joint sparse representation method in order to extract the common component of double-trial observations, instead of the evoked potential in each trial. A series of experiments carried out on simulated and human test responses confirmed the superior performance of our method. © 2013 Elsevier Ltd. Published by Elsevier Ltd. All rights reserved.

Consecutive pharmacological activation of PKA and PKC mimics the potent cardioprotection of temperature preconditioning

PubMed Central

Khaliulin, Igor; Parker, Joanna E.; Halestrap, Andrew P.

2010-01-01

Aims Temperature preconditioning (TP) provides very powerful protection against ischaemia/reperfusion. Understanding the signalling pathways involved may enable the development of effective pharmacological cardioprotection. We investigated the interrelationship between activation of protein kinase A (PKA) and protein kinase C (PKC) in the signalling mechanisms of TP and developed a potent pharmacological intervention based on this mechanism. Methods and results Isolated rat hearts were subjected to TP, 30 min global ischaemia, and 60 min reperfusion. Other control and TP hearts were perfused with either sotalol (β-adrenergic blocker) or H-89 (PKA inhibitor). Some hearts were pre-treated with either isoproterenol (β-adrenergic agonist) or adenosine (PKC activator) that were given alone, simultaneously, or sequentially. Pre-treatment with isoproterenol, adenosine, and the consecutive isoproterenol/adenosine treatment was also combined with the PKC inhibitor chelerythrine. Cardioprotection was evaluated by haemodynamic function recovery, lactate dehydrogenase release, measurement of mitochondrial permeability transition pore opening, and protein carbonylation during reperfusion. Cyclic AMP and PKA activity were increased in TP hearts. H-89 and sotalol blocked the cardioprotective effect of TP and TP-induced PKC activation. Isoproterenol, adenosine, and the consecutive treatment increased PKC activity during pre-ischaemia. Isoproterenol significantly reduced myocardial glycogen content. Isoproterenol and adenosine, alone or simultaneously, protected hearts but the consecutive treatment gave the highest protection. Cardioprotective effects of adenosine were completely blocked by chelerythrine but those of the consecutive treatment only attenuated. Conclusion The signal transduction pathway of TP involves PKA activation that precedes PKC activation. Pharmacologically induced consecutive PKA/PKC activation mimics TP and induces extremely potent cardioprotection. PMID:20558443

Different methods of treatment related to the bilateral occurrence of Perthes' disease.

PubMed

Futami, T; Suzuki, S

1997-11-01

We treated 98 consecutive patients with Perthes' disease by a unilateral brace in external rotation, flexion and abduction and a further consecutive 110 by a bilateral cast with the hips in internal rotation and abduction. During treatment in the unilateral brace, six (6.1%) hips on the opposite side developed evidence of Perthes' disease and one developed this after the brace had been removed. In children managed in bilateral casts, no contralateral Perthes' disease was seen. Adequate containment of the femoral head may prevent subsequent changes in the opposite hip.

Annually recurring parthenogenesis in a zebra shark Stegostoma fasciatum.

PubMed

Robinson, D P; Baverstock, W; Al-Jaru, A; Hyland, K; Khazanehdari, K A

2011-11-01

A zebra shark, Stegostoma fasciatum, held in captivity at the Burj Al Arab aquarium, produced embryos and pups in the absence of a male. A total of 15 pups were produced from eggs laid within the aquarium over a period of four consecutive years commencing 2007. Parthenogenesis was confirmed through DNA analysis for three pups sampled during the first two consecutive egg cycles and is presumed to be the method of reproduction responsible thereafter. © 2011 The Authors. Journal of Fish Biology © 2011 The Fisheries Society of the British Isles.

Evidence That The Citizenship Mandate Curtailed Participation In Oregon’s Medicaid Family Planning Program

PubMed Central

Angus, Lisa; DeVoe, Jennifer

2016-01-01

The 2005 federal Deficit Reduction Act made proof of citizenship a requirement for Medicaid eligibility. We examined the effects on visits to Oregon’s Medicaid family planning services eighteen months after the citizenship requirement was implemented. We analyzed 425,381 records of visits that occurred between May 2005 and April 2008 and found that, compared to the eighteen-month period before the mandate went into effect, visits declined by 33 percent. We conclude that Medicaid citizenship documentation requirements have been burdensome for Oregon Family Planning Expansion Project patients and costly for health care providers, reducing access to family planning and preventive measures and increasing the strain on the safety net. PMID:20368600

Evidence that the citizenship mandate curtailed participation in Oregon's Medicaid family planning program.

PubMed

Angus, Lisa; Devoe, Jennifer

2010-04-01

The 2005 federal Deficit Reduction Act made proof of citizenship a requirement for Medicaid eligibility. We examined the effects on visits to Oregon's Medicaid family planning services eighteen months after the citizenship requirement was implemented. We analyzed 425,381 records of visits that occurred between May 2005 and April 2008 and found that, compared to the eighteen-month period before the mandate went into effect, visits declined by 33 percent. We conclude that Medicaid citizenship documentation requirements have been burdensome for Oregon Family Planning Expansion Project patients and costly for health care providers, reducing access to family planning and preventive measures and increasing the strain on the safety net.

40 CFR 280.43 - Methods of release detection for tanks.

Code of Federal Regulations, 2012 CFR

2012-07-01

... two consecutive stick readings at both the beginning and ending of the period; (3) The equipment used... UNDERGROUND STORAGE TANKS (UST) Release Detection § 280.43 Methods of release detection for tanks. Each method... of the tank is made to the nearest one-eighth of an inch at least once a month. Note: Practices...

40 CFR 280.43 - Methods of release detection for tanks.

Code of Federal Regulations, 2011 CFR

2011-07-01

... two consecutive stick readings at both the beginning and ending of the period; (3) The equipment used... UNDERGROUND STORAGE TANKS (UST) Release Detection § 280.43 Methods of release detection for tanks. Each method... of the tank is made to the nearest one-eighth of an inch at least once a month. Note: Practices...

Diagnostic Accuracy and Cost-Effectiveness of Alternative Methods for Detection of Soil-Transmitted Helminths in a Post-Treatment Setting in Western Kenya

PubMed Central

Kepha, Stella; Kihara, Jimmy H.; Njenga, Sammy M.; Pullan, Rachel L.; Brooker, Simon J.

2014-01-01

Objectives This study evaluates the diagnostic accuracy and cost-effectiveness of the Kato-Katz and Mini-FLOTAC methods for detection of soil-transmitted helminths (STH) in a post-treatment setting in western Kenya. A cost analysis also explores the cost implications of collecting samples during school surveys when compared to household surveys. Methods Stool samples were collected from children (n = 652) attending 18 schools in Bungoma County and diagnosed by the Kato-Katz and Mini-FLOTAC coprological methods. Sensitivity and additional diagnostic performance measures were analyzed using Bayesian latent class modeling. Financial and economic costs were calculated for all survey and diagnostic activities, and cost per child tested, cost per case detected and cost per STH infection correctly classified were estimated. A sensitivity analysis was conducted to assess the impact of various survey parameters on cost estimates. Results Both diagnostic methods exhibited comparable sensitivity for detection of any STH species over single and consecutive day sampling: 52.0% for single day Kato-Katz; 49.1% for single-day Mini-FLOTAC; 76.9% for consecutive day Kato-Katz; and 74.1% for consecutive day Mini-FLOTAC. Diagnostic performance did not differ significantly between methods for the different STH species. Use of Kato-Katz with school-based sampling was the lowest cost scenario for cost per child tested ($10.14) and cost per case correctly classified ($12.84). Cost per case detected was lowest for Kato-Katz used in community-based sampling ($128.24). Sensitivity analysis revealed the cost of case detection for any STH decreased non-linearly as prevalence rates increased and was influenced by the number of samples collected. Conclusions The Kato-Katz method was comparable in diagnostic sensitivity to the Mini-FLOTAC method, but afforded greater cost-effectiveness. Future work is required to evaluate the cost-effectiveness of STH surveillance in different settings. PMID:24810593

Comparative Evaluation of Quantitative Test Methods for Gases on a Hard Surface

DTIC Science & Technology

2017-02-01

COMPARATIVE EVALUATION OF QUANTITATIVE TEST METHODS FOR GASES ON A HARD SURFACE ECBC-TR-1426 Vipin Rastogi...1 COMPARATIVE EVALUATION OF QUANTITATIVE TEST METHODS FOR GASES ON A HARD SURFACE 1. INTRODUCTION Members of the U.S. Environmental...Generator 4 2.4 Experimental Design Each quantitative method was performed three times on three consecutive days. For the CD runs, three

Antibacterial efficacy of the seed extracts of Melia azedarach against some hospital isolated human pathogenic bacterial strains

PubMed Central

Khan, Abdul Viqar; Ahmed, Qamar Uddin; Mir, M Ramzan; Shukla, Indu; Khan, Athar Ali

2011-01-01

Objective To investigate the antibacterial potential of the polar and non-polar extracts of the seeds of Melia azedarach (M. azedarach) L. (Meliaceae) against eighteen hospital isolated human pathogenic bacterial strains. Methods Petrol, benzene, ethyl acetate, methanol, and aqueous extracts at five different concentrations (1, 2, 5, 10 and 15 mg/mL) were evaluated. Disk diffusion method was followed to evaluate the antibacterial efficacy. Results All extracts of the seeds demonstrated significant antibacterial activity against tested pathogens. Among all extracts, ethyl acetate extract revealed the highest inhibition comparatively. The present study also favored the traditional uses reported earlier. Conclusions Results of this study strongly confirm that the seed extracts of M. azedarach could be effective antibiotics, both in controlling gram-positive and gram-negative human pathogenic infections. PMID:23569812

Results of interlaboratory comparison of fission track ages for 1992 fission track workshop

USGS Publications Warehouse

Miller, D.S.; Crowley, K.D.; Dokka, R.K.; Galbraith, R.F.; Kowallis, B.J.; Naeser, C.W.

1993-01-01

Two apatites and one sphene were made available to the fission track research community for analysis prior to the 1992 Fission Track Workshop held in Philadelphia, U.S.A., 13-17 July. Eighteen laboratories throughout the world received aliquots of apatite and sphene. To date, analyses by 33 different scientists have been representing 15 different laboratories. With respect to the previous two interlaboratory comparisons, there is a noticeable improvement in the accuracy of the age results (Naeser and Cebula, 1978; Naeser et al., 1981; Miller et al., 1985;Miller et al.1990). Ninety-four percent of the analysis used the external detector method (EDM) combined with the zeta technique while the remaining individuals used the population method (POP). Track length measurements (requested for the first time in the interlaboratory comparison studies) were in relatively good agreement. ?? 1993.

Residue depletion of tilmicosin in cattle after subcutaneous administration.

PubMed

Jiang, Haiyang; Ding, Shuangyang; Li, Jiancheng; An, Dianjin; Li, Cun; Shen, Jianzhong

2006-07-12

A study of tissue residue depletion of tilmicosin in cattle was conducted after a single subcutaneous injection at the therapeutic level of 10 mg per kg body weight. Eighteen cross cattle were treated with the tilmicosin oil formulation (30%). Three treated animals (two males and one female) were selected randomly to be scarified at 1, 7, 14, 28, and 35 days withdrawal after injection. Samples of the injection site and of muscle, liver, kidney, and fat were collected. Tilmicosin residue concentrations were determined using a high-performance liquid chromatography (HPLC) method with a UV detector at 290 nm. Using a statistical method recommended by the Committee for Veterinary Medical Products of European Medical Evaluation Agency, the withdrawal time of 34 days was established when all tissue residues except samples in the injection site were below the accepted maximum residue limits.

Portfolio Development as a Three-Semester Process: The Value of Sequential Experience.

ERIC Educational Resources Information Center

Senne, Terry A.

This study examined nine cohort teacher candidates from each of two physical education teacher education (PETE) programs developed teaching portfolios in three consecutive semesters of comparable courses: (1) elementary methods; (2) secondary methods; and (3) the student teaching internship. Studied were changes over time in teacher candidate…

Dosimetric Analysis of Organs at Risk During Expiratory Gating in Stereotactic Body Radiation Therapy for Pancreatic Cancer

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

Taniguchi, Cullen M.; Murphy, James D.; Eclov, Neville

2013-03-15

Purpose: To determine how the respiratory phase impacts dose to normal organs during stereotactic body radiation therapy (SBRT) for pancreatic cancer. Methods and Materials: Eighteen consecutive patients with locally advanced, unresectable pancreatic adenocarcinoma treated with SBRT were included in this study. On the treatment planning 4-dimensional computed tomography (CT) scan, the planning target volume (PTV), defined as the gross tumor volume plus 3-mm margin, the duodenum, and the stomach were contoured on the end-expiration (CT{sub exp}) and end-inspiration (CT{sub insp}) phases for each patient. A separate treatment plan was constructed for both phases with the dose prescription of 33 Gymore » in 5 fractions with 95% coverage of the PTV by the 100% isodose line. The dose-volume histogram (DVH) endpoints, volume of duodenum that received 20 Gy (V{sub 20}), V{sub 25}, and V{sub 30} and maximum dose to 5 cc of contoured organ (D{sub 5cc}), D{sub 1cc}, and D{sub 0.1cc}, were evaluated. Results: Dosimetric parameters for the duodenum, including V{sub 25}, V{sub 30}, D{sub 1cc}, and D{sub 0.1cc} improved by planning on the CT{sub exp} compared to those on the CT{sub insp}. There was a statistically significant overlap of the PTV with the duodenum but not the stomach during the CT{sub insp} compared to the CT{sub exp} (0.38 ± 0.17 cc vs 0.01 ± 0.01 cc, P=.048). A larger expansion of the PTV, in accordance with a Danish phase 2 trial, showed even more overlapping volume of duodenum on the CT{sub insp} compared to that on the CT{sub exp} (5.5 ± 0.9 cc vs 3.0 ± 0.8 cc, P=.0003) but no statistical difference for any stomach dosimetric DVH parameter. Conclusions: Dose to the duodenum was higher when treating on the inspiratory than on the expiratory phase. These data suggest that expiratory gating may be preferable to inspiratory breath-hold and free breathing strategies for minimizing risk of toxicity.« less

PAH air pollution at a Portuguese urban area: carcinogenic risks and sources identification.

PubMed

Slezakova, K; Pires, J C M; Castro, D; Alvim-Ferraz, M C M; Delerue-Matos, C; Morais, S; Pereira, M C

2013-06-01

This study aimed to characterize air pollution and the associated carcinogenic risks of polycyclic aromatic hydrocarbon (PAHs) at an urban site, to identify possible emission sources of PAHs using several statistical methodologies, and to analyze the influence of other air pollutants and meteorological variables on PAH concentrations.The air quality and meteorological data were collected in Oporto, the second largest city of Portugal. Eighteen PAHs (the 16 PAHs considered by United States Environment Protection Agency (USEPA) as priority pollutants, dibenzo[a,l]pyrene, and benzo[j]fluoranthene) were collected daily for 24 h in air (gas phase and in particles) during 40 consecutive days in November and December 2008 by constant low-flow samplers and using polytetrafluoroethylene (PTFE) membrane filters for particulate (PM10 and PM2.5 bound) PAHs and pre-cleaned polyurethane foam plugs for gaseous compounds. The other monitored air pollutants were SO2, PM10, NO2, CO, and O3; the meteorological variables were temperature, relative humidity, wind speed, total precipitation, and solar radiation. Benzo[a]pyrene reached a mean concentration of 2.02 ng m(-3), surpassing the EU annual limit value. The target carcinogenic risks were equal than the health-based guideline level set by USEPA (10(-6)) at the studied site, with the cancer risks of eight PAHs reaching senior levels of 9.98 × 10(-7) in PM10 and 1.06 × 10(-6) in air. The applied statistical methods, correlation matrix, cluster analysis, and principal component analysis, were in agreement in the grouping of the PAHs. The groups were formed according to their chemical structure (number of rings), phase distribution, and emission sources. PAH diagnostic ratios were also calculated to evaluate the main emission sources. Diesel vehicular emissions were the major source of PAHs at the studied site. Besides that source, emissions from residential heating and oil refinery were identified to contribute to PAH levels at the respective area. Additionally, principal component regression indicated that SO2, NO2, PM10, CO, and solar radiation had positive correlation with PAHs concentrations, while O3, temperature, relative humidity, and wind speed were negatively correlated.

Vacuum assisted closure for the treatment of sternal wounds: the bridge between débridement and definitive closure.

PubMed

Song, David H; Wu, Liza C; Lohman, Robert F; Gottlieb, Lawrence J; Franczyk, Mieczyslawa

2003-01-01

A method to refine the treatment of sternal wounds using Vacuum Assisted Closure (V.A.C.) therapy as the bridge between débridement and delayed definitive closure is described. A retrospective review of 35 consecutive patients with sternal wound complications over a 2-year period (March of 1999 to March of 2001) was performed. The treatment of sternal wounds with traditional twice-a-day dressing changes was compared with the treatment with the wound V.A.C. device. An analysis of the number of days between initial débridement and closure, number of dressing changes, number and types of flaps needed for reconstruction, and complications was performed. Eighteen patients were treated with traditional twice-a-day dressing changes and 17 patients were treated with V.A.C. therapy alone. The two groups were similar regarding age, sex, type of cardiac procedure, and type of sternal wound. The V.A.C. therapy group had a trend toward a shorter interval between débridement and closure, with a mean of 6.2 days, whereas the dressing change group had mean of 8.5 days. The V.A.C. therapy group had a significantly lower number of dressing changes, with a mean of three, whereas the twice-a-day dressing change group had a mean of 17 (p < 0.05). Reconstruction required an average of 1.5 soft-tissue flaps per patient treated with traditional dressing changes versus 0.9 soft-tissue flaps per patient for those treated with V.A.C. therapy (p < 0.05). Before closure, there was one death among patients undergoing dressing changes and three in the V.A.C. therapy group, all of which were unrelated to the management of the sternal wound. Patients with sternal wounds who have benefited from V.A.C. therapy alone have a significant decrease in the number of dressing changes and number of soft-tissue flaps needed for closure. Finally, the V.A.C. therapy group had a trend toward a decreased number of days between débridement and closure.

The positive effect of targeted marketing on an existing uterine fibroid embolization practice.

PubMed

Chrisman, Howard B; Basu, Pat Auveek; Omary, Reed A

2006-03-01

Although uterine fibroid embolization is an effective treatment option for symptomatic women, it is unclear what methods can be used to expand referrals in an already established practice. The authors tested the hypothesis that an advertising strategy focused on a defined target market can expand an existing uterine fibroid embolization practice. A market-driven planning sequence was employed. This included a determination of goals, an examination of current competition, determination of target market based on local environment and previous consumer use, pretest of product sample, and implementation of advertisement. Based on the analysis the authors determined that the target audience was professional black women aged 35 to 45. A specific weekly magazine was selected due to readership demographics. An advertisement was run for 8 consecutive weeks. The authors prospectively tracked patient inquiries, clinic visits, cases performed, and revenues generated for 3 months following the initial advertisement. All patients were seen in a fully staffed, preexisting fibroid clinic located within an urban, university-based academic practice performing 250 uterine fibroid embolizations annually. Ninety calls were received directly related to the advertisement. There were 35 clinic visits, which resulted in 17 uterine fibroid embolizations and 52 total MR imaging procedures. Eighteen patients were not considered candidates based on established protocols. The 17 extra cases performed over 3 months represented a 27% increase in case volume. Total professional cash collections for these cases (including MR imaging) were 58,317 US dollars. The cost of advertising was 8,000 US dollars. As a result of existing infrastructure, no additional costs were necessary. This resulted in a net revenue gain 50,317 US dollars and a nonannualized rate of return of approximately 625%. As Interventional Radiologists look to develop and expand existing practices, traditional marketing tools such as those utilized in this study can be used to facilitate practice growth for specific clinical programs, such as uterine artery embolization. Defining a target market can significantly expand an existing uterine fibroid embolization practice. The optimal choice of targeted media awaits verification from future studies.

Child Abuse and the Eye in an African Population

PubMed Central

Adebayo, Modupe

2017-01-01

Purpose There is a paucity of data on child abuse and the eye in West Africa. Therefore, a need exists to determine the causes and circumstances surrounding these occurrences and their effects on the eye and vision in a pediatric population. Methods A 3-year study of consecutive cases of ocular features that presented to an eye clinic following a history suggestive of child abuse along with any associated eye injury was carried out. Socio-demographic characteristics were obtained, as were the presenting and posttreatment visual acuity, and a full clinical eye examination was also done. Results Fifty-six children with 56 affected eyes were examined. The male to female ratio was 1.8 : 1; the mean age was 8.25 ± 3.5 years; and the subjects were predominately primary school children 30 (53.6%). The most common ocular disorders were conjunctiva hyperemia (46.4%), corneal abrasion/ulcer (25.4%), hyphema/uveitis (42.9%), retinal detachment (7.1%), sclera rupture (7.1%), and globe perforation (21.4%). The intraocular pressure was raised in 17.9% of participants. Presenting versus posttreatment visual acuities showed normal vision in four (7.1%) vs. eighteen (32.1%), visual impairment in 12 (21.4%) vs. six (10.7%), severe visual impairment in 20 (35.7%) vs. 12 (21.4%), and blindness in 12 (21.4%) vs. 14 (25%), p < 0.001. The most common injurious agents were canes (25.0%) and sticks (17.9%). The people who inflicted the injuries were parents/relatives (uncles) in 35.7% of cases and the children themselves (accidents) in 21.4% of cases. Circumstances predisposing participants to eye injuries were child labor in 39.3% and beatings in 25.0%. Complications were cataracts (25.0%), corneal opacity (39.3%), and retinal detachment (7.1%). Conclusions Injuries commonly resulted from canes and sticks used during beatings, as well as from child labor, corporal punishment, accidents, and assaults. Legislation and laws need to be enacted to prevent negative psychosocial and economic impacts on the child, family and country as a whole. PMID:28367043

Diagnostic accuracy and cost-effectiveness of alternative methods for detection of soil-transmitted helminths in a post-treatment setting in western Kenya.

PubMed

Assefa, Liya M; Crellen, Thomas; Kepha, Stella; Kihara, Jimmy H; Njenga, Sammy M; Pullan, Rachel L; Brooker, Simon J

2014-05-01

This study evaluates the diagnostic accuracy and cost-effectiveness of the Kato-Katz and Mini-FLOTAC methods for detection of soil-transmitted helminths (STH) in a post-treatment setting in western Kenya. A cost analysis also explores the cost implications of collecting samples during school surveys when compared to household surveys. Stool samples were collected from children (n = 652) attending 18 schools in Bungoma County and diagnosed by the Kato-Katz and Mini-FLOTAC coprological methods. Sensitivity and additional diagnostic performance measures were analyzed using Bayesian latent class modeling. Financial and economic costs were calculated for all survey and diagnostic activities, and cost per child tested, cost per case detected and cost per STH infection correctly classified were estimated. A sensitivity analysis was conducted to assess the impact of various survey parameters on cost estimates. Both diagnostic methods exhibited comparable sensitivity for detection of any STH species over single and consecutive day sampling: 52.0% for single day Kato-Katz; 49.1% for single-day Mini-FLOTAC; 76.9% for consecutive day Kato-Katz; and 74.1% for consecutive day Mini-FLOTAC. Diagnostic performance did not differ significantly between methods for the different STH species. Use of Kato-Katz with school-based sampling was the lowest cost scenario for cost per child tested ($10.14) and cost per case correctly classified ($12.84). Cost per case detected was lowest for Kato-Katz used in community-based sampling ($128.24). Sensitivity analysis revealed the cost of case detection for any STH decreased non-linearly as prevalence rates increased and was influenced by the number of samples collected. The Kato-Katz method was comparable in diagnostic sensitivity to the Mini-FLOTAC method, but afforded greater cost-effectiveness. Future work is required to evaluate the cost-effectiveness of STH surveillance in different settings.

Neodymium:yttrium-aluminum-garnet laser fusion of endarterectomy flaps.

PubMed

Humphrey, P W; Slocum, M M; Loy, T S; Silver, D

1995-07-01

This study evaluated the efficacy of neodymium:yttrium-aluminum-garnet laser welding of flaps in canine arteries and in securing the distal flap during human carotid endarterectomy. Endarterectomy flaps were created in both common carotid and both common femoral arteries in 12 dogs. The flaps were repaired with either the neodymium:yttrium-aluminum-garnet laser or with 6-0 polypropylene sutures. The arteries were removed after duplex scanning at either 7 or 28 days. Eighteen high carotid endarterectomy flaps in 16 patients have been subsequently secured with the laser welding technique. Laser repairs (125 +/- 19 joule) of the canine arteries were completed more quickly than suture repairs (mean 25 seconds vs 135 seconds, respectively; p < 0.04). Duplex ultrasonography revealed no discernable differences between the two groups of arteries. Arteries studied at 7 days revealed three microscopic flaps (two suture, one laser), more subintimal fibroblastic proliferation in suture than laser-repaired carotid arteries (3: 1, p = 0.0530), and similar amounts of inflammation in suture- and laser-repaired arteries. Arteries studied at 28 days revealed one microscopic intimal flap (suture-repaired); equal fibroblastic and inflammatory responses in suture- and laser-repaired vessels; and no evidence of laser thermal injury. Eighteen carotid endarterectomy flaps have been successfully fused with no immediate or long-term complications in 16 patients (follow-up of 0 to 24 months). Laser fusion appears to be a safe and effective method for securing distal carotid endarterectomy flaps.

Evaluation of the effect of torsemide on warfarin dosage requirements.

PubMed

Lai, Sophia; Momper, Jeremiah D; Yam, Felix K

2017-08-01

Background According to drug interaction databases, torsemide may potentiate the effects of warfarin. Evidence for this drug-drug interaction, however, is conflicting and the clinical significance is unknown. Objective The aim of this study is to evaluate the impact of torsemide initiation on warfarin dosage requirements. Setting This study was conducted at the Veterans Affairs Healthcare System in San Diego, California. Method A retrospective cohort study was conducted using Veterans Affairs data from patients who were converted from bumetanide to torsemide between March 2014 and July 2014. Patients were also prescribed and taking warfarin during the observation period. Warfarin dosage requirements were evaluated to determine if any changes occurred within the first 3 months of starting torsemide. Main outcome measure The primary outcome was the average weekly warfarin dose before and after torsemide initiation. Results Eighteen patients met study inclusion criteria. The weekly warfarin dose before and after initiation of torsemide was not significantly different (34 ± 15 and 34 ± 13 mg, p > 0.05). Of those eighteen patients, only two experienced elevations in INR that required a decrease in warfarin dosage after torsemide initiation. Between those two patients, dosage reductions ranged from 5.3 to 18%. Conclusion These results indicated that most patients did not require any warfarin dosage adjustments after torsemide was initiated. The potential for interaction, however, still exists. While empiric warfarin dosage adjustments are not recommended when initiating torsemide, increased monitoring is warranted to minimize the risk of adverse effects.

Taking Stock

ERIC Educational Resources Information Center

Wykes, James

1970-01-01

The Director of Television for the Inner London Education Authority discusses the experience gained and lessons learnt after eighteen months of transmission on the Authority's educational television network." (Editor)

Probability-Based Recognition Framework for Underwater Landmarks Using Sonar Images †.

PubMed

Lee, Yeongjun; Choi, Jinwoo; Ko, Nak Yong; Choi, Hyun-Taek

2017-08-24

This paper proposes a probability-based framework for recognizing underwater landmarks using sonar images. Current recognition methods use a single image, which does not provide reliable results because of weaknesses of the sonar image such as unstable acoustic source, many speckle noises, low resolution images, single channel image, and so on. However, using consecutive sonar images, if the status-i.e., the existence and identity (or name)-of an object is continuously evaluated by a stochastic method, the result of the recognition method is available for calculating the uncertainty, and it is more suitable for various applications. Our proposed framework consists of three steps: (1) candidate selection, (2) continuity evaluation, and (3) Bayesian feature estimation. Two probability methods-particle filtering and Bayesian feature estimation-are used to repeatedly estimate the continuity and feature of objects in consecutive images. Thus, the status of the object is repeatedly predicted and updated by a stochastic method. Furthermore, we develop an artificial landmark to increase detectability by an imaging sonar, which we apply to the characteristics of acoustic waves, such as instability and reflection depending on the roughness of the reflector surface. The proposed method is verified by conducting basin experiments, and the results are presented.

The frequency of alcoholism in patients with advanced cancer admitted to an acute palliative care unit and a home care program.

PubMed

Mercadante, Sebastiano; Porzio, Giampiero; Caruselli, Amanda; Aielli, Federica; Adile, Claudio; Girelli, Nicola; Casuccio, Alessandra

2015-02-01

Cancer patients with a history of alcoholism may be problematic. The frequency of alcoholism among patients with advanced cancer has never been reported in Italy or other European countries. The aim of this prospective study was to determine the frequency of alcoholism, assessed with a simple and validated instrument, among patients with advanced cancer who were referred to two different palliative care settings: an acute inpatient palliative care unit (PCU) of a comprehensive cancer center in a metropolitan area and a home care program (HCP) in a territorial district, localized in the mountains of Italy. A consecutive sample of patients admitted to an inpatient PCU and to an HCP was assessed for a period of eight months. Each patient who agreed to be interviewed completed the Cut down, Annoyed, Guilty, Eye-opener (CAGE) questionnaire. Patients were then interviewed informally to gather information about their history with alcohol. In total, 443 consecutive patients were surveyed; data from 249 to 194 patients were collected in the PCU and HCP, respectively, in the eight-month period. The mean age was 66.4 (SD 12.7) years, and 207 were males. The mean Karnofsky level was 54.2 (SD 14.6). Eighteen patients were CAGE positive (4.06%). Males (Pearson Chi-squared, P = 0.027) and younger patients (analysis of variance test, P = 0.009) were more likely to be CAGE positive. Informal interviews revealed that 17 patients (3.83%) were alcoholics or had a history of alcoholism, and that alcoholism was strongly correlated with CAGE (Pearson Chi-squared, P < 0.0001). Only a minority of patients were CAGE positive, with a similar frequency in the PCU and HCP settings. CAGE-positive patients were more likely to be male and younger, independent of diagnosis and performance status. CAGE was positively correlated with informal interviews for detecting alcoholism. As CAGE patients express more symptom distress, it is important to detect this problem with a simple tool that has a high sensitivity and specificity and is easy to use even in patients with advanced disease. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Some aspects of the DSM-III personality disorders illustrated by a consecutive sample of hospitalized patients.

PubMed

Dahl, A A

1986-01-01

The main innovations of DSM-III concerning the personality disorders are the assignment of a separate axis and definitions of diagnostic criteria for these disorders. Even with these improvements, diagnosis of the personality disorders shows only moderate interrater reliability. Reasons for this are discussed. Data from a consecutive sample of hospitalized patients are used to illustrate the prevalence of the personality disorders, the coexistence of axis I disorders, and the overlap within the personality disorders. The method of conditional probabilities is presented as a way to get better separation of these disorders.

Computing sparse derivatives and consecutive zeros problem

NASA Astrophysics Data System (ADS)

Chandra, B. V. Ravi; Hossain, Shahadat

2013-02-01

We describe a substitution based sparse Jacobian matrix determination method using algorithmic differentiation. Utilizing the a priori known sparsity pattern, a compression scheme is determined using graph coloring. The "compressed pattern" of the Jacobian matrix is then reordered into a form suitable for computation by substitution. We show that the column reordering of the compressed pattern matrix (so as to align the zero entries into consecutive locations in each row) can be viewed as a variant of traveling salesman problem. Preliminary computational results show that on the test problems the performance of nearest-neighbor type heuristic algorithms is highly encouraging.

Stationary and non-stationary extreme value modeling of extreme temperature in Malaysia

NASA Astrophysics Data System (ADS)

Hasan, Husna; Salleh, Nur Hanim Mohd; Kassim, Suraiya

2014-09-01

Extreme annual temperature of eighteen stations in Malaysia is fitted to the Generalized Extreme Value distribution. Stationary and non-stationary models with trend are considered for each station and the Likelihood Ratio test is used to determine the best-fitting model. Results show that three out of eighteen stations i.e. Bayan Lepas, Labuan and Subang favor a model which is linear in the location parameter. A hierarchical cluster analysis is employed to investigate the existence of similar behavior among the stations. Three distinct clusters are found in which one of them consists of the stations that favor the non-stationary model. T-year estimated return levels of the extreme temperature are provided based on the chosen models.

THE ENGINE AND THE REAPER: INDUSTRIALIZATION AND MORTALITY IN LATE NINETEENTH CENTURY JAPAN.

PubMed

Tang, John P

2017-12-01

Economic development improves long-run health outcomes through access to medical treatment, sanitation, and higher income. Short run impacts, however, may be ambiguous given disease exposure from market integration. Using a panel dataset of Japanese vital statistics and multiple estimation methods, I find that railroad network expansion is associated with a six percent increase in gross mortality rates among newly integrated regions. Communicable diseases accounted for most of the rail-associated mortality, which indicate railways behaved as transmission vectors. At the same time, market integration facilitated by railways corresponded with an eighteen percent increase in total capital investment nationwide over ten years. Copyright © 2017 Elsevier B.V. All rights reserved.

School-Based Prevention of Bullying and Relational Aggression in Adolescence: The Fairplayer.manual

ERIC Educational Resources Information Center

Scheithauer, Herbert; Hess, Markus; Schultze-Krumbholz, Anja; Bull, Heike Dele

2012-01-01

The fairplayer.manual is a school-based program to prevent bullying. The program consists of fifteen to seventeen consecutive ninety-minute lessons using cognitive-behavioral methods, methods targeting group norms and group dynamics, and discussions on moral dilemmas. Following a two-day training session, teachers, together with skilled…

Implementing a Flipped Classroom Approach in a University Numerical Methods Mathematics Course

ERIC Educational Resources Information Center

Johnston, Barbara M.

2017-01-01

This paper describes and analyses the implementation of a "flipped classroom" approach, in an undergraduate mathematics course on numerical methods. The approach replaced all the lecture contents by instructor-made videos and was implemented in the consecutive years 2014 and 2015. The sequential case study presented here begins with an…

Encouraging College Student Active Engagement in Learning: The Influence of Response Methods

ERIC Educational Resources Information Center

Barr, Michele L.

2014-01-01

The purpose of this study was to examine the use of two student response methods within selected college lecture halls. Kinesiology majors from three universities were asked to respond to questions during two consecutive lectures, one using "clickers" and the other using hand-raising. Participation and comprehension rates were…

A comparison of economy and sagittal plane trunk movements among back-, back/front- and head-loading.

PubMed

Hudson, Sean; Cooke, Carlton; Davies, Simeon; West, Sacha; Gamieldien, Raeeq; Low, Chris; Lloyd, Ray

2018-05-14

It has been suggested that freedom of movement in the trunk could influence load carriage economy. This study aimed to compare the economy and sagittal plane trunk movements associated with three load carriage methods that constrain posture differently. Eighteen females walked at 3 km.h -1 with loads of 0, 3, 6, 9, 12, 15 and 20 kg carried on the back, back/front and head. Load carriage economy was assessed using the Extra Load Index (ELI). Change in sagittal plane trunk forward lean and trunk angle excursion from unloaded to loaded walking were assessed. Results show no difference in economy between methods (p = 0.483), despite differences in the change in trunk forward lean (p = 0.001) and trunk angle excursion (p = 0.021) from unloaded to loaded walking. We conclude that economy is not different among the three methods of load carriage, despite significant differences in sagittal plane trunk movements.

Diurnal variation in the diving bradycardia response in young men.

PubMed

Konishi, Masayuki; Kawano, Hiroshi; Xiang, Mi; Kim, Hyeon-Ki; Ando, Karina; Tabata, Hiroki; Nishimaki, Mio; Sakamoto, Shizuo

2016-04-01

The present study aimed to examine diurnal variation of the diving bradycardia responses on the same day. Eighteen young men (age 26 ± 2 years; height 174.2 ± 6.0 cm; body mass 70.2 ± 8.1 kg; body fat 18.0 ± 3.8 %; mean ± standard deviation) participated in this study. Oral temperature, heart rate variability (HRV) from 5-min of electrocardiogram data, and diving bradycardia responses were measured at 0900, 1300, and 1700 hours daily. All participants performed diving reflex tests twice in the sitting position with the face immersed in cold water (1.9-3.1 °C) and apnea at midinspiration for a minimum of 30 s and as long as possible, in consecutive order. Oral temperature was found to be less in the morning (0900) than in the afternoon (1300) and evening (1700). In the frequency domain parameters of heart rate variability, the natural logarithms of high-frequency power were higher in the morning than in the evening. All participants showed bradycardia response to the two diving reflex tests. The peak values of R-R interval during the diving reflex test both for as long as possible and 30 s were longer in the morning than in the afternoon and evening. Our results indicated that the maximal bradycardia during the diving reflex test exhibits a diurnal variation, with peak levels at morning and gradual decrease towards the evening. The HRV indexes show the same variation.

Long-term results of pneumatic dilatation for relapsing symptoms of achalasia after Heller myotomy.

PubMed

Legros, Ludivine; Ropert, Alain; Brochard, Charlène; Bouguen, Guillaume; Pagenault, Maël; Siproudhis, Laurent; Bretagne, Jean-François

2014-09-01

The aim of this study was to assess the efficacy and safety of pneumatic dilatation (PD) to treat symptom recurrence after Heller myotomy (HM). Consecutive patients receiving PD for relapsing symptoms following prior HM were included in this retrospective single-center study. Eckardt score ≤3 and/or ∆ Eckardt (difference between Eckardt score before and after dilatation) ≥3 defined the success of initial dilatation. Patients who maintained response longer than 2 months after initial dilatation were defined as short-term responders. Relapsers were offered further on-demand dilatation. Remission was defined as an Eckardt score ≤3 at the study endpoint. Kaplan-Meier survival curves were used to determine relapse rates. Eighteen patients (11 women, seven men) were included from January 2004 to January 2013. Ten patients had type I achalasia, and seven had type III, according to the Chicago classification. Thirty-nine PDs were performed (1.5 [1-2.25] per patient). All patients had short-term responses. The remission rate at the endpoint, after a median follow-up of 33 months, was 78%, but 44% were treated with on-demand PD during the follow-up interval. The proportions of patients without relapse and subsequent PD were 72% at 12 months, 65% at 24 and 36 months, and 49% at 48 months. No factors predictive of long-term response, particularly the type of achalasia, could be identified in this series. There were no perforations. In treating symptom recurrence following HM, PD was safe and effective over the long term when combined with subsequent PD. © 2014 John Wiley & Sons Ltd.

Use of New Imaging CARTO® Segmentation Module Software to Facilitate Ablation of Ventricular Arrhythmias.

PubMed

Tovia-Brodie, Oholi; Belhassen, Bernard; Glick, Aharon; Shmilovich, Haim; Aviram, Galit; Rosso, Raphael; Michowitz, Yoav

2017-02-01

A new imaging software (CARTO® Segmentation Module, Biosense Webster) allows preprocedural 3-D reconstruction of all heart chambers based on cardiac CT. We describe our initial experience with the new module during ablation of ventricular arrhythmias. Eighteen consecutive patients with idiopathic ventricular arrhythmias or ischemic ventricular tachycardia (VT) were studied. In the latter group, a combined endocardial and epicardial ablation was performed. Of the 14 patients with idiopathic arrhythmias, 12 were ablated in the outflow tract (OT), 1 in the midseptal left ventricle, and 1 at the left posterior fascicular area; acute successful ablation was achieved in 11 (78.6%) patients. The procedure was discontinued due to close proximity of the arrhythmia origin to the coronary arteries (CA) in 2 patients. Acute successful uncomplicated ablation was achieved in all 4 patients with ischemic VT. During ablation in the coronary cusps commissures, the CARTO® Segmentation Module accurately defined the cusps anatomy. The precise anatomic location provided by the module assisted in successfully ablating when information from activation mapping was not optimal, by ablating at the opposite side of the cusps. In addition, by demonstrating the precise location of the CA, it allowed safe ablation of arrhythmias that originated in close proximity to the CA both in the OT area and the epicardium, eliminating the need for repeat angiography. The CARTO® Segmentation Module is useful for accurate definition of the exact anatomic location of ventricular arrhythmias and for safely ablating them especially in close proximity to the CA. © 2016 Wiley Periodicals, Inc.

The pathophysiological mechanism of fluid retention in advanced cancer patients treated with docetaxel, but not receiving corticosteroid comedication

PubMed Central

Béhar, A.; Pujade-Lauraine, E.; Maurel, A.; Brun, M. D.; Lagrue, G.; Feuilhade De Chauvin, F.; Oulid-Aissa, D.; Hille, D.

1997-01-01

Aims Fluid retention is a phenomenon associated with taxoids. The principal objective of this study was to investigate the pathophysiological mechanism of docetaxel-induced fluid retention in advanced cancer patients. Methods Docetaxel was administered as a 1 h intravenous infusion every 3 weeks, for at least 4–6 consecutive cycles, to patients with advanced breast (n=21) or ovarian (n=3) carcinoma, who had received previous chemotherapy, 21 for advanced disease. Phase II clinical trials have shown that 5 day corticosteroid comedication, starting 1 day before docetaxel infusion, significantly reduces the incidence and severity of fluid retention. This prophylactic corticosteroid regimen is currently recommended for patients receiving docetaxel but was not permitted in this study because of its possible interference with the underlying pathophysiology of the fluid retention. Results Fluid retention occurred in 21 of the 24 patients but was mainly mild to moderate, with only five patients experiencing severe fluid retention. Eighteen patients received symptomatic flavonoid treatment, commonly prescribed after the last cycle. Specific investigations for fluid retention confirmed a relationship between cumulative docetaxel dose and development of fluid retention. Capillary filtration test analysis showed a two-step process for fluid retention generation, with progressive congestion of the interstitial space by proteins and water starting between the second and the fourth cycle, followed by insufficient lymphatic drainage. Conclusions A vascular protector such as micronized diosmine hesperidine with recommended corticosteroid premedication and benzopyrones may be useful in preventing and treating docetaxel-induced fluid retention. PMID:9205828

Low bone mineral density in Greek patients with inflammatory bowel disease: prevalence and risk factors.

PubMed

Koutroubakis, Ioannis E; Zavos, Christos; Damilakis, John; Papadakis, Georgios Z; Neratzoulakis, John; Karkavitsas, Nikolaos; Kouroumalis, Elias A

2011-01-01

A high prevalence of osteopenia and osteoporosis is observed in patients with inflammatory bowel disease (IBD). Various risk factors of bone loss have been suggested in IBD. The aim of the present study was to investigate the prevalence of low bone mineral density (BMD) and to identify related risk factors in Greek patients with IBD. One hundred and eighteen consecutive IBD patients were included. All patients underwent bone densitometry by dual energy X-ray absorptiometry at the femoral neck and lumbar spine levels. Serum levels of 25 hydroxyvitamin D (25 OH D), 1.25 dihydroxyvitamin D (1.25 OH 2D), osteocalcin, calcitonin and homocysteine were measured in all participants. Forty (33.9%) patients were normal, 55 (46.6%) were osteopenic, and 23 (19.5%) were osteoporotic. No significant differences between IBD patients with osteopenia or osteoporosis and those with normal BMD concerning the use of steroids and the examined biochemical markers were found. Statistically significant differences among the three groups were found for body mass index (BMI), age and disease duration (P=0.002, P<0.0001 and P=0.03 respectively). Multivariate analysis revealed that the most significant factors associated with BMD were age and BMI (P<0.0001). A weak but statistically significant correlation was also found for disease duration (P=0.04). There is a high prevalence of osteopenia and osteoporosis in Greek patients with IBD. Low BMI, age and disease duration are the most important independent risk factors for osteoporosis in Greek IBD patients.

Sustainability in humanitarian surgery during medical short-term trips (MSTs): feasibility of inguinal hernia repair in rural Nigeria over 6 years and 13 missions.

PubMed

Oehme, F; Fourie, L; Beeres, F J-P; Ogbaji, S; Nussbaumer, P

2018-06-01

Surgical teaching missions are known to contribute significantly in reducing the local burden of disease. However, the value of short-term medical service trips (MSTs) remains under debate. Humanitarian surgery is highly dependent on funding, and consequently, data evaluation is needed to secure funding for future projects. The aim of this trial is to evaluate the results of 6-year MSTs to rural Nigeria with a specific emphasis on hernia repairs. Retrospective series of consecutive operations performed between 2011 and 2016 in rural Nigeria during 13 MSTs. Operations were categorized into type and number of procedures and origin of the surgeon. In terms of inguinal hernia repairs additional data was evaluated such as frequency of local anaesthesia (LA) and the type of hernia. The total amount of disability-adjusted life years (DALYs) averted during each mission are presented and discussed with regard to sustainability of these missions. From 2011 to 2016, a total of 1674 patients were operated. Of these, 1302 patients were operated for 1481 hernias of which 36.7% accounting as inguinoscrotal hernias. The percentage of operations performed by Nigerian staff increased from 31 to 55%. Overall, eighteen percent of the operations was solely performed by Nigerians. Totally, we averted 8092.83 DALY's accounting for 5.46 DALY's per hernia. The presented missions contribute significantly to an improvement in local healthcare and decrease the burden of disease. We were able to show the sustainable character of these surgical missions. As a next step, we will analyse the cost-effectiveness of MSTs.

Aggressive posterior retinopathy of prematurity in Asian Indian babies: spectrum of disease and outcome after laser treatment.

PubMed

Sanghi, Gaurav; Dogra, Mangat R; Das, Pranab; Vinekar, Anand; Gupta, Amod; Dutta, Saurabh

2009-10-01

To analyze the spectrum of aggressive posterior retinopathy of prematurity and outcome after laser treatment. This is a retrospective review of 81 eyes of 44 consecutive infants diagnosed to have aggressive posterior retinopathy of prematurity and treated between September 2005 and March 2007 from a large tertiary care center in North India. Qualitative variables were tested for statistical significance using the chi-square test and independent samples with the student's t-test. Mean birth weight and gestational age were 1,259.66 +/- 310.51 g (range, 660-2,000 g) and 29.75 +/- 2.35 weeks (range, 26-36 weeks), respectively. Twenty-one infants (47.72%) had a birth weight > 1,250 g. Thirty-three (40.74%) eyes had Zone 1, and 48 (59.26%) had posterior Zone 2 disease. All eyes underwent confluent laser photocoagulation at a mean postconceptional age of 34.58 +/- 2.19 weeks (range, 31-40.5 weeks). Mean follow-up was 12.8 months (range, 6-24 months). At the last follow-up visit, 55 (71.4%) of 77 eyes had a favorable outcome. Eighteen eyes (23.4%) had a localized (1-3 clock hours) partial peripheral tractional detachment (Stage 4a), which remained stable at last follow-up. Two eyes (2.6%) developed falciform fold involving the macular area, and 2 (2.6%) developed Stage 5 retinopathy of prematurity. Aggressive posterior retinopathy of prematurity is encountered not only in low birth weight infants, but also in heavier and more mature Asian Indian infants. Early, aggressive confluent laser photocoagulation is necessary to maximize outcomes in these eyes.

[Laboratory diagnosis of auto-immune hemolytic anemia: characteristics of the manual direct test of Polybrene].

PubMed

Braga, G W; Bordin, J O; Moreira Júnior, G; Kuroda, A

1998-01-01

The direct manual Polybrene test (DPT) and the direct antiglobulin tests (DAT) were employed to detect antibody sensitizing red blood cell (RCB) in patients with clinical and laboratorial findings of autoimmune hemolytic anemia (AIHA). To compare the sensitivity and specificity of DPT and DAT in the diagnosis of AIHA. Eighteen consecutive patients with diagnosis of AIHA were evaluated. The control group consisted of 20 normal volunteers blood donors and 20 patients with sickle cell anemia. All patients and controls were submitted to DPT and DAT. All DAT positive samples were further tested using monospecific reagents (anti-IgG heavy chain and anti-C3d). Positive samples for either DPT or DAT were evaluated by eluate technique using. The dichloromethane (DCM). The DAT was positive in 14 patients and negative in 4 subjects, while the DPT was positive in 17 patients and negative in 1 individual who had a positive DAT owing to complement (C3d). All positive eluates performed with DCM showed RBC autoantibodies with presumed "anti-Rh" specificity. The sensitivity rate of the DPT (94%) was significantly (p < 0.05) higher than the sensitivity rate of DAT (78%) to determine whether IgG was bound in vivo, but no difference was found regarding the specificity of the two tests. 1) The DPT is more sensitive than the DAT in detecting IgG autoantibody on the RBCs of patients with AIHA; 2) because of its simplicity and rapidity, the DPT is a useful additional screening test for the investigation of Coombs-negative AIHA.

Assessment of chronic toxicity from stormwater runoff in Lincoln Creek, Milwaukee, WI

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

Kleist, J.; Crunkilton, R.

1995-12-31

Stormwater runoff is believed to be responsible for a severely degraded biotic community in Lincoln Creek, a stream which drains portions of metropolitan Milwaukee. A previous study using Ceriodaphnia dubia and Pimephales promelas indicated little or no acute toxicity could be attributed to stormwater runoff. The purpose of this study was to assess the potential for chronic toxicity in the stream during periods of stormwater runoff. Reproduction and survival in Daphnia magna, and growth and survival in P. promelas were monitored to assess chronic effects. Seven consecutive 14 day tests were performed between June and September, 1994, in eighteen flow-throughmore » aquaria housed within a US Geological Survey gauging station located adjacent to Lincoln Creek. Mortality in D. magna consistently did not occur before day 4 of exposure, but averaged 64% at day 14. Reproduction in D. magna and growth in P. promelas in surviving individuals was not significantly reduced; all effects were manifested as mortality. Results of data analysis after 14 days of exposure contrast markedly with analysis made earlier in the same test. Statistical interpretation of the mortality data at typical endpoints of 48 hours for invertebrates and 96 hours for fish failed to identify adverse impacts of stormwater runoff the authors observed in longer exposures. Short-term toxicity tests appear insensitive to the detection of contaminant related effects. Long-term tests (greater than 7 days) were needed to identify adverse biological impacts that could in part explain the severely degraded biotic community of this urban stream.« less

The Applicability of the American College of Cardiology Appropriate Use Criteria for Myocardial Perfusion Scintigraphy in Australia.

PubMed

Chow, Chee Loong; Ponnuthurai, Francis A; Allman, Kevin C; van Gaal, William

2018-04-01

The American College of Cardiology (ACC) Appropriate Use Criteria (AUC) for radionuclide myocardial perfusion scans (MPS) was developed to promote its rational use in the assessment of stable ischaemic heart disease (IHD). We sought to validate the applicability of this document in the Australian context. 1009 consecutive patients who underwent MPS were retrospectively audited at a single major metropolitan hospital in Victoria, Australia. Appropriateness was assigned based on the 2013 ACC AUC, and common indications and predictors of positive scan results were examined. The AUC was successfully applied (99.1%) retrospectively. A large proportion of scans were deemed appropriate (82.7%), whilst 7.8% were maybe appropriate. Positive detection rates in these groups were 17.0% and 17.9% respectively. Eighteen patients (1.8%) were unclassifiable, but had a detection rate of 44.4%. Positive predictors of an abnormal MPS result included prior history of coronary artery disease, typical angina, and following the conservative management of an acute coronary syndrome. Scans that were rarely appropriate had a detection rate of 0%. The retrospective application of the 2013 ACC AUC is feasible. Whilst the majority of the scans were appropriate, a group of unclassifiable patients was observed to have a high detection rate. Scans that were rarely appropriate could potentially be rationalised to reduce radiation risk. Copyright © 2017 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

Calpain inhibitors ameliorate muscle wasting in a cachectic mouse model bearing CT26 colorectal adenocarcinoma.

PubMed

Lin, Xing-Yu; Chen, Si-Zeng

2017-03-01

Cancer-related cachexia involves increased protein breakdown through various proteolytic pathways, including the ubiquitin-proteasome pathway (UPP). We hypothesized that a calcium- and calpain-dependent pathway might play a crucial role during the proteolytic procedure, and that pathway interventions would ameliorate cancer cachexia in vivo. After being inoculated with CT26 adenocarcinoma cell culture subcutaneously, BALB/c mice developed cachexia in 12 days. They were then administered with different types of calpain inhibitors individually or in combination for 7 consecutive days. Eighteen healthy mice were also assessed as a control group. Changes in body weight, gastrocnemius muscle mass, tumor volume, food intake, survival time, and serum nutritional markers were monitored. Also measured were the levels of calpains, E3 ubiquitin ligases, and apoptosis-associated markers in gastrocnemius muscle. Our study showed that the intraperitoneal administration of calpain inhibitors significantly improved tumor-free body weight and gastrocnemius muscle mass in all treatment groups. Treatment with calpain inhibitors also ameliorated cachexia-associated negative effects in metabolic profiles and increased survival time in most of the tumor-bearing mice compared with the cachexia controls. Furthermore, calpain inhibitors reduced the calpain activity and the expression of MuRF-1 and atrogin-1 in all treatment groups, while increasing the level of cleaved caspase-3 and BAX and lowering the level of BCL-2 in some groups. These results justify further evaluation of calpain inhibitors both alone and in combination with other candidate agents as a potential new therapeutic strategy for treating cancer cachexia.

Management of tibial non-unions according to a novel treatment algorithm.

PubMed

Ferreira, Nando; Marais, Leonard Charles

2015-12-01

Tibial non-unions represent a spectrum of conditions that are challenging to treat. The optimal management remains unclear despite the frequency with which these diagnoses are encountered. The aim of this study was to determine the outcome of tibial non-unions managed according to a novel tibial non-union treatment algorithm. One hundred and eighteen consecutive patients with 122 uninfected tibial non-unions were treated according to our proposed tibial non-union treatment algorithm. All patients were followed-up clinically and radiologically for a minimum of six months after external fixator removal. Four patients were excluded because they did not complete the intended treatment process. The final study population consisted of 94 men and 24 women with a mean age of 34 years. Sixty-seven non-unions were stiff hypertrophic, 32 mobile atrophic, 16 mobile oligotrophic and one true pseudoarthrosis. Six non-unions were classified as type B1 defect non-unions. Bony union was achieved after the initial surgery in 113/122 (92.6%) tibias. Nine patients had failure of treatment. Seven persistent non-unions were successfully retreated according to the tibial non-union treatment algorithm. This resulted in final bony union in 120/122 (98.3%) tibias. The proposed tibial non-union treatment algorithm appears to produce high union rates across a diverse group of tibial non-unions. Tibial non-unions however, remain difficult to treat and should be referred to specialist units where advanced reconstructive techniques are practiced on a regular basis. Copyright © 2015 Elsevier Ltd. All rights reserved.

Clinical outcome of node-negative oligometastatic non-small cell lung cancer.

PubMed

Sakai, Kiyohiro; Takeda, Masayuki; Hayashi, Hidetoshi; Tanaka, Kaoru; Okuda, Takeshi; Kato, Amami; Nishimura, Yasumasa; Mitsudomi, Tetsuya; Koyama, Atsuko; Nakagawa, Kazuhiko

2016-11-01

The concept of "oligometastasis" has emerged as a basis on which to identify patients with stage IV non-small cell lung cancer (NSCLC) who might be most amenable to curative treatment. Limited data have been available regarding the survival of patients with node-negative oligometastatic NSCLC. Consecutive patients with advanced NSCLC who attended Kindai University Hospital between January 2007 and January 2016 were recruited to this retrospective study. Patients with regional lymph node-negative disease and a limited number of metastatic lesions (≤5) per organ site and a limited number of affected organ sites (1 or 2) were eligible. Eighteen patients were identified for analysis during the study period. The most frequent metastatic site was the central nervous system (CNS, 72%). Most patients (83%) received systemic chemotherapy, with only three (17%) undergoing surgery, for the primary lung tumor. The CNS failure sites for patients with CNS metastases were located outside of the surgery or radiosurgery field. The median overall survival for all patients was 15.9 months, with that for EGFR mutation-positive patients tending to be longer than that for EGFR mutation-negative patients. Cure is difficult to achieve with current treatment strategies for NSCLC patients with synchronous oligometastases, although a few long-term survivors and a smaller number of patients alive at last follow-up were present among the study cohort. There is an urgent clinical need for prospective evaluation of surgical resection as a treatment for oligometastatic NSCLC, especially negative for driver mutations. © 2016 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.

Evaluation of the appropriateness and outcome of in-hospital telemetry monitoring.

PubMed

Fålun, Nina; Nordrehaug, Jan Erik; Hoff, Per Ivar; Langørgen, Jørund; Moons, Philip; Norekvål, Tone M

2013-10-15

The American Heart Association classifies monitored patients into 3 categories. The aims of this study were to (1) investigate how patients are assigned according to the American Heart Association classification, (2) determine the number and type of arrhythmic events experienced by these patients, and (3) describe subsequent changes in management. A prospective observational study design was used. All patients assigned to telemetry during a 3-month period were consecutively enrolled in our study. Data were collected 24/7. Only arrhythmias that might require a change in management were recorded. Monitor watchers at the central monitoring station completed a standard data sheet assessing 64 variables. These data, as well as medical records, were reviewed by the investigator. Overall, 1,194 patients were included. Eighteen percent of the patients were assigned to American Heart Association class I (monitoring indicated), 71% to class II (monitoring may be of benefit), and 11% to class III (monitoring not indicated). The overall arrhythmia event rate was 33%. Forty-three percent of class I patients, 28% of class II patients, and 47% of class III patients experienced arrhythmia events. Change in management occurred in 25% of class I patients, 14% of class II patients, and 29% of class III patients. Although the number of class III indications should have been reduced, nearly 1/2 of class III patients experienced arrhythmia events and 1/3 of them received management changes. This outcome challenges existing guidelines. In conclusion, most patients in this study were monitored appropriately, according to class I and II indications. Copyright © 2013 Elsevier Inc. All rights reserved.

Effect of season, month of parturition and lactation on estrus behavior and ovarian activity in Barki x Rahmani crossbred ewes under subtropical conditions.

PubMed

Hashem, N M; El-Zarkouny, S Z; Taha, T A; Abo-Elezz, Z R

2011-04-15

The correlations between some meteorological parameters and fertility data were evaluated in Barki x Rahmani crossbred ewes using the records of five consecutive years (2003-2007). Additionally, estrus detection and ultrasonic evaluation were applied on eighteen mature dry ewes during breeding and non-breeding seasons. The effect of lactation was evaluated by monitoring estrus behavior in ninety four lactating ewes from 40 to 120 d after parturition. Moreover, ultrasonography was used to identify ovarian activity in six cyclic and six acyclic non-lactating ewes. Results revealed that relative estrus occurrence and fertile mating were positively correlated (P <0.05) with high temperature and long photoperiod (conditions of summer season), and were negatively correlated (P < 0.01) with rainfall (condition of winter season). During breeding season, estrus rate, serum progesterone concentration, and diameter of largest follicle were significantly (P < 0.05) higher than those observed during the non-breeding season. Furthermore, month of parturition had a significant effect (P < 0.05) on estrus rate of lactating ewes where ewes that lambed in August, September, and October recorded higher estrus rate than those lambed in November and December. However, the lactational strength did not exert any deleterious effect on the reproductive performance of lactating ewes. In conclusion, in Egypt under subtropical conditions, Barki x Rahmani crossbred ewes exerted optimum estrus behavior and fertile mating during summer season. The reduction in estrus activity during lactation was due to the seasonal effect rather than lactational stress. Copyright © 2011 Elsevier Inc. All rights reserved.

Increase of forage dryness induces differentiated anatomical response in the sheep rumen compartments.

PubMed

Scocco, Paola; Mercati, Francesca; Tardella, Federico Maria; Catorci, Andrea

2016-08-01

The aim of this study was to investigate how the Surface Enlargement Factor (SEF) and the epithelial keratinization degree of sheep rumen change in response to phytomass production, and to forage fiber and water content during the pasture vegetative cycle. The study used eighteen sheep nourished with dry hay and cereals during the winter season and with fresh hay during the pasture vegetative cycle. We collected samples from rumen indicative regions for two consecutive years characterized by different rainfall and pasture productivity values. We evaluated the densities (D) of rumen papillae to estimate the rumen SEF, and the keratinization percentage of the epithelial lining; these parameters showed differentiated modifications in the four ruminal analyzed compartments in response to pasture seasonal conditions. In addition, we performed Canonical Redundancy Analysis (RDA) on the "keratinization and SEF" matrix constrained by phytomass, water, and crude fiber contents of pasture at different time in the two considered years to highlight how rumen features answer to pasture conditions. Atrium (A) and ventral sac (VS) keratinization showed a strict positive correlation to crude fiber, while SEF of VS was positively related to phytomass and forage water content. The degree of keratinization of the rumen VS epithelium proved to be a useful parameter for evaluating anatomical variations in the short term period related to pasture features; in addition, its monitoring could be carried out through biopsy, thus avoiding the killing of animals. The study also leads to the application of the 3Rs (Replacement; Reduction; and Refinement). Microsc. Res. Tech. 79:738-743, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Heart rate variability is a trait marker of major depressive disorder: evidence from the sertraline vs. electric current therapy to treat depression clinical study.

PubMed

Brunoni, Andre Russowsky; Kemp, Andrew H; Dantas, Eduardo M; Goulart, Alessandra C; Nunes, Maria Angélica; Boggio, Paulo S; Mill, José Geraldo; Lotufo, Paulo A; Fregni, Felipe; Benseñor, Isabela M

2013-10-01

Decreased heart rate variability (HRV) is a cardiovascular predictor of mortality. Recent debate has focused on whether reductions in HRV in major depressive disorder (MDD) are a consequence of the disorder or a consequence of pharmacotherapy. Here we report on the impact of transcranial direct current stimulation (tDCS), a non-pharmacological intervention, vs. sertraline to further investigate this issue. The employed design was a double-blind, randomized, factorial, placebo-controlled trial. One hundred and eighteen moderate-to-severe, medication-free, low-cardiovascular risk depressed patients were recruited for this study and allocated to either active/sham tDCS (10 consecutive sessions plus two extra sessions every other week) or placebo/sertraline (50 mg/d) for 6 wk. Patients were age and gender-matched to healthy controls from a concurrent cohort study [the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)]. The impact of disorder, treatment and clinical response on HRV (root mean square of successive differences and high frequency) was examined. Our findings confirmed that patients displayed decreased HRV relative to controls. Furthermore, HRV scores did not change following treatment with either a non-pharmacological (tDCS) or pharmacological (sertraline) intervention, nor did HRV increase with clinical response to treatment. Based on these findings, we discuss whether reduced HRV is a trait-marker for MDD, which may predispose patients to a host of conditions and disease even after response to treatment. Our findings have important implications for our understanding of depression pathophysiology and the relationship between MDD, cardiovascular disorders and mortality.

The role of strength and power during performance of high intensity military tasks under heavy load carriage.

PubMed

Mala, Jesse; Szivak, Tunde K; Flanagan, Shawn D; Comstock, Brett A; Laferrier, Justin Z; Maresh, Carl M; Kraemer, William J

2015-01-01

Previous research has investigated the physiological determinants of heavy load carriage while performing medium to long distance road marching, yet research examining the physiological underpinnings of high-intensity battlefield tasks is limited. This study sought to examine the role of strength and power during high-intensity combat tasks under heavy load carriage. Eighteen recreationally trained men (mean±SD: age, 21±2 years; height, 172±6 cm; weight, 80±13 kg) participated in this study and performed an anaerobic combat course under 2 randomized experimental conditions; unloaded and loaded. Subjects performed 3 trials under each condition on separate days, with a 5-minute rest between each trial. In the unloaded trial, subjects wore a uniform with boots weighing approximately 3.2 kg. During the loaded trial, in addition to the uniform and boots, subjects wore Interceptor body armor (6.94 kg-9.10 kg) and a MOLLE rucksack weighing 30 kg. The course consisted of 3 consecutive tasks, which began from the prone position, led into a 30 m sprint, followed by a 27 m zigzag run, and ended with a 10 m casualty drag weighing approximately 79.4 kg. Pearson correlations showed significant (P≤.05) strong correlations between lower body strength (r=-0.63, -0.62), lower body power (r=-0.67, -0.67) and upper body strength (r=-0.60, -0.62) and overall performance times in the unloaded and loaded condition, respectively. Strength and power are strongly related to high-intensity military tasks with and without heavy load carriage.

Magnetic resonance defecography versus videodefecography in the study of obstructed defecation syndrome: Is videodefecography still the test of choice after 50 years?

PubMed

Martín-Martín, G P; García-Armengol, J; Roig-Vila, J V; Espí-Macías, A; Martínez-Sanjuán, V; Mínguez-Pérez, M; Lorenzo-Liñán, M Á; Mulas-Fernández, C; González-Argenté, F X

2017-10-01

The aim of the present study was to evaluate the diagnostic accuracy of magnetic resonance (MR) defecography and compare it with videodefecography in the evaluation of obstructed defecation syndrome. This was a prospective cohort test accuracy study conducted at one major tertiary referral center on patients with a diagnosis of obstructed defecation syndrome who were referred to the colorectal surgery clinic in a consecutive series from 2009 to 2012. All patients underwent a clinical examination, videodefecography, and MR defecography in the supine position. We analyzed diagnostic accuracy for MR defecography and performed an agreement analysis using Cohen's kappa index (κ) for each diagnostic imaging examination performed with videodefecography and MR defecography. We included 40 patients with Rome III diagnostic criteria of obstructed defecation syndrome. The degree of agreement between the two tests was as follows: almost perfect for anismus (κ = 0.88) and rectal prolapse (κ = 0.83), substantial for enterocele (κ = 0.80) and rectocele grade III (κ = 0.65), moderate for intussusception (κ = 0.50) and rectocele grade II (κ = 0.49), and slight for rectocele grade I (κ = 0.30) and excessive perineal descent (κ = 0.22). Eighteen cystoceles and 11 colpoceles were diagnosed only by MR defecography. Most patients (54%) stated that videodefecography was the more uncomfortable test. MR defecography could become the imaging test of choice for evaluating obstructed defecation syndrome.

Prospective cohort study showing persistent HSV-2 shedding in women with genital herpes 2 years after acquisition.

PubMed

Ramchandani, Meena; Selke, Stacy; Magaret, Amalia; Barnum, Gail; Huang, Meei-Li Wu; Corey, Lawrence; Wald, Anna

2017-11-25

Herpes simplex virus type 2 (HSV-2) is a prevalent infection with great variability in clinical and virological manifestations among individuals. This prospective cohort study aims to evaluate the natural history of HSV-2 reactivation in the genital area in the same group of women over time. Eighteen immunocompetent HSV-2 seropositive women were evaluated for viral shedding for 70 consecutive days within a median of 8 months (range 1-24 months) of HSV-2 acquisition and again approximately 2.5 years later from the original study. Participants obtained daily swabs of genital secretions for HSV PCR and recorded genital symptoms. The viral shedding rate was 29% during the initial study and 19% in the follow-up study (32% reduction, P=0.019). Subclinical shedding rate also decreased from 24% to 13% (37% reduction, P=0.032), as did the rate of days with genital lesions from 22% to 15% (33% reduction, P=0.24). The mean copy number during viral shedding remained unchanged over time at 4.8 log 10 c/mL (SD=2.0 and 1.6 during each study, respectively, P=0.33). Women with high viral shedding rates in the past were likely to continue to have high shedding rates (r=0.63, P=0.005). Despite some reduction, high viral shedding rates persist in women with genital HSV-2 greater than 2 years after acquisition. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Retrograde recanalization of chronic total occlusions from the transradial approach; early Canadian experience.

PubMed

Rinfret, Stéphane; Joyal, Dominique; Nguyen, Can Manh; Bagur, Rodrigo; Hui, William; Leung, Raymond; Larose, Eric; Love, Michael P; Mansour, Samer

2011-09-01

Retrograde approach for chronic total occlusions (CTO) improves recanalization success rates. Eight French (Fr) catheters and the femoral approach are advocated. Evaluate whether transradial operators can achieve similar success rates using smaller catheters. This is a single-operator series of 42 consecutive cases performed between January and December 2010, including 13 while demonstrating CTO recanalization. Patients were referred because of complexity of the CTO or after failed attempt. Most frequent indications for recanalization were CCS 3-4 angina (52%) and CCS 1-2 in 21%. Eighteen (43%) patients underwent previous failed attempts. CTO was in the right coronary in 74%, left anterior descending in 24%, and a left main in 1. Most lesions (88%) were ≥20 mm long and 52% were calcified. We used septal collateral channels (CC) in 33 (79%), epicardial CC in 8 (20%), and a saphenous vein graft in one case. Radial access was used in all patients and was bilateral in 37 (88%). Five cases required one radial and one femoral access. Six French guides were used in 91% for the retrograde side and 71% for the antegrade side. Otherwise, 7 Fr guides were used. The Corsair(®) was used in 38 (90%). Procedural success was achieved in 37 (88%), mostly using reverse controlled antegrade-retrograde tracking (60%) or retrograde crossing (29%). The average <24-h Hb drop was 0.75 ± 0.84 g/dl. No in-hospital major cardiac events occurred. Transradial retrograde CTO recanalization is feasible, safe, and still associated with high success rates despite the use of smaller guide catheters. Copyright © 2011 Wiley-Liss, Inc.

Viscoelastic response of the lateral side of the ankle to cyclic inversion: a time course analysis.

PubMed

Malmir, K; Olyaei, G R; Talebian, S; Jamshidi, A A

2014-12-01

Although important, viscoelastic behavior of the ankle's lateral side has rarely been studied. The present study assesses the viscoelastic behavior during cyclic inversions. Eighteen recreationally active healthy males underwent 40 passive cyclic inversions using a Biodex dynamometer at 5 °/s through 80% of maximum range of motion. Energy absorption and restitution and dissipation coefficient were calculated for each repetition. Changes in the mean of the dependent variables for repetitions 1 (R1 ), R5 , R10 , R15 , R20 , R25 , R30 , R35 and R40 were compared by three one-way analyses of variance with repeated measures. There was a significant difference between the means of energy absorption for the selected repetitions from R1 to R20 (P < 0.01), but there was no significant difference between them from R20 to R40 (P > 0.05). There was no significant difference between the means of energy restitution for the selected repetitions (P > 0.05). Whereas there was no significant difference consecutively between the means of dissipative coefficient for the selected repetitions (P > 0.05), there was a significant difference between the means of R30 or R40 relative to the baseline (P < 0.005). The decrease in the energy absorbed and the dissipation coefficient following repeated inversions may be due to the slippage of collagen fibers. The decrease in the shock absorbing ability of the tissues may expose them to injury. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Subjective and clinical assessment criteria suggestive for five clinical patterns discernible in nonspecific neck pain patients. A Delphi-survey of clinical experts.

PubMed

Dewitte, Vincent; Peersman, Wim; Danneels, Lieven; Bouche, Katie; Roets, Arne; Cagnie, Barbara

2016-12-01

Nonspecific neck pain patients form a heterogeneous group with different musculoskeletal impairments. Classifying nonspecific neck pain patients into subgroups based on clinical characteristics might lead to more comprehensive diagnoses and can guide effective management. To establish consensus among a group of experts regarding the clinical criteria suggestive of a clinical dominance of 'articular', 'myofascial', 'neural', 'central' and 'sensorimotor control' dysfunction patterns distinguishable in patients with nonspecific neck pain. Delphi study. A focus group with 10 academic experts was organized to elaborate on the different dysfunction patterns discernible in neck pain patients. Consecutively, a 3-round online Delphi-survey was designed to obtain consensual symptoms and physical examination findings for the 5 distinct dysfunction patterns resulting from the focus group. A total of 21 musculoskeletal physical therapists from Belgium and the Netherlands experienced in assessing and treating neck pain patients completed the 3-round Delphi-survey. Respectively, 33 (response rate, 100.0%), 27 (81.8%) and 21 (63.6%) respondents replied to rounds 1, 2 and 3. Eighteen 'articular', 16 'myofascial', 20 'neural', 18 'central' and 10 'sensorimotor control' clinical indicators reached a predefined ≥80% consensus level. These indicators suggestive of a clinical dominance of 'articular', 'myofascial', 'neural', 'central', and 'sensorimotor control' dysfunction patterns may help clinicians to assess and diagnose patients with nonspecific neck pain. Future validity testing is needed to determine how these criteria may help to improve the outcome of physical therapy interventions in nonspecific neck pain patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

Effects of tetrahydrocannabinol on balance and gait in patients with dementia: A randomised controlled crossover trial.

PubMed

van den Elsen, Geke Ah; Tobben, Lieke; Ahmed, Amir Ia; Verkes, Robbert Jan; Kramers, Cornelis; Marijnissen, Radboud M; Olde Rikkert, Marcel Gm; van der Marck, Marjolein A

2017-02-01

Oral tetrahydrocannabinol (THC) is currently studied for its possible efficacy on dementia-related neuropsychiatric symptoms (NPS), but might lead to increased risk of falling. This was a randomised, double-blind, crossover study to evaluate the effects of THC on mobility in dementia patients. Eighteen community-dwelling patients ( M age =77 years) received 1.5 mg of oral THC twice daily and placebo, in random order, for three days, separated by a four-day washout. Balance and gait were assessed using SwayStar TM and GAITRite TM within two hours after administration, in two consecutive intervention periods, under the following conditions: standing with eyes open (EO) and eyes closed (EC), preferred speed walking with and without a cognitive dual task. THC significantly increased sway during standing EC (roll angle 0.32[±0.6]°, p=0.05; pitch angle 1.04[±1.5]°, p=0.009; pitch velocity 1.96[±3.3]°/s, p=0.02), but not during standing EO. During preferred speed walking, THC increased stride length (4.3[±5.4] cm, p=0.005) and trunk sway (pitch angle 1.18[±1.6]°, p=0.005). No effects were observed during dual task walking. No differences in the number and type of adverse events were found, and no falls occurred after administration of THC. This study showed that 3 mg of THC per day has a benign adverse event profile regarding mobility and was well tolerated by community-dwelling dementia patients.

The hydration status of young female elite soccer players during an official tournament.

PubMed

Chapelle, Laurent; Tassignon, Bruno; Aerenhouts, Dirk; Mullie, Patrick; Clarys, Peter

2017-09-01

The hydration status of elite female soccer players is a concern, especially during high-volume training periods or tournaments. Furthermore, scientific literature on this topic is scarce to non-existent. Therefore, the primary aim of this study was to evaluate the hydration status in elite youth female soccer players during an official tournament. The secondary aim was to identify a possible relationship between pre-training hydration status and fluid intake. Eighteen players were followed during eight consecutive days. Urine specific gravity was used to assess hydration status. Body weight was monitored before and after every training and match, whilst individual fluid intake was only registered during training. The players were informed about their hydration status on day 5. On days 1 to 4, the percentage of players who were at least minimally hypohydrated ranged between 44% and 78%. On day 5 (rest day), all the players were at least minimally hypohydrated. After the information session on day 5, the relative number of euhydrated players increased to 89% on both day 6 (training day) and day 7 (match day). On the final day (rest day), all players were either minimally hypohydrated or hypohydrated. Furthermore, a moderate and significant negative correlation (r=-0.44; N.=54; P=0.01) was found between fluid intake during and USG value before the training sessions. The data illustrates that the hydration status of this population of elite youth female soccer players may be suboptimal and is of substantial concern on rest days during this tournament under temperate conditions. Receiving personal advice about rehydration seems to have a positive effect.

Combined treatment of advanced stages of recurrent skin cancer of the head.

PubMed

Pompucci, Angelo; Rea, Giancarla; Farallo, Eugenio; Salgarello, Marzia; Campanella, Antonino; Fernandez, Eduardo

2004-04-01

The authors investigated whether skull base resection and primary free-flap reconstruction in a single-stage surgery is oncologically effective for treating advanced stages of recurrent skin cancer (RSC) of the head. Eighteen consecutive patients were surgically treated. Twelve of them underwent an anterolateral skull base resection, which was performed using a pterional craniotomy combined with an orbitozygomatic osteotomy. Six patients underwent a posterolateral skull base resection, which was performed using an asterional craniotomy combined with a retrolabyrinthine petrosectomy. The wide postoperative defects were covered with muscular or myocutaneous free flaps. The main factor influencing survival was the extent of the resection: patients with no or minimal residual disease showed a statistically significant longer survival time than those with consistent residual disease. Basal cell carcinoma had a better prognosis than squamous cell carcinoma. A trend toward improved survival was observed in patients classified as T4M0 with negative lymph nodes (N0), but this trend was not statistically significant. Adjuvant radiotherapy significantly influenced both survival time and the rate of local recurrence. The surgical morbidity rate was 27.8%; there were two transient cerebrospinal fluid leaks and three seventh cranial nerve injuries. Late complications included radionecrosis in one patient and skin erosion requiring a second surgery in another patient. No deaths occurred during a 30-day postoperative period. Advances in skull base surgery and free-flap reconstruction allowed the authors to treat patients with advanced-stage RSC of the head in a rather satisfactory manner. Only when it is impossible to achieve no or minimal residual disease should aggressive treatment be considered.

Alternating Bi-Weekly Intravitreal Ranibizumab and Bevacizumab for Refractory Neovascular Age-Related Macular Degeneration with Pigment Epithelial Detachment.

PubMed

Witkin, Andre J; Rayess, Nadim; Garg, Sunir J; Maguire, Joseph I; Storey, Philip; Kaiser, Richard S; Hsu, Jason; Vander, James F; Ho, Allen C

2017-01-01

To describe visual and anatomical outcomes following bi-weekly intravitreal ranibizumab/bevacizumab injections in eyes with refractory neovascular age-related macular degeneration (AMD) and pigment epithelial detachment (PED). Retrospective, consecutive, interventional case series. Eighteen patients diagnosed with neovascular AMD that were refractory to anti-VEGF therapy and received alternating biweekly ranibizumab/bevacizumab injections were included. Patients with neovascular AMD and PED that were refractory to at least 11 monthly ranibizumab or bevacizumab injections were included in this study at a large, single retina practice. Following inclusion, patients received four bi-weekly alternating ranibizumab/bevacizumab intravitreal injections. After completing a course of four bi-weekly injections, patients were treated with variable regimens of intravitreal anti-vascular endothelial growth factor (VEGF) therapy. The primary outcomes of the study included change in visual acuity (VA) and central foveal thickness (CFT) at eight weeks follow-up. Study eyes had previously received a mean of 22 intravitreal anti-VEGF injections. At enrollment, mean VA was 20/95 and mean CFT was 455 µm. After four bi-weekly anti-VEGF injections, mean VA improved to 20/65 (p < 0.001), and mean CFT decreased to 387 µm (p = 0.029). In patients with PED, there was a mean 27.9% reduction in height (p = 0.046) at eight weeks' follow-up. Four injections of bi-weekly alternating ranibizumab/bevacizumab improved visual acuity and reduced macular thickness in a number of patients with refractory neovascular AMD and PED.

A controlled trial of colostomy management by natural evacuation, irrigation and foam enema.

PubMed

Doran, J; Hardcastle, J D

1981-10-01

Twenty patients entered a prospective controlled trial of colostomy management by three techniques--natural evacuation, colostomy irrigation and foam enema. Every patient spent 2 months using each technique. The mean number of colostomy actions weekly was 17 during natural evacuation, 6 during irrigation and 10 with the enema. There was no significant difference in the time taken to manage the colostomy by each technique. Eighteen patients considered that both irrigation and the foam enema improved the quality of their life, and opted to continue with irrigation on completion of the study. There were no major complications during the trial but leakage of foam and an increase in flatus were problems with the foam enema. It is concluded that patients should be made aware of the alternative methods available for colostomy management and be encouraged to use the method of their choice.

Classification of microbial α-amylases for food manufacturing using proteinase digestion.

PubMed

Akiyama, Takumi; Yamazaki, Takeshi; Tada, Atsuko; Ito, Yusai; Otsuki, Noriko; Akiyama, Hiroshi

2014-09-01

Enzymes produced by microorganisms and plants are used as food additives to aid the processing of foods. Identification of the origin of these enzyme products is important for their proper use. Proteinase digestion of α-amylase products, followed by high performance liquid chromatography (HPLC) analysis, was applied to α-amylase from the mold Aspergillus species, the bacteria Bacillus species, and the actinomycetes Saccharomonospora species. Eighteen commercial products of α-amylase were digested with trypsin and endoproteinase Lys-C and HPLC analyzed. For some proteinase/sample combinations, the area of the intact α-amylase peak decreased and new peaks were detected after digestion. The presence and retention times of the novel peaks were used to group the products. The results from this method, called the proteinase digestion-HPLC method, allowed the classification of the α-amylase products into 10 groups, whereas the results from sodium dodecyl sulfate polyacrylamide gel electrophoresis allowed their classification into seven groups.

Classification of passive auditory event-related potentials using discriminant analysis and self-organizing feature maps.

PubMed

Schönweiler, R; Wübbelt, P; Tolloczko, R; Rose, C; Ptok, M

2000-01-01

Discriminant analysis (DA) and self-organizing feature maps (SOFM) were used to classify passively evoked auditory event-related potentials (ERP) P(1), N(1), P(2) and N(2). Responses from 16 children with severe behavioral auditory perception deficits, 16 children with marked behavioral auditory perception deficits, and 14 controls were examined. Eighteen ERP amplitude parameters were selected for examination of statistical differences between the groups. Different DA methods and SOFM configurations were trained to the values. SOFM had better classification results than DA methods. Subsequently, measures on another 37 subjects that were unknown for the trained SOFM were used to test the reliability of the system. With 10-dimensional vectors, reliable classifications were obtained that matched behavioral auditory perception deficits in 96%, implying central auditory processing disorder (CAPD). The results also support the assumption that CAPD includes a 'non-peripheral' auditory processing deficit. Copyright 2000 S. Karger AG, Basel.

Screening and identification of radical scavengers from Neo-Taraxacum siphonanthum by online rapid screening method and nuclear magnetic resonance experiments.

PubMed

Shi, Shu Yun; Zhang, Yu Ping; Zhou, Hong Hao; Huang, Ke Long; Jiang, Xin Yu

2010-01-01

An online rapid screening method, the high-performance liquid chromatography (HPLC)-diode array detector (DAD)-radical scavenging detection (RSD)-electrospray ionization (ESI)-mass spectroscopy (MS)/MS system, was developed for the screening and identification of radical scavengers from Neo-Taraxacum siphonanthum, a new species found in China in 1989. For further characterization, the target compounds were isolated by silica column chromatography, preparative high-performance liquid chromatography (HPLC), HSCCC, and Sephadex LH-20 column chromatography and elucidated on the basis of ultraviolet (UV), ESI-MS/MS, and nuclear magnetic resonance (NMR) spectroscopy, as well as the chemical analysis. Eighteen antioxidative polyphenols (5 caffeic acid derivatives and 13 flavonoid derivatives) were characterized from Neo-T. siphonanthum. The distribution of all compounds was discussed in a chemosystematic context, which suggested that the genera Neo-Taraxacum and Taraxacum might relate chemosystematically.

Multi-objective optimization for an automated and simultaneous phase and baseline correction of NMR spectral data

NASA Astrophysics Data System (ADS)

Sawall, Mathias; von Harbou, Erik; Moog, Annekathrin; Behrens, Richard; Schröder, Henning; Simoneau, Joël; Steimers, Ellen; Neymeyr, Klaus

2018-04-01

Spectral data preprocessing is an integral and sometimes inevitable part of chemometric analyses. For Nuclear Magnetic Resonance (NMR) spectra a possible first preprocessing step is a phase correction which is applied to the Fourier transformed free induction decay (FID) signal. This preprocessing step can be followed by a separate baseline correction step. Especially if series of high-resolution spectra are considered, then automated and computationally fast preprocessing routines are desirable. A new method is suggested that applies the phase and the baseline corrections simultaneously in an automated form without manual input, which distinguishes this work from other approaches. The underlying multi-objective optimization or Pareto optimization provides improved results compared to consecutively applied correction steps. The optimization process uses an objective function which applies strong penalty constraints and weaker regularization conditions. The new method includes an approach for the detection of zero baseline regions. The baseline correction uses a modified Whittaker smoother. The functionality of the new method is demonstrated for experimental NMR spectra. The results are verified against gravimetric data. The method is compared to alternative preprocessing tools. Additionally, the simultaneous correction method is compared to a consecutive application of the two correction steps.

A new patient registration method for intensive care department management.

PubMed

Van Aken, P; Bossaert, L; Gilot, C; Tielemans, L

1987-01-01

A new method to describe intensive care department performance is presented. The method is a complication of available administrative and medical data, completed with a severity of illness measure (Acute Physiology And Chronic Health Evaluation, APACHE) and the registration of nursing care intensity. The development of this latter patient stratification system (Intensive Care Activity Score, INCAS) is described. The performance of the method is demonstrated by a study of 200 consecutive admissions.

Gastrointestinal Injuries in Blunt Abdominal Traumas.

PubMed

Gönüllü, D; Ilgun, S; Gedik, M L; Demiray, O; Öner, Z; Er, M; Köksoy, F N

2015-01-01

To discuss the efficiency of RTS (Revised TraumaScore), ISS (Injury Severity Score), and factors that affect mortality and morbidity in gastrointestinal injuries due to blunt trauma.Method and methods: Patients with gastrointestinal injuries due to blunt trauma operated within the last six years have been studied retrospectively in terms of demographics,injury mechanism and localization, additional injuries, RTS and ISS, operative technique, morbidity, mortality and duration of hospitalization. Of the eighteen cases, cause of injury was a traffic accident for 11 (61.1%), fall from height for 5 (27%) and physical attack for 2 (11%). Among the eighteen patients,there were 21 gastrointestinal injuries (11 intestinal, 6 colon,3 duodenum, 1 stomach). 10 (55.6%) had additional intraabdominal injuries while the number for extra-abdominal injuries were 12 (66.7%). Primary suture (10), segmentary resection (9) and pyloric exclusion (2) were the operations performed for the twenty-one gastrointestinal injuries.Although statistically not significant, 13(72.2%) patients with additional injuries compared with 5 (27.8%) patients with isolated gastrointestinal injuries, were found to have lower RTS (7.087/7.841), higher ISS (19.4/12.2), longer duration of hospitalization (11.5/8.4 day) as well as higher morbidity (7/1) and mortality (2/0) rates. Comparing the RTS (7.059/7.490) of patients who have and have not developed morbidity revealed no significant difference.However, ISS (23.9/12.2) was significantly higher in patients who have developed morbidity (p=0.003). RTS (6.085 7.445) and ISS (39.5/14.6) of patients who have survived were significantly different than patients who have not(p=0.037 and p=0.023, respectively) Additional injuries in patients with gastrointestinal injury due blunt abdominal traumas increases, although not significantly, morbidity, mortality and duration of hospitalization even when operated early. High ISS is significantly related to the risk of both morbidity and mortality while low RTS is significantly related only to the mortality risk. Celsius.

Learning outcomes associated with patient simulation method in pharmacotherapy education: an integrative review.

PubMed

Aura, Suvi M; Sormunen, Marjorita S T; Jordan, Sue E; Tossavainen, Kerttu A; Turunen, Hannele E

2015-06-01

The aims of this systematic integrative review were to identify evidence for the use of patient simulation teaching methods in pharmacotherapy education and to explore related learning outcomes. A systematic literature search was conducted using 6 databases as follows: CINAHL, PubMed, SCOPUS, ERIC, MEDIC, and the Cochrane Library, using the key words relating to patient simulation and pharmacotherapy. The methodological quality of each study was evaluated. Eighteen articles met the inclusion criteria. The earliest article was published in 2005. The selected research articles were subjected to qualitative content analysis. Patient simulation has been used in pharmacotherapy education for preregistration nursing, dental, medical, and pharmacy students and for the continuing education of nurses. Learning outcomes reported were summarized as follows: (1) commitment to pharmacotherapy learning, (2) development of pharmacotherapy evaluation skills, (3) improvement in pharmacotherapy application skills, and (4) knowledge and understanding of pharmacotherapy. To develop effective teaching methods and ensure health care professionals' competence in medication management, further research is needed to determine the educational and clinical effectiveness of simulation teaching methods.

Comparative evaluation of matrix-assisted laser desorption ionisation-time of flight mass spectrometry and conventional phenotypic-based methods for identification of clinically important yeasts in a UK-based medical microbiology laboratory.

PubMed

Fatania, Nita; Fraser, Mark; Savage, Mike; Hart, Jason; Abdolrasouli, Alireza

2015-12-01

Performance of matrix-assisted laser desorption ionisation-time of flight mass spectrometry (MALDI-TOF MS) was compared in a side-by side-analysis with conventional phenotypic methods currently in use in our laboratory for identification of yeasts in a routine diagnostic setting. A diverse collection of 200 clinically important yeasts (19 species, five genera) were identified by both methods using standard protocols. Discordant or unreliable identifications were resolved by sequencing of the internal transcribed spacer region of the rRNA gene. MALDI-TOF and conventional methods were in agreement for 182 isolates (91%) with correct identification to species level. Eighteen discordant results (9%) were due to rarely encountered species, hence the difficulty in their identification using traditional phenotypic methods. MALDI-TOF MS enabled rapid, reliable and accurate identification of clinically important yeasts in a routine diagnostic microbiology laboratory. Isolates with rare, unusual or low probability identifications should be confirmed using robust molecular methods. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Eighteen-ninety-six and all that

NASA Astrophysics Data System (ADS)

Heilbron, J. L.

1996-01-01

This year's commemorative platter includes ether anaesthesia, smallpox vaccination, radioactivity and several mathematical morsels, as well as an accidental death (Otto Lilienthal) and the mother of all births (the Universe).

Financing the health care Internet.

PubMed

Robinson, J C

2000-01-01

Internet-related health care firms have accelerated through the life cycle of capital finance and organizational destiny, including venture capital funding, public stock offerings, and consolidation, in the wake of heightened competition and earnings disappointments. Venture capital flooded into the e-health sector, rising from $3 million in the first quarter of 1998 to $335 million two years later. Twenty-six e-health firms went public in eighteen months, raising $1.53 billion at initial public offering (IPO) and with post-IPO share price appreciation greater than 100 percent for eighteen firms. The technology-sector crash hit the e-health sector especially hard, driving share prices down by more than 80 percent for twenty-one firms. The industry now faces an extended period of consolidation between e-health and conventional firms.

A Double Take: The Practical and Ethical Dilemmas of Teaching the Visual Method of Photo Elicitation

ERIC Educational Resources Information Center

Wakefield, Caroline; Watt, Sal

2014-01-01

This paper advocates the teaching of photo elicitation in higher education as a valuable data collection technique and draws on our experience of teaching this visual method across two consecutive postgraduate cohorts. Building on previous work (Watt & Wakefield, 2014) and based on a former concern regarding student duty of care, a…

A new method of evaluating tight gas sands pore structure from nuclear magnetic resonance (NMR) logs

NASA Astrophysics Data System (ADS)

Xiao, Liang; Mao, Zhi-qiang; Xie, Xiu-hong

2016-04-01

Tight gas sands always display such characteristics of ultra-low porosity, permeability, high irreducible water, low resistivity contrast, complicated pore structure and strong heterogeneity, these make that the conventional methods are invalid. Many effective gas bearing formations are considered as dry zones or water saturated layers, and cannot be identified and exploited. To improve tight gas sands evaluation, the best method is quantitative characterizing rock pore structure. The mercury injection capillary pressure (MICP) curves are advantageous in predicting formation pore structure. However, the MICP experimental measurements are limited due to the environment and economy factors, this leads formation pore structure cannot be consecutively evaluated. Nuclear magnetic resonance (NMR) logs are considered to be promising in evaluating rock pore structure. Generally, to consecutively quantitatively evaluate tight gas sands pore structure, the best method is constructing pseudo Pc curves from NMR logs. In this paper, based on the analysis of lab experimental results for 20 core samples, which were drilled from tight gas sandstone reservoirs of Sichuan basin, and simultaneously applied for lab MICP and NMR measurements, the relationships of piecewise power function between nuclear magnetic resonance (NMR) transverse relaxation T2 time and pore-throat radius Rc are established. A novel method, which is used to transform NMR reverse cumulative curve as pseudo capillary pressure (Pc) curve is proposed, and the corresponding model is established based on formation classification. By using this model, formation pseudo Pc curves can be consecutively synthesized. The pore throat radius distribution, and pore structure evaluation parameters, such as the average pore throat radius (Rm), the threshold pressure (Pd), the maximum pore throat radius (Rmax) and so on, can also be precisely extracted. After this method is extended into field applications, several tight gas sandstone reservoirs are processed, and the predicted results are compared with core derived results. Good consistency between evaluated results with core derived results illustrates the dependability of the proposed method. Comparing with the previous methods, this presented model is much more theoretical, and the applicability is much improved. Combining with the evaluated results, our target tight gas sands are well evaluated, and many potential gas-bearing layers are effectively identified.

Prevalence and risk factors for renal scars in children with febrile UTI and/or VUR: A cross-sectional observational study of 565 consecutive patients

PubMed Central

Snodgrass, Warren T.; Shah, Anjana; Yang, Mary; Kwon, Jeannie; Villanueva, Carlos; Traylor, Janelle; Pritzker, Karen; Nakonezny, Paul A.; Haley, Robert W.; Bush, Nicol Corbin

2013-01-01

Purpose To determine prevalence and risk factors for renal scar in children referred for urologic assessment of febrile UTI and/or VUR. Methods Pre-determined risk factors for renal scar were prospectively recorded in consecutive patients referred for UTI/VUR. Age, gender, VUR grade, and reported number of febrile and non-febrile UTIs were analyzed with logistic regression to determine risk for focal cortical defects on non-acute DMSA. Results Of 565 consecutive children, 24 (4%) had congenital renal dysplasia and 84 (15.5%) had focal defect(s). VUR, especially grades IV–V, recurrent febrile UTI, and older age increased risk. For any age child with the same number of UTIs, VUR increased odds of renal defect 5.4-fold (OR = 5.4, 95% CI = 2.7–10.6, AUC = 0.759). Conclusions Focal DMSA defects were present in 15.5% of 565 consecutive children referred for febrile UTI and/or VUR; 4% had presumed congenital reflux nephropathy without cortical defect. All VUR grades increased risk for these defects, as did recurrent febrile UTIs and older age. However, 43% with grades IV–V VUR and 76% with recurrent UTI had normal DMSA. PMID:23465483

Data volume reduction for imaging radar polarimetry

NASA Technical Reports Server (NTRS)

Zebker, Howard A. (Inventor); Held, Daniel N. (Inventor); Vanzyl, Jakob J. (Inventor); Dubois, Pascale C. (Inventor); Norikane, Lynne (Inventor)

1988-01-01

Two alternative methods are presented for digital reduction of synthetic aperture multipolarized radar data using scattering matrices, or using Stokes matrices, of four consecutive along-track pixels to produce averaged data for generating a synthetic polarization image.

Data volume reduction for imaging radar polarimetry

NASA Technical Reports Server (NTRS)

Zebker, Howard A. (Inventor); Held, Daniel N. (Inventor); van Zul, Jakob J. (Inventor); Dubois, Pascale C. (Inventor); Norikane, Lynne (Inventor)

1989-01-01

Two alternative methods are disclosed for digital reduction of synthetic aperture multipolarized radar data using scattering matrices, or using Stokes matrices, of four consecutive along-track pixels to produce averaged data for generating a synthetic polarization image.

EST! best practices

DOT National Transportation Integrated Search

2000-10-05

This booklet presents the eighteen winners in a competition for projects that promote environmentally sustainable transportation (EST). These range from car sharing to hydrogen fueled buses to public transit promotion campaign. Each project is presen...

Evaluation of laboratory tests for dengue diagnosis in clinical specimens from consecutive patients with suspected dengue in Belo Horizonte, Brazil.

PubMed

Ferraz, Fernanda Oliveira; Bomfim, Maria Rosa Quaresma; Totola, Antônio Helvécio; Ávila, Thiago Vinícius; Cisalpino, Daniel; Pessanha, José Eduardo Marques; da Glória de Souza, Danielle; Teixeira Júnior, Antônio Lúcio; Nogueira, Maurício Lacerda; Bruna-Romero, Oscar; Teixeira, Mauro Martins

2013-09-01

Dengue is a widely spread arboviral disease in tropical and subtropical regions of the world. Dengue fever presents clinical characteristics similar to other febrile illness. Thus laboratory diagnosis is important for adequate management of the disease. The present study was designed to evaluate the diagnostic performance of real-time PCR and serological methods for dengue in a real epidemic context. Clinical data and blood samples were collected from consecutive patients with suspected dengue who attended a primary health care unit in Belo Horizonte, Brazil. Serologic methods and real-time PCR were performed in serum samples to confirm dengue diagnosis. Among the 181 consecutive patients enrolled in this study with suspected dengue, 146 were considered positive by serological criteria (positive NS1 ELISA and/or anti-dengue IgM ELISA) and 138 were positive by real-time PCR. Clinical criteria were not sufficient for distinguishing between dengue and non-dengue febrile illness. The PCR reaction was pre-optimized using samples from patients with known viral infection. It had similar sensitivity compared to NS1 ELISA (88% and 89%, respectively). We also evaluated three commercial lateral flow immunochromatographic tests for NS1 detection (BIOEASY, BIORAD and PANBIO). All three tests showed high sensitivity (94%, 91% and 81%, respectively) for dengue diagnosis. According to our results it can be suggested that lateral flow tests for NS1 detection are the most feasible methods for early diagnosis of dengue. Copyright © 2013 Elsevier B.V. All rights reserved.

The use of salinity contrast for density difference compensation to improve the thermal recovery efficiency in high-temperature aquifer thermal energy storage systems

NASA Astrophysics Data System (ADS)

van Lopik, Jan H.; Hartog, Niels; Zaadnoordijk, Willem Jan

2016-08-01

The efficiency of heat recovery in high-temperature (>60 °C) aquifer thermal energy storage (HT-ATES) systems is limited due to the buoyancy of the injected hot water. This study investigates the potential to improve the efficiency through compensation of the density difference by increased salinity of the injected hot water for a single injection-recovery well scheme. The proposed method was tested through numerical modeling with SEAWATv4, considering seasonal HT-ATES with four consecutive injection-storage-recovery cycles. Recovery efficiencies for the consecutive cycles were investigated for six cases with three simulated scenarios: (a) regular HT-ATES, (b) HT-ATES with density difference compensation using saline water, and (c) theoretical regular HT-ATES without free thermal convection. For the reference case, in which 80 °C water was injected into a high-permeability aquifer, regular HT-ATES had an efficiency of 0.40 after four consecutive recovery cycles. The density difference compensation method resulted in an efficiency of 0.69, approximating the theoretical case (0.76). Sensitivity analysis showed that the net efficiency increase by using the density difference compensation method instead of regular HT-ATES is greater for higher aquifer hydraulic conductivity, larger temperature difference between injection water and ambient groundwater, smaller injection volume, and larger aquifer thickness. This means that density difference compensation allows the application of HT-ATES in thicker, more permeable aquifers and with larger temperatures than would be considered for regular HT-ATES systems.

Geriatric Conditions in Acutely Hospitalized Older Patients: Prevalence and One-Year Survival and Functional Decline

PubMed Central

Buurman, Bianca M.; Hoogerduijn, Jita G.; de Haan, Rob J.; Abu-Hanna, Ameen; Lagaay, A. Margot; Verhaar, Harald J.; Schuurmans, Marieke J.; Levi, Marcel; de Rooij, Sophia E.

2011-01-01

Background To study the prevalence of eighteen geriatric conditions in older patients at admission, their reporting rate in discharge summaries and the impact of these conditions on mortality and functional decline one year after admission. Method A prospective multicenter cohort study conducted between 2006 and 2008 in two tertiary university teaching hospitals and one regional teaching hospital in the Netherlands. Patients of 65 years and older, acutely admitted and hospitalized for at least 48 hours, were invited to participate. Eighteen geriatric conditions were assessed at hospital admission, and outcomes (mortality, functional decline) were assessed one year after admission. Results 639 patients were included, with a mean age of 78 years. IADL impairment (83%), polypharmacy (61%), mobility difficulty (59%), high levels of primary caregiver burden (53%), and malnutrition (52%) were most prevalent. Except for polypharmacy and cognitive impairment, the reporting rate of the geriatric conditions in discharge summaries was less than 50%. One year after admission, 35% had died and 33% suffered from functional decline. A high Charlson comorbidity index score, presence of malnutrition, high fall risk, presence of delirium and premorbid IADL impairment were associated with mortality and overall poor outcome (mortality or functional decline). Obesity lowered the risk for mortality. Conclusion Geriatric conditions were highly prevalent and associated with poor health outcomes after admission. Early recognition of these conditions in acutely hospitalized older patients and improving the handover to the general practitioner could lead to better health outcomes and reduce the burden of hospital admission for older patients. PMID:22110598

Impact on cognitive functions following gamma knife radiosurgery for cerebral arteriovenous malformations

PubMed Central

Raghunath, A.; Bennett, Niranjana; Arimappamagan, Arivazhagan; Bhat, Dhananjaya I.; Srinivas, Dwarakanath; Thennarasu, K.; Jamuna, R.; Somanna, Sampath

2016-01-01

Background: Radiosurgery is an alternative to surgical resection of arteriovenous malformation (AVM). Very few studies have addressed the concern of radiation injury to the brain and its attendant adverse effects on cognitive function. Materials and Methods: This prospective study included all patients who underwent gamma knife radiosurgery (GKRS) at our institute for cerebral AVM between 2006 and December 2008 (n = 34). All patients underwent neuropsychological evaluation before the procedure. Neuropsychological evaluation was repeated in eighteen patients 2 years following GKRS. Clinical outcome, AVM obliteration, and factors influencing outcome were analyzed in these eighteen patients. Results: Before GKRS, more than 50% had significant impairment of neuropsychological functions compared to normal population norms. 66.6% achieved the excellent radiosurgical outcome. At 2 years follow-up, patients showed varied improvement in neuropsychological function in various categories. Pretherapeutic median value for percentage perseverative responses was 26.5 and at follow-up, it reduced to 18.2 (P = 0.039). Set shifting improved in 11 patients (61.1%), remained same in 5 patients (27.7%), and deteriorated in two patients (11.1%). Patients with a higher Spetzler-Martin grade AVM demonstrated a significantly more favorable shift in follow-up test values for set shifting function (P = 0.021). Patients with postradiation imaging changes had lesser tendency to improve in neuropsychological performance at follow-up. Conclusions: GKRS has no clinically harmful effect on cognitive and neuropsychological functioning in patients with brain AVM. On the contrary, there is an improvement in majority of patients at 2 years following radiosurgery when nidus is obliterated. PMID:26933340

Identification of trends in rainfall, rainy days and 24 h maximum rainfall over subtropical Assam in Northeast India

NASA Astrophysics Data System (ADS)

Jhajharia, Deepak; Yadav, Brijesh K.; Maske, Sunil; Chattopadhyay, Surajit; Kar, Anil K.

2012-01-01

Trends in rainfall, rainy days and 24 h maximum rainfall are investigated using the Mann-Kendall non-parametric test at twenty-four sites of subtropical Assam located in the northeastern region of India. The trends are statistically confirmed by both the parametric and non-parametric methods and the magnitudes of significant trends are obtained through the linear regression test. In Assam, the average monsoon rainfall (rainy days) during the monsoon months of June to September is about 1606 mm (70), which accounts for about 70% (64%) of the annual rainfall (rainy days). On monthly time scales, sixteen and seventeen sites (twenty-one sites each) witnessed decreasing trends in the total rainfall (rainy days), out of which one and three trends (seven trends each) were found to be statistically significant in June and July, respectively. On the other hand, seventeen sites witnessed increasing trends in rainfall in the month of September, but none were statistically significant. In December (February), eighteen (twenty-two) sites witnessed decreasing (increasing) trends in total rainfall, out of which five (three) trends were statistically significant. For the rainy days during the months of November to January, twenty-two or more sites witnessed decreasing trends in Assam, but for nine (November), twelve (January) and eighteen (December) sites, these trends were statistically significant. These observed changes in rainfall, although most time series are not convincing as they show predominantly no significance, along with the well-reported climatic warming in monsoon and post-monsoon seasons may have implications for human health and water resources management over bio-diversity rich Northeast India.

Recovery of decreased bone mineral mass after lower-limb fractures in adolescents.

PubMed

Ceroni, Dimitri; Martin, Xavier E; Delhumeau, Cécile; Farpour-Lambert, Nathalie J; De Coulon, Geraldo; Dubois-Ferrière, Victor; Rizzoli, René

2013-06-05

Loss of bone mineral mass, muscle atrophy, and functional limitations are predictable consequences of immobilization and subsequent weight-bearing restriction due to leg or ankle fractures. The aim of this study was to prospectively determine whether decreased bone mineral mass following lower-limb fractures recovers at follow-up durations of six and eighteen months in adolescents. In the present study, we included fifty adolescents who underwent cast immobilization for a leg or ankle fracture. Dual x-ray absorptiometry scans of four different sites (total hip, femoral neck, entire lower limb, and calcaneus) were performed at the time of the fracture, at cast removal, and at follow-ups of six and eighteen months. Patients with fractures were paired with healthy controls according to sex, age, and ethnicity. Dual x-ray absorptiometry values were compared between groups and between injured and non-injured legs in adolescents with fractures. Among those with fractures, lower-limb bone mineral variables were significantly lower at the injured side compared with the non-injured side at cast removal, with differences ranging from 6.2% to 31.7% (p < 0.0001). Similarly, injured adolescents had significantly lower bone mineral values at the level of the injured lower limb compared with healthy controls (p < 0.0001). At the six-month follow-up, there were still significant residual differences between injured and non-injured legs in adolescents with fractures (p < 0.0001). However, a significant residual difference between healthy controls and injured adolescents was present only for femoral neck bone mineral density (p = 0.011). At the eighteen-month follow-up, no significant difference was observed at any lower-limb site. Bone mineral loss following a fracture of the lower limb in adolescents is highly significant and affects the lower limb both proximal to and distal to the fracture site. In contrast to observations in adults, a rapid bone mass reversal occurs with full bone recovery by eighteen months. Prognostic Level I. See Instructions for Authors for a complete description of levels of evidence.

Preventing unintended pregnancies and improving contraceptive use among young adult women in a rural, Midwestern state: health promotion implications.

PubMed

Campo, Shelly; Askelson, Natoshia M; Spies, Erica L; Losch, Mary

2010-05-01

Despite high rates of unintended pregnancy among women aged 18 to 30 years, little research has been conducted to understand the factors associated with their contraceptive use. Eighteen focus groups were conducted with young adult women (N = 106) who were mostly white, non-Hispanic. Results suggested that contraceptive use was negatively affected by low contraceptive knowledge; use of alcohol; a lack of planning for sex; a misperception of the likelihood of pregnancy; forgetting to use contraceptives; and concerns about side effects, cost, and confidentiality. Women liked the peace of mind that using contraceptives gave them and the benefits of regular periods from some hormonal methods. Implications for reducing unintended pregnancies through interventions are offered.

Hyaline membrane disease is underreported in a linked birth-infant death certificate database.

PubMed Central

Hamvas, A; Kwong, P; DeBaun, M; Schramm, W; Cole, F S

1998-01-01

OBJECTIVE: This study compared the Missouri State Department of Health linked birth-infant death certificate database and medical records with respect to recording hyaline membrane disease in very low-birth-weight infants. METHODS: We reviewed the records for all 976 infants weighing 500 to 1500 g who were born to St. Louis, Mo, residents in 1989, 1991, and 1992. RESULTS: Eighteen percent of the birth certificates and 54% of the medical records documented hyaline membrane disease, resulting in 34% sensitivity and 99% specificity. CONCLUSIONS: The Missouri State Department of Health birth-infant death certificate database underestimates the incidence of hyaline membrane disease, which suggest that national statistics for the disease are also underestimated. PMID:9736884

Twinkle artefact in the ultrasound diagnosis of superficial epidermoid cysts

PubMed Central

Clarke, Richard; Suresh, Priya; Thomas, Rose

2016-01-01

Aim The aim of the study was to evaluate whether the twinkle artefact is a valuable feature in the sonographic diagnosis of superficial epidermoid cysts. Materials and methods A retrospective search was undertaken of our institution’s Radiology Information System and pathology database to identify cases of superficial masses showing the twinkle artefact that proceeded to surgical excision. Results Eighteen superficial masses demonstrating the twinkle artefact were identified that were submitted for pathological analysis. Of these, 17 were confirmed to represent epidermoid cysts and only 1 case had an alternative diagnosis (proliferating trichilemmal cyst). Conclusion The presence of the twinkle artefact appears to be a specific and valuable ancillary sonographic feature for the diagnosis of superficial epidermoid cysts. PMID:27867407

Trace-metal concentrations, waters from selected sky lakes, streams and springs, northern Shawangunk Mountains, New York: geologic and ecologic implications

USGS Publications Warehouse

Friedman, J.D.; Huth, P.C.; Smiley, D.

1990-01-01

Reconnaissance sampling and chemical analysis of water from selected lakes, streams and springs of the northern Shawangunk Mountains in 1987 to 1988 to determine the influence of lithology on trace-metal concentrations in surface water, and to establish a base level of concentration of 27 selected metals by ICP-AES and Hg by cold-vapor AAS methods, for geochemical exploration, ecologic, acid-rain, and climatic-change studies, have yielded trace-metal concentrations greater than detection limits for 10 metallic elements. Eighteen additional metallic elements were also present in trace quantities below the quantitative detection limit. Two distinct geochemical populations are related to source lithology and pH. -from Authors

Long-term cryogenic space storage system

NASA Technical Reports Server (NTRS)

Hopkins, R. A.; Chronic, W. L.

1973-01-01

Discussion of the design, fabrication and testing of a 225-cu ft spherical cryogenic storage system for long-term subcritical applications under zero-g conditions in storing subcritical cryogens for space vehicle propulsion systems. The insulation system design, the analytical methods used, and the correlation between the performance test results and analytical predictions are described. The best available multilayer insulation materials and state-of-the-art thermal protection concepts were applied in the design, providing a boiloff rate of 0.152 lb/hr, or 0.032% per day, and an overall heat flux of 0.066 Btu/sq ft hr based on a 200 sq ft surface area. A six to eighteen month cryogenic storage is provided by this system for space applications.

Apparatus Notes

ERIC Educational Resources Information Center

Miles, C. L., Ed.

1974-01-01

Describes an approach wherein the student selects a single type of simple item and uses it as the basis for making a physics demonstration. Provides an example that uses a cheese dish in eighteen different demonstrations. (GS)

9 CFR 113.3 - Sampling of biological products.

Code of Federal Regulations, 2013 CFR

2013-01-01

... bacterial vaccines; (iii) Two samples of Coccidiosis Vaccine; (iv) Eighteen samples of Rabies Vaccine...) Twenty-two single-dose or 14 multiple-dose samples of Rabies Vaccine, Killed Virus; (viii) Sixteen single...

9 CFR 113.3 - Sampling of biological products.

Code of Federal Regulations, 2014 CFR

2014-01-01

... bacterial vaccines; (iii) Two samples of Coccidiosis Vaccine; (iv) Eighteen samples of Rabies Vaccine...) Twenty-two single-dose or 14 multiple-dose samples of Rabies Vaccine, Killed Virus; (viii) Sixteen single...

9 CFR 113.3 - Sampling of biological products.

Code of Federal Regulations, 2012 CFR

2012-01-01

... bacterial vaccines; (iii) Two samples of Coccidiosis Vaccine; (iv) Eighteen samples of Rabies Vaccine...) Twenty-two single-dose or 14 multiple-dose samples of Rabies Vaccine, Killed Virus; (viii) Sixteen single...

The Effects of Teaching and Assessment Methods on Academic Performance: A Study of an Operations Management Course

ERIC Educational Resources Information Center

Sacristán-Díaz, Macarena; Garrido-Vega, Pedro; Alfalla-Luque, Rafaela; González-Zamora, María-del-Mar

2016-01-01

Whether the use of more active teaching-learning methods has a positive impact on academic performance remains unanswered. This article seeks to contribute to the issue by conducting a study of an Operations Management course with almost 1000 students per year over three consecutive academic years. The study compares three scenarios with differing…

Conditions That Facilitate Music Learning among Students with Special Needs: A Mixed-Methods Inquiry

ERIC Educational Resources Information Center

Gerrity, Kevin W.; Hourigan, Ryan M.; Horton, Patrick W.

2013-01-01

The purpose of this mixed-methods study was to identify and define the conditions that facilitate learning in music among students with special needs. Children with special needs met once a week for 10 consecutive weeks and received instruction in primarily music as well as the other arts. The children completed pre- and posttest evaluations that…

Determining the mean hydraulic gradient of ground water affected by tidal fluctuations

USGS Publications Warehouse

Serfes, Michael E.

1991-01-01

Tidal fluctuations in surface-water bodies produce progressive pressure waves in adjacent aquifers. As these pressure waves propagate inland, ground-water levels and hydraulic gradients continuously fluctuate, creating a situation where a single set of water-level measurements cannot be used to accurately characterize ground-water flow. For example, a time series of water levels measured in a confined aquifer in Atlantic City, New Jersey, showed that the hydraulic gradient ranged from .01 to .001 with a 22-degree change in direction during a tidal day of approximately 25 hours. At any point where ground water tidally fluctuates, the magnitude and direction of the hydraulic gradient fluctuates about the mean or regional hydraulic gradient. The net effect of these fluctuations on ground-water flow can be determined using the mean hydraulic gradient, which can be calculated by comparing mean ground- and surface-water elevations. Filtering methods traditionally used to determine daily mean sea level can be similarly applied to ground water to determine mean levels. Method (1) uses 71 consecutive hourly water-level observations to accurately determine the mean level. Method (2) approximates the mean level using only 25 consecutive hourly observations; however, there is a small error associated with this method.

[Changes of resistant phenotype and CRISPR/Cas system of four Shigella strains passaged for 90 times without antibiotics].

PubMed

Zhang, B; Hong, L J; Duan, G C; Liang, W J; Yang, H Y; Xi, Y L

2017-02-10

Objective: To explore the stability of resistant phenotypes and changes of clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated (Cas) gene system on four Shigella strains in the absence of antibiotics. Methods: Four clinical isolated Shigella strains that resistant to different antibiotics were consecutive passaged for 90 times without antibiotics. Agar dilution method was used to determine the minimum inhibitory concentration of Shigella strains. After sequence analysis with PCR, CRISPR Finder and Clustal X 2.1 were applied to identify the changes of CRISPR loci in the Shigella strains. Results: After the consecutive transfer of 90 generations, sensitivity to certain antibiotics of four Shigella strains with different drug resistant spectrums increased. Mel-sf1998024/zz resistance to ampicillin, cephalexin, cefotaxime, chloramphenicol decreased, mel-s2014026/sx resistance to norfloxacin, trimethoprim decreased, mel-sf2004004/sx drug resistance to ampicillin, cefuroxime, cefotaxime, chloramphenicol, trimethoprim decreased and mel-sf2013004/bj resistance to chloramphenicol decreased. The spacer of which matched gene codes Cas and its upstream repeat in 3'end of CRISPR3 got lost in mel-sf1998024/zz and mel-sf2013004/bj. Conclusions: Shigella strains could reduce or lose their resistance to some antibiotics after consecutive transfers, without the interference of antibiotics. CRISPR3 locus had dynamic spacers in Shigella strains while CRISPR3 locus and cas genes might have been co-evolved.

An improved method for determination of refractive index of absorbing films: A simulation study

NASA Astrophysics Data System (ADS)

Özcan, Seçkin; Coşkun, Emre; Kocahan, Özlem; Özder, Serhat

2017-02-01

In this work an improved version of the method presented by Gandhi was presented for determination of refractive index of absorbing films. In this method local maxima of consecutive interference order in transmittance spectrum are used. The method is based on the minimizing procedure leading to the determination of interference order accurately by using reasonable Cauchy parameters. It was tested on theoretically generated transmittance spectrum of absorbing film and the details of the minimization procedure were discussed.

Eighteen ninety five and all that

NASA Astrophysics Data System (ADS)

Heilbron, J. L.; Bynum, W. F.

1995-01-01

Anniversarial commemorations this year include the discovery of X-rays, the calculation of the position of the undiscovered planet Neptune, the emergence of syphilis and the mandatory serving of lime juice to British sailors.

Highway engineers assess the public hearing process.

DOT National Transportation Integrated Search

1976-01-01

Representatives from the eight construction districts of the Virginia Department of Highways and Transportation were interviewed concerning their involvement in public hearings. The sample consisted of seven district engineers and eighteen other dist...

Ordinal Position, Sex of Sibling, Sex, and Personal Preferences in a Group of Eighteen Year Olds

ERIC Educational Resources Information Center

Oberlander, Mark I.; And Others

1970-01-01

Investigates three hypotheses derived from previous research, that different ordinal position groups manifest differential personal preference patterns, as measured by the Kuder Preference Record. (Author)

Eighteen new oleaginous yeast species.

PubMed

Garay, Luis A; Sitepu, Irnayuli R; Cajka, Tomas; Chandra, Idelia; Shi, Sandy; Lin, Ting; German, J Bruce; Fiehn, Oliver; Boundy-Mills, Kyria L

2016-07-01

Of 1600 known species of yeasts, about 70 are known to be oleaginous, defined as being able to accumulate over 20 % intracellular lipids. These yeasts have value for fundamental and applied research. A survey of yeasts from the Phaff Yeast Culture Collection, University of California Davis was performed to identify additional oleaginous species within the Basidiomycota phylum. Fifty-nine strains belonging to 34 species were grown in lipid inducing media, and total cell mass, lipid yield and triacylglycerol profiles were determined. Thirty-two species accumulated at least 20 % lipid and 25 species accumulated over 40 % lipid by dry weight. Eighteen of these species were not previously reported to be oleaginous. Triacylglycerol profiles were suitable for biodiesel production. These results greatly expand the number of known oleaginous yeast species, and reveal the wealth of natural diversity of triacylglycerol profiles within wild-type oleaginous Basidiomycetes.

Development of eighteen microsatellite loci in walleye (Sander vitreus)

USGS Publications Warehouse

Coykendall, D. Katharine; Morrison, Cheryl L.; Stott, Wendylee; Springmann, Marcus J.

2014-01-01

A suite of tri- and tetra-nucleotide microsatellite loci were developed for walleye (Sander vitreus) from 454 pyrosequencing data. Eighteen of the 50 primer sets tested amplified consistently in 35 walleye from two lakes on Isle Royale, Lake Superior: Chickenbone Lake and Whittlesey Lake. The loci displayed moderate levels of allelic diversity (average 5.5 alleles/locus) and heterozygosity (average 35.8 %). Levels of genetic diversity were sufficient to produce unique multi-locus genotypes and detect phylogeographic structuring as individuals assigned back to their population of origin. Cross-species amplification within S. canadensis(sauger) was successful for 15 loci, and 11 loci were diagnostic to species. The loci characterized here will be useful for detecting fine-scale spatial structuring, resolving the taxonomic status of Sander species and sub-species, and detecting walleye/sauger hybrids.

SeSaM-Tv-II generates a protein sequence space that is unobtainable by epPCR.

PubMed

Mundhada, Hemanshu; Marienhagen, Jan; Scacioc, Andreea; Schenk, Alexander; Roccatano, Danilo; Schwaneberg, Ulrich

2011-07-04

Generating high-quality mutant libraries in which each amino acid is equally targeted and substituted in a chemically diverse manner is crucial to obtain improved variants in small mutant libraries. The sequence saturation mutagenesis method (SeSaM-Tv(+) ) offers the opportunity to generate such high-quality mutant libraries by introducing consecutive mutations and by enriching transversions. In this study, automated gel electrophoresis, real-time quantitative PCR, and a phosphorimager quantification system were developed and employed to optimize each step of previously reported SeSaM-Tv(+) method. Advancements of the SeSaM-Tv(+) protocol and the use of a novel DNA polymerase quadrupled the number of transversions, by doubling the fraction of consecutive mutations (from 16.7 to 37.1 %). About 33 % of all amino acid substitutions observed in a model library are rarely introduced by epPCR methods, and around 10 % of all clones carried amino acid substitutions that are unobtainable by epPCR. Copyright © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

9 CFR 77.20 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... INTERSTATE TRANSPORTATION OF ANIMALS (INCLUDING POULTRY) AND ANIMAL PRODUCTS TUBERCULOSIS Captive Cervids... “Uniform Methods and Rules—Bovine Tuberculosis Eradication” and in which tuberculosis is prevalent in less.... A herd of captive cervids that has tested negative to at least two consecutive official tuberculosis...

9 CFR 77.20 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... INTERSTATE TRANSPORTATION OF ANIMALS (INCLUDING POULTRY) AND ANIMAL PRODUCTS TUBERCULOSIS Captive Cervids... “Uniform Methods and Rules—Bovine Tuberculosis Eradication” and in which tuberculosis is prevalent in less.... A herd of captive cervids that has tested negative to at least two consecutive official tuberculosis...

9 CFR 77.20 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... INTERSTATE TRANSPORTATION OF ANIMALS (INCLUDING POULTRY) AND ANIMAL PRODUCTS TUBERCULOSIS Captive Cervids... “Uniform Methods and Rules—Bovine Tuberculosis Eradication” and in which tuberculosis is prevalent in less.... A herd of captive cervids that has tested negative to at least two consecutive official tuberculosis...

9 CFR 77.20 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... INTERSTATE TRANSPORTATION OF ANIMALS (INCLUDING POULTRY) AND ANIMAL PRODUCTS TUBERCULOSIS Captive Cervids... “Uniform Methods and Rules—Bovine Tuberculosis Eradication” and in which tuberculosis is prevalent in less.... A herd of captive cervids that has tested negative to at least two consecutive official tuberculosis...

9 CFR 77.20 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... INTERSTATE TRANSPORTATION OF ANIMALS (INCLUDING POULTRY) AND ANIMAL PRODUCTS TUBERCULOSIS Captive Cervids... “Uniform Methods and Rules—Bovine Tuberculosis Eradication” and in which tuberculosis is prevalent in less.... A herd of captive cervids that has tested negative to at least two consecutive official tuberculosis...

Research on the development of space target detecting system and three-dimensional reconstruction technology

NASA Astrophysics Data System (ADS)

Li, Dong; Wei, Zhen; Song, Dawei; Sun, Wenfeng; Fan, Xiaoyan

2016-11-01

With the development of space technology, the number of spacecrafts and debris are increasing year by year. The demand for detecting and identification of spacecraft is growing strongly, which provides support to the cataloguing, crash warning and protection of aerospace vehicles. The majority of existing approaches for three-dimensional reconstruction is scattering centres correlation, which is based on the radar high resolution range profile (HRRP). This paper proposes a novel method to reconstruct the threedimensional scattering centre structure of target from a sequence of radar ISAR images, which mainly consists of three steps. First is the azimuth scaling of consecutive ISAR images based on fractional Fourier transform (FrFT). The later is the extraction of scattering centres and matching between adjacent ISAR images using grid method. Finally, according to the coordinate matrix of scattering centres, the three-dimensional scattering centre structure is reconstructed using improved factorization method. The three-dimensional structure is featured with stable and intuitive characteristic, which provides a new way to improve the identification probability and reduce the complexity of the model matching library. A satellite model is reconstructed using the proposed method from four consecutive ISAR images. The simulation results prove that the method has gotten a satisfied consistency and accuracy.

Probability-Based Recognition Framework for Underwater Landmarks Using Sonar Images †

PubMed Central

Choi, Jinwoo; Choi, Hyun-Taek

2017-01-01

This paper proposes a probability-based framework for recognizing underwater landmarks using sonar images. Current recognition methods use a single image, which does not provide reliable results because of weaknesses of the sonar image such as unstable acoustic source, many speckle noises, low resolution images, single channel image, and so on. However, using consecutive sonar images, if the status—i.e., the existence and identity (or name)—of an object is continuously evaluated by a stochastic method, the result of the recognition method is available for calculating the uncertainty, and it is more suitable for various applications. Our proposed framework consists of three steps: (1) candidate selection, (2) continuity evaluation, and (3) Bayesian feature estimation. Two probability methods—particle filtering and Bayesian feature estimation—are used to repeatedly estimate the continuity and feature of objects in consecutive images. Thus, the status of the object is repeatedly predicted and updated by a stochastic method. Furthermore, we develop an artificial landmark to increase detectability by an imaging sonar, which we apply to the characteristics of acoustic waves, such as instability and reflection depending on the roughness of the reflector surface. The proposed method is verified by conducting basin experiments, and the results are presented. PMID:28837068

Enterobius vermicularis egg positive rate of pre-school children in Chunchon, Korea (1999)

PubMed Central

Yoon, Hyung-Jun; Choi, Ye-Jong; Lee, Soo-Ung; Park, Hyun-Young; Yang, Yong-Sang

2000-01-01

Pre-school children were examined for the presence of Enterobius vermicularis egg by perianal swab method. We visited 67 nurseries and 25 kindergartens between January, 1999 and April, 1999 in Chunchon, Korea. Of the 4,711 children examined, 434 (9.2%) were found to be positive for E. vermicularis egg. The egg positive rates of boys and girls were 10.1% and 8.1%, respectively. The rates were 7.8% in kindergartens and 9.7% in nurseries. Positive rate of 50 institutions was less than 10%. Rate in 35 institutions was from 10% to less than 20%. Rate in 7 institutions was equal to or over 20%. Out of 1,113 children examined twice, 28 (2.5%) children were positive consecutively, 53 (4.8%) were positive with negative conversion, 47 (4.2%) were negative with positive conversion, and 985 (88.5%) were consecutively negative. It means that in the low endemic area of enterobiasis with around 10% positive rate, the two consecutive examinations may increase the egg detection rate of 4.2-4.8%. The small number of consecutive egg positive children also suggests that the worm burden of the positive children might be low. Since the egg positive rate of that age group in this City increased from 1.85% (1997), and 3.0% (1998), the more intensive regular control should be executed. PMID:11138323

Baseline Predictors of Missed Visits in the Look AHEAD Study

PubMed Central

Fitzpatrick, Stephanie L.; Jeffery, Robert; Johnson, Karen C.; Roche, Cathy C.; Van Dorsten, Brent; Gee, Molly; Johnson, Ruby Ann; Charleston, Jeanne; Dotson, Kathy; Walkup, Michael P.; Hill-Briggs, Felicia; Brancati, Frederick L.

2013-01-01

Objective To identify baseline attributes associated with consecutively missed data collection visits during the first 48 months of Look AHEAD—a randomized, controlled trial in 5145 overweight/obese adults with type 2 diabetes designed to determine the long-term health benefits of weight loss achieved by lifestyle change. Design and Methods The analyzed sample consisted of 5016 participants who were alive at month 48 and enrolled at Look AHEAD sites. Demographic, baseline behavior, psychosocial factors, and treatment randomization were included as predictors of missed consecutive visits in proportional hazard models. Results In multivariate Cox proportional hazard models, baseline attributes of participants who missed consecutive visits (n=222) included: younger age ( Hazard Ratio [HR] 1.18 per 5 years younger; 95% Confidence Interval 1.05, 1.30), higher depression score (HR 1.04; 1.01, 1.06), non-married status (HR 1.37; 1.04, 1.82), never self-weighing prior to enrollment (HR 2.01; 1.25, 3.23), and randomization to minimal vs. intensive lifestyle intervention (HR 1.46; 1.11, 1.91). Conclusions Younger age, symptoms of depression, non-married status, never self-weighing, and randomization to minimal intervention were associated with a higher likelihood of missing consecutive data collection visits, even in a high-retention trial like Look AHEAD. Whether modifications to screening or retention efforts targeted to these attributes might enhance long-term retention in behavioral trials requires further investigation. PMID:23996977

Preparative isolation and purification of hainanmurpanin, meranzin, and phebalosin from leaves of Murraya exotica L. using supercritical fluid extraction combined with consecutive high-speed countercurrent chromatography.

PubMed

Yan, Rongwei; Shen, Jie; Liu, Xiaojing; Zou, Yong; Xu, Xinjun

2018-05-01

The objective of this study was to develop a consecutive preparation method for the isolation and purification of hainanmurpanin, meranzin, and phebalosin from leaves of Murraya exotica L. The process involved supercritical fluid extraction with CO 2 , solvent extraction, and two-step high-speed countercurrent chromatography. Pressure, temperature, and the volume of entrainer were optimized as 27 MPa, 52°C, and 60 mL by response surface methodology in supercritical fluid extraction with CO 2 , and the yield of the crude extracts was 7.91 g from 100 g of leaves. Subsequently, 80% methanol/water was used to extract and condense the three compounds from the crude extracts, and 4.23 g of methanol/water extracts was obtained. Then, a two-step high-speed countercurrent chromatography procedure was developed for the isolation of the three target compounds from methanol/water extracts, including conventional high-speed countercurrent chromatography for further enrichment and consecutive high-speed countercurrent chromatography for purification. The yield of concentrates from high-speed countercurrent chromatography was 2.50 g from 4.23 g of methanol/water extracts. Finally, the consecutive high-speed countercurrent chromatography produced 103.2 mg of hainanmurpanin, 244.7 mg of meranzin, and 255.4 mg of phebalosin with purities up to 97.66, 99.36, and 98.64%, respectively, from 900 mg of high-speed countercurrent chromatography concentrates in one run of three consecutive sample loadings without exchanging a solvent system. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Very Long (> 48 hours) Shifts and Cardiovascular Strain in Firefighters: a Theoretical Framework

PubMed Central

2014-01-01

Shift work and overtime have been implicated as important work-related risk factors for cardiovascular disease (CVD). Many firefighters who contractually work on a 24-hr work schedule, often do overtime (additional 24-hr shifts) which can result in working multiple, consecutive 24-hr shifts. Very little research has been conducted on firefighters at work that examines the impact of performing consecutive 24-hr shifts on cardiovascular physiology. Also, there have been no standard field methods for assessing in firefighters the cardiovascular changes that result from 24-hr shifts, what we call “cardiovascular strain”. The objective of this study, as the first step toward elucidating the role of very long (> 48 hrs) shifts in the development of CVD in firefighters, is to develop and describe a theoretical framework for studying cardiovascular strain in firefighters on very long shifts (i.e., > 2 consecutive 24-hr shifts). The developed theoretical framework was built on an extensive literature review, our recently completed studies with firefighters in Southern California, e-mail and discussions with several firefighters on their experiences of consecutive shifts, and our recently conducted feasibility study in a small group of firefighters of several ambulatory cardiovascular strain biomarkers (heart rate, heart rate variability, blood pressure, salivary cortisol, and salivary C-reactive protein). The theoretical framework developed in this study will facilitate future field studies on consecutive 24-hr shifts and cardiovascular health in firefighters. Also it will increase our understanding of the mechanisms by which shift work or long work hours can affect CVD, particularly through CVD biological risk factors, and thereby inform policy about sustainable work and rest schedules for firefighters. PMID:24602344

Very Long (> 48 hours) Shifts and Cardiovascular Strain in Firefighters: a Theoretical Framework.

PubMed

Choi, Bongkyoo; Schnall, Peter L; Dobson, Marnie; Garcia-Rivas, Javier; Kim, Hyoungryoul; Zaldivar, Frank; Israel, Leslie; Baker, Dean

2014-03-06

Shift work and overtime have been implicated as important work-related risk factors for cardiovascular disease (CVD). Many firefighters who contractually work on a 24-hr work schedule, often do overtime (additional 24-hr shifts) which can result in working multiple, consecutive 24-hr shifts. Very little research has been conducted on firefighters at work that examines the impact of performing consecutive 24-hr shifts on cardiovascular physiology. Also, there have been no standard field methods for assessing in firefighters the cardiovascular changes that result from 24-hr shifts, what we call "cardiovascular strain". The objective of this study, as the first step toward elucidating the role of very long (> 48 hrs) shifts in the development of CVD in firefighters, is to develop and describe a theoretical framework for studying cardiovascular strain in firefighters on very long shifts (i.e., > 2 consecutive 24-hr shifts). The developed theoretical framework was built on an extensive literature review, our recently completed studies with firefighters in Southern California, e-mail and discussions with several firefighters on their experiences of consecutive shifts, and our recently conducted feasibility study in a small group of firefighters of several ambulatory cardiovascular strain biomarkers (heart rate, heart rate variability, blood pressure, salivary cortisol, and salivary C-reactive protein). The theoretical framework developed in this study will facilitate future field studies on consecutive 24-hr shifts and cardiovascular health in firefighters. Also it will increase our understanding of the mechanisms by which shift work or long work hours can affect CVD, particularly through CVD biological risk factors, and thereby inform policy about sustainable work and rest schedules for firefighters.

29 CFR 570.120 - Eighteen-year minimum.

Code of Federal Regulations, 2010 CFR

2010-07-01

... mining, other than coal. No. 10. Occupations in or about slaughtering and meat packing establishments and... July 19, 2010. For the convenience of the user, the revised text is set forth as follows: § 570.120...

How Much Geology is Relevant to an Eighteen Year Old Voter?

ERIC Educational Resources Information Center

Yannacone, Victor John, Jr.

1974-01-01

Discusses the earth science concepts which an informed voter should know in order to responsibly vote on ecologically-oriented issues, such as land use planning, mining exploration, and resources management. (MLH)

43 CFR 2710.0-6 - Policy.

Code of Federal Regulations, 2012 CFR

2012-10-01

... construed as limiting children eighteen years or older from bidding in their own right. (f) Sales under this... provisions is required by law or for protection of valid existing rights. [45 FR 39418, June 10, 1980, as...

16 CFR 803.7 - Expiration of notification.

Code of Federal Regulations, 2010 CFR

2010-01-01

... material if and when the proposed transaction is ever revived. A's notification expires July 15 of Year 2, eighteen months following the date of receipt of its notification. If A and B wish to revive their...

Prevention of Stripping under Chip Seals

DOT National Transportation Integrated Search

2017-10-01

Eighteen chip-sealed roadways in eight cities and counties in Minnesota were evaluated both in the field (for condition surveys and density tests) and in the laboratory (for permeability, stripping, tensile-strength ratio, asphalt film thickness, and...

A new method for calculating time-dependent atomic level populations

NASA Technical Reports Server (NTRS)

Kastner, S. O.

1981-01-01

A method is described for reducing the number of levels to be dealt with in calculating time-dependent populations of atoms or ions in plasmas. The procedure effectively extends the collisional-radiative model to consecutive stages of ionization, treating ground and metastable levels explicitly and excited levels implicitly. Direct comparisons of full and simulated systems are carried out for five-level models.

Efficacy and safety of osimertinib in a Japanese compassionate use program.

PubMed

Fujiwara, Yutaka; Goto, Yasushi; Kanda, Shintaro; Horinouchi, Hidehito; Yamamoto, Noboru; Sakiyama, Naomi; Ando Makihara, Reiko; Ohe, Yuichiro

2017-07-01

Osimertinib is a third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) that targets the T790M mutation of EGFR. In 2016, AstraZeneca conducted a compassionate use program for osimertinib in Japan. Eighteen consecutive patients with histologically proven non-small-cell lung cancer (NSCLC) and harboring the T790M EGFR mutation participated in the compassionate use program between 1 April and 25 May 2016, at the National Cancer Center Hospital. We examined the efficacy and safety of osimertinib in a compassionate use program. All patients had been previously treated with both cytotoxic chemotherapy and EGFR TKIs. Overall response rate was 62.5% (95% confidence interval (CI): 35.9-89.1%). Among the six patients pretreated with a third-generation EGFR TKI, two (33%) responded to osimertinib. On administration with osimertinib, median progression-free and overall survival rates at six months were 66.7% (95% CI: 44.9-88.5) and 88.9% (95% CI: 74.4-100), respectively. Although the toxicity of osimertinib was mild in most patients, three patients had severe adverse events: two developed interstitial lung disease (ILD) and one developed Grade 3 hepatotoxicity. Among these, two (33%) of the six patients who received osimertinib following nivolumab treatment developed severe adverse events, with one each developing Grade 3 hepatotoxicity and Grade 3 ILD. Only one patient visited our hospital seeking to participate in the compassionate program from another hospital. Osimertinib demonstrated efficacy even in patients with heavily pretreated NSCLC harboring the T790M mutation. Some patients pretreated with another third-generation EGFR TKI also responded to osimertinib. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Closed-cell stent for coil embolization of intracranial aneurysms: clinical and angiographic results.

PubMed

Wakhloo, A K; Linfante, I; Silva, C F; Samaniego, E A; Dabus, G; Etezadi, V; Spilberg, G; Gounis, M J

2012-10-01

Recanalization is observed in 20-40% of endovascularly treated intracranial aneurysms. To further reduce the recanalization and expand endovascular treatment, we evaluated the safety and efficacy of closed-cell SACE. Between 2007 and 2010, 147 consecutive patients (110 women; mean age, 54 years) presenting at 2 centers with 161 wide-neck ruptured and unruptured aneurysms were treated by using SACE. Inclusion criteria were wide-neck aneurysms (>4 mm or a dome/neck ratio ≤ 2). Clinical outcomes were assessed by the mRS score at baseline, discharge, and follow-up. Aneurysm occlusion was assessed on angiograms by using the RS immediately after SACE and at follow-up. Eighteen aneurysms (11%) were treated following rupture. Procedure-related mortality and permanent neurologic deficits occurred in 2 (1.4%) and 5 patients (3.4%), respectively. In total, 7 patients (4.8%) died, including 2 with reruptures. Of the 140 surviving patients, 113 (80.7%) patients with 120 aneurysms were available for follow-up neurologic examination at a mean of 11.8 months. An increase in mRS score from admission to follow-up by 1, 2, or 3 points was seen in 7 (6.9%), 1 (1%), and 2 (2%) patients, respectively. Follow-up angiography was performed in 120 aneurysms at a mean of 11.9 months. Recanalization occurred in 12 aneurysms (10%), requiring retreatment in 7 (5.8%). Moderate in-stent stenosis was seen in 1 (0.8%), which remained asymptomatic. This series adds to the evidence demonstrating the safety and effectiveness of SACE in the treatment of intracranial aneurysms. However, SACE of ruptured aneurysms and premature termination of antiplatelet treatment are associated with increased morbidity and mortality.

Predictors of fibrosis in Asian patients with non-alcoholic steatohepatitis.

PubMed

Tsang, Steven Woon Choy; Ng, Wing Fung; Wu, Brian Ping Ying; Chow, David Alan; Li, Eric Ting Ho; Wong, Tak Cheung

2006-01-01

Non-alcoholic steatohepatitis (NASH) is increasingly recognized as an important cause of chronic liver disease. However, data on Asians with NASH is lacking in the literature. The aim of the present study was to describe the clinical, biochemical and histological characteristics of NASH in Asians and to determine the predictors for septal fibrosis. Sixty consecutive patients aged over 18 years with elevated serum alanine transferase, sonographic evidence of steatosis, and consent for liver biopsy were included. Patients with chronic hepatitis B or C, alcoholic, autoimmune, genetic, or drug-induced liver disease were excluded. Clinical, biochemical and histological variables were tested for association with septal liver fibrosis (F2/3). Median age of the cohort was 45.5 years (range 21-75 years) and 63% were male. Ninety percent of patients were obese (body mass index [BMI]>or= 25), 70% had hypertriglyceridemia, 68% had hypercholesterolemia, 58% had metabolic syndrome, 53% had hypertension, 47% had diabetes mellitus (DM), and 18% had obstructive sleep apnea. Sixty-eight percent had gamma-glutamyl transferase (GGT) >or= 2 x upper limit of normal (ULN), 55% had alanine aminotransferase (ALT) >or= 2 x ULN, and 23% had aspartate aminotransferase (AST) >or= 2 x ULN. Of the 40 non-diabetic patients undergoing oral glucose tolerance testing, 45% had normal tests, 30% had impaired glucose tolerance, 23% DM, and 2% impaired fasting glucose. Eighteen patients (30%) had septal fibrosis (F2/3), but none had cirrhosis. Necroinflammatory grade >or= 2 (odds ratio [OR] 13), AST >or= 2 x ULN (OR 5.3) and DM (OR 5) were significantly and independently correlated with septal fibrosis. Septal fibrosis is common in Asians with NASH. Necroinflammatory grade >or= 2, AST >or= 2 x ULN and DM are independent predictors for septal fibrosis.

Early hypofractionated salvage radiotherapy for postprostatectomy biochemical recurrence.

PubMed

Kruser, Tim J; Jarrard, David F; Graf, Andrew K; Hedican, Sean P; Paolone, David R; Wegenke, John D; Liu, Glenn; Geye, Heather M; Ritter, Mark A

2011-06-15

Postprostatectomy adjuvant or salvage radiotherapy, when using standard fractionation, requires 6.5 to 8 weeks of treatment. The authors report on the safety and efficacy of an expedited radiotherapy course for salvage prostate radiotherapy. A total of 108 consecutive patients were treated with salvage radiation therapy to 65 grays (Gy) in 26 fractions of 2.5 Gy. Median follow-up was 32.4 months. Median presalvage prostate-specific antigen (PSA) was 0.44 (range, 0.05-9.50). Eighteen (17%) patients received androgen deprivation after surgery or concurrently with radiation. The actuarial freedom from biochemical failure for the entire group at 4 years was 67% ± 5.3%. An identical 67% control rate was seen at 5 years for the first 50 enrolled patients, whose median follow-up was longer at 43 months. One acute grade 3 genitourinary toxicity occurred, with no acute grade 3 gastrointestinal and no late grade 3 toxicities observed. On univariate analysis, higher Gleason score (P = .006), PSA doubling time ≤12 months (P = .03), perineural invasion (P = .06), and negative margins (P = .06) showed association with unsuccessful salvage. On multivariate analysis, higher Gleason score (P = .057) and negative margins (P = .088) retained an association with biochemical failure. Hypofractionated radiotherapy (65 Gy in 2.5 Gy fractions in about 5 weeks) reduces the length of treatment by from 1-½ to 3 weeks relative to other treatment schedules commonly used, produces low rates of toxicity, and demonstrates encouraging efficacy at 4 to 5 years. Hypofractionation may provide a convenient, resource-efficient, and well-tolerated salvage approach for the estimated 20,000 to 35,000 US men per year experiencing biochemical recurrence after prostatectomy. Copyright © 2010 American Cancer Society.

Detection of Total Knee Arthroplasties at Airport Security Checkpoints: How Do Updated Security Measures Affect Patients?

PubMed

Issa, Kimona; Pierce, Todd P; Gwam, Chukwuweieke; Goljan, Peter; Festa, Anthony; Scillia, Anthony J; Mont, Michael A

2017-07-01

Airport security measures continue to be updated with the incorporation of the new body scanners and automatic target recognition software. The purpose of this study was analyze the incidence of: (1) triggering the security alarm; (2) extra security searches; (3) perceived inconvenience; and (4) presence of other surgical hardware in those who underwent total knee arthroplasty (TKA) and passed through airport security. A questionnaire was given to 125 consecutive patients with a TKA. Those who passed through airport security after January 2014 were considered for inclusion. A questionnaire was administered that addressed the number of encounters with airport security, metal detector activation, additional screening procedures, and perceived inconvenience. Out of the 125 patients, 53 met inclusion criteria. Out of the 53 patients, 20 (38%) reported that their prosthesis triggered a metal detector. Out of the 20 patients, 8 (40%) who reported triggering of metal detectors also reported the presence of surgical hardware elsewhere in the body. Eighteen of the 53 patients (34%) believed having a TKA was inconvenient for airplane travel. Compared with the historical cohort, alarms were triggered in 70 of 97 patients ( p  = 0.0001) and 50 of 97 reported inconvenience when traveling ( n  = 50 of 97 patients; p  = 0.04). The incidences of those who underwent TKA triggering alarms and perceiving inconvenience when passing through airport security have decreased from previously published studies. This is most likely due to the recent updates and modifications to screening. As these security measures are modified and implant designs continue to evolve, this is an area of investigation that should continue. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Impact of esophagectomy for cancer on patients' occupational status.

PubMed

Pinto, E; Cavallin, F; Alfieri, R; Saadeh, L M; Mantoan, S; Cagol, M; Castoro, C; Scarpa, M

2016-01-01

The aim of our study was to investigate the impact of esophagectomy for cancer on patients' occupational status. All 109 consecutive patients presenting with esophageal cancer to the Surgical Oncology Unit of the Veneto Institute of Oncology Padua (Italy) between November 1, 2009 and March 15, 2012, were included in the study. Information on occupational status at diagnosis and at 1 year after esophagectomy was retrieved. Health-related quality of life was evaluated at discharge after surgery using selected aspects of the EORTC QLQ-C30 questionnaire. Non parametric statistics were used. Sixty-one patients (49.6%) were active workers at diagnosis and 50 of them (82.0%) underwent esophagectomy. Eighteen active workers (18/50, 36.0%) quit their job within one year from esophagectomy. They received jejunostomy more often than patients still working after surgery (50.0% vs. 18.8%, respectively; p = 0.03) and reported lower social functioning at discharge (mean ± SD 63.6 ± 16.4 vs. 80.2 ± 25.6 in others, p = 0.02). Multivariable analysis identified jejunostomy as independent predictor of job-quitting at 1 year after esophagectomy (p = 0.03; OR 4.75, 95% C.I. 1.11-20.39) but not social functioning at discharge (p = 0.21). Patients should be informed that they may experience social and work disability due to cancer treatment and adequate interventions of return-to-work support should be provided. Adequate welfare strategy should be implemented for esophageal cancer survivors, enhancing their role competences and contributing to precision care medicine. Copyright © 2015 Elsevier Ltd. All rights reserved.

Transient ischaemic attack clinic: an evaluation of diagnoses and clinical decision making.

PubMed

Lee, Will; Frayne, Judith

2015-04-01

The diagnosis of transient ischaemic attack (TIA) is based largely on the patient's symptom recall and clinical judgement. This decision-making process is highly subjective and the inter-observer reliability of TIA diagnosis is at best moderate, even among neurologists. The aim of this study is to examine the presenting features and final diagnoses of referrals to a TIA clinic and to evaluate characteristics that favoured the diagnosis of TIA over other TIA "mimics". Consecutive new referrals to a tertiary metropolitan hospital TIA clinic over a 9month period were examined. Characteristics between TIA and non-TIA diagnoses were compared and analysed. Eighty-two patients were recruited. Eighteen (22%) were given a final diagnosis of TIA or stroke. Major alternative diagnoses included migraine (n=17, 21%), presyncope/syncope (n=13, 16%) and anxiety (n=7, 9%). Four (5%) patients had unclassifiable symptoms with no clear final diagnosis. Mean age was 67±a standard deviation of 17years and patients diagnosed with TIA/stroke were on average older than those with non-TIA diagnoses (77±10 versus 64±17years, p=0.003). A diagnosis of TIA/stroke was favoured in the presence of moderate to severe weakness (p=0.032), dysphasia (p=0.037) or dysarthria (p=0.005). Unclassifiable symptoms (for example, palpitations, confusion, headache) were reported in 27 patients (33%) and their presence favoured non-TIA diagnoses (p=0.0003). TIA constituted a minority of the referrals to our clinic. Accurate clinical diagnosis of TIA facilitates early stroke prevention and avoids unnecessary investigations and prescriptions. Attempts to improve diagnostic accuracy of TIA should target improving the education and awareness of frontline medical practitioners. Copyright © 2014 Elsevier Ltd. All rights reserved.

Between-session intra-individual variability in sustained, selective, and integrational non-linguistic attention in aphasia.

PubMed

Villard, Sarah; Kiran, Swathi

2015-01-01

A number of studies have identified impairments in one or more types/aspects of attention processing in patients with aphasia (PWA) relative to healthy controls; person-to-person variability in performance on attention tasks within the PWA group has also been noted. Studies using non-linguistic stimuli have found evidence that attention is impaired in this population even in the absence of language processing demands. An underlying impairment in non-linguistic, or domain-general, attention processing could have implications for the ability of PWA to attend during therapy sessions, which in turn could impact long-term treatment outcomes. With this in mind, this study aimed to systematically examine the effect of task complexity on reaction time (RT) during a non-linguistic attention task, in both PWA and controls. Additional goals were to assess the effect of task complexity on between-session intra-individual variability (BS-IIV) in RT and to examine inter-individual differences in BS-IIV. Eighteen PWA and five age-matched neurologically healthy controls each completed a novel computerized non-linguistic attention task measuring five types of attention on each of four different non-consecutive days. A significant effect of task complexity on both RT and BS-IIV in RT was found for the PWA group, whereas the control group showed a significant effect of task complexity on RT but not on BS-IIV in RT. Finally, in addition to these group-level findings, it was noted that different patients exhibited different patterns of BS-IIV, indicating the existence of inter-individual variability in BS-IIV within the PWA group. Results may have implications for session-to-session fluctuations in attention during language testing and therapy for PWA. Copyright © 2014 Elsevier Ltd. All rights reserved.

Role of ghrelin and insulin-like growth factor binding protein-3 in the development of osteoporosis in inflammatory bowel disease.

PubMed

Koutroubakis, Ioannis E; Zavos, Christos; Damilakis, John; Papadakis, Georgios; Neratzoulakis, John; Karkavitsas, Nikolaos; Kouroumalis, Elias A

2011-07-01

A high prevalence of bone loss is observed in patients with inflammatory bowel disease (IBD). Leptin, ghrelin, insulin-like growth factor (IGF)-1, and IGF binding protein (IGFBP)-3 have been suggested to interfere in the bone metabolism. The aim of this study was to investigate the role of these peptides in the development of osteoporosis in IBD. One hundred and eighteen consecutive IBD patients were included. All patients underwent bone densitometry by dual energy x-ray absorptiometry at the femoral neck and lumbar spine levels. Serum samples were collected from all patients and analyzed for concentrations of the aforementioned peptides by radioimmunoassay. Forty (33.9%) patients were normal, 55 (46.6%) were osteopenic, and 23 (19.5%) were osteoporotic. Positive statistically significant correlations were found between body mass index (BMI), leptin, IGFBP-3 levels, and the bone mineral density (BMD) of the femoral neck and lumbar spine. Moreover, an inverse statistically significant correlation was found between BMD of the femoral neck and the lumbar spine, and age, duration of the disease, and ghrelin levels. Multivariate analysis revealed that the most significant factors associated with the BMD were age and BMI. A weak but statistically significant correlation was found between IGFBP-3 and femoral neck BMD (P=0.045) and between ghrelin and spine BMD (P=0.039). No correlation was observed between leptin and BMD. Low BMI is the most important independent risk factor for osteoporosis in IBD patients. There is no independent influence of leptin but ghrelin and IGFBP-3 may play a role in the bone metabolism in the IBD.

Safety and efficacy of mild compression (18-25 mm Hg) therapy in patients with diabetes and lower extremity edema.

PubMed

Wu, Stephanie C; Crews, Ryan T; Najafi, Bijan; Slone-Rivera, Nancy; Minder, Jessica L; Andersen, Charles A

2012-05-01

Patients with diabetes often present with lower extremity (LE) edema; however, because of concomitant peripheral arterial disease, compression therapy is generally avoided by providers in fear of compromising arterial circulation. This pilot study sought to assess whether diabetic socks with mild compression (18-25 mm Hg) can reduce LE edema in patients with diabetes without negatively impacting vascularity. Eighteen subjects (9 males, 9 females) aged 61 ± 11 years with diabetes, LE edema, and a mean ankle-brachial index (ABI) of 1.10 ± 0.21 successfully completed this uncontrolled study. At baseline, subjects were fitted and instructed to wear the socks during all waking hours. Follow-up visits occurred weekly for four consecutive weeks. Edema was quantified through midfoot, ankle, and calf circumferences and cutaneous fluid measurements. Vascular status was tracked via ABI. Repeated measures analysis of variance and least significant difference post hoc analyses were used for data analyses. Calf circumferences showed a statistically significant (p < .05) decrease of 1.3 ± 0.28 cm after just one week and remained significantly smaller than baseline throughout the study. Foot circumferences were significantly reduced at week 2 (-0.98 ± 0.35 cm) and remained significantly below baseline for the remainder of the study. The ankle also demonstrated a trend of circumference reduction but was not statistically significant. Cutaneous edema significantly reduced by week 3 (-3.1 ± 1.3 U) and remained so at week 4. Ankle-brachial index significantly increased (0.14 ± 0.049) at week 2 but was not significantly higher at weeks 3 or 4. No adverse events occurred during the study. Mild compression therapy (18-25 mm Hg) decreased swelling in diabetes patients with LE edema without compromising vascularity. © 2012 Diabetes Technology Society.

Eighteen years experience of granulocyte donations-acceptable donor safety?

PubMed

Axdorph Nygell, Ulla; Sollén-Nilsson, Agneta; Lundahl, Joachim

2015-10-01

Granulocyte transfusions are given to patients with life-threatening infections, refractory to treatment. The donors are stimulated with corticosteroids ± granulocyte colony stimulating factor (G-CSF). However, data regarding the donors' safety is sparse. The objective was therefore to evaluate short- and long-term adverse events (AE) in G-CSF stimulated donors. All consecutive granulocyte donors from 1994 to 2012 were identified through our registry. From the donation records, the number of aphereses, stimulation therapy, AE, blood values post donation, and recent status were evaluated. One hundred fifty-four volunteer donors were mobilized for 359 collections. Age at first granulocyte donation was 43 years (median; range 19-64 years). Follow-up was 60 months (median; range 0-229 months). The dose of G-CSF per collection was 3.8 ug/kg body weight (median; range 1.6-6.0 ug/kg). Sedimentation agent was HES. Short-term AE were mild. Blood values 4 weeks post donation with minor reductions/elevations mostly resolved in later donations. Fourteen donors were excluded from the registry due to hypertension (4), diabetes (2), atrial flutter (1), breast carcinoma (1), urethral carcinoma in situ (1), MGUS (1), thrombosis (1), anaphylaxis (1), primary biliary cirrhosis (1), and unknown (1). Three donors are deceased due to diabetes, acute myocardial infarction, and unknown cause. All excluded/deceased donors except one were excluded/died at least 6 months after first granulocyte donation. No serious short-term AE were observed. Due to the variability of diagnoses among excluded/deceased donors, we propose that it is less likely that granulocyte donations have a causative impact on these donors' exclusion or death. © 2014 Wiley Periodicals, Inc.

Prevalence of Thyroid Peroxidase Antibody and Pregnancy Outcome in Euthyroid Autoimmune Positive Pregnant Women from a Tertiary Care Center in Haryana.

PubMed

Rajput, Rajesh; Yadav, Tekchand; Seth, Shashi; Nanda, Smiti

2017-01-01

To study the prevalence of thyroid peroxidase autoantibody in euthyroid pregnant women and to evaluate the association between thyroid peroxidase autoantibody and pregnancy outcomes. One thousand thirty consecutive pregnant women attending the antenatal clinic over a period of 1 year and were carrying a healthy singleton uncomplicated intrauterine pregnancy and consuming iodized salt were recruited for the study. Outcomes of the pregnancy was compared between TPO antibody positive euthyroid women (group 1) and TPO antibody negative euthyroid women (group 2). Out of 1030 women, 164 (18.9%) were detected TPO antibody positive with euthyroid status. The mean FT4 and TSH level were significantly different in those who were TPO Ab positive as compared TPO Ab negative euthyroid pregnant women. No correlation was observed between the maternal age, gestational age and gravidity with anti TPO antibody levels. Eighteen (12%) women in Group 1and 5 (3.3%) women in Group 2 had miscarriages and the difference was found to be statistically significant ( P value of 0.004). Twenty-one (14%) women in Group 1 and 5 (3.3%) women in Group 2 had preterm deliveries, which was also found to be statistically significantly (p value of 0.001). Other pregnancy related complications like Intrauterine death, IUGR, preeclampsia and PIH though are present in comparatively higher number in TPO Ab positive euthyroid pregnant women as compared to TPO Ab negative euthyroid pregnant women but this difference was not found to be statistically significant. To conclude with the present study shows that a good number of pregnant women with euthyroid status have TPO Ab positivity and this is associated with some adverse pregnancy outcomes like miscarriage and preterm birth of the baby.

Association between implementation of a code stroke system and poststroke epilepsy.

PubMed

Chen, Ziyi; Churilov, Leonid; Chen, Ziyuan; Naylor, Jillian; Koome, Miriam; Yan, Bernard; Kwan, Patrick

2018-03-27

We aimed to investigate the effect of a code stroke system on the development of poststroke epilepsy. We retrospectively analyzed consecutive patients treated with IV thrombolysis under or outside the code stroke system between 2003 and 2012. Patients were followed up for at least 2 years or until death. Factors with p < 0.1 in univariate comparisons were selected for multivariable logistic and Cox regression. A total of 409 patients met the eligibility criteria. Their median age at stroke onset was 75 years (interquartile range 64-83 years); 220 (53.8%) were male. The median follow-up duration was 1,074 days (interquartile range 119-1,671 days). Thirty-two patients (7.8%) had poststroke seizures during follow-up, comprising 7 (1.7%) with acute symptomatic seizures and 25 (6.1%) with late-onset seizures. Twenty-six patients (6.4%) fulfilled the definition of poststroke epilepsy. Three hundred eighteen patients (77.8%) were treated with the code stroke system while 91 (22.2%) were not. After adjustment for age and stroke etiology, use of the code stroke system was associated with decreased odds of poststroke epilepsy (odds ratio = 0.36, 95% confidence interval 0.14-0.87, p = 0.024). Cox regression showed lower adjusted hazard rates for poststroke epilepsy within 5 years for patients managed under the code stroke system (hazard ratio = 0.60, 95% confidence interval 0.47-0.79, p < 0.001). The code stroke system was associated with reduced odds and instantaneous risk of poststroke epilepsy. Further studies are required to identify the contribution of the individual components and mechanisms against epileptogenesis after stroke. This study provides Class III evidence that for people with acute ischemic stroke, implementation of a code stroke system reduces the risk of poststroke epilepsy. © 2018 American Academy of Neurology.

Combining clinical and thallium data optimizes preoperative assessment of cardiac risk before major vascular surgery

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

Eagle, K.A.; Coley, C.M.; Newell, J.B.

1989-06-01

STUDY OBJECTIVE: To determine whether clinical markers and preoperative dipyridamole-thallium imaging are both useful in predicting ischemic events after vascular surgery. Two hundred fifty-four consecutive patients were referred to a nuclear cardiology laboratory before surgery. Forty-four patients had surgery cancelled or postponed after clinical evaluation and dipyridamole-thallium imaging. Surgery was not confirmed for ten. Two hundred patients receiving prompt vascular surgery were the study group. Thirty patients (15%) had early postoperative cardiac ischemic events, with cardiac death in 6 (3%) and nonfatal myocardial infarction in 9 (4.5%). Logistic regression identified five clinical predictors (Q waves, history of ventricular ectopic activity,more » diabetes, advanced age, angina) and two dipyridamole-thallium predictors of postoperative events. Of patients with none of the clinical variables (n = 64), only 2 (3.1%; 95% CI, 0% to 8%) had ischemic events with no cardiac deaths. Ten of twenty (50%; 95% CI, 29% to 71%) patients with three or more clinical markers had events. Eighteen of one hundred sixteen (15.5%; 95% CI, 7% to 21%) patients with either 1 or 2 clinical predictors had events. Within this group, 2 of 62 (3.2%; 95% CI, 0% to 8%) patients without thallium redistribution had events compared with 16 events in 54 patients (29.6%; 95% CI, 16% to 44%) with thallium redistribution. The multivariate model using both clinical and thallium variables showed significantly higher specificity at equivalent sensitivity levels than models using either clinical or thallium variables alone. Preoperative dipyridamole-thallium imaging appears most useful to stratify vascular patients determined to be at intermediate risk by clinical evaluation.« less

Late Administration of a Palladium Lipoic Acid Complex (POLY-MVA) Modifies Cardiac Mitochondria but Not Functional or Structural Manifestations of Radiation-Induced Heart Disease in a Rat Model

PubMed Central

Sridharan, Vijayalakshmi; Seawright, John W.; Antonawich, Francis J.; Garnett, Merrill; Cao, Maohua; Singh, Preeti; Boerma, Marjan

2017-01-01

Exposure of the heart to ionizing radiation can cause adverse myocardial remodeling. In small animal models, local heart irradiation causes persistent alterations in cardiac mitochondrial function and swelling. POLY-MVA is a dietary supplement that contains a palladium lipoic acid complex that targets mitochondrial complex I and has been demonstrated to have greater redox potential than lipoic acid alone. POLY-MVA improves mitochondrial function and anti-oxidant enzyme activity in the aged rat heart. In this study, we tested whether POLY-MVA can mitigate cardiac effects of ionizing radiation. Adult male rats were exposed to local heart X rays with a daily dose of 9 Gy for 5 consecutive days. Eighteen weeks after irradiation, POLY-MVA was administered orally at 1 ml/kg bodyweight per day during weekdays, for 6 weeks. Alterations in cardiac function as measured with echocardiography coincided with enhanced mitochondrial swelling, a reduction in mitochondrial expression of complex II, manifestations of adverse remodeling such as a reduction in myocardial microvessel density and an increase in collagen deposition and mast cell numbers. POLY-MVA enhanced left ventricular expression of superoxide dismutase 2, but only in sham-irradiated animals. In irradiated animals, POLY-MVA caused a reduction in markers of inflammatory infiltration, CD2 and CD68. Moreover, POLY-MVA mitigated the effects of radiation on mitochondria. Nonetheless, POLY-MVA did not mitigate adverse cardiac remodeling, suggesting that this tissue remodeling may not be alleviated by altering cardiac mitochondria alone. However, we cannot exclude the possibility that an earlier onset of POLY-MVA administration may have more profound effects on radiation-induced cardiac remodeling. PMID:28231026

Enhancing inhibition-induced plasticity in tinnitus--spectral energy contrasts in tailor-made notched music matter.

PubMed

Stein, Alwina; Engell, Alva; Lau, Pia; Wunderlich, Robert; Junghoefer, Markus; Wollbrink, Andreas; Bruchmann, Maximilian; Rudack, Claudia; Pantev, Christo

2015-01-01

Chronic tinnitus seems to be caused by reduced inhibition among frequency selective neurons in the auditory cortex. One possibility to reduce tinnitus perception is to induce inhibition onto over-activated neurons representing the tinnitus frequency via tailor-made notched music (TMNM). Since lateral inhibition is modifiable by spectral energy contrasts, the question arises if the effects of inhibition-induced plasticity can be enhanced by introducing increased spectral energy contrasts (ISEC) in TMNM. Eighteen participants suffering from chronic tonal tinnitus, pseudo randomly assigned to either a classical TMNM or an ISEC-TMNM group, listened to notched music for three hours on three consecutive days. The music was filtered for both groups by introducing a notch filter centered at the individual tinnitus frequency. For the ISEC-TMNM group a frequency bandwidth of 3/8 octaves on each side of the notch was amplified, additionally, by about 20 dB. Before and after each music exposure, participants rated their subjectively perceived tinnitus loudness on a visual analog scale. During the magnetoencephalographic recordings, participants were stimulated with either a reference tone of 500 Hz or a test tone with a carrier frequency representing the individual tinnitus pitch. Perceived tinnitus loudness was significantly reduced after TMNM exposure, though TMNM type did not influence the loudness ratings. Tinnitus related neural activity in the N1m time window and in the so called tinnitus network comprising temporal, parietal and frontal regions was reduced after TMNM exposure. The ISEC-TMNM group revealed even enhanced inhibition-induced plasticity in a temporal and a frontal cortical area. Overall, inhibition of tinnitus related neural activity could be strengthened in people affected with tinnitus by increasing spectral energy contrast in TMNM, confirming the concepts of inhibition-induced plasticity via TMNM and spectral energy contrasts.

Multiple typing for the epidemiological study of the contamination of broilers with Salmonella from the hatchery to the slaughterhouse.

PubMed

Heyndrickx, M; Herman, L; Vlaes, L; Butzler, J P; Wildemauwe, C; Godard, C; De Zutter, L

2007-02-01

Eighteen Belgian broiler flocks were followed from the hatchery to the slaughterhouse by a multiple typing approach (sero-, geno-, and phage types) for the investigation of the transmission of Salmonella and its subtypes. For 12 of the 18 flocks, there was no correlation between the serotypes found preharvest and those isolated from the feces in the transport crates and on the carcasses in the slaughterhouse. Serotypes found in the crates were usually also found on the carcasses. In 5 of the 10 flocks with Salmonella-positive broilers, complex contamination patterns with the involvement of different serotypes, genotypes, or both were revealed. In two of these flocks (flocks 8 and 9), the Salmonella Enteritidis contamination of the broilers could be traced to the hatchery. In flock 9, evidence was found for the acquisition, during rearing, of a megaplasmid in the Salmonella Enteritidis strain. In the other three positive flocks (flocks 6, 7, and 10), the environment and movable material (e.g., footwear) played a determining role in the infection and shedding pattern of the broilers. For flocks 6 and 7, reared consecutively in the same broiler house, a persistent Salmonella Hadar geno/phage type predominated in the preharvest period, while another Salmonella Hadar geno/phage type was found in the house or the environment but never in the broilers. Only for the above-mentioned five flocks were the same strains that were found preharvest also recovered from the carcasses, although these strains were not predominant on the carcasses, with the exception of one flock (flock 10). In conclusion, it can be said that most of the time, Salmonella strains that contaminate Belgian broiler carcasses do not predominate in the preharvest environment.

What factors determine the severity of hepatitis A-related acute liver failure?

PubMed

Ajmera, V; Xia, G; Vaughan, G; Forbi, J C; Ganova-Raeva, L M; Khudyakov, Y; Opio, C K; Taylor, R; Restrepo, R; Munoz, S; Fontana, R J; Lee, W M

2011-07-01

The reason(s) that hepatitis A virus (HAV) infection may progress infrequently to acute liver failure are poorly understood. We examined host and viral factors in 29 consecutive adult patients with HAV-associated acute liver failure enrolled at 10 sites participating in the US ALF Study Group. Eighteen of twenty-four acute liver failure sera were PCR positive while six had no detectable virus. HAV genotype was determined using phylogenetic analysis and the full-length genome sequences of the HAV from a cute liver failure sera were compared to those from self-limited acute HAV cases selected from the CDC database. We found that rates of nucleotide substitution did not vary significantly between the liver failure and non-liver failure cases and there was no significant variation in amino acid sequences between the two groups. Four of 18 HAV isolates were sub-genotype IB, acquired from the same study site over a 3.5-year period. Sub-genotype IB was found more frequently among acute liver failure cases compared to the non-liver failure cases (chi-square test, P < 0.01). At another centre, a mother and her son presented with HAV and liver failure within 1 month of each other. Predictors of spontaneous survival included detectable serum HAV RNA, while age, gender, HAV genotype and nucleotide substitutions were not associated with outcome. The more frequent appearance of rapid viral clearance and its association with poor outcomes in acute liver failure as well as the finding of familial cases imply a possible host genetic predisposition that contributes to a fulminant course. Recurrent cases of the rare sub-genotype IB over several years at a single centre imply a community reservoir of infection and possible increased pathogenicity of certain infrequent viral genotypes. © 2010 Blackwell Publishing Ltd.

Reinforced cementoplasty using dedicated spindles in the management of unstable malignant lesions of the cervicotrochanteric region.

PubMed

Premat, Kévin; Clarençon, Frédéric; Bonaccorsi, Raphael; Degos, Vincent; Cormier, Évelyne; Chiras, Jacques

2017-09-01

In long bones, cementoplasty alone does not provide sufficient stability, which may cause secondary fractures. This study reviewed the safety and efficacy of reinforced cementoplasty (RC) (percutaneous internal fixation using dedicated spindles combined with cementoplasty) for unstable malignant lesions of the cervicotrochanteric region (CTR) of the proximal femur. Eighteen consecutive patients (nine women [50%] and nine men [50%]; mean age 55.1 ± 16.2 years; range 22-85) underwent RC for 19 unstable lesions of the CTR (16/19 [84.2%] bone metastases, 3/19 [15.8%] multiple myeloma lesions). All the patients were considered unsuitable for surgery. Clinical outcome was judged with a mean follow-up of 8.8 ± 7.2 months (range 1-27). The primary endpoints were occurrence of secondary fractures during the follow-up period and local pain relief measured by a visual analogue scale (VAS). No secondary fracture occurred. Mean VAS improved from 5.9 ± 3.1 (range 0-10) to 2.3 ± 2.4 (range 0-7) at 1 month (p = 0.001) to 1.6 ± 1.7 (range 0-5) at final follow-up (p = 0.0002). One symptomatic cement pulmonary embolism was recorded. RC is an original minimally invasive technique providing pain relief and effective bone stability for unstable malignant lesions of the cervicotrochanteric region in patients unsuitable for open surgery. • Reinforced cementoplasty (RC) combines intralesional spindling with cementoplasty. • RC provides effective bone stability and pain relief. • RC is a suitable minimally invasive option for patients in poor general condition.

Obstructive sleep apnea in Down syndrome: Benefits of surgery and noninvasive respiratory support.

PubMed

Dudoignon, Benjamin; Amaddeo, Alessandro; Frapin, Annick; Thierry, Briac; de Sanctis, Livio; Arroyo, Jorge Olmo; Khirani, Sonia; Fauroux, Brigitte

2017-08-01

Children with Down syndrome are at increased risk of obstructive sleep apnea (OSA). The aim of the study was to describe the management of OSA in a large cohort of children with Down syndrome. A retrospective analysis of sleep studies and consequent management was performed for all consecutive Down syndrome patients evaluated between September 2013 and April 2016. The data of 57 patients were analyzed: 51/53 had an interpretable overnight polygraphy and 4 the recording of nocturnal gas exchange. Mean age at baseline sleep study was 6.2 ± 5.9 years. Eighteen patients (32%) had prior upper airway surgery. Mean apnea-hypopnea index (AHI) was 14 ± 16 events/hr with 41 of the 51 (80%) patients having OSA with an AHI >1 event/hr and 20 patients (39%) having an AHI ≥10 events/hr. Consequently, eight patients (14%) had upper airway surgery. OSA improved in all patients except two who needed noninvasive respiratory support. Nineteen (33%) patients required noninvasive respiratory support. Mean age at noninvasive respiratory support initiation was 7 ± 7 years. On 11 patients with objective adherence data available, mean compliance at 2 ± 1 years of treatment was excellent with an average use per night of 8 hr46 ± 3 hr59 and 9 patients using the noninvasive respiratory support >4 hr/night. Noninvasive respiratory support was associated with an improvement of nocturnal gas exchange. The prevalence of OSA is high in Down syndrome. Upper airway surgery is not always able to correct OSA. Noninvasive respiratory support represents then an effective treatment for OSA and good compliance may be achieved in a majority of patients. © 2017 Wiley Periodicals, Inc.

Case series on chronic whiplash related neck pain treated with intraarticular zygapophysial joint regeneration injection therapy.

PubMed

Hooper, R Allen; Frizzell, J Bevan; Faris, Peter

2007-03-01

Although in clinical use, there is only 1 published case report on the efficacy of intraarticular regeneration injection therapy (RIT) (a.k.a. prolotheraphy). This report supports a rationale for future clinical trials of this technique. To assess the efficacy of intraarticular zygapophysial joint RIT in patients with chronic whiplash related neck pain that failed other conservative and interventional procedures. Patients were treated with intraarticular RIT and reassessed over 1 year. Retrospective case review of prospective data. Eighteen consecutive patients were treated with intraarticular prolotherapy by placing 0.5 - 1mL of 20% dextrose solution into each zygapophysial joint, after confirmation of intraarticular location with radiographic contrast, using 25-gauge spinal needles and fluoroscopic guidance. Solution was prepared by diluting D50W with 1% lidocaine. Fifteen patients completed treatment. Three patients had bilateral treatment, leaving 18 sides for analysis. Mean Neck Disability Index (NDI) pre-treatment was 24.71 and decreased post-treatment to 14.21 (2 months), 13.45 (6 months), 10.94 (12 months). Average change NDI=13.77 (p<0.0001) baseline versus 12 months. Symptoms for 14 patients were from motor vehicle accident, of which 13 were in litigation. Patients attending physiotherapy over the course of treatment had better outcomes than those without physiotherapy. Women needed more injections (5.4) than men (3.2) p=0.0003. Intraarticular RIT improved pain and function in this case series. The procedure appears safe, more effective than periarticular RIT, and lasted as long, or longer, than those patients with previous radiofrequency neurotomy. Concurrent physiotherapy helped reduce post-procedure neck stiffness. Future trials should consider gender when deciding how many treatments to administer. Litigation was not a barrier to recovery.

What factors determine the severity of hepatitis A-related acute liver failure?

PubMed Central

Ajmera, V.; Xia, G.; Vaughan, G.; Forbi, J. C.; Ganova-Raeva, L. M.; Khudyakov, Y.; Opio, C. K.; Taylor, R.; Restrepo, R.; Munoz, S.; Fontana, R. J.; Lee, W. M.

2016-01-01

SUMMARY The reason(s) that hepatitis A virus (HAV) infection may progress infrequently to acute liver failure are poorly understood. We examined host and viral factors in 29 consecutive adult patients with HAV-associated acute liver failure enrolled at 10 sites participating in the US ALF Study Group. Eighteen of twenty-four acute liver failure sera were PCR positive while six had no detectable virus. HAV genotype was determined using phylogenetic analysis and the full-length genome sequences of the HAV from a cute liver failure sera were compared to those from self-limited acute HAV cases selected from the CDC database. We found that rates of nucleotide substitution did not vary significantly between the liver failure and non-liver failure cases and there was no significant variation in amino acid sequences between the two groups. Four of 18 HAV isolates were subgenotype IB, acquired from the same study site over a 3.5-year period. Sub-genotype IB was found more frequently among acute liver failure cases compared to the non-liver failure cases (chi-square test, P < 0.01). At another centre, a mother and her son presented with HAV and liver failure within 1 month of each other. Predictors of spontaneous survival included detectable serum HAV RNA, while age, gender, HAV genotype and nucleotide substitutions were not associated with outcome. The more frequent appearance of rapid viral clearance and its association with poor outcomes in acute liver failure as well as the finding of familial cases imply a possible host genetic predisposition that contributes to a fulminant course. Recurrent cases of the rare subgenotype IB over several years at a single centre imply a community reservoir of infection and possible increased pathogenicity of certain infrequent viral genotypes. PMID:21143345

Optimizing the use of antithrombotic therapy for atrial fibrillation in older people: a pharmacist-led multidisciplinary intervention.

PubMed

Bajorek, Beata V; Krass, Ines; Ogle, Susan J; Duguid, Margaret J; Shenfield, Gillian M

2005-11-01

To develop, implement, and evaluate a pharmacist-led multidisciplinary intervention in a hospital setting that would optimize antithrombotic use in elderly atrial fibrillation patients. The hypothesis that there would be an increase in the proportion of patients receiving antithrombotic therapy at discharge was tested. Evidence-based algorithms were developed to define the criteria (stroke risk vs contraindications) by which an elderly patient's requirement for antithrombotic therapy was assessed. A major Sydney teaching hospital. Two hundred eighteen consecutively admitted elderly patients (mean age 85.2) were recruited over a 6-month period. A pharmacist-coordinated multidisciplinary review process was implemented to coordinate risk assessments and subsequently recommend appropriate antithrombotic therapy, as per the algorithms. The proportion of patients receiving antithrombotic therapy was assessed on admission (preintervention), at discharge (postintervention), and postdischarge (follow-up at 3 and 6 months). As a result of the intervention, 78 patients (35.8%) required changes to their existing antithrombotic therapy. Of these changes, 60 (76.9%) were "upgrades" to more-effective treatment options (e.g., from no therapy to any agent or from aspirin to warfarin). The remaining 18 (23.1%) changes were "downgrades" to less-effective, albeit safer, options. Despite a significant increase in anti thrombotic use overall (59.6% vs 81.2%, P<.001), fewer patients received warfarin postintervention, after having been assessed as inappropriate candidates (20.7% vs 17.4%, P=.39). A pharmacist-led multidisciplinary process was successfully developed and implemented within the hospital setting to increase overall antithrombotic use. Having addressed some of the known barriers and limitations to warfarin use, these algorithms may allow allied health workers, patients, and clinicians to work collaboratively to achieve optimal and, importantly, appropriate (i.e., safe and effective) antithrombotic use in at-risk elderly patients.

Neuropsychological profiles and outcomes in children with new onset frontal lobe epilepsy.

PubMed

Matricardi, Sara; Deleo, Francesco; Ragona, Francesca; Rinaldi, Victoria Elisa; Pelliccia, Sarah; Coppola, Giangennaro; Verrotti, Alberto

2016-02-01

Frontal lobe epilepsy (FLE) is the second most frequent type of localization-related epilepsy, and it may impact neurocognitive functioning with high variability. The prevalence of neurocognitive impairment in affected children remains poorly defined. This report outlines the neuropsychological profiles and outcomes in children with new onset FLE, and the impact of epilepsy-related factors, such as seizure frequency and antiepileptic drug (AED) load, on the neurocognitive development. Twenty-three consecutive children (15 males and 8 females) with newly diagnosed cryptogenic FLE were enrolled; median age at epilepsy onset was 7 years (6-9.6 years). They underwent clinical and laboratory evaluation and neuropsychological assessment before starting AED treatment (time 0) and after one year of treatment (time 1). Twenty age-matched patients affected by idiopathic generalized epilepsy (10 male and 10 females) and eighteen age-matched healthy subjects (9 males and 9 females) were enrolled as controls and underwent the same assessment. All patients with FLE showed a significant difference in almost all assessed cognitive domains compared with controls, mainly in frontal functions and memory. At time 1, patients were divided into two groups according to epilepsy-related factors: group 1 (9 patients) with persisting seizures despite AED polytherapy, and group 2 (14 patients) with good seizure control in monotherapy. A significant difference was highlighted in almost all subtests in group 1 compared with group 2, both at time 0 and at time 1. In children with FLE showing a broad range of neurocognitive impairments, the epilepsy-related factors mostly related to a worse neurocognitive outcome are poor seizure control and the use of AED polytherapy, suggesting that epileptic discharges may have a negative impact on the functioning of the involved cerebral regions. Copyright © 2015 Elsevier Inc. All rights reserved.

Prevalence and Safety of Intravenous Immunoglobulin Administration During Maintenance Chemotherapy in Children with Acute Lymphoblastic Leukemia in First Complete Remission: A Health Maintenance Organization Perspective.

PubMed

Van Winkle, Patrick; Burchette, Raoul; Kim, Raymond; Raghunathan, Rukmani; Qureshi, Naveen

2018-04-09

Children with acute lymphoblastic leukemia (ALL) in first complete remission (CR1) experience hypogammaglobulinemia and are at risk of sepsis during maintenance chemotherapy. Intravenous immunoglobulin (IVIG) has been used to try to circumvent this risk, but no data exist regarding its safety and prevalence in a health maintenance organization. To evaluate the prevalence and safety of IVIG in children with ALL in CR1 during maintenance chemotherapy. A multicenter, retrospective cohort study of consecutive children with ALL in CR1 during maintenance chemotherapy from 2008 to 2014. Groups treated with or without IVIG were compared using nonparametric statistics. Multivariate logistic regression involved all variables available before maintenance therapy began. One hundred eighteen patients were included (53% males), aged 9 months to 19 years. Thirty of 31 patients (97%) who had immunoglobulins analyzed before IVIG were hypogammaglobulinemic. Thirty-six patients (30%) received IVIG during maintenance chemotherapy. Patients received an average of 10.5 IVIG doses (range = 1-31). Ninety-seven percent of doses were administered without a transfusion reaction. Other factors associated with IVIG use were prior double-delayed intensification (odds ratio = 5.36, 95% confidence interval = 1.3-27.49, p = 0.026) and episodes of bacteremia or fungemia before maintenance chemotherapy (odds ratio = 3.04, 95% confidence interval = 1.25-7.51, p = 0.015). Use of IVIG in children with ALL in CR1 with hypogammaglobulinemia occurred in approximately 30% of patients and was well tolerated. Administration of IVIG significantly correlated with a history of double-delayed intensification and prior bacteremia or fungemia.

Comparison of the analgesic effect of intravenous acetaminophen with that of flurbiprofen axetil on post-breast surgery pain: a randomized controlled trial.

PubMed

Nonaka, Takahiro; Hara, Marie; Miyamoto, Chisato; Sugita, Michiko; Yamamoto, Tatsuo

2016-06-01

Acetaminophen is known to be a relatively weak analgesic with fewer side effects than nonsteroidal anti-inflammatory drugs (NSAIDs). This study aimed to determine whether intravenous (iv) acetaminophen produces comparable analgesic effects to those of flurbiprofen (positive control drug), an intravenously injectable NSAID, after partial mastectomies. The primary outcome assessed was pain intensity during the first 24 h after the operation, and the secondary outcome was the satisfaction rating at discharge. After obtaining Institutional Ethics Committee approval, a series of 40 consecutive female patients who were scheduled for partial mastectomies were enrolled. Participants were randomly divided into two groups: an acetaminophen (1000 mg × 3) group (group A) and a flurbiprofen (50 mg × 3) group (group F). Each drug was administered 15 min before the end of surgery, and at 6 and 12 h after the operation. Postoperative pain was evaluated using a 100-mm visual analog scale (VAS) at 3, 6, and 24 h postoperatively. Satisfaction rating was evaluated on a 5-point scale (very good, good, well, bad, and very bad). VAS scores (mm) with movement in groups A and F at 3, 6, and 24 h after the surgery were 22 vs. 28, 14 vs. 24, and 12 vs. 20.5 (median), respectively, with no significant differences between the two groups. Eighteen of 20 patients in group A and 20 of 20 patients in group F expressed a satisfaction rating of greater than good. Acetaminophen produces an equivalent analgesic effect to flurbiprofen in post-partial mastectomy patients.

Socio-demographic characteristics and risk factors among HIV/AIDS patients in Kano, Northern Nigeria.

PubMed

Iliyasu, Z; Arotiba, J T; Babashani, M

2004-01-01

There has been no description of the characteristics of HIV/AIDS patients that are referred to this antiretroviral treatment centre. The information could be useful in planning for prevention, care and support of people living with HIV/AIDS (PLWHA) and people affected by AIDS (PABA). To describe the socio-demographic characteristics and identify risk factors among HIV/AIDS patients presenting to Aminu Kano Teaching Hospital. Analysis of a prospectively collected data on 205 consecutive patients presenting to Aminu Kano Teaching Hospital from May 2002 to June 2003. Out of the 205 HIV positive patients seen, there were 112 (54.6%) males and 93 (45.4%) females giving a sex ratio of 1.2:1. The age range was 18 to 61 years with an overall mean S.D of 33.7 +/- [corrected] 8 years. The mean for males was 37.3 +/- [corrected] 7.8 years compared to 29.56 years for females. This difference was statistically significant (t = 8.1 DF = 201 P < 0.001). About 38.5% of the patients had secondary school education, 36.1% had tertiary education and 10.2% had primary education. Half of the patients were Hausas, 18.5% Igbos, 4.9% Idomas and 3.4% Igalas. Sixty percent were Muslims, the rest were Christians. About 64.0% were married, 23.0% were single and 11.0 % were divorced. Only 17.0% reported having multiple sexual partners. Eighteen percent claimed they use condoms always, 67.8% occasionally and 8.3% never. Twenty percent of the patients had previous blood transfusion. None reported intravenous drug abuse or homosexuality. The need for a sustained multi-sectoral preventive effort and the scaling up of treatment and community care initiatives were stressed.

Minimal Pleural Effusion in Small Cell Lung Cancer: Proportion, Mechanisms, and Prognostic Effect.

PubMed

Ryu, Jeong-Seon; Lim, Jun Hyeok; Lee, Jeong Min; Kim, Woo Chul; Lee, Kyung-Hee; Memon, Azra; Lee, Seul-Ki; Yi, Bo-Rim; Kim, Hyun-Jung; Hwang, Seung-Sik

2016-02-01

To determine the frequency and investigate possible mechanisms and prognostic relevance of minimal (<10-mm thickness) pleural effusion in patients with small cell lung cancer (SCLC). The single-center retrospective study was approved by the institutional review board of the hospital, and informed consent was waived by the patients. A cohort of 360 consecutive patients diagnosed with SCLC by using histologic analysis was enrolled in this study. Based on the status of pleural effusion on chest computed tomographic (CT) scans at diagnosis, patients were classified into three groups: no pleural effusion, minimal pleural effusion, and malignant pleural effusion. Eighteen variables related to patient, environment, stage, and treatment were included in the final model as potential confounders. Minimal pleural effusion was present in 74 patients (20.6%) and malignant pleural effusion in 83 patients (23.0%). Median survival was significantly different in patients with no, minimal, or malignant pleural effusion (median survival, 11.2, 5.93, and 4.83 months, respectively; P < .001, log-rank test). In the fully adjusted final model, patients with minimal pleural effusion had a significantly increased risk of death compared with those with no pleural effusion (adjusted hazard ratio, 1.454 [95% confidence interval: 1.012, 2.090]; P = .001). The prognostic effect was significant in patients with stage I-III disease (adjusted hazard ratio, 2.751 [95% confidence interval: 1.586, 4.773]; P < .001), but it disappeared in stage IV disease. An indirect mechanism representing mediastinal lymphadenopathy was responsible for the accumulation in all but one patient with minimal pleural effusion. Minimal pleural effusion is a common clinical finding in staging SCLC. Its presence is associated with worse survival in patients and should be considered when CT scans are interpreted. © RSNA, 2015.

Thalamic Activation in the Kleine-Levin Syndrome

PubMed Central

Engström, Maria; Karlsson, Thomas; Landtblom, Anne-Marie

2014-01-01

Study Objectives: The objective of this study was to investigate if combined measures of activation in the thalamus and working memory capacity could guide the diagnosis of Kleine-Levin Syndrome (KLS). A second objective was to obtain more insight into the neurobiological causes of KLS. Design: Matched group and consecutive recruitment. Setting: University hospital neurology department and imaging center. Patients or Participants: Eighteen patients with KLS diagnosed according to the International Classification of Sleep Disorders and 26 healthy controls were included. Interventions: N/A. Measurements and Results: Working memory capacity was assessed by the listening span task. A version of this task (reading span) was presented to the participants during functional magnetic resonance imaging (fMRI). Activation in the thalamus was measured in a region of interest analysis. A combination of the working memory capacity and the thalamic activation measures resulted in 80% prediction accuracy, 81% sensitivity, and 78% specificity regarding the ability to separate KLS patients from healthy controls. The controls had an inverse relation between working memory capacity and thalamic activation; higher performing participants had lower thalamic activation (r = -0.41). KLS patients showed the opposite relationship; higher performing participants had a tendency to higher thalamic activation (r = -0.35). Conclusions: This study shows that functional neuroimaging of the thalamus combined with neuropsychological assessment of working memory function provides a means to guide diagnosis of Kleine-Levin Syndrome. Results in this study also indicate that imaging of brain function and evaluation of cognitive capacity can give insights into the neurobiological mechanisms of Kleine-Levin Syndrome. Citation: Engström M; Karlsson T; Landtblom AM. Thalamic activation in the Kleine-Levin Syndrome. SLEEP 2014;37(2):379-386. PMID:24497666

Femtosecond laser-assisted cataract surgeries reported to the European Registry of Quality Outcomes for Cataract and Refractive Surgery: Baseline characteristics, surgical procedure, and outcomes.

PubMed

Lundström, Mats; Dickman, Mor; Henry, Ype; Manning, Sonia; Rosen, Paul; Tassignon, Marie-José; Young, David; Stenevi, Ulf

2017-12-01

To describe a large cohort of femtosecond laser-assisted cataract surgeries in terms of baseline characteristics and the related outcomes. Eighteen cataract surgery clinics in 9 European countries and Australia. Prospective multicenter case series. Data on consecutive eyes having femtosecond laser-assisted cataract surgery in the participating clinics were entered in the European Registry of Quality Outcomes for Cataract and Refractive Surgery (EUREQUO). A trained registry manager in each clinic was responsible for valid reporting to the EUREQUO. Demographics, preoperative corrected distance visual acuity (CDVA), risk factors, type of surgery, type of intraocular lens, visual outcomes, refractive outcomes, and complications were reported. Complete data were available for 3379 cases. The mean age was 64.4 years ± 10.9 (SD) and 57.8% (95% confidence interval [CI], 56.1-59.5) of the patients were women. A surgical complication was reported in 2.9% of all cases (95% CI, 2.4-3.5). The mean postoperative CDVA was 0.04 ± 0.15. logarithm of the minimum angle of resolution. A biometry prediction error (spherical equivalent) was within ±0.5 diopter in 71.8% (95% CI, 70.3-73.3) of all surgeries. Postoperative complications were reported in 3.3% (95% CI, 2.7-4.0). Patients with good preoperative CDVA had the best visual and refractive outcomes; patients with poor preoperative visual acuity had poorer outcomes. The visual and refractive outcomes of femtosecond laser-assisted cataract surgery were favorable compared with manual phacoemulsification. The outcomes were highly influenced by the preoperative visual acuity, but all preoperative CDVA groups had acceptable outcomes. Copyright © 2017 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Viable, lyophilized lactobacilli do not increase iron absorption from a lactic acid-fermented meal in healthy young women, and no iron absorption occurs in the distal intestine.

PubMed

Bering, Stine; Sjøltov, Laila; Wrisberg, Seema S; Berggren, Anna; Alenfall, Jan; Jensen, Mikael; Højgaard, Liselotte; Tetens, Inge; Bukhave, Klaus

2007-11-01

Lactic acid-fermented foods have been shown to increase Fe absorption in human subjects, possibly by lowering pH, activation of phytases, production of organic acids, or by the viable lactic acid bacteria. In this study the effect of a heat-inactivated lactic acid-fermented oat gruel with and without added viable, lyophilized Lactobacillus plantarum 299v on non-haem Fe absorption was investigated. Furthermore, Fe absorption in the distal intestine was determined. In a randomized, double-blinded crossover trial eighteen healthy young women aged 22 (SD 3) years with low Fe status (serum ferritin < 30 microg/l) were served the two test gruels, extrinsically labelled with 59Fe and served with two enterocoated capsules (containing 55Fe(II) and 55Fe(III), respectively) designed to disintegrate in the ileum. The meals were consumed on two consecutive days, e.g. in the order AA followed by BB in a second period. Non-haem Fe absorption was determined from 59Fe whole-body retention and isotope activities in blood samples. The concentrations of Fe, lactate, phytate, and polyphenols, and the pH were similar in the heat-inactivated lactic acid-fermented oat gruels with and without added L. plantarum 299v, and no difference in Fe absorption was observed between the test gruels (1.4 and 1.3%, respectively). Furthermore, no absorption of Fe in the distal intestine was observed. In conclusion, addition of viable, lyophilized lactobacillus to a heat-inactivated lactic acid-fermented oat gruel does not affect Fe absorption, and no absorption seems to occur in the distal part of the intestine from low Fe bioavailability meals in these women.

Utility of Routine Outpatient Cervical Spine Imaging Following Anterior Cervical Corpectomy and Fusion.

PubMed

Desai, Atman; Pendharkar, Arjun V; Swienckowski, Jessica G; Ball, Perry A; Lollis, Scott; Simmons, Nathan E

2015-11-23

Construct failure is an uncommon but well-recognized complication following anterior cervical corpectomy and fusion (ACCF). In order to screen for these complications, many centers routinely image patients at outpatient visits following surgery. There remains, however, little data on the utility of such imaging. The electronic medical record of all patients undergoing anterior cervical corpectomy and fusion at Dartmouth-Hitchcock Medical Center between 2004 and 2009 were reviewed. All patients had routine cervical spine radiographs performed perioperatively. Follow-up visits up to two years postoperatively were analyzed.  Sixty-five patients (mean age 52.2) underwent surgery during the time period. Eighteen patients were female. Forty patients had surgery performed for spondylosis, 20 for trauma, three for tumor, and two for infection. Forty-three patients underwent one-level corpectomy, 20 underwent two-level corpectomy, and two underwent three-level corpectomy, using an allograft, autograft, or both. Sixty-two of the fusions were instrumented using a plate and 13 had posterior augmentation. Fifty-seven patients had follow-up with imaging at four to 12 weeks following surgery, 54 with plain radiographs, two with CT scans, and one with an MRI scan. Unexpected findings were noted in six cases. One of those patients, found to have asymptomatic recurrent kyphosis following a two-level corpectomy, had repeat surgery because of those findings. Only one further patient was found to have abnormal imaging up to two years, and this patient required no further intervention. Routine imaging after ACCF can demonstrate asymptomatic occurrences of clinically significant instrument failure. In 43 consecutive single-level ACCF however, routine imaging did not change management, even when an abnormality was discovered. This may suggest a limited role for routine imaging after ACCF in longer constructs involving multiple levels.

Elbow hemiarthroplasty using a "triceps-on" approach for the management of acute distal humeral fractures.

PubMed

Phadnis, Joideep; Banerjee, Samik; Watts, Adam C; Little, Nicholas; Hearnden, Anthony; Patel, Vipul R

2015-08-01

Total elbow arthroplasty is an established option for the primary treatment of acute distal humeral fractures, but there are sparse data regarding elbow hemiarthroplasty (EHA) as an alternative. We present the outcome of EHA performed with a modular anatomic prosthesis and a "triceps-on" surgical technique. Eighteen consecutive patients underwent EHA for an acute fracture. Two patients died, leaving a study group of 16 patients with minimum 2-year follow-up. Clinical evaluation included range of motion; Mayo Elbow Performance Score; Quick Disabilities of the Arm, Shoulder, and Hand score; and Oxford Elbow Score. Radiographic assessment looked at alignment, evidence of loosening, ulnar and radial head wear, heterotopic ossification, and whether healing of the condyles had occurred. Mean follow-up was 35 months (24-79 months). The mean scores were as follows: Mayo Elbow Performance Score, 89.6; shortened Disabilities of the Arm, Shoulder, and Hand score, 11.2; and Oxford Elbow Score, 43.7. The mean flexion and pronation-supination arcs were 116° and 172° respectively. Radial head wear was absent in 13 patients and mild in 3. Ulnar wear was absent in 6 patients, mild in 8, and moderate in 2. Wear was not associated with greater pain or inferior functional scores. There was no sign of aseptic loosening, and complete condylar bone union occurred in 15 elbows. There was 1 complication, a transient ulnar nerve neurapraxia that resolved without intervention. EHA with a modular anatomic implant using a triceps-on approach is a reliable technique for the management of acute unreconstructible distal humeral fractures in older patients. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

Treatment of aneurysmal bone cysts of the pelvis and sacrum.

PubMed

Papagelopoulos, P J; Choudhury, S N; Frassica, F J; Bond, J R; Unni, K K; Sim, F H

2001-11-01

Aneurysmal bone cysts are benign, non-neoplastic, highly vascular bone lesions. The purpose of this study was to describe the prevalence, the clinical presentation, and the recurrence rate of aneurysmal bone cysts of the pelvis and sacrum and to examine the diagnostic and therapeutic options and prognosis for patients with this condition. Forty consecutive patients with an aneurysmal bone cyst of the pelvis and/or sacrum were treated from 1921 to 1996. Their medical records and radiographic and imaging studies were reviewed, and histological sections from the cysts were examined. Seventeen lesions were iliosacral, sixteen were acetabular, and seven were ischiopubic. Seven involved the hip joint, and two involved the sacroiliac joint. All twelve sacral lesions extended to more than one sacral segment and were associated with neurological signs and symptoms. Destructive acetabular lesions were associated with pathological fracture in five patients and with medial migration of the femoral head, hip subluxation, and hip dislocation in one patient each. The mean duration of follow-up was thirteen years (range, three to fifty-three years). Thirty-five patients who were initially treated for a primary lesion had surgical treatment (twenty-one had excision-curettage and fourteen had intralesional excision); two patients also had adjuvant radiation therapy. Of the thirty-five patients, five (14%) had a local recurrence noted less than eighteen months after the operation. Of five patients initially treated for a recurrent lesion, one had a local recurrence. At the latest follow-up examination, all forty patients were disease-free and twenty-eight (70%) were asymptomatic. There were two deep infections. Aneurysmal bone cysts of the pelvis and sacrum are usually aggressive lesions associated with substantial bone destruction, pathological fractures, and local recurrence. Current management recommendations include preoperative selective arterial embolization, excision-curettage, and bone-grafting.

Traction-assisted Internal Negative Pressure Wound Therapy With Bridging Retention Sutures to Facilitate Staged Closure of High-risk Wounds Under Tension.

PubMed

DeFazio, Michael V; Economides, James M; Anghel, Ersilia L; Mathis, Ryan K; Barbour, John R; Attinger, Christopher E

2017-10-01

Loss of domain often complicates attempts at delayed wound closure in regions of high tension. Wound temporization with traction-assisted internal negative pressure wound therapy (NPWT), using bridging retention sutures, can minimize the effects of edema and elastic recoil that contribute to progressive tissue retraction over time. The investigators evaluated the safety and efficacy of this technique for complex wound closure. Between May 2015 and November 2015, 18 consecutive patients underwent staged reconstruction of complex and/or contaminated soft tissue defects utilizing either conventional NPWT or modified NPWT with instillation and continuous dermatotraction via bridging retention sutures. Instillation of antimicrobial solution was reserved for wounds containing infected/exposed hardware or prosthetic devices. Demographic data, wound characteristics, reconstructive outcomes, and complications were reviewed retrospectively. Eighteen wounds were treated with traction-assisted internal NPWT using the conventional (n = 11) or modified instillation (n = 7) technique. Defects involved the lower extremity (n = 14), trunk (n = 3), and proximal upper extremity (n = 1), with positive cultures identified in 12 wounds (67%). Therapy continued for 3 to 8 days (mean, 4.3 days), resulting in an average wound surface area reduction of 78% (149 cm² vs. 33 cm²) at definitive closure. Seventeen wounds (94%) were closed directly, whereas the remaining defect required coverage with a local muscle flap and skin graft. At final follow-up (mean, 12 months), 89% of wounds remained closed. In 2 patients with delayed, recurrent periprosthetic infection (mean, 7.5 weeks), serial debridement/hardware removal mandated free tissue transfer for composite defect reconstruction. Traction-assisted internal NPWT provides a safe and effective alternative to reduce wound burden and facilitate definitive closure in cases where delayed reconstruction of high-tension wounds is planned.

Predicting changes in flow category in patients with severe aortic stenosis and preserved left ventricular ejection fraction on medical therapy.

PubMed

Ngiam, Jinghao Nicholas; Kuntjoro, Ivandito; Tan, Benjamin Y Q; Sim, Hui-Wen; Kong, William K F; Yeo, Tiong-Cheng; Poh, Kian-Keong

2017-11-01

Controversy surrounds the prognosis and management of patients with paradoxical low-flow severe aortic stenosis (AS) with preserved left ventricular ejection fraction (LVEF). It was not certain if patients in a particular flow category remained in the same category as disease progressed. We investigated whether there were switches in categories and if so, their predictors. Consecutive subjects (n = 203) with isolated severe AS and paired echocardiography (>180 days apart) were studied. They were divided into 4 groups, based on their flow categories and if they progressed on subsequent echocardiography to switch or remain in the same flow category. Univariate analyses of clinical and echocardiographic parameters identified predictors of these changes in flow category. One hundred eighteen were normal flow (SVI ≥ 35 mL/m 2 ), while 85 were low flow on index echocardiography. In the patients with normal flow, 33% switched to low flow. This was associated with higher valvuloarterial impedance (Zva, P < .001) and lower systemic arterial compliance (SAC, P < .001) compared to index echocardiography, and predicted by higher initial Zva (optimized cutoff >4.77 mm Hg/mL/m 2 , AUC = 0.81 [95% CI:0.75-0.87, P < .001]). In patients with low flow, 25% switched to normal flow, which was associated with lower Zva and higher SAC and the switch was predicted by a higher initial mean transaortic pressure gradient. A significant number of patients switched flow categories in severe AS with preserved LVEF on subsequent echocardiography. Changes in flow were reflected by respective changes in Zva and SAC. Identifying echocardiographic predictors of a switch in category may guide prognostication and management of such patients. © 2017, Wiley Periodicals, Inc.

Shifts in an invasive rodent community favoring black rats (Rattus rattus) following restoration of native forest

USGS Publications Warehouse

Shiels, Aaron B.; Medeiros, Arthur C.; von Allmen, Erica I.

2017-01-01

One potential, unintended ecological consequence accompanying forest restoration is a shift in invasive animal populations, potentially impacting conservation targets. Eighteen years after initial restoration (ungulate exclusion, invasive plant control, and out planting native species) at a 4 ha site on Maui, Hawai'i, we compared invasive rodent communities in a restored native dry forest and adjacent non-native grassland. Quarterly for 1 year, we trapped rodents on three replicate transects (107 rodent traps) in each habitat type for three consecutive nights. While repeated trapping may have reduced the rat (Black rat, Rattus rattus) population in the forest, it did not appear to reduce the mouse (House mouse, Mus musculus) population in the grassland. In unrestored grassland, mouse captures outnumbered rat captures 220:1, with mice averaging 54.9 indiv./night versus rats averaging 0.25 indiv./night. In contrast, in restored native forest, rat captures outnumbered mouse captures by nearly 5:1, averaging 9.0 indiv./night versus 1.9 indiv./night for mice. Therefore, relatively recent native forest restoration increased Black rat abundance and also increased their total biomass in the restored ecosystem 36-fold while reducing House mouse biomass 35-fold. Such a community shift is worrisome because Black rats pose a much greater threat than do mice to native birds and plants, perhaps especially to large-seeded tree species. Land managers should be aware that forest restoration (i.e. converting grassland to native forest) can invoke shifts in invasive rodent populations, potentially favoring Black rats. Without intervention, this shift may pose risks for intended conservation targets and modify future forest restoration trajectories.

Screening for intermediate and severe forms of thalassaemia in discarded red blood cells: optimization and feasibility.

PubMed

George, Elizabeth; Lai, Mei I; Teh, Lai Kuan; Ramasamy, Rajesh; Goh, Ern Huei; Asokan, Kamalan; Tan, J A M A; Vasudevan, Maithili; Low, Sharon

2011-12-01

Detection and quantification of Hb subtypes of human blood is integral to presumptive identification of thalassaemias. It has been used in neonatal screening of thalassaemia and Hb variants. The use of discarded red blood cells following processing of the cord blood for stem cells provides readily available diagnostic material for thalassaemia screening. In this study, we determined the range of Hb subtypes in 195 consecutive cord blood samples collected for cord blood banking. The 'cord blood samples' analysed were those of the remaining red blood cells after the cord blood was processed for stem cell storage. Quantification of Hb subtypes by high performance liquid chromatography (HPLC) was done on BioRad Variant II Hb testing system. Only 73 (36.5%) of the samples could be analyzed neat without dilution. With a 1:300 dilution with wash solution the acceptable area as recommended by the manufacturer for reading of a C-gram within the 1 to 3 million ranges were achieved in all. Eighteen (9%) 12 showed classical Hb Barts (y4) prerun peaks were confirmed by Sebia Hydrasys automated Hb gel electrophoresis and quantified by Sebia Capillarys 2 capillary electrophoresis. Only 1 (0.5%) was presumptively identified with HbH disease. Due to the limited number of samples no beta-thalassaemia major, Hb E beta-thalassaemia and Hb Barts hydrops fetalis were found. The HPLC assay was possible at a cost US$ 5 per sample and a turnover time of 10 samples per hour without technical difficulties. This study reports an effective and valuable protocol for thalassaemia screening in red blood cells which would otherwise be discarded during cord blood processing. Cord blood with severe and intermediate forms of thalassaemia can be preselected and not stored.

Rehabilitative, psychiatric, functional and aesthetic problems in patients treated for burn injuries--a preliminary follow-up study.

PubMed

Jonsson, C E; Schüldt, K; Linder, J; Björnhagen, V; Ekholm, J

1997-01-01

Patients consecutively treated for burn injuries for four or more days during 1994 were examined one year after admission by a plastic surgeon, a specialist in rehabilitation medicine and a psychiatrist. Of thirty-nine such patients treated, two were dead, 11 did not present and six thought they had no remaining problems. Aesthetic and functional problems were present in 16 patients, in 11 reconstructive surgery given in one or more sessions was judged to have improved the condition. Of eighteen patients referred to a rehabilitation medicine specialist, 14 were assessed. Nine of these had functional impairments in the burn-injured body regions. A majority had functional impairments, persistent decrease in range of upper extremity motion, reduced muscle force, altered sensibility and itch. One patient suffered from pain. Three patients had occupational handicaps. Work disability occurred in two patients and further two were in need of vocational counselling due to the burn injury. In a subgroup of 11 patients four fulfilled criteria for one or more personality disorders, and two of these also suffered from major depression. Quality of life assessed with the SF-36 was lower than in a normal population. Some of the patients had psychiatric disease and personality disorders. Although rehabilitation started early in the acute phase of treatment, rehabilitation medicine function-increasing measures were needed in several cases. Individual rehabilitation programmes based on the patient's particular features and needs are recommended. The findings support the idea of a multidisciplinary approach for patients with burn injury and indicate that a subgroup of burn injury patients have functional impairments and/or disabilities which can probably be improved with reconstructive surgery and rehabilitation.

Characteristics and Outcomes of Patients With Breast Cancer With Leptomeningeal Metastasis.

PubMed

Morikawa, Aki; Jordan, Lilly; Rozner, Raquel; Patil, Sujata; Boire, Adrienne; Pentsova, Elena; Seidman, Andrew D

2017-02-01

Disease presentation, prognostic factors, and treatment patterns for patients with breast cancer with leptomeningeal metastasis are not well characterized. In this study, we examined patient characteristics and prognostic factors for survival after a diagnosis of leptomeningeal metastasis. Three hundred eighteen consecutive patients with breast cancer diagnosed with leptomeningeal metastasis from January 1998 to December 2013 at Memorial Sloan Kettering Cancer Center were identified. Clinicopathologic and treatment information were obtained in a retrospective review. Associations with time from leptomeningeal diagnosis to death were evaluated according to Kaplan-Meier curves, log rank tests, and Cox proportional hazard models. Of the 318 patients, 44% were hormone receptor-positive (HR+) HER2 - , 18% were HR + HER2 + , 8.5% were HR - HER2 + , 25.5% were triple-negative; and 4% had missing information. The median survival was 3.5 months (95% confidence interval, 3.0-4.0) with 63 patients (20%) surviving >1 year. Recent diagnosis (after 2006), HER2 + subtype, higher performance status, cranial-only involvement, and no evidence of noncentral nervous system disease were independently associated with improved survival in multivariate analysis. Despite the improvement noted with the more recent years of diagnosis, survival after a diagnosis of leptomeningeal metastasis remains poor. Similar to patients with parenchymal brain metastasis only, the survival differs among different receptor subtypes. A closer examination to identify factors, such as introduction of new systemic therapies that might contribute to longer-term survival might provide insight to improve management of these patients. In addition, factors we identified that are associated with survival might be considered as stratification variables in the design of future randomized clinical trials in this population. Copyright © 2016 Elsevier Inc. All rights reserved.

Impact of menstrual cycle phase on endocrine effects of partial sleep restriction in healthy women.

PubMed

LeRoux, Amanda; Wright, Lisa; Perrot, Tara; Rusak, Benjamin

2014-11-01

There is extensive evidence that sleep restriction alters endocrine function in healthy young men, increasing afternoon cortisol levels and modifying levels of other hormones that regulate metabolism. Recent studies have confirmed these effects in young women, but have not investigated whether menstrual cycle phase influences these responses. The effects on cortisol levels of limiting sleep to 3h for one night were assessed in two groups of women at different points in their menstrual cycles: mid-follicular and mid-luteal. Eighteen healthy, young women, not taking oral contraceptives (age: 21.8±0.53; BMI: 22.5±0.58 [mean±SEM]), were studied. Baseline sleep durations, eating habits and menstrual cycles were monitored. Salivary samples were collected at six times of day (08:00, 08:30, 11:00, 14:00, 17:00, 20:00) during two consecutive days: first after a 10h overnight sleep opportunity (Baseline) and then after a night with a 3h sleep opportunity (Post-sleep restriction). All were awakened at the same time of day. Women in the follicular phase showed a significant decrease (p=0.004) in their cortisol awakening responses (CAR) after sleep restriction and a sustained elevation in afternoon/evening cortisol levels (p=0.008), as has been reported for men. Women in the luteal phase showed neither a depressed CAR, nor an increase in afternoon/evening cortisol levels. Secondary analyses examined the impact of sleep restriction on self-reported hunger and mood. Menstrual cycle phase dramatically altered the cortisol responses of healthy, young women to a single night of sleep restriction, implicating effects of spontaneous changes in endocrine status on adrenal responses to sleep loss. Copyright © 2014 Elsevier Ltd. All rights reserved.

Glioblastoma Segmentation: Comparison of Three Different Software Packages.

PubMed

Fyllingen, Even Hovig; Stensjøen, Anne Line; Berntsen, Erik Magnus; Solheim, Ole; Reinertsen, Ingerid

2016-01-01

To facilitate a more widespread use of volumetric tumor segmentation in clinical studies, there is an urgent need for reliable, user-friendly segmentation software. The aim of this study was therefore to compare three different software packages for semi-automatic brain tumor segmentation of glioblastoma; namely BrainVoyagerTM QX, ITK-Snap and 3D Slicer, and to make data available for future reference. Pre-operative, contrast enhanced T1-weighted 1.5 or 3 Tesla Magnetic Resonance Imaging (MRI) scans were obtained in 20 consecutive patients who underwent surgery for glioblastoma. MRI scans were segmented twice in each software package by two investigators. Intra-rater, inter-rater and between-software agreement was compared by using differences of means with 95% limits of agreement (LoA), Dice's similarity coefficients (DSC) and Hausdorff distance (HD). Time expenditure of segmentations was measured using a stopwatch. Eighteen tumors were included in the analyses. Inter-rater agreement was highest for BrainVoyager with difference of means of 0.19 mL and 95% LoA from -2.42 mL to 2.81 mL. Between-software agreement and 95% LoA were very similar for the different software packages. Intra-rater, inter-rater and between-software DSC were ≥ 0.93 in all analyses. Time expenditure was approximately 41 min per segmentation in BrainVoyager, and 18 min per segmentation in both 3D Slicer and ITK-Snap. Our main findings were that there is a high agreement within and between the software packages in terms of small intra-rater, inter-rater and between-software differences of means and high Dice's similarity coefficients. Time expenditure was highest for BrainVoyager, but all software packages were relatively time-consuming, which may limit usability in an everyday clinical setting.

Enhancing Inhibition-Induced Plasticity in Tinnitus – Spectral Energy Contrasts in Tailor-Made Notched Music Matter

PubMed Central

Stein, Alwina; Engell, Alva; Lau, Pia; Wunderlich, Robert; Junghoefer, Markus; Wollbrink, Andreas; Bruchmann, Maximilian; Rudack, Claudia; Pantev, Christo

2015-01-01

Chronic tinnitus seems to be caused by reduced inhibition among frequency selective neurons in the auditory cortex. One possibility to reduce tinnitus perception is to induce inhibition onto over-activated neurons representing the tinnitus frequency via tailor-made notched music (TMNM). Since lateral inhibition is modifiable by spectral energy contrasts, the question arises if the effects of inhibition-induced plasticity can be enhanced by introducing increased spectral energy contrasts (ISEC) in TMNM. Eighteen participants suffering from chronic tonal tinnitus, pseudo randomly assigned to either a classical TMNM or an ISEC-TMNM group, listened to notched music for three hours on three consecutive days. The music was filtered for both groups by introducing a notch filter centered at the individual tinnitus frequency. For the ISEC-TMNM group a frequency bandwidth of 3/8 octaves on each side of the notch was amplified, additionally, by about 20 dB. Before and after each music exposure, participants rated their subjectively perceived tinnitus loudness on a visual analog scale. During the magnetoencephalographic recordings, participants were stimulated with either a reference tone of 500 Hz or a test tone with a carrier frequency representing the individual tinnitus pitch. Perceived tinnitus loudness was significantly reduced after TMNM exposure, though TMNM type did not influence the loudness ratings. Tinnitus related neural activity in the N1m time window and in the so called tinnitus network comprising temporal, parietal and frontal regions was reduced after TMNM exposure. The ISEC-TMNM group revealed even enhanced inhibition-induced plasticity in a temporal and a frontal cortical area. Overall, inhibition of tinnitus related neural activity could be strengthened in people affected with tinnitus by increasing spectral energy contrast in TMNM, confirming the concepts of inhibition-induced plasticity via TMNM and spectral energy contrasts. PMID:25951605

Patterns of failure in patients with early onset (synchronous) resectable liver metastases from rectal cancer.

PubMed

Butte, Jean M; Gonen, Mithat; Ding, Peirong; Goodman, Karyn A; Allen, Peter J; Nash, Garrett M; Guillem, Jose; Paty, Philip B; Saltz, Leonard B; Kemeny, Nancy E; Dematteo, Ronald P; Fong, Yuman; Jarnagin, William R; Weiser, Martin R; D'Angelica, Michael I

2012-11-01

The optimal combination of available therapies for patients with resectable synchronous liver metastases from rectal cancer (SLMRC) is unknown, and the pattern of recurrence after resection has been poorly investigated. In this study, the authors examined recurrence patterns and survival after resection of SLMRC. Consecutive patients with SLMRC (disease-free interval, ≤12 months) who underwent complete resection of the rectal primary and liver metastases between 1990 and 2008 were identified from a prospective database. Demographics, tumor-related variables, and treatment-related variables were correlated with recurrence patterns. Competing risk analysis was used to determine the risk of pelvic and extrapelvic recurrence. In total, 185 patients underwent complete resection of rectal primary and liver metastases. One hundred eighty patients (97%) received chemotherapy during their treatment course, and 91 patients (49%) received pelvic radiation therapy either before (N = 65; 71.4%), or after (N = 26; 28.6%) rectal resection. The 5-year disease-specific survival rate was 51% for the entire cohort with a median follow-up of 44 months for survivors. One hundred thirty patients (70%) developed a recurrence: Eighteen patients (10%) had recurrences in the pelvis in combination with other sites, and 7 of these (4%) had an isolated pelvic recurrence. Recurrence pattern did not correlate with survival. Competing risk analysis demonstrated that the likelihood of a pelvic recurrence was significantly lower than that of an extrapelvic recurrence (P < .001). Of the patients with SLMRC who developed recurrent disease, systemic sites were overwhelmingly more common than pelvic recurrences. The current results indicated that the selective exclusion of radiotherapy may be considered in patients who are diagnosed with simultaneous disease. Copyright © 2012 American Cancer Society.

Entecavir monotherapy is effective in suppressing hepatitis B virus after liver transplantation.

PubMed

Fung, James; Cheung, Cindy; Chan, See-Ching; Yuen, Man-Fung; Chok, Kenneth S H; Sharr, William; Dai, Wing-Chiu; Chan, Albert C Y; Cheung, Tan-To; Tsang, Simon; Lam, Banny; Lai, Ching-Lung; Lo, Chung-Mau

2011-10-01

We investigated the efficacy of entecavir, a cyclopentyl guanosine nucleoside analogue, as monoprophylaxis in patients with chronic hepatitis B who received a liver transplant. We studied data from 80 consecutive patients who received a liver transplant (47 from living donors and 33 from deceased donors) for hepatitis B-related disease and entecavir monotherapy as prophylaxis. None of the patients received hepatitis B immunoglobulin. Indications for transplant included decompensation from cirrhosis (27.5%), acute-on-chronic hepatitis B (47.5%), and hepatocellular carcinoma (25%). The median follow-up time was 26 months (range, 5-40 months). Before transplant, 33 patients were not on antiviral therapy and 47 were on oral therapy (18 had received less than 3 months of treatment). At the time of transplant, the median log HBV DNA level was 3.5 copies/mL (range, 1.54-8.81); 21 patients (26%) had undetectable levels of HBV DNA. The cumulative rate of hepatitis B surface antigen (HBsAg) loss was 86% and 91% after 1 and 2 years, respectively. Ten patients had reappearance of HBsAg. Eighteen patients (22.5%) were HBsAg positive at the time of their last examination; 17 of these had undetectable levels of HBV DNA, and the remaining patient had a low level of HBV DNA (217 copies/mL). There was no evidence of mutations at sites that confer resistance to entecavir among patients who were HBsAg positive. Although only 26% of patients had complete viral suppression at the time of transplant, 91% lost HBsAg, with 98.8% achieving undetectable levels of HBV DNA. A hepatitis B immunoglobulin-free regimen of entecavir monotherapy is effective after liver transplantation for chronic hepatitis B. Copyright © 2011 AGA Institute. Published by Elsevier Inc. All rights reserved.

Acute versus chronic partial sleep deprivation in middle-aged people: differential effect on performance and sleepiness.

PubMed

Philip, Pierre; Sagaspe, Patricia; Prague, Mélanie; Tassi, Patricia; Capelli, Aurore; Bioulac, Bernard; Commenges, Daniel; Taillard, Jacques

2012-07-01

To evaluate the effects of acute sleep deprivation and chronic sleep restriction on vigilance, performance, and self-perception of sleepiness. Habitual night followed by 1 night of total sleep loss (acute sleep deprivation) or 5 consecutive nights of 4 hr of sleep (chronic sleep restriction) and recovery night. Eighteen healthy middle-aged male participants (age [(± standard deviation] = 49.7 ± 2.6 yr, range 46-55 yr). Multiple sleep latency test trials, Karolinska Sleepiness Scale scores, simple reaction time test (lapses and 10% fastest reaction times), and nocturnal polysomnography data were recorded. Objective and subjective sleepiness increased immediately in response to sleep restriction. Sleep latencies after the second and third nights of sleep restriction reached levels equivalent to those observed after acute sleep deprivation, whereas Karolinska Sleepiness Scale scores did not reach these levels. Lapse occurrence increased after the second day of sleep restriction and reached levels equivalent to those observed after acute sleep deprivation. A statistical model revealed that sleepiness and lapses did not progressively worsen across days of sleep restriction. Ten percent fastest reaction times (i.e., optimal alertness) were not affected by acute or chronic sleep deprivation. Recovery to baseline levels of alertness and performance occurred after 8-hr recovery night. In middle-aged study participants, sleep restriction induced a high increase in sleep propensity but adaptation to chronic sleep restriction occurred beyond day 3 of restriction. This sleepiness attenuation was underestimated by the participants. One recovery night restores daytime sleepiness and cognitive performance deficits induced by acute or chronic sleep deprivation. Philip P; Sagaspe P; Prague M; Tassi P; Capelli A; Bioulac B; Commenges D; Taillard J. Acute versus chronic partial sleep deprivation in middle-aged people: differential effect on performance and sleepiness. SLEEP 2012;35(7):997-1002.

Structural evolution of Halaban Area, Eastern Arabian Shield, Saudi Arabia

NASA Astrophysics Data System (ADS)

Al-Amri, Yousef; Kassem1, Osama M. K.

2017-04-01

Neoproterozoic basement complex comprises a metamorphic/igneous suite (Abt schist and sheared granitoids) with syn-accretionary transpressive structures, unconformably overlain by a post-amalgamation volcanosedimentary sequence. This study aims to attempt to exposed post-accretionary thrusting and thrust-related structures at Halaban area, Eastern Arabian Shield. The Rf/ϕ and Fry methods are utilized on quartz and feldspar porphyroclasts, as well as on mafic crystals, such as hornblende and biotite, in eighteen samples. The X/Z axial ratios range from 1.12 to 4.99 for Rf/ϕ method and from 1.65 to 4.00 for Fry method. The direction of finite strain for the long axes displays clustering along the WNW trend (occasionally N) with slight plunging. Finite strain accumulated without any significant volume change contemporaneously with syn-accretionary transpressive structures. It indicates that the contacts between various lithological units in the Halaban area were formed under brittle to semi-ductile deformation conditions. The penetrative subhorizontal foliation was concurrent with thrusting and shows nearly the same attitudes of tectonic contacts with the overlying nappes. Keywords: Finite strain analysis, volcanosedimentary sequence, Halaban area, Eastern Arabian Shield, Saudi Arabia.

Acute effect of different stretching methods on flexibility and jumping performance in competitive artistic gymnasts.

PubMed

Dallas, G; Smirniotou, A; Tsiganos, G; Tsopani, D; Di Cagno, A; Tsolakis, Ch

2014-12-01

The purpose of this study was to investigate the acute effects of 3 different warm up methods of stretching (static, proprioceptive neuromuscular facilitation, and stretching exercises on a Vibration platform) on flexibility and legs power-jumping performance in competitive artistic gymnasts. Eighteen competitive artistic gymnasts were recruited to participate in this study. Subjects were exposed to each of 3 experimental stretching conditions: static stretching (SS), proprioceptive neuromuscular facilitation stretching (PNF), and stretching exercises on a Vibration platform (S+V). Flexibility assessed with sit and reach test (S & R) and jumping performance with squat jump (SJ) and counter movement jump (CMJ) and were measured before, immediately after and 15 min after the interventions. Significant differences were observed for flexibility after all stretching conditions for S+V (+1.1%), SS (+5.7%) and PNF (+6.8%) (P=0.000), which remained higher 15 min after interventions (S+V (1.1%), SS (5.3%) and PNF (5.5%), respectively (P=0.000). PNF stretching increased flexibility in competitive gymnasts, while S+V maintained jumping performance when both methods were used as part of a warm-up procedure.

Complementary Electromagnetic Non-Destructive Evaluation

NASA Astrophysics Data System (ADS)

Tian, Gui Yun; Wilson, John; Morozov, Maxim

2011-06-01

The use of non-destructive evaluation (NDE) for defect detection and failure prediction in structures and specimens is widespread in energy industries, aimed at ageing power plants and pipelines, material degradation, fatigue and radiation damage, etc. At present there are no suitable electromagnetic NDE methods for the measurement and characterization of material degradation, in irradiated samples in particular, which is very important and timely for the nuclear power industry in the UK. This paper reports recent developments in the field of electromagnetic (EM) NDE at Newcastle University, including pulsed eddy current (PEC), pulsed magnetic flux leakage (PMFL), magnetic Barkhausen emission (MBE) and magneto-acoustic emission (MAE). As different EM methods have different strengths, an integrative EM framework is introduced. Case studies through the second round robin tests organized by the Universal Network for Magnetic Non-Destructive Evaluation (UNMNDE), representing eighteen leading research groups worldwide in the area of electromagnetic NDE, are reported. Twelve samples with different ageing times and rolling reduction ratios were tested using different magnetic methods among the UNMNDE members. Based on the studies, the complementary characteristics of electromagnetic techniques for NDE are discussed.

Seed mycoflora of Ephedra aphylla and amino acid profile of seed-borne Aspergillus flavus.

PubMed

Al-Qarawi, Abdulaziz A; Hashem, Abeer; Abd-Allah, Elsayed F

2012-09-01

Twenty-seven seed samples of Ephedra aphylla were collected from different rangelands in Riyadh region, Saudi Arabia during seed production season of 2010. They were assessed to determine the incidence of seedborne fungal flora using both agar plate and blotter paper methods. The investigation of the seeds yielded thirty four fungal species belonging to twelve genera, which are new record to seed-brone mycoflora of E. aphylla in Saudi Arabia. The agar plate method was found superior over blotter methods. The genus Aspergillus was the most prevalent one followed by Fusarium, Penicillium, Alternaria, and Chaetomium. Only eighteen isolates of A. flavus (∼ 28.6% of total isolates) were able to produce aflatoxins. Mycelial amino acids profile of selected aflatoxigenic isolates of A. flavus was investigated and five amino acids, namely cystein, lysine, praline, tryptophan and valine were common in mycelia and all of them were aflatoxins producers. Based on the dissimilarity coefficient between the isolates and their amino acids patterns, high diversity among the population of A. flavus has been recorded.

Fully automatic and reference-marker-free image stitching method for full-spine and full-leg imaging with computed radiography

NASA Astrophysics Data System (ADS)

Wang, Xiaohui; Foos, David H.; Doran, James; Rogers, Michael K.

2004-05-01

Full-leg and full-spine imaging with standard computed radiography (CR) systems requires several cassettes/storage phosphor screens to be placed in a staggered arrangement and exposed simultaneously to achieve an increased imaging area. A method has been developed that can automatically and accurately stitch the acquired sub-images without relying on any external reference markers. It can detect and correct the order, orientation, and overlap arrangement of the subimages for stitching. The automatic determination of the order, orientation, and overlap arrangement of the sub-images consists of (1) constructing a hypothesis list that includes all cassette/screen arrangements, (2) refining hypotheses based on a set of rules derived from imaging physics, (3) correlating each consecutive sub-image pair in each hypothesis and establishing an overall figure-of-merit, (4) selecting the hypothesis of maximum figure-of-merit. The stitching process requires the CR reader to over scan each CR screen so that the screen edges are completely visible in the acquired sub-images. The rotational displacement and vertical displacement between two consecutive sub-images are calculated by matching the orientation and location of the screen edge in the front image and its corresponding shadow in the back image. The horizontal displacement is estimated by maximizing the correlation function between the two image sections in the overlap region. Accordingly, the two images are stitched together. This process is repeated for the newly stitched composite image and the next consecutive sub-image until a full-image composite is created. The method has been evaluated in both phantom experiments and clinical studies. The standard deviation of image misregistration is below one image pixel.

STIP, the Private Sector Connection

ERIC Educational Resources Information Center

Stevenson, Gloria

1978-01-01

Skill Training Improvement Program (STIP), a Comprehensive Employment and Training Act (CETA) program, provides up to eighteen months of training in highly skilled industrial jobs. Discusses STIP guidelines and describes several STIP projects being conducted in various communities. (EM)

Biotechnology and Education.

ERIC Educational Resources Information Center

Journal of Biological Education, 1982

1982-01-01

Summarizes a Royal Society report on the educational implications of the growth of biotechnology (application of biological organisms, systems, or processes to manufacturing and service industries). Eighteen recommendations are made including the inclusion of biotechnological content into science curricula. (Author/JN)

Development of Eighteen Microsatellite Markers in Anemone amurensis (Ranunculaceae) and Cross-Amplification in Congeneric Species

PubMed Central

Sun, Mingzhou; Yin, Xiao; Shi, Fengxue; Li, Lin; Li, Mingrui; Li, Linfeng; Xiao, Hongxing

2012-01-01

Polyploidy plays an important role in the evolution of plant genomes. To enable the investigation of the polyploidy events within the genus Anemone, we developed eighteen microsatellite markers from the hexaploid species A. amurensis (Ranunculaceae), and tested their transferability in five closely related species. The number of total alleles (NA) for each resulting locus varied from one to eight. The polymorphism information content (PIC) and Nei’s genetic diversity (NGD) for these microsatellites ranged from 0.00 to 0.71 and 0.00 to 0.91, respectively. For each population, the NA was one to seven, and the values of PIC and NGD varied from 0.00 to 0.84 and 0.00 to 0.95, respectively. In addition, most of these microsatellites can be amplified successfully in the congeneric species. These microsatellite primers provide us an opportunity to study the polyploid evolution in the genus Anemone. PMID:22606017

Development of eighteen microsatellite markers in Anemone amurensis (Ranunculaceae) and cross-amplification in congeneric species.

PubMed

Sun, Mingzhou; Yin, Xiao; Shi, Fengxue; Li, Lin; Li, Mingrui; Li, Linfeng; Xiao, Hongxing

2012-01-01

Polyploidy plays an important role in the evolution of plant genomes. To enable the investigation of the polyploidy events within the genus Anemone, we developed eighteen microsatellite markers from the hexaploid species A. amurensis (Ranunculaceae), and tested their transferability in five closely related species. The number of total alleles (N(A)) for each resulting locus varied from one to eight. The polymorphism information content (PIC) and Nei's genetic diversity (N(GD)) for these microsatellites ranged from 0.00 to 0.71 and 0.00 to 0.91, respectively. For each population, the N(A) was one to seven, and the values of PIC and N(GD) varied from 0.00 to 0.84 and 0.00 to 0.95, respectively. In addition, most of these microsatellites can be amplified successfully in the congeneric species. These microsatellite primers provide us an opportunity to study the polyploid evolution in the genus Anemone.

Integrated versus isolated training of the hemiparetic upper extremity in haptically rendered virtual environments.

PubMed

Qiu, Qinyin; Fluet, Gerard G; Saleh, Soha; Lafond, Ian; Merians, Alma S; Adamovich, Sergei V

2010-01-01

This paper describes the preliminary results of an ongoing study of the effects of two training approaches on motor function and learning in persons with hemi paresis due to cerebrovascular accidents. Eighteen subjects with chronic stroke performed eight, three-hour sessions of sensorimotor training in haptically renedered environments. Eleven subjects performed training activities that integrated hand and arm movement while another seven subjects performed activities that trained the hand and arm with separately. As a whole, the eighteen subjects made statistically significant improvements in motor function as evidenced by robust improvements in Wolf Motor Function Test times and corresponding improvements in Jebsen Test of Hand Function times. There were no significant between group effects for these tests. However, the two training approaches elicited different patterns and magnitudes of performance improvement that suggest that they may elicit different types of change in motor learning and or control.

Protocol for a randomized comparison of integrated versus consecutive dual task practice in Parkinson’s disease: the DUALITY trial

PubMed Central

2014-01-01

Background Multiple tasking is an integral part of daily mobility. Patients with Parkinson’s disease have dual tasking difficulties due to their combined motor and cognitive deficits. Two contrasting physiotherapy interventions have been proposed to alleviate dual tasking difficulties: either to discourage simultaneous execution of dual tasks (consecutive training); or to practice their concurrent use (integrated training). It is currently unclear which of these training methods should be adopted to achieve safe and consolidated dual task performance in daily life. Therefore, the proposed randomized controlled trial will compare the effects of integrated versus consecutive training of dual tasking (tested by combining walking with cognitive exercises). Methods and design Hundred and twenty patients with Parkinson’s disease will be recruited to participate in this multi-centered, single blind, randomized controlled trial. Patients in Hoehn & Yahr stage II-III, with or without freezing of gait, and who report dual task difficulties will be included. All patients will undergo a six-week control period without intervention after which they will be randomized to integrated or consecutive task practice. Training will consist of standardized walking and cognitive exercises delivered at home four times a week during six weeks. Treatment is guided by a physiotherapist twice a week and consists of two sessions of self-practice using an MP3 player. Blinded testers will assess patients before and after the control period, after the intervention period and after a 12-week follow-up period. The primary outcome measure is dual task gait velocity, i.e. walking combined with a novel untrained cognitive task to evaluate the consolidation of learning. Secondary outcomes include several single and dual task gait and cognitive measures, functional outcomes and a quality of life scale. Falling will be recorded as a possible adverse event using a weekly phone call for the entire study period. Discussion This randomized study will evaluate the effectiveness and safety of integrated versus consecutive task training in patients with Parkinson’s disease. The study will also highlight whether dual task gait training leads to robust motor learning effects, and whether these can be retained and carried-over to untrained dual tasks and functional mobility. Trial registration Clinicaltrials.gov NCT01375413. PMID:24674594

Constituent Components of Out-of-Field Scatter Dose for 18-MV Intensity Modulated Radiation Therapy Versus 3-Dimensional Conformal Radiation Therapy: A Comparison With 6-MV and Implications for Carcinogenesis

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

Ruben, Jeremy D., E-mail: jeremy.ruben@wbrc.org.au; Department of Surgery, Monash University, Melbourne; Smith, Ryan

Purpose: To characterize and compare the components of out-of-field dose for 18-MV intensity modulated radiation therapy (IMRT) versus 3-dimensional conformal radiation therapy (3D-CRT) and their 6-MV counterparts and consider implications for second cancer induction. Methods and Materials: Comparable plans for each technique/energy were delivered to a water phantom with a sloping wall; under full scatter conditions; with field edge abutting but outside the bath to prevent internal/phantom scatter; and with shielding below the linear accelerator head to attenuate head leakage. Neutron measurements were obtained from published studies. Results: Eighteen-megavolt IMRT produces 1.7 times more out-of-field scatter than 18-MV 3D-CRT. Inmore » absolute terms, however, differences are just approximately 0.1% of central axis dose. Eighteen-megavolt IMRT reduces internal/patient scatter by 13%, but collimator scatter (C) is 2.6 times greater than 18-MV 3D-CRT. Head leakage (L) is minimal. Increased out-of-field photon scatter from 18-MV IMRT carries out-of-field second cancer risks of approximately 0.2% over and above the 0.4% from 18-MV 3D-CRT. Greater photoneutron dose from 18-MV IMRT may result in further maximal, absolute increased risk to peripheral tissue of approximately 1.2% over 18-MV 3D-CRT. Out-of-field photon scatter remains comparable for the same modality irrespective of beam energy. Machine scatter (C+L) from 18 versus 6 MV is 1.2 times higher for IMRT and 1.8 times for 3D-CRT. It is 4 times higher for 6-MV IMRT versus 3D-CRT. Reduction in internal scatter with 18 MV versus 6 MV is 27% for 3D-CRT and 29% for IMRT. Compared with 6-MV 3D-CRT, 18-MV IMRT increases out-of-field second cancer risk by 0.2% from photons and adds 0.28-2.2% from neutrons. Conclusions: Out-of-field photon dose seems to be independent of beam energy for both techniques. Eighteen-megavolt IMRT increases out-of-field scatter 1.7-fold over 3D-CRT because of greater collimator scatter despite reducing internal/patient scatter. Out-of-field carcinogenic risk is thus increased (but improved in-field dose conformity may offset this). Potentially increased carcinogenic risk should be weighed against any benefit 18-MV IMRT may provide.« less

Probability analysis for consecutive-day maximum rainfall for Tiruchirapalli City (south India, Asia)

NASA Astrophysics Data System (ADS)

Sabarish, R. Mani; Narasimhan, R.; Chandhru, A. R.; Suribabu, C. R.; Sudharsan, J.; Nithiyanantham, S.

2017-05-01

In the design of irrigation and other hydraulic structures, evaluating the magnitude of extreme rainfall for a specific probability of occurrence is of much importance. The capacity of such structures is usually designed to cater to the probability of occurrence of extreme rainfall during its lifetime. In this study, an extreme value analysis of rainfall for Tiruchirapalli City in Tamil Nadu was carried out using 100 years of rainfall data. Statistical methods were used in the analysis. The best-fit probability distribution was evaluated for 1, 2, 3, 4 and 5 days of continuous maximum rainfall. The goodness of fit was evaluated using Chi-square test. The results of the goodness-of-fit tests indicate that log-Pearson type III method is the overall best-fit probability distribution for 1-day maximum rainfall and consecutive 2-, 3-, 4-, 5- and 6-day maximum rainfall series of Tiruchirapalli. To be reliable, the forecasted maximum rainfalls for the selected return periods are evaluated in comparison with the results of the plotting position.

Analysis of noise-induced temporal correlations in neuronal spike sequences

NASA Astrophysics Data System (ADS)

Reinoso, José A.; Torrent, M. C.; Masoller, Cristina

2016-11-01

We investigate temporal correlations in sequences of noise-induced neuronal spikes, using a symbolic method of time-series analysis. We focus on the sequence of time-intervals between consecutive spikes (inter-spike-intervals, ISIs). The analysis method, known as ordinal analysis, transforms the ISI sequence into a sequence of ordinal patterns (OPs), which are defined in terms of the relative ordering of consecutive ISIs. The ISI sequences are obtained from extensive simulations of two neuron models (FitzHugh-Nagumo, FHN, and integrate-and-fire, IF), with correlated noise. We find that, as the noise strength increases, temporal order gradually emerges, revealed by the existence of more frequent ordinal patterns in the ISI sequence. While in the FHN model the most frequent OP depends on the noise strength, in the IF model it is independent of the noise strength. In both models, the correlation time of the noise affects the OP probabilities but does not modify the most probable pattern.

Comparison of a wipe method with and without a rinse to recover wall losses in closed face 37-mm cassettes used for sampling lead dust particulates

PubMed Central

Ceballos, Diana; King, Bradley; Beaucham, Catherine; Brueck, Scott E.

2015-01-01

Closed-face 37-millimeter (mm) polystyrene cassettes are often used for exposure monitoring of metal particulates. Several methods have been proposed to account for the wall loss in air sampling cassettes, including rinsing, wiping, within-cassette dissolution, and an internal capsule fused to the filter that could be digested with the filter. Until internal capsules replace filters, other methods for assessing wall losses may be considered. To determine if rinsing and wiping or wiping alone is adequate to determine wall losses on cassettes, we collected 54 full-shift area air samples at a battery recycling facility. We collected six replicate samples at three locations within the facility for 3 consecutive days. The wall losses of three replicate cassettes from each day-location were analyzed following a rinse and two consecutive wipes. The wall losses of the other three replicates from each day-location were analyzed following two consecutive wipes only. Mixed-cellulose ester membrane filter, rinse, and wipes were analyzed separately following NIOSH Method 7303. We found an average of 29% (range: 8%–54%) recovered lead from the cassette walls for all samples. We also found that rinsing prior to wiping the interior cassette walls did not substantially improve recovery of wall losses compared to wiping alone. A rinse plus one wipe recovered on average 23% (range: 13%–33%) of the lead, while one wipe alone recovered on average 21% (range: 16%–22%). Similarly we determined that a second wipe did not provide substantial additional recovery of lead (average: 4%, range: 0.4%–19%) compared to the first wipe disregarding the rinse (average: 18%, range: 4%–39%). We concluded that when an internal capsule is not used, wall losses of lead dust in air sampling cassettes can be adequately recovered by wiping the internal wall surfaces of the cassette with a single wipe. PMID:26125330

Double row equivalent for rotator cuff repair: A biomechanical analysis of a new technique.

PubMed

Robinson, Sean; Krigbaum, Henry; Kramer, Jon; Purviance, Connor; Parrish, Robin; Donahue, Joseph

2018-06-01

There are numerous configurations of double row fixation for rotator cuff tears however, there remains to be a consensus on the best method. In this study, we evaluated three different double-row configurations, including a new method. Our primary question is whether the new anchor and technique compares in biomechanical strength to standard double row techniques. Eighteen prepared fresh frozen bovine infraspinatus tendons were randomized to one of three groups including the New Double Row Equivalent, Arthrex Speedbridge and a transosseous equivalent using standard Stabilynx anchors. Biomechanical testing was performed on humeri sawbones and ultimate load, strain, yield strength, contact area, contact pressure, and a survival plots were evaluated. The new double row equivalent method demonstrated increased survival as well as ultimate strength at 415N compared to the remainder testing groups as well as equivalent contact area and pressure to standard double row techniques. This new anchor system and technique demonstrated higher survival rates and loads to failure than standard double row techniques. This data provides us with a new method of rotator cuff fixation which should be further evaluated in the clinical setting. Basic science biomechanical study.

Cremated human and animal remains of the Roman period--microscopic method of analysis (Sepkovcica, Croatia).

PubMed

Hincak, Zdravka; Mihelić, Damir; Bugar, Aleksandra

2007-12-01

Human and animal cremated osteological remains from twelve graves of Roman Period from archaeological site Sepkovcica near Velika Gorica (Turopolje region, NW Croatia) were analysed. Beside the content of urns and grave pits, fillings of grave vessels like bowls, pots and amphoras from twentytwo grave samples were included in this study. The preservation of osteological and dental remains of human and animal origin was very poor, majority of fragments hardly reach lengths of 10 mm. Weight of each specimen barely exceeds 100 g per person. Apart from traditional macroscopic methods of analysing cremated remains, microscopic method for determination of age at death was also tested. Fragments of femoral bone diaphysis of eighteen persons whose remains had been found on the site were analysed. Person's age at death was presented in the range of five or ten years, and the long bone fragments of a child (infants) were detected. Taxonomic position for each analysed specimen was determined by microscopic analysis of animal cremated bones. Analysis results confirm validity of microscopic method in determination of age at death for human remains and taxonomic qualification of cremated animal remains from archaeological sites.

An improved cost-effective, reproducible method for evaluation of bone loss in a rodent model.

PubMed

Fine, Daniel H; Schreiner, Helen; Nasri-Heir, Cibele; Greenberg, Barbara; Jiang, Shuying; Markowitz, Kenneth; Furgang, David

2009-02-01

This study was designed to investigate the utility of two "new" definitions for assessment of bone loss in a rodent model of periodontitis. Eighteen rats were divided into three groups. Group 1 was infected by Aggregatibacter actinomycetemcomitans (Aa), group 2 was infected with an Aa leukotoxin knock-out, and group 3 received no Aa (controls). Microbial sampling and antibody titres were determined. Initially, two examiners measured the distance from the cemento-enamel-junction to alveolar bone crest using the three following methods; (1) total area of bone loss by radiograph, (2) linear bone loss by radiograph, (3) a direct visual measurement (DVM) of horizontal bone loss. Two "new" definitions were adopted; (1) any site in infected animals showing bone loss >2 standard deviations above the mean seen at that site in control animals was recorded as bone loss, (2) any animal with two or more sites in any quadrant affected by bone loss was considered as diseased. Using the "new" definitions both evaluators independently found that infected animals had significantly more disease than controls (DVM system; p<0.05). The DVM method provides a simple, cost effective, and reproducible method for studying periodontal disease in rodents.

Perspectives of unlicensed assistive personnel on career development.

PubMed

Akaragian, Salpy; Crooks, Heidi; Pieters, Huibrie C

2013-09-01

An equivalency program, Method 3, is a viable but underused option for unlicensed assistive personnel (UAP) who pursue licensure. This study describes the perceptions of UAP on opportunities for career development. Eighteen UAP participated in three focus groups. Thematic analysis was conducted with verbatim transcription. Three major themes represented the lively discussions that occurred: core driving forces, processes of career development, and anticipated and desirable outcomes. Various subthemes described these major themes. Method 3 provides a realistic approach to help UAP persevere with career development. Collaboration with management and peers, encouragement, and effective communication contributed to the success of participants, despite obstacles and challenges. Camaraderie and flexible scheduling were critical elements in participants' pursuit of first licensure. Taking small steps was described as an effective approach for UAP to persevere with career development. Support for informal career development is essential. Nursing leaders should consider an equivalency approach to accommodate individual preferences and learning needs for career development. Copyright 2013, SLACK Incorporated.

Primary Self-Expandable Nitinol Stent Placement in Focal Lesions of Infrarenal Abdominal Aorta: Long Term Results

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

Lastovickova, Jarmila, E-mail: jala@medicon.cz; Peregrin, Jan H.

Purpose. To evaluate the technical and clinical success, safety and long term results of percutaneous transluminal angioplasty/self-expandable nitinol stent placement of infrarenal abdominal aorta focal lesions. Materials and Methods. Eighteen patients underwent PTA of focal atherosclerotic occlusive disease of distal abdominal aorta. Two symptomatic occlusions and 16 stenoses in 10 male and 8 female patients (mean age 68.2 years) were treated with primary self-expandable nitinol stent placement. Results. Primary self-expandable nitinol stent placement was technically successful in all 18 procedures; clinical success was achieved in 100% of patients. No complications associated with the procedure occurred. During the 49.4 months ofmore » mean follow up (range 3-96, 4 months) all treated aortic segments remained patent. Conclusions. Endovascular treatment (primary self-expandable nitinol stent placement) of focal atherosclerotic lesions of distal abdominal aorta is a safe method with excellent primary technical and clinical success rates and favourable Long term results.« less

Ponseti's manipulation in neglected clubfoot in children more than 7 years of age: a prospective evaluation of 25 feet with long-term follow-up.

PubMed

Khan, Shah Alam; Kumar, Ashok

2010-09-01

We wanted to evaluate the efficacy of Ponseti's technique in neglected clubfoot in children more than 7 years of age. The results of Ponseti's method were evaluated in 21 children (25 feet) with neglected club feet. Patients were evaluated using the Dimeglio scoring system. All patients underwent percutaneous tenotomy of the Achilles tendon. The mean age at the time of treatment was 8.9 years. The mean follow-up period was 4.7 years. The average Dimeglio score at the start of the treatment was 14.2 compared with an average score of 0.95 at the end of the treatment at 1-year follow-up. Eighteen feet (85.7%) had full correction. Recurrence was seen in six feet (24%). At 4-year follow-up, the average Dimeglio score for 19 feet was 0.18. We recommend that Ponseti's method should be the preferred initial treatment modality for neglected clubfeet.

Genome dynamics and evolution in yeasts: A long-term yeast-bacteria competition experiment

PubMed Central

Katz, Michael; Knecht, Wolfgang; Compagno, Concetta; Piškur, Jure

2018-01-01

There is an enormous genetic diversity evident in modern yeasts, but our understanding of the ecological basis of such diversifications in nature remains at best fragmented so far. Here we report a long-term experiment mimicking a primordial competitive environment, in which yeast and bacteria co-exist and compete against each other. Eighteen yeasts covering a wide phylogenetic background spanning approximately 250 million years of evolutionary history were used to establish independent evolution lines for at most 130 passages. Our collection of hundreds of modified strains generated through such a rare two-species cross-kingdom competition experiment re-created the appearance of large-scale genomic rearrangements and altered phenotypes important in the diversification history of yeasts. At the same time, the methodology employed in this evolutionary study would also be a non-gene-technological method of reprogramming yeast genomes and then selecting yeast strains with desired traits. Cross-kingdom competition may therefore be a method of significant value to generate industrially useful yeast strains with new metabolic traits. PMID:29624585

The integrated quality assessment of Chinese commercial dry red wine based on a method of online HPLC-DAD-CL combined with HPLC-ESI-MS.

PubMed

Yu, Hai-Xiang; Sun, Li-Qiong; Qi, Jin

2014-07-01

To apply an integrated quality assessment strategy to investigate the quality of multiple Chinese commercial dry red wine samples. A comprehensive method was developed by combining a high performance liquid chromatography-diode array detector-chemiluminescence (HPLC-DAD-CL) online hyphenated system with an HPLC-ESI-MS technique. Chromatographic and H2O2-scavenging active fingerprints of thirteen batches of different, commercially available Chinese dry red wine samples were obtained and analyzed. Twenty-five compounds, including eighteen antioxidants were identified and evaluated. The dominant and characteristic antioxidants in the samples were identified. The relationships between antioxidant potency and the cultivated variety of grape, producing area, cellaring period, and trade mark are also discussed. The results provide the feasibility for an integrated quality assessment strategy to be efficiently and objectively used in quality (especially antioxidant activity) assessment and identification of dry red wine. Copyright © 2014 China Pharmaceutical University. Published by Elsevier B.V. All rights reserved.

Image quality evaluation of eight complementary metal-oxide semiconductor intraoral digital X-ray sensors.

PubMed

Teich, Sorin; Al-Rawi, Wisam; Heima, Masahiro; Faddoul, Fady F; Goldzweig, Gil; Gutmacher, Zvi; Aizenbud, Dror

2016-10-01

To evaluate the image quality generated by eight commercially available intraoral sensors. Eighteen clinicians ranked the quality of a bitewing acquired from one subject using eight different intraoral sensors. Analytical methods used to evaluate clinical image quality included the Visual Grading Characteristics method, which helps to quantify subjective opinions to make them suitable for analysis. The Dexis sensor was ranked significantly better than Sirona and Carestream-Kodak sensors; and the image captured using the Carestream-Kodak sensor was ranked significantly worse than those captured using Dexis, Schick and Cyber Medical Imaging sensors. The Image Works sensor image was rated the lowest by all clinicians. Other comparisons resulted in non-significant results. None of the sensors was considered to generate images of significantly better quality than the other sensors tested. Further research should be directed towards determining the clinical significance of the differences in image quality reported in this study. © 2016 FDI World Dental Federation.

A New Surgical Approach for the Treatment of Conjunctivochalasis: Reduction of the Conjunctival Fold with Bipolar Electrocautery Forceps

PubMed Central

Arenas, Eduardo; Muñoz, Diana

2016-01-01

Aim. To report a new surgical technique for the treatment of conjunctivochalasis. Methods. A new surgical technique in which specially designed bipolar electrocautery forceps facilitate the complete reduction of the conjunctival folds without creating lesions near the corneoscleral limbus was designed. A retrospective revision of the medical records of patients treated with this technique between the years 2011 and 2013 was made, and eighteen eyes of sixteen patients with conjunctivochalasis treated with this new technique were included. Results. All the eyes treated showed a significant improvement with no evidence of scar lesions after a mean follow-up time of 10 months. Conclusions. The surgical technique presented here could be a good alternative for the management of conjunctivochalasis. PMID:27200408

Unusual solvent effects on the fluorescence quenching rate constants of a thioxanthone derivative by n-butylamine and isoprene

NASA Astrophysics Data System (ADS)

Burget, D.; Jacques, P.

1998-07-01

The fluorescence quenching rate constants of a thioxanthone derivative by two electron donors ( n-butylamine and isoprene) were studied in eighteen solvents of different polarity. Both the empirical polarity parameter ET(30) and the more elaborate solvatochromic comparative method (SCM) π*, α, β (used without any precautions) failed to explain the relevant data. However, when in the frame of the SCM the sequential procedure is applied, unexpected solvent effects were revealed for hydroxylic solvents. These effects can be well accounted for by introducing a parameter χ for the whole set of solvents studied, equal to one or zero, depending on whether OH groups are involved or not in the quenching mechanism. A clue to the introduction of the parameter χ is presented.

Long-Term Outcomes of Incredible Years Parenting Program: Predictors of Adolescent Adjustment*

PubMed Central

Webster-Stratton, Carolyn; Rinaldi, Julie; Jamila, M. Reid

2010-01-01

Background and method Fifty-eight boys and 20 girls with early onset conduct problems whose parents received the Incredible Years (IY) parent treatment program when they were 3–8 years (mean 58.7 months) were contacted and reassessed regarding their social and emotional adjustment 8–12 years later. Assessments included home interviews with parents and teenagers separately. Results and conclusion Adolescent reports indicated that 10% were in the clinical range on internalising behaviours, 23% had engaged in major delinquent acts, and 46% reported some substance use. Eighteen percent of children had criminal justice system involvement and 42% had elevated levels of externalising behaviours (mother report). Post-treatment factors predicting negative outcomes (delinquent acts) were maternal reports of behaviour problems and observed mother–child coercion. PMID:21499534

The usefulness of the sum of relative enhancement ratio in making a differential diagnosis of hepatocellular carcinoma from cirrhosis-related nodules.

PubMed

Yoon, Ki Woong; Song, Ji Soo; Han, Young Min

2014-01-01

To estimate the diagnostic accuracy of the sum of relative enhancement ratio (sRER) in making a differential diagnosis of hepatocellular carcinoma (HCC) from benign cirrhosis-related nodules. Eighteen benign cirrhosis-related nodules and 18 HCCs were evaluated. Three radiologists independently reviewed computed tomography images using visual assessment and sRER. sRER was estimated by adding region-of-interest measurement in the arterial phase and the delayed phase. Diagnostic performance and accuracy were evaluated. The mean values of sRER were significantly higher in HCCs than in benign cirrhosis-related nodules. The sRER method improved diagnostic accuracy of differentiating HCCs from benign cirrhosis-related nodules. Copyright © 2014 Elsevier Inc. All rights reserved.

Comparing barrier algorithms

NASA Technical Reports Server (NTRS)

Arenstorf, Norbert S.; Jordan, Harry F.

1987-01-01

A barrier is a method for synchronizing a large number of concurrent computer processes. After considering some basic synchronization mechanisms, a collection of barrier algorithms with either linear or logarithmic depth are presented. A graphical model is described that profiles the execution of the barriers and other parallel programming constructs. This model shows how the interaction between the barrier algorithms and the work that they synchronize can impact their performance. One result is that logarithmic tree structured barriers show good performance when synchronizing fixed length work, while linear self-scheduled barriers show better performance when synchronizing fixed length work with an imbedded critical section. The linear barriers are better able to exploit the process skew associated with critical sections. Timing experiments, performed on an eighteen processor Flex/32 shared memory multiprocessor, that support these conclusions are detailed.

Colon diversion versus primary colonic repair in gunshot abdomen with penetrating colon injury in Libyan revolution conflict 2011 (a single center experience).

PubMed

Mansor, Salah; Bendardaf, Rashed; Bougrara, Muftah; Hagam, Mohamed

2014-09-01

The objective of this study is comparing colon diversion versus primary repair in penetrating colon gunshot injuries. A retrospective study of 63 cases of gunshot abdomen with penetrating colon injury were admitted to Al-jalla Hospital in 2011 in Benghazi, Libya. After surgical intervention, these patients were observed for any postoperative complications. During the study period, 63 eligible patients included, 62 (98.4%) were males and 1 (1.6%) was female. And the mean age was 29.24 years. Eighteen patients had an injury on the right side of the colon, while 16, 6, 11, 6, 2, 3, and 1 patients had an injury on the transverse, left, sigmoid, rectum, right transverse, left transverse, and total colonic injury, respectively. In the first group, 23 patients (36.5%) was treated with colon diversion, (2 with Hartmann's operation, 21 with loop colostomy). In the second group, 40 patients (63.4 %) was treated with primary repair. Eighteen (28.5%) with right hemicolectomy, 5 (7.9%) with transverse colon resection and anastomosis, and 17 (26.9%) with simple repair. We evaluate the rate of postoperative complication and compare the postoperative morbidity between both groups. In our study, there was no significant statistical difference between types of operations and rate of complications (P = 0.18). We could not see any advantage of the diversion over the primary repair. To reduce risk of the psychological trauma, complications of colostomy, unnecessary repeated hospitalization, decrease of economic cost, and complications of stoma revision operation, we should consider that the primary repair of penetrating colon injuries is an acceptable alternative method of treatment over the colostomy.

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

PubMed

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

2014-01-01

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

Single-step transepithelial photorefractive keratectomy in myopia and astigmatism: 18-month follow-up.

PubMed

Adib-Moghaddam, Soheil; Soleyman-Jahi, Saeed; Salmanian, Bahram; Omidvari, Amir-Houshang; Adili-Aghdam, Fatemeh; Noorizadeh, Farsad; Eslani, Medi

2016-11-01

To evaluate the long-term quantitative and qualitative optical outcomes of 1-step transepithelial photorefractive keratectomy (PRK) to correct myopia and astigmatism. Bina Eye Hospital, Tehran, Iran. Prospective interventional case series. Eyes with myopia with or without astigmatism were evaluated. One-step transepithelial PRK was performed with an aberration-free aspheric optimized profile and the Amaris 500 laser. Eighteen-month follow-up results for refraction, visual acuities, vector analysis, higher-order aberrations, contrast sensitivity, postoperative pain, and haze grade were assessed. The study enrolled 146 eyes (74 patients). At the end of follow-up, 93.84% of eyes had an uncorrected distance visual acuity of 20/20 or better and 97.94% of eyes were within ±0.5 diopter of the targeted spherical refraction. On vector analysis, the mean correction index value was close to 1 and the mean index of success and magnitude of error values were close to 0. The achieved correction vector was on an axis counterclockwise to the axis of the intended correction. Photopic and mesopic contrast sensitivities and ocular and corneal spherical, cylindrical, and corneal coma aberrations significantly improved (all P < .001). A slight amount of trefoil aberration was induced (P < .001, ocular aberration; P < .01, corneal aberration). No eye lost more than 1 line of corrected distance visual acuity. No eye had a haze grade of 2+ degrees or higher throughout the follow-up. Eighteen-month results indicate the efficacy and safety of transepithelial PRK to correct myopia and astigmatism. It improved refraction and quality of vision. None of the authors has a financial or proprietary interest in any material or method mentioned. Copyright © 2016 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Phase I study of bortezomib in combination with irinotecan in patients with relapsed/refractory high-risk neuroblastoma.

PubMed

Mody, Rajen; Zhao, Lili; Yanik, Gregory Anthony; Opipari, Valerie

2017-11-01

Prognosis for relapsed/refractory high-risk neuroblastoma (HR-NBL) remains poor. Bortezomib, a proteasome inhibitor, has shown preclinical activity against NBL as a single agent and in combination with cytotoxic chemotherapy including irinotecan. Eighteen HR-NBL patients with primary refractory (n = 8) or relapsed (n = 10) disease were enrolled in a Phase I study using modified Time To Event Continual Reassessment Method. Bortezomib (1.2 mg/m 2 /day) was administered on days 1, 4, 8, and 11 intravenously (IV) and irinotecan was given IV on days 1-5 (35, 40, or 45 mg/m 2 /day, on dose levels [DL] 1-3, respectively). The maximum tolerated dose (MTD), dose-limiting toxicity (DLT), and response rate were examined. Eighteen NBL patients were evaluable for toxicity; 17 were evaluable for response assessment. A total of 142 courses were delivered (mean 8.2, median 2, range 1-48), with two patients receiving more than 40 courses of therapy. Two DLTs were reported, including a grade 4 thrombocytopenia (DL2) and a grade 3 irritability (DL3). MTD was estimated as DL3. Two of 17 (12%) evaluable patients showed objective responses (ORs) lasting more than 40 courses, including 1 partial remission and 1 complete remission. Four patients (23%) had prolonged stable disease (SD) lasting six or more courses, with a total of 35% study patients demonstrating clinical benefit in the form of prolonged OR or SD. The combination of bortezomib and irinotecan was well tolerated by patients with relapsed/refractory NBL with favorable toxicity profile. It also showed modest but promising clinical activity and merits further testing in Phase II studies. © 2017 Wiley Periodicals, Inc.

Robot-assisted Partial Nephrectomy: 5-yr Oncological Outcomes at a Single European Tertiary Cancer Center.

PubMed

Vartolomei, Mihai Dorin; Matei, Deliu Victor; Renne, Giuseppe; Tringali, Valeria Maria; Crisan, Nicolae; Musi, Gennaro; Mistretta, Francesco Alessandro; Russo, Andrea; Cozzi, Gabriele; Cordima, Giovani; Luzzago, Stefano; Cioffi, Antonio; Di Trapani, Ettore; Catellani, Michele; Delor, Maurizio; Bottero, Danilo; Imbimbo, Ciro; Mirone, Vincenzo; Ferro, Matteo; de Cobelli, Ottavio

2017-10-27

Nowadays, there is a debate about which surgical treatment should be best for clinical T1 renal tumors. If the oncological outcomes are considered, there are many open and laparoscopic series published. As far as robotic series are concerned, only a few of them report 5-yr oncological outcomes. The aim of this study was to analyze robot-assisted partial nephrectomy (RAPN) midterm oncological outcomes achieved in a tertiary robotic reference center. Between April 2009 and September 2013, 123 consecutive patients with clinical T1-stage renal masses underwent RAPN in our tertiary cancer center. Inclusion criteria were as follows: pathologically confirmed renal cell carcinomas (RCCs) and follow-up for >12 mo. Eighteen patients were excluded due to follow-up of <12 mo and 15 due to benign final pathology. Median follow-up was 59 mo (interquartile range 44-73 mo). Patients were followed according to guideline recommendations and institutional protocol. Outcomes were measured by time to disease progression, overall survival, or time to cancer-specific death. Kaplan-Meier method was used to estimate survival; log-rank tests were applied for pair-wise comparison of survival. From the 90 patients included, 66 (73.3%) had T1a, 12 (13.3%) T1b, three (3.3%) T2a, and nine (10%) T3a tumors. Predominant histological type was clear cell carcinoma: 67 (74.5%). Fuhrmann grade 1 and 2 was found in 73.3% of all malignant tumors. Two patients (2.2%) had positive surgical margins, and complication rate was 17.8%. Relapse rate was 7.7%, including two cases (2.2%) of local recurrences and five (5.5%) distant metastasis. Five-year disease-free survival was 90.9%, 5-yr cancer-specific survival was 97.5%, and 5-yr overall survival was 95.1%. Midterm oncological outcomes after RAPN for localized RCCs (predominantly T1a tumors of low anatomic complexity) were shown to be good, adding significant evidence to support the oncological efficacy and safety of RAPN for the treatment of this type of tumors. Robot-assisted partial nephrectomy seems to be the most promising minimally invasive approach in the treatment of renal masses suitable for organ-sparing surgery as midterm (5 yr) oncological outcomes are excellent. Copyright © 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.

The utility of ambulatory pH monitoring in patients presenting with chronic cough and asthma

PubMed Central

AlHabib, KF; Vedal, S; Champion, P; FitzGerald, JM

2007-01-01

OBJECTIVE: To evaluate the prevalence of gastroesophageal reflux disease (GERD) in patients presenting with asthma and chronic cough. PATIENTS AND METHODS: The charts of 358 consecutive patients who were referred for ambulatory gastroesophageal pH monitoring to the Lung Centre in Vancouver, British Columbia, were reviewed, and the data of 108 (30%) patients with asthma and 134 (37%) patients with chronic cough were analyzed. The maintenance treatment for GERD was discontinued before patients underwent the pH monitoring study. One hundred eighteen (33%) patients were excluded. RESULTS: Reflux episodes identified reflux events as the percentage of time where the pH was less than four. For asthma patients, 70 (64.8%) had distal total reflux, 50 (46.3%) had distal upright reflux, 41 (38.3%) had distal supine reflux and 73 (67.6%) had other distal refluxes. Proximal total reflux in asthmatic patients was present in 56 (52%), proximal upright reflux in 55 (51%) and proximal supine reflux in 56 (52%) patients. For chronic cough patients, 70 (52.6%) had distal total reflux, 59 (44.4%) had distal upright reflux, 45 (34.4%) had distal supine reflux and 75 (56%) patients had other distal refluxes. In chronic cough patients, proximal total reflux was present in 70 (52%), proximal upright reflux in 80 (60%) and proximal supine reflux in 59 (44%). Presenting respiratory and/or reflux symptoms were absent in approximately 25% of patients with asthma and reflux, and in approximately 50% of patients with chronic cough and reflux. During pH monitoring, symptoms did not differ significantly between those with and without distal reflux in both study groups, except for more significant heartburn in patients with chronic cough and reflux (RR 2.0). CONCLUSIONS: The data of the present study support the observation that there is a high prevalence of GERD in patients with asthma or chronic cough. The use of different pH parameters for detecting acid reflux during 24 h ambulatory pH monitoring, such as proximal esophageal acid measurement, should be considered as part of the routine interpretation of such testing. A low threshold for diagnosing GERD in patients with asthma or chronic cough is essential, because respiratory and/or reflux symptoms can be absent or atypical in some of these patients. PMID:17377644

Ambulatory 24-hour multichannel intraluminal impedance-pH monitoring and high resolution endoscopy distinguish patients with non-erosive reflux disease from those with functional heartburn

PubMed Central

Chu, Chuanlian; Du, Quanlin; Li, Changqing; Zhang, Linlu; Zhou, Xiaoyan; Zuo, Fang; Zhang, Yanmin; Li, Fang; Xie, Guofeng; Li, Yanqing

2017-01-01

Aims To assess the contribution of 24-h esophageal multichannel intraluminal impedance and pH (MII-pH) monitoring and high resolution endoscopy (HRE) with i-scan imaging in differentiating non erosive reflux disease (NERD) from functional heartburn (FH). Methods This is a retrospective cohort study of patients with heartburn from the Endoscopy Unit. NERD patients and FH patients were defined by 24-h MII-pH monitoring and white light endoscopy. Minimal mucosal changes were assessed by HRE with i-scan imaging. Results Total of 156 consecutive patients with heartburn but without esophageal mucosal erosions were studied. Forty-eight of these subjects had NERD, with increased acid exposure time (AET) and positive SAP and/or SI. Eighteen had FH with normal AET and negative SAP and SI. When compared to FH patients and healthy controls, NERD patients had significantly increased number of total acid reflux episodes, as well as increased number of weakly acidic reflux episodes (p<0.01). The rate of proximal reflux episodes in NERD patients was higher than that of FH patients and healthy controls (p<0.01). Irregular or blurring of the Z-line (58.3%) and white mucosal turbidity (47.9%) were the most common endoscopic findings of minimal mucosal changes observed in this study. NERD patients had more prevalent minimal changes than FH patients and the controls (87.5%vs. 66.6%vs. 61.9%; p = 0.004) with sensitivity of 87.5%. Histopathological evaluation showed that NERD patients had significantly higher average scores of intercellular spaces dilation (2.82±0.9 vs. 1.2±0.6, p = 0.005) and papillae elongation (2.65±1.0 vs. 1.5±0.8, p = 0.014), but not for basal cell proliferation (1.6±1.3 vs. 1.0±0.9, p = 0.070). The histological scores of the NERD patients were 7.1±1.2, which were higher than those of FH patients (3.4±1.0, p = 0.004). Conclusions Minimal mucosal changes could be useful markers to support clinical diagnosis of NERD. Combination of 24-h MII-pH monitoring and i-scan high resolution endoscopy can distinguish patients with NERD from those with FH. PMID:28384225

Value of Surveillance Studies for Patients With Stage I to II Diffuse Large B-Cell Lymphoma in the Rituximab Era

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

Hiniker, Susan M.; Pollom, Erqi L.; Khodadoust, Michael S.

2015-05-01

Background: The role of surveillance studies in limited-stage diffuse large B-cell lymphoma (DLBCL) in the rituximab era has not been well defined. We sought to evaluate the use of imaging (computed tomography [CT] and positron emission tomography [PET]-CT) scans and lactate dehydrogenase (LDH) in surveillance of patients with stage I to II DLBCL. Methods: A retrospective analysis was performed of patients who received definitive treatment between 2000 and 2013. Results: One hundred sixty-two consecutive patients with stage I to II DLBCL were treated with chemotherapy +/− rituximab, radiation, or combined modality therapy. The 5-year rates of overall survival (OS) and freedommore » from progression (FFP) were 81.2% and 80.8%, respectively. Of the 162 patients, 124 (77%) were followed up with at least 1 surveillance PET scan beyond end-of-treatment scans; of those, 94 of 124 (76%) achieved a complete metabolic response on PET scan after completion of chemotherapy, and this was associated with superior FFP (P=.01, HR=0.3) and OS (P=.01, HR 0.3). Eighteen patients experienced relapse after initial response to therapy. Nine relapses were initially suspected by surveillance imaging studies (8 PET, 1 CT), and 9 were suspected clinically (5 by patient-reported symptoms and 4 by symptoms and physical examination). No relapses were detected by surveillance LDH. The median duration from initiation of treatment to relapse was 14.3 months among patients with relapses suspected by imaging, and 59.8 months among patients with relapses suspected clinically (P=.077). There was no significant difference in OS from date of first therapy or OS after relapse between patients whose relapse was suspected by imaging versus clinically. Thirteen of 18 patients underwent successful salvage therapy after relapse. Conclusions: A complete response on PET scan immediately after initial chemotherapy is associated with superior FFP and OS in stage I to II DLBCL. The use of PET scans as posttreatment surveillance is not associated with a survival advantage. LDH is not a sensitive marker for relapse. Our results argue for limiting the use of posttreatment surveillance in patients with limited-stage DLBCL.« less

SU-F-R-48: Early Prediction of Pathological Response of Locally Advanced Rectal Cancer Using Perfusion CT:A Prospective Clinical Study

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

Nie, K; Yue, N; Jabbour, S

Purpose: To prospectively evaluate the tumor vascularity assessed by perfusion CT for prediction of chemo-radiation treatment (CRT) response in locally advanced rectal cancer (LARC). Methods: Eighteen consecutive patients (61.9±8.8 years, from March–June 2015) diagnosed with LARC who underwent 6–8 weeks CRT followed by surgery were included. The pre-treatment perfusion CT was acquired after a 5s delay of contrast agent injection for 45s with 1s interval. A total of 7-cm craniocaudal range covered the tumor region with 3-mm slice thickness. The effective radiation dose is around 15mSv, which is about 1.5 the conventional abdomen/pelvis CT dose. The parametric map of bloodmore » flow (BF), blood volume (BV), mean transit time (MTT), permeability (PMB), and maximum intensity map (MIP) were obtained from commercial software (Syngo-CT 2011A, Siemens). An experienced radiation oncologist outlined the tumor based on the pre-operative MR and pathologic residual region, but was blinded with regards to pathological tumor stage. The perfusion parameters were compared to histopathological response quantified by tumor regression grade as good-responder (GR, TRG 0-1) vs. non-good responder (non-GR). Furthermore, the predictive value for pathological complete response (pCR) was also investigated. Results: Both BV (p=0.02) and MTT (P=0.02) was significantly higher and permeambility was lower (p=0.004) in the good responders. The BF was higher in GR group but not statistically significant. Regarding the discrimination of pCR vs non-pCR, the BF was higher in the pCR group (p=0.08) but none of those parameters showed statistically significant differences. Conclusion: BV and MTT can discriminate patients with a favorable response from those that fail to respond well, potentially selecting high-risk patients with resistant tumors that may benefit from an aggressive preoperative treatment approach. However, future studies with more patient data are needed to verify the prognostic value of perfusion CT especially for pCR prediction. This work is supported by the National High-tech R&D program for Young Scientists by the Ministry of Science and Technology of China (Grant No. 2015AA020917), Natural Science Foundation of China (NSFC Grant No. 81201091).« less

Sparse deconvolution for the large-scale ill-posed inverse problem of impact force reconstruction

NASA Astrophysics Data System (ADS)

Qiao, Baijie; Zhang, Xingwu; Gao, Jiawei; Liu, Ruonan; Chen, Xuefeng

2017-01-01

Most previous regularization methods for solving the inverse problem of force reconstruction are to minimize the l2-norm of the desired force. However, these traditional regularization methods such as Tikhonov regularization and truncated singular value decomposition, commonly fail to solve the large-scale ill-posed inverse problem in moderate computational cost. In this paper, taking into account the sparse characteristic of impact force, the idea of sparse deconvolution is first introduced to the field of impact force reconstruction and a general sparse deconvolution model of impact force is constructed. Second, a novel impact force reconstruction method based on the primal-dual interior point method (PDIPM) is proposed to solve such a large-scale sparse deconvolution model, where minimizing the l2-norm is replaced by minimizing the l1-norm. Meanwhile, the preconditioned conjugate gradient algorithm is used to compute the search direction of PDIPM with high computational efficiency. Finally, two experiments including the small-scale or medium-scale single impact force reconstruction and the relatively large-scale consecutive impact force reconstruction are conducted on a composite wind turbine blade and a shell structure to illustrate the advantage of PDIPM. Compared with Tikhonov regularization, PDIPM is more efficient, accurate and robust whether in the single impact force reconstruction or in the consecutive impact force reconstruction.

Interpersonal Relationships in the Workplace.

ERIC Educational Resources Information Center

Danner, Jean Ortowski; And Others

This curriculum guide on interpersonal relations in the workplace give techniques for instructors to use in evaluating these skills in their students. Eighteen competencies are included in this guide: adaptability; attendance; attitude; communication (nonverbal); communication (verbal); communication (written); confidence; cooperation; enthusiasm;…

7. GENERAL VIEW OF SOUTHEAST SIDE OF SHED, SHOWING ALL ...

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

7. GENERAL VIEW OF SOUTHEAST SIDE OF SHED, SHOWING ALL EIGHTEEN LOADING BAYS, LOOKING WEST FROM ACROSS TURNING BASIN - Oakland Army Base, Transit Shed, East of Dunkirk Street & South of Burma Road, Oakland, Alameda County, CA

Aircraft crashworthiness studies : findings in accidents involving an aerial application aircraft.

DOT National Transportation Integrated Search

1980-04-01

Aircraft crashworthiness features are presented, as others have done, in terms of packaging principles. Modern aerial application aircraft are recognized as being the most crashworthy in the civil aviation fleet. Eighteen accidents involving an aeria...

Nutritional modulation of cataract

USDA-ARS?s Scientific Manuscript database

Cataract, or lens opacification, remains a major cause of blindness worldwide. Cataracts reduce vision in over eighty million people, causing blindness in eighteen million people. The number afflicted by cataract will increase dramatically as the proportion of the elderly global population increase...

Guidelines for the design and placement of curb ramps.

DOT National Transportation Integrated Search

1982-01-01

Information was obtained through surveys of ten state departments of transportation, four large U. S. cities, and eighteen departments of public works in Virginia. A sample inventory of curb ramps was made in 15 municipalities in Virginia. Interviews...

A simple method for plasma total vitamin C analysis suitable for routine clinical laboratory use.

PubMed

Robitaille, Line; Hoffer, L John

2016-04-21

In-hospital hypovitaminosis C is highly prevalent but almost completely unrecognized. Medical awareness of this potentially important disorder is hindered by the inability of most hospital laboratories to determine plasma vitamin C concentrations. The availability of a simple, reliable method for analyzing plasma vitamin C could increase opportunities for routine plasma vitamin C analysis in clinical medicine. Plasma vitamin C can be analyzed by high performance liquid chromatography (HPLC) with electrochemical (EC) or ultraviolet (UV) light detection. We modified existing UV-HPLC methods for plasma total vitamin C analysis (the sum of ascorbic and dehydroascorbic acid) to develop a simple, constant-low-pH sample reduction procedure followed by isocratic reverse-phase HPLC separation using a purely aqueous low-pH non-buffered mobile phase. Although EC-HPLC is widely recommended over UV-HPLC for plasma total vitamin C analysis, the two methods have never been directly compared. We formally compared the simplified UV-HPLC method with EC-HPLC in 80 consecutive clinical samples. The simplified UV-HPLC method was less expensive, easier to set up, required fewer reagents and no pH adjustments, and demonstrated greater sample stability than many existing methods for plasma vitamin C analysis. When compared with the gold-standard EC-HPLC method in 80 consecutive clinical samples exhibiting a wide range of plasma vitamin C concentrations, it performed equivalently. The easy set up, simplicity and sensitivity of the plasma vitamin C analysis method described here could make it practical in a normally equipped hospital laboratory. Unlike any prior UV-HPLC method for plasma total vitamin C analysis, it was rigorously compared with the gold-standard EC-HPLC method and performed equivalently. Adoption of this method could increase the availability of plasma vitamin C analysis in clinical medicine.

Clinical Practice Improvement Approach in Multiple Sclerosis Rehabilitation: A Pilot Study

ERIC Educational Resources Information Center

Khan, Fary

2010-01-01

The objective of this study was to explore methods examining patient complexity and therapy interventions in relation to functional outcomes from an inpatient multiple sclerosis (MS) rehabilitation program. Retrospective and prospective data for 24 consecutive inpatients at a tertiary rehabilitation facility assessed (i)…

Temporally diffeomorphic cardiac motion estimation from three-dimensional echocardiography by minimization of intensity consistency error.

PubMed

Zhang, Zhijun; Ashraf, Muhammad; Sahn, David J; Song, Xubo

2014-05-01

Quantitative analysis of cardiac motion is important for evaluation of heart function. Three dimensional (3D) echocardiography is among the most frequently used imaging modalities for motion estimation because it is convenient, real-time, low-cost, and nonionizing. However, motion estimation from 3D echocardiographic sequences is still a challenging problem due to low image quality and image corruption by noise and artifacts. The authors have developed a temporally diffeomorphic motion estimation approach in which the velocity field instead of the displacement field was optimized. The optimal velocity field optimizes a novel similarity function, which we call the intensity consistency error, defined as multiple consecutive frames evolving to each time point. The optimization problem is solved by using the steepest descent method. Experiments with simulated datasets, images of anex vivo rabbit phantom, images of in vivo open-chest pig hearts, and healthy human images were used to validate the authors' method. Simulated and real cardiac sequences tests showed that results in the authors' method are more accurate than other competing temporal diffeomorphic methods. Tests with sonomicrometry showed that the tracked crystal positions have good agreement with ground truth and the authors' method has higher accuracy than the temporal diffeomorphic free-form deformation (TDFFD) method. Validation with an open-access human cardiac dataset showed that the authors' method has smaller feature tracking errors than both TDFFD and frame-to-frame methods. The authors proposed a diffeomorphic motion estimation method with temporal smoothness by constraining the velocity field to have maximum local intensity consistency within multiple consecutive frames. The estimated motion using the authors' method has good temporal consistency and is more accurate than other temporally diffeomorphic motion estimation methods.

Radiological and Environmental Research Division annual report, July 1975--June 1976

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

None

1976-01-01

Separate abstracts were prepared for eighteen sections of the report. Abstracts of an additional nine items are also included in the report as well as appendices presenting exposure data for radium patients and radium-induced malignancies. (HLW)

Eighteen Years of Safe Storage and Counting

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

Moren, Richard J.; Morton, M.

2016-03-28

The purpose of this paper is to share the status and condition of the six reactor buildings at the Hanford Site in Washington State that are in this SAFSTOR condition (for between 4 and 18 years as of summer of 2016).

Autogenous accelerated curing of concrete cylinders. Part IV, Moisture relationships.

DOT National Transportation Integrated Search

1971-01-01

Eighteen different concrete mixtures were proportioned to investigate the influence of cement types (II and III), water cement ratios (0.4, 0.5, and 0.6), and admixtures (accelerator, retarder, and air entraining agent) on the moisture changes during...

Weather or Not To Teach Junior High Meteorology.

ERIC Educational Resources Information Center

Knorr, Thomas P.

1984-01-01

Presents a technique for teaching meteorology allowing students to observe and analyze consecutive weather maps and relate local conditions; a model illustrating the three-dimensional nature of the atmosphere is employed. Instructional methods based on studies of daily weather maps to trace systems sweeping across the United States are discussed.…

Rest-Activity Cycles in Childhood and Adolescent Depression.

ERIC Educational Resources Information Center

Armitage, Roseanne; Hoffmann, Robert; Emslie, Graham; Rintelman, Jeanne; Moore, Jarrette; Lewis, Kelly

2004-01-01

Objective: To quantify circadian rhythms in rest-activity cycles in depressed children and adolescents. Method: Restactivity cycles were evaluated by actigraphy over five consecutive 24-hour periods in 100 children and adolescents, including 59 outpatients with major depressive disorder (MDD) and 41 healthy normal controls. Total activity, total…

Rural versus Suburban Primary Care Needs, Utilization, and Satisfaction with Telepsychiatric Consultation

ERIC Educational Resources Information Center

Hilty, Donald M.; Nesbitt, Thomas S.; Kuenneth, Christina A.; Cruz, Grace M.; Hales, Robert E.

2007-01-01

Context and Purpose: Rural and suburban populations remain underserved in terms of psychiatric services but have not been compared directly in terms of using telepsychiatry. Methods: Patient demographics, reasons for consultation, diagnosis, and alternatives to telepsychiatric consultation were collected for 200 consecutive, first-time…

Tense Marking in the English Narrative Retells of Dual Language Preschoolers

ERIC Educational Resources Information Center

Gusewski, Svenja; Rojas, Raul

2017-01-01

Purpose: This longitudinal study investigated the emergence of English tense marking in young (Spanish-English) dual language learners (DLLs) over 4 consecutive academic semesters, addressing the need for longitudinal data on typical acquisition trajectories of English in DLL preschoolers. Method: Language sample analysis was conducted on 139…

Clinical Characteristics of Voice, Speech, and Swallowing Disorders in Oromandibular Dystonia

ERIC Educational Resources Information Center

Kreisler, Alexandre; Vepraet, Anne Caroline; Veit, Solène; Pennel-Ployart, Odile; Béhal, Hélène; Duhamel, Alain; Destée, Alain

2016-01-01

Purpose: To better define the clinical characteristics of idiopathic oromandibular dystonia, we studied voice, speech, and swallowing disorders and their impact on activities of daily living. Method: Fourteen consecutive patients with idiopathic oromandibular dystonia and 14 matched, healthy control subjects were included in the study. Results:…

Is Adolescent-Onset First-Episode Psychosis Different from Adult Onset?

ERIC Educational Resources Information Center

Ballageer, Trevor; Malla, Ashok; Manchanda, Rahul; Takhar, Jatinder; Haricharan, Raj

2005-01-01

Objective: To examine whether first-episode psychosis patients with onset during adolescence (ages 15-18) differ significantly from those with young-adult onset (ages 19-30). Method: Consecutive patients presenting with first-episode psychosis (N = 242) were assessed for demographic and illness characteristics such as duration of untreated…

Generalized Anxiety Disorder in Referred Children and Adolescents.

ERIC Educational Resources Information Center

Masi, Gabriele; Millepiedi, Stefania; Mucci, Maria; Poli, Paola; Bertini, Nicoletta; Milantoni, Luca

2004-01-01

Objective: There are insufficient data on generalized anxiety disorder in children and adolescents. Symptoms and comorbidity of generalized anxiety disorder are described as a function of age, gender, and comorbidity in a consecutive series of referred children and adolescents. Method: One hundred fifty-seven outpatients (97 males and 60 females,…

49 CFR 228.405 - Limitations on duty hours of train employees engaged in commuter or intercity rail passenger...

Code of Federal Regulations, 2013 CFR

2013-10-01

... consecutive hours, until that employee has had at least 10 consecutive hours off duty; or (3) In a series of... first series of at most 14 consecutive calendar days begins on the first calendar day that the employee....413. A series of at most 14 consecutive calendar days either ends on the 14th consecutive day or may...

49 CFR 228.405 - Limitations on duty hours of train employees engaged in commuter or intercity rail passenger...

Code of Federal Regulations, 2014 CFR

2014-10-01

... consecutive hours, until that employee has had at least 10 consecutive hours off duty; or (3) In a series of... first series of at most 14 consecutive calendar days begins on the first calendar day that the employee....413. A series of at most 14 consecutive calendar days either ends on the 14th consecutive day or may...

49 CFR 228.405 - Limitations on duty hours of train employees engaged in commuter or intercity rail passenger...

Code of Federal Regulations, 2012 CFR

2012-10-01

... consecutive hours, until that employee has had at least 10 consecutive hours off duty; or (3) In a series of... first series of at most 14 consecutive calendar days begins on the first calendar day that the employee....413. A series of at most 14 consecutive calendar days either ends on the 14th consecutive day or may...

Inventory on the dietary assessment tools available and needed in africa: a prerequisite for setting up a common methodological research infrastructure for nutritional surveillance, research, and prevention of diet-related non-communicable diseases.

PubMed

Pisa, Pedro T; Landais, Edwige; Margetts, Barrie; Vorster, Hester H; Friedenreich, Christine M; Huybrechts, Inge; Martin-Prevel, Yves; Branca, Francesco; Lee, Warren T K; Leclercq, Catherine; Jerling, Johann; Zotor, Francis; Amuna, Paul; Al Jawaldeh, Ayoub; Aderibigbe, Olaide Ruth; Amoussa, Waliou Hounkpatin; Anderson, Cheryl A M; Aounallah-Skhiri, Hajer; Atek, Madjid; Benhura, Chakare; Chifamba, Jephat; Covic, Namukolo; Dary, Omar; Delisle, Hélène; El Ati, Jalila; El Hamdouchi, Asmaa; El Rhazi, Karima; Faber, Mieke; Kalimbira, Alexander; Korkalo, Liisa; Kruger, Annamarie; Ledo, James; Machiweni, Tatenda; Mahachi, Carol; Mathe, Nonsikelelo; Mokori, Alex; Mouquet-Rivier, Claire; Mutie, Catherine; Nashandi, Hilde Liisa; Norris, Shane A; Onabanjo, Oluseye Olusegun; Rambeloson, Zo; Saha, Foudjo Brice U; Ubaoji, Kingsley Ikechukwu; Zaghloul, Sahar; Slimani, Nadia

2018-01-02

To carry out an inventory on the availability, challenges, and needs of dietary assessment (DA) methods in Africa as a pre-requisite to provide evidence, and set directions (strategies) for implementing common dietary methods and support web-research infrastructure across countries. The inventory was performed within the framework of the "Africa's Study on Physical Activity and Dietary Assessment Methods" (AS-PADAM) project. It involves international institutional and African networks. An inventory questionnaire was developed and disseminated through the networks. Eighteen countries responded to the dietary inventory questionnaire. Various DA tools were reported in Africa; 24-Hour Dietary Recall and Food Frequency Questionnaire were the most commonly used tools. Few tools were validated and tested for reliability. Face-to-face interview was the common method of administration. No computerized software or other new (web) technologies were reported. No tools were standardized across countries. The lack of comparable DA methods across represented countries is a major obstacle to implement comprehensive and joint nutrition-related programmes for surveillance, programme evaluation, research, and prevention. There is a need to develop new or adapt existing DA methods across countries by employing related research infrastructure that has been validated and standardized in other settings, with the view to standardizing methods for wider use.

Cognitions of Expert Supervisors in Academe: A Concept Mapping Approach

ERIC Educational Resources Information Center

Kemer, Gülsah; Borders, L. DiAnne; Willse, John

2014-01-01

Eighteen expert supervisors reported their thoughts while preparing for, conducting, and evaluating their supervision sessions. Concept mapping (Kane & Trochim, [Kane, M., 2007]) yielded 195 cognitions classified into 25 cognitive categories organized into 5 supervision areas: conceptualization of supervision, supervisee assessment,…

Staff Differentiation; An Annotated Bibliography Addendum.

ERIC Educational Resources Information Center

Marin County Public Schools, Corte Madera, CA.

Differentiated staffing has emphasized development of teacher leadership roles, the importance of shared decision making in schools, and the constructive ways in which paid instructional aides and volunteer aides can support the professional teaching staff. Eighteen annotated bibliographic citations concerning the various aspects of differentiated…

Capacity and road user cost analysis of selected freeway work zones in Texas.

DOT National Transportation Integrated Search

2009-09-01

This research was developed to produce usable and meaningful estimates for work zone capacities under a variety of roadway and traffic conditions, work zone configurations, and lane closure scenarios within Texas. Using data collected at eighteen wor...

Honoring Teachers: A World of Perspectives

ERIC Educational Resources Information Center

Thirumurthy, Vidya; Szecsi, Tunde; Hardin, Belinda J.; Koo, Ramsey D.

2007-01-01

This cross-cultural study examines early childhood professionals' perceptions of their social status, working conditions, and public appreciation in seven countries/territories: Guatemala, Hong Kong, Hungary, India, Mexico, Peru, and the United States of America. One hundred eighteen participants, consisting of preschool and elementary school…

Malaysian Physicians' Evaluation of Their Training Abroad

ERIC Educational Resources Information Center

Wellington, John S.

1969-01-01

Eighteen Malaysian physicians evaluate their postgraduate training in the United Kingdom, Australia and the US in terms of its relevance to Malaysian health needs, the extent to which it is actually used, and its importance to them in teaching medical students in Malaysia. (WM)

Primary Teachers' Representational Practices: From Competency to Fluency

ERIC Educational Resources Information Center

Nichols, Kim; Stevenson, Michael; Hedberg, John; Gillies, Robyn Margaret

2016-01-01

Eighteen primary teachers across three conditions (Representational Fluency, Representational Agency, Comparison) received two days of training around an inquiry unit on plate tectonics replete with representations. The Representational Agency group also received training around the semiotic and material affordances of representations while the…

Designing Interactive Online Nursing Courses

ERIC Educational Resources Information Center

Jain, Smita; Jain, Pawan

2015-01-01

This study empirically tests the relation between the instructional design elements and the overall meaningful interactions among online students. Eighteen online graduate nursing courses are analyzed using bivariate and multivariate analysis techniques. Findings suggest that the quantity of meaningful interaction among learners can be improved by…

Clavicipitaceous anamorphic endophytes in Hordeum germplasm

Treesearch

A. Dan Wilson

2007-01-01

The incidence of clavicipitaceous anamorphic endophytes, non-choke inducing endosymbiotic fungi of the genus Neotyphodium that systemically infect grasses, in eighteen Hordeum species from the U.S. National Plant Germplasm System was examined using light and Scanning Electron Microscopy (SEM). Seventeen plant inventory accessions...

Comparison of cumulative dissipated energy between the Infiniti and Centurion phacoemulsification systems

PubMed Central

Chen, Ming; Anderson, Erik; Hill, Geoffrey; Chen, John J; Patrianakos, Thomas

2015-01-01

Purpose To compare cumulative dissipated energy between two phacoemulsification machines. Setting An ambulatory surgical center, Honolulu, Hawaii, USA. Design Retrospective chart review. Methods A total of 2,077 consecutive cases of cataract extraction by phacoemulsification performed by five surgeons from November 2012 to November 2014 were included in the study; 1,021 consecutive cases were performed using the Infiniti Vision System, followed by 1,056 consecutive cases performed using the Centurion Vision System. Results The Centurion phacoemulsification system required less energy to remove a cataractous lens with an adjusted average energy reduction of 38% (5.09 percent-seconds) (P<0.001) across all surgeons in comparison to the Infiniti phacoemulsification system. The reduction in cumulative dissipated energy was statistically significant for each surgeon, with a range of 29%–45% (2.25–12.54 percent-seconds) (P=0.005–<0.001). Cumulative dissipated energy for both the Infiniti and Centurion systems varied directly with patient age, increasing an average of 2.38 percent-seconds/10 years. Conclusion The Centurion phacoemulsification system required less energy to remove a cataractous lens in comparison to the Infiniti phacoemulsification system. PMID:26229430

PREVALENCE OF HELICOBACTER PYLORI TEN YEARS AGO COMPARED TO THE CURRENT PREVALENCE IN PATIENTS UNDERGOING UPPER ENDOSCOPY

PubMed Central

FRUGIS, Sandra; CZECZKO, Nicolau Gregori; MALAFAIA, Osvaldo; PARADA, Artur Adolfo; POLETTI, Paula Bechara; SECCHI, Thiago Festa; DEGIOVANI, Matheus; RAMPANAZZO-NETO, Alécio; D´AGOSTINO, Mariza D.

2016-01-01

ABSTRACT Background: Helicobacter pylori has been extensively studied since 1982 it is estimated that 50% of the world population is affected. The literature lacks studies that show the change of its prevalence in the same population over time. Aim: To compare the prevalence of H. pylori in 10 years interval in a population that was submitted to upper endoscopy in the same endoscopy service. Method: Observational, retrospective and cross-sectional study comparing the prevalence of H. pylori in two samples with 10 years apart (2004 and 2014) who underwent endoscopy with biopsy and urease. Patients were studied in three consecutive months of 2004, compared to three consecutive months of 2014. The total number of patients was 2536, and 1406 in 2004 and 1130 in 2014. Results: There were positive for H. pylori in 17 % of the sample as a whole. There was a significant decrease in the prevalence from 19.3% in 2004 to 14.1% in 2014 (p<0.005). Conclusion: There was a 5.2% reduction in the prevalence of H. pylori comparing two periods of three consecutive months with 10 years apart in two equivalent population samples. PMID:27759776

Lack of energy compensation over 4 days when white button mushrooms are substituted for beef.

PubMed

Cheskin, Lawrence J; Davis, Lisa M; Lipsky, Leah M; Mitola, Andrea H; Lycan, Thomas; Mitchell, Vanessa; Mickle, Brooke; Adkins, Emily

2008-07-01

Increasing intake of low energy density (ED) foods in place of high ED foods has been proposed as a strategy for preventing or treating obesity. This study investigated how substituting mushrooms for beef in a test lunch affected energy intake, fat intake, palatability, appetite, satiation and satiety in normal weight, overweight and obese adults. Each subject consumed a total of eight test lunches in our lab over two consecutive weeks. The order of presentation of four consecutive meat lunches and four consecutive mushroom lunches was randomized. Energy content of meat and mushroom lunches varied (783 kcal versus 339 kcal), while volume was held constant. Energy intakes were significantly higher during meat lunches than mushroom lunches (730+/-7.9 kcal versus 310+/-5.8 kcal). Subjects exhibited only partial compensation (11.4+/-12.0%) for this difference over 4 days. Total daily energy intake and fat intake were significantly greater in the meat condition than in the mushroom condition, while ratings of palatability, appetite, satiation and satiety did not differ significantly. These results suggest that substituting low ED foods for high ED foods in otherwise similar recipes can be an effective method for reducing daily energy and fat intake.

Method and apparatus for detecting flaws and defects in heat seals

NASA Technical Reports Server (NTRS)

Rai, Kula R. (Inventor); Lew, Thomas M. (Inventor); Sinclair, Robert B. (Inventor)

1993-01-01

Flaws and defects in heat seals formed between sheets of translucent film are identified by optically examining consecutive lateral sections of the seal along the seal length. Each lateral seal section is illuminated and an optical sensor array detects the intensity of light transmitted through the seal section for the purpose of detecting and locating edges in the heat seal. A line profile for each consecutive seal section is derived having an amplitude proportional to the change in light intensity across the seal section. Instances in the derived line profile where the amplitude is greater than a threshold level indicate the detection of a seal edge. The detected edges in each derived line profile are then compared to a preset profile edge standard to identify the existence of a flaw or defect.

Recurrence of breech presentation in consecutive pregnancies

PubMed Central

Ford, JB; Roberts, CL; Nassar, N; Giles, W; Morris, JM

2010-01-01

Objective To investigate the recurrence risk of breech presentation at term, and to assess the risk factors that contribute to its recurrence. Design Cohort study. Setting New South Wales, Australia. Population Women with their first two (n = 113 854) and first three (n = 21 690) consecutive singleton term pregnancies, in the period 1994–2002. Methods Descriptive statistics including rates, relative risks and adjusted relative risks, as determined from logistic regression and Poisson analyses. Main outcome measures Rates and risks of occurrence and recurrence of breech presentation at birth in each pregnancy, and maternal and infant risk factors associated with breech recurrence. Results First-time breech presentation at term occurred in 4.2% of first pregnancy deliveries, 2.2% of second pregnancies and 1.9% of third pregnancies. The rate of breech recurrence in a second consecutive pregnancy was 9.9%, and in a third consecutive pregnancy (after two prior breech deliveries) was 27.5%. The relative risk of breech recurrence in a second pregnancy was 3.2 (95% CI 2.8–3.6), and in a third consecutive breech pregnancy was 13.9 (95% CI 8.8–22.1). First pregnancy factors associated with recurrence included placenta praevia [adjusted relative risk (aRR) 2.2; 95% CI 1.3–3.7], maternal diabetes (aRR 1.4; 95% CI 1.0–2.1) and a maternal age of ≥35 years (aRR 1.2; 95% CI 0.9–1.6). Second pregnancy factors included birth defects (aRR 2.5; 95% CI 1.4–4.2), placenta praevia (aRR 2.5; 95% CI 1.5–4.1) and a female infant (aRR 1.2; 95% CI 1.0–1.5). Conclusions The increased recurrence risk of breech presentations suggests that women with a history of breech delivery should be closely monitored in the latter stages of pregnancy. PMID:20482538

Characteristics of ovulation method acceptors: a cross-cultural assessment.

PubMed

Klaus, H; Labbok, M; Barker, D

1988-01-01

Five programs of instruction in the ovulation method (OM) in diverse geographic and cultural settings are described, and characteristics of approximately 200 consecutive OM acceptors in each program are examined. Major findings include: the religious background and family size of acceptors are variable, as is the level of previous contraceptive use. Acceptors are drawn from a wide range of socioeconomic and religious backgrounds; however, family planning intention was similarly distributed in all five countries. In sum, the ovulation method is accepted by persons from a variety of backgrounds within and between cultural setting.

An inventory of irrigated lands for selected counties within the state of California based on LANDSAT and supporting aircraft data

NASA Technical Reports Server (NTRS)

Colwell, R. N. (Principal Investigator)

1977-01-01

The author has identified the following significant results: (1) Goals of the irrigated lands project were addressed by the design and implementation of a multiphase sampling scheme that was founded on the utilization of a LANDSAT-based remote sensing system. (2) The synoptic coverage of LANDSAT and the eighteen day orbit cycle allowed the project to study agricultural test sites in a variety of environmental regions and monitor the development of crops throughout the major growing season. (3) The capability to utilize multidate imagery is crucial to the reliable estimation of irrigated acreage in California where multiple cropping is widespread and current estimation systems must rely on single data survey techniques. (4) In addition, the magnitude of agricultural acreage in California makes estimation by conventional methods impossible.

Chemical composition, antioxidant properties and antimicrobial activity of the essential oil of Murraya paniculata leaves from the mountains of Central Cuba.

PubMed

Rodríguez, Elisa Jorge; Ramis-Ramos, Guillermo; Heyden, Yvan Vander; Simó-Alfonso, Ernesto F; Lerma-García, María Jesús; Saucedo-Hernández, Yanelis; Monteagudo, Urbano; Morales, Yeni; Holgado, Beatriz; Herrero-Martínez, José Manuel

2012-11-01

The essential oil of Murraya paniculata L leaves from the mountains of the Central Region of Cuba, obtained by hydrodistillation, was analyzed by gas chromatography-mass spectrometry. Eighteen compounds, accounting for 95.1% of the oil were identified. The major component was beta-caryophyllene (ca. 30%). The antioxidant activity of essential oil was evaluated against Cucurbita seed oil by peroxide, thiobarbituric acid and p-anisidine methods. The essential oil showed stronger antioxidant activity than that of butylated hydroxyanisole and butylated hydroxytoluene, but lower than that of propyl gallate. Moreover, this antioxidant activity was supported by the complementary antioxidant assay in the linoleic acid system and 2, 2'-diphenyl-1-picrylhydrazyl. The essential oil also showed good to moderate inhibitory effects against Klebsiellapneumoniae and Bacillus subtilis.

Application of Fourier Transform Infrared Spectra (FTIR) Fingerprint in the Quality Control of Mineral Chinese Medicine Limonitum.

PubMed

Liu, Sheng-jin; Yang, Huan; Wu, De-kang; Xu, Chun-xiang; Lin, Rui-chao; Tian, Jin-gai; Fang, Fang

2015-04-01

In the present paper, the fingerprint of Limonitum (a mineral Chinese medicine) by FTIR was established, and the spectrograms among crude samples, processed one and the adulterant sample were compared. Eighteen batches of Limonitum samples from different production areas were analyzed and the angle cosine value of transmittance (%) of common peaks was calculated to get the similarity of the FTIR fingerprints. The result showed that the similarities and the coefficients of the samples were all more than 0.90. The processed samples revealed significant differences compared with the crude one. This study analyzed the composition characteristics of Limonitum in FTIR fingerprint, and it was simple and fast to distinguish the crude, processed and the counterfeit samples. The FTIR fingerprints provide a new method for evaluating the quality of Limonitum.

Collaborative ring-trial of Dynabeads anti-Salmonella for immunomagnetic separation of stressed Salmonella cells from herbs and spices.

PubMed

Mansfield, L; Forsythe, S

1996-02-01

Eight laboratories participated in a Salmonella detection ring-trial which compared selective enrichment by conventional broths with immunomagnetic separation (IMS) using Dynabeads Anti-Salmonella. Laboratories analyzed six types of herbs and spices that were spiked with one of six freeze-dried Salmonella species. Each herb and spice analysis comprised of 12 samples (25 g each) which had been spiked at three different levels, plus a negative control and stored for one week prior to testing. Out of a total 468 samples analyzed, 195 (41.7%) were positive by both methods. Eighteen samples were positive only by IMS enrichment, in comparison with 19 positive samples by conventional enrichment broths and not IMS. These results confirm the potential use of IMS as an alternative to enrichment broths for Salmonella isolation.

Heart Rate Assessment Immediately after Birth.

PubMed

Phillipos, Emily; Solevåg, Anne Lee; Pichler, Gerhard; Aziz, Khalid; van Os, Sylvia; O'Reilly, Megan; Cheung, Po-Yin; Schmölzer, Georg M

2016-01-01

Heart rate assessment immediately after birth in newborn infants is critical to the correct guidance of resuscitation efforts. There are disagreements as to the best method to measure heart rate. The aim of this study was to assess different methods of heart rate assessment in newborn infants at birth to determine the fastest and most accurate method. PubMed, EMBASE and Google Scholar were systematically searched using the following terms: 'infant', 'heart rate', 'monitoring', 'delivery room', 'resuscitation', 'stethoscope', 'auscultation', 'palpation', 'pulse oximetry', 'electrocardiogram', 'Doppler ultrasound', 'photoplethysmography' and 'wearable sensors'. Eighteen studies were identified that described various methods of heart rate assessment in newborn infants immediately after birth. Studies examining auscultation, palpation, pulse oximetry, electrocardiography and Doppler ultrasound as ways to measure heart rate were included. Heart rate measurements by pulse oximetry are superior to auscultation and palpation, but there is contradictory evidence about its accuracy depending on whether the sensor is connected to the infant or the oximeter first. Several studies indicate that electrocardiogram provides a reliable heart rate faster than pulse oximetry. Doppler ultrasound shows potential for clinical use, however future evidence is needed to support this conclusion. Heart rate assessment is important and there are many measurement methods. The accuracy of routinely applied methods varies, with palpation and auscultation being the least accurate and electrocardiogram being the most accurate. More research is needed on Doppler ultrasound before its clinical use. © 2015 S. Karger AG, Basel.

Development and validation of stability indicating HPLC methods for related substances and assay analyses of amoxicillin and potassium clavulanate mixtures.

PubMed

Bellur Atici, Esen; Yazar, Yücel; Ağtaş, Çağan; Ridvanoğlu, Nurten; Karlığa, Bekir

2017-03-20

Antibacterial combinations consisting of the semisynthetic antibiotic amoxicillin (amox) and the β-lactamase inhibitor potassium clavulanate (clav) are commonly used and several chromatographic methods were reported for their quantification in mixtures. In the present work, single HPLC method for related substances analyses of amoxicillin and potassium clavulanate mixtures was developed and validated according to international conference on harmonization (ICH) guidelines. Eighteen amoxicillin and six potassium clavulanate impurities were successfully separated from each other by using triple gradient elution using a Thermo Hypersil Zorbax BDS C18 (250 mm×4.6mm, 3μm) column with 50μL injection volumes at a wavelength of 215nm. Commercially unavailable impurities were formed by degradation of amoxicillin and potassium clavulanate, identified by LC-MS studies and used during analytical method development and validation studies. Also, process related amoxicillin impurity-P was synthesized and characterized by using nuclear magnetic resonance (NMR) and mass spectroscopy (MS) for the first time. As complementary of this work, an assay method for amoxicillin and potassium clavulanate mixtures was developed and validated; stress-testing and stability studies of amox/clav mixtures was carried out under specified conditions according to ICH and analyzed by using validated stability-indicating assay and related substances methods. Copyright © 2016 Elsevier B.V. All rights reserved.

The Eighteen-Electron Rule

ERIC Educational Resources Information Center

Mitchell, P. R.; Parish, R. V.

1969-01-01

Discusses the stability of the structures of transition metal complexes (primarily carbonyls and organometallic compounds) having 18 electrons or less in their valence shell. Presents molecular orbital diagrams for various structures involving alpha and pi bonding and describes the conditions under which the 18 electron rule applies. (RR)

"We Do Care," Say Parents

ERIC Educational Resources Information Center

Mistretta, Regina M.

2013-01-01

Parents can positively impact children's learning of mathematics. To productively engage families in the learning process, teachers must support such interpersonal relationships. The author describes the investigative work of a group of teacher candidates as they sought to attain such understanding. Eighteen preservice teachers, who were…

Hazardous Waste Cleanup: Akzo Nobel Polymer Chemicals, LLC, Burt, New York

EPA Pesticide Factsheets

Akzo Nobel Polymer Chemicals, LLC is located in northern Niagara County, south of Lake Ontario. The facility encompasses 350 acres, of which 30 acres are used for the production of organic peroxides. Eighteen Mile Creek is located immediately west of the

Challenges of Virtual School Leadership

ERIC Educational Resources Information Center

Richardson, Jayson W.; LaFrance, Jason; Beck, Dennis

2015-01-01

The purpose of this case study was to examine challenges faced by virtual school leaders in the United States. Through semistructured interviews, the researchers explored challenges faced by eighteen leaders of fully online or blended online programs. Analysis revealed six main challenges: funding, staff, accountability, time, parents, and…

Defense Management Education and Training Catalog.

ERIC Educational Resources Information Center

Office of the Assistant Secretary of Defense for Manpower and Reserve Affairs (DOD), Washington, DC.

This catalog provides information on a wide variety of courses, programs, and school made available by Department of Defense organizations. The program consists of eighteen primarily service-operated schools offering joint training in management covering a wide variety of subjects including automatic data processing, production management,…

Wild Cat Wilderness Center.

ERIC Educational Resources Information Center

Moffett, Fran

1982-01-01

Eighteen staff members from Roselle Park (NJ) High School were the first faculty group in New Jersey to experience a workshop to acquaint them with the Wild Cat Mountain Wilderness Center and improve communication, trust, and enhance problem-solving skills. Challenging activities, suitable to the area, are described. (CM)

Ecological Land Classification: Applications to Identify the Productive Potential of Southern Forests

Treesearch

Dennis L. Mengel; D. Thompson Tew; [Editors

1991-01-01

Eighteen papers representing four categories-Regional Overviews; Classification System Development; Classification System Interpretation; Mapping/GIS Applications in Classification Systems-present the state of the art in forest-land classification and evaluation in the South. In addition, nine poster papers are presented.

Electronic nose for detecting strawberry fruit maturity

USDA-ARS?s Scientific Manuscript database

An electronic nose (e-nose) composed of eighteen different metal oxide gas sensors was used to characterize the volatile patterns of ‘Strawberry Festival’ and ‘Florida Radiance’ strawberry fruit at five developmental stages: white, half red, three-quarter red, full ripe, and overripe. Strawberry sam...

Training for Agriculture and Rural Development--1975.

ERIC Educational Resources Information Center

United Nations Food and Agriculture Organization, Rome (Italy).

Eighteen papers about education, training, and extension in rural areas of the developing world are presented in this 1975 journal published jointly by three United Nations agencies closely concerned with education and rural development: Food and Agriculture Organization; Education, Scientific, and Cultural Organization; International Labor…

Organisational Learning and Employees' Intrinsic Motivation

ERIC Educational Resources Information Center

Remedios, Richard; Boreham, Nick

2004-01-01

This study examined the effects of organisational learning initiatives on employee motivation. Four initiatives consistent with theories of organisational learning were a priori ranked in terms of concepts that underpin intrinsic-motivation theory. Eighteen employees in a UK petrochemical company were interviewed to ascertain their experiences of…

Investigations in Mathematics Education, Vol. 10, No. 3.

ERIC Educational Resources Information Center

Osborne, Alan R., Ed.

Eighteen research reports related to mathematics education are abstracted and analyzed in this publication. Three of the reports deal with aspects of learning theory, seven with topics in mathematics instruction (problem solving, weight, quadratic inequalities, probability and statistics, area and volume conservation, cardinality), five with…

The 2017 Space Resources Roundtable and New Space Resources Graduate Program at Colorado School of Mines

NASA Astrophysics Data System (ADS)

Abbud-Madrid, A.

2017-10-01

For eighteen years, SRR has brought together interested individuals from the space exploration community, the mining and minerals industries, and the financial sector to discuss issues related to the ISRU of lunar, asteroidal, and martian resources.

76 FR 7627 - Petition for Waiver of Compliance

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-10

.... Eighteen (18) separate groups of locomotives were identified for investigation in the waiver approval... groups that must be investigated. In support of this petition, AAR says that this extension will be... electronic air brake equipment. They have also submitted information from WRE supporting combining EPIC...

Marathon Group: Changes in Scores on the California Psychological Inventory

ERIC Educational Resources Information Center

Foulds, Melvin L.; And Others

1974-01-01

Eighteen college students participated in a 24-hour marathon group and responded to the California Psychological Inventory (CPI) immediately before and after the experience. The results disclosed significant positive changes at the .05 level on 11 of 18 scales on this inventory. (Author)

Image phase shift invariance based cloud motion displacement vector calculation method for ultra-short-term solar PV power forecasting

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

Wang, Fei; Zhen, Zhao; Liu, Chun

Irradiance received on the earth's surface is the main factor that affects the output power of solar PV plants, and is chiefly determined by the cloud distribution seen in a ground-based sky image at the corresponding moment in time. It is the foundation for those linear extrapolation-based ultra-short-term solar PV power forecasting approaches to obtain the cloud distribution in future sky images from the accurate calculation of cloud motion displacement vectors (CMDVs) by using historical sky images. Theoretically, the CMDV can be obtained from the coordinate of the peak pulse calculated from a Fourier phase correlation theory (FPCT) method throughmore » the frequency domain information of sky images. The peak pulse is significant and unique only when the cloud deformation between two consecutive sky images is slight enough, which is likely possible for a very short time interval (such as 1?min or shorter) with common changes in the speed of cloud. Sometimes, there will be more than one pulse with similar values when the deformation of the clouds between two consecutive sky images is comparatively obvious under fast changing cloud speeds. This would probably lead to significant errors if the CMDVs were still only obtained from the single coordinate of the peak value pulse. However, the deformation estimation of clouds between two images and its influence on FPCT-based CMDV calculations are terrifically complex and difficult because the motion of clouds is complicated to describe and model. Therefore, to improve the accuracy and reliability under these circumstances in a simple manner, an image-phase-shift-invariance (IPSI) based CMDV calculation method using FPCT is proposed for minute time scale solar power forecasting. First, multiple different CMDVs are calculated from the corresponding consecutive images pairs obtained through different synchronous rotation angles compared to the original images by using the FPCT method. Second, the final CMDV is generated from all of the calculated CMDVs through a centroid iteration strategy based on its density and distance distribution. Third, the influence of different rotation angle resolution on the final CMDV is analyzed as a means of parameter estimation. Simulations under various scenarios including both thick and thin clouds conditions indicated that the proposed IPSI-based CMDV calculation method using FPCT is more accurate and reliable than the original FPCT method, optimal flow (OF) method, and particle image velocimetry (PIV) method.« less

Image phase shift invariance based cloud motion displacement vector calculation method for ultra-short-term solar PV power forecasting

DOE PAGES

Wang, Fei; Zhen, Zhao; Liu, Chun; ...

2017-12-18

Irradiance received on the earth's surface is the main factor that affects the output power of solar PV plants, and is chiefly determined by the cloud distribution seen in a ground-based sky image at the corresponding moment in time. It is the foundation for those linear extrapolation-based ultra-short-term solar PV power forecasting approaches to obtain the cloud distribution in future sky images from the accurate calculation of cloud motion displacement vectors (CMDVs) by using historical sky images. Theoretically, the CMDV can be obtained from the coordinate of the peak pulse calculated from a Fourier phase correlation theory (FPCT) method throughmore » the frequency domain information of sky images. The peak pulse is significant and unique only when the cloud deformation between two consecutive sky images is slight enough, which is likely possible for a very short time interval (such as 1?min or shorter) with common changes in the speed of cloud. Sometimes, there will be more than one pulse with similar values when the deformation of the clouds between two consecutive sky images is comparatively obvious under fast changing cloud speeds. This would probably lead to significant errors if the CMDVs were still only obtained from the single coordinate of the peak value pulse. However, the deformation estimation of clouds between two images and its influence on FPCT-based CMDV calculations are terrifically complex and difficult because the motion of clouds is complicated to describe and model. Therefore, to improve the accuracy and reliability under these circumstances in a simple manner, an image-phase-shift-invariance (IPSI) based CMDV calculation method using FPCT is proposed for minute time scale solar power forecasting. First, multiple different CMDVs are calculated from the corresponding consecutive images pairs obtained through different synchronous rotation angles compared to the original images by using the FPCT method. Second, the final CMDV is generated from all of the calculated CMDVs through a centroid iteration strategy based on its density and distance distribution. Third, the influence of different rotation angle resolution on the final CMDV is analyzed as a means of parameter estimation. Simulations under various scenarios including both thick and thin clouds conditions indicated that the proposed IPSI-based CMDV calculation method using FPCT is more accurate and reliable than the original FPCT method, optimal flow (OF) method, and particle image velocimetry (PIV) method.« less

Study on Incompatibility of Traditional Chinese Medicine: Evidence from Formula Network, Chemical Space, and Metabolism Room

PubMed Central

Zhang, Xiao-Dong; Wu, Hong-Ying; Jin, Jin; Yu, Guang-Yun; He, Xin; Wang, Hao; Shen, Xiu; Zhou, Ze-Wei; Liu, Pei-Xun; Fan, Sai-Jun

2013-01-01

A traditional Chinese medicine (TCM) formula network including 362 TCM formulas was built by using complex network methodologies. The properties of this network were analyzed including network diameter, average distance, clustering coefficient, and average degree. Meanwhile, we built a TCM chemical space and a TCM metabolism room under the theory of chemical space. The properties of chemical space and metabolism room were calculated and analyzed. The properties of the medicine pairs in “eighteen antagonisms and nineteen mutual inhibitors,” an ancient rule for TCM incompatibility, were studied based on the TCM formula network, chemical space, and metabolism room. The results showed that the properties of these incompatible medicine pairs are different from those of the other TCM based on the analysis of the TCM formula network, chemical space, and metabolism room. The lines of evidence derived from our work demonstrated that the ancient rule of TCM incompatibility, “eighteen antagonisms and nineteen mutual inhibitors,” is probably scientifically based. PMID:24369478

The Effects of Skill Training on Social Workers' Professional Competences in Norway: Results of a Cluster-Randomised Study

PubMed Central

Malmberg-Heimonen, Ira; Natland, Sidsel; Tøge, Anne Grete; Hansen, Helle Cathrine

2016-01-01

Using a cluster-randomised design, this study analyses the effects of a government-administered skill training programme for social workers in Norway. The training programme aims to improve social workers' professional competences by enhancing and systematising follow-up work directed towards longer-term unemployed clients in the following areas: encountering the user, system-oriented efforts and administrative work. The main tools and techniques of the programme are based on motivational interviewing and appreciative inquiry. The data comprise responses to baseline and eighteen-month follow-up questionnaires administered to all social workers (n = 99) in eighteen participating Labour and Welfare offices randomised into experimental and control groups. The findings indicate that the skill training programme positively affected the social workers' evaluations of their professional competences and quality of work supervision received. The acquisition and mastering of combinations of specific tools and techniques, a comprehensive supervision structure and the opportunity to adapt the learned skills to local conditions were important in explaining the results. PMID:27559232

Strategies for dereplication of natural compounds using high-resolution tandem mass spectrometry.

PubMed

Kind, Tobias; Fiehn, Oliver

2017-09-01

Complete structural elucidation of natural products is commonly performed by nuclear magnetic resonance spectroscopy (NMR), but annotating compounds to most likely structures using high-resolution tandem mass spectrometry is a faster and feasible first step. The CASMI contest 2016 (Critical Assessment of Small Molecule Identification) provided spectra of eighteen compounds for the best manual structure identification in the natural products category. High resolution precursor and tandem mass spectra (MS/MS) were available to characterize the compounds. We used the Seven Golden Rules, Sirius2 and MS-FINDER software for determination of molecular formulas, and then we queried the formulas in different natural product databases including DNP, UNPD, ChemSpider and REAXYS to obtain molecular structures. We used different in-silico fragmentation tools including CFM-ID, CSI:FingerID and MS-FINDER to rank these compounds. Additional neutral losses and product ion peaks were manually investigated. This manual and time consuming approach allowed for the correct dereplication of thirteen of the eighteen natural products.

Numerical Investigations of Subduction of Eighteen Degree Water in the Subtropical Northwest Atlantic Ocean

NASA Astrophysics Data System (ADS)

Zhai, P.; He, R.

2016-02-01

Mode waters are upper-ocean water masses with nearly uniform water properties over a thickness of a few hundred meters. Subduction of mode waters plays an important role in changing atmospheric and oceanic long-term variability because they store "memory" of wintertime air-sea interaction. In this study, we investigated dynamic processes associated with subduction of the Eighteen Degree Water (EDW, the principal mode water) in the subtropical Northwest Atlantic during January to June 2007. Numerical simulations of the temporal and spatial evolutions of EDW were performed using both uncoupled (ocean only) and air-sea coupled configurations and results were contrasted. We find the coupled simulation produced deeper mixed layer depth, stronger eddy kinetic energy, and larger subduction areas than their counterparts in the uncoupled ocean simulation. In both configurations, mesoscale eddies enhance the total subduction and eddy-induced subduction has the same order as the mean component. Resolving strong air-sea coupling and mesoscale eddies is therefore important for understanding EDW dynamics.

A Naturalistic Study of Referred Children and Adolescents with Obsessive-Compulsive Disorder.

ERIC Educational Resources Information Center

Masi, Gabriele; Millepiedi, Stefania; Mucci, Maria; Bertini, Nicoletta; Milantoni, Luca; Arcangeli, Francesca

2005-01-01

Objective: To report on clinical features, comorbidity, and response to pharmacotherapy in children and adolescents with obsessive-compulsive disorder (OCD) naturalistically followed and treated with serotonin reuptake inhibitors (SRIs). Method: A consecutive series of 94 patients (65 males, 29 females, age 13.6 [+ or -] 2.8 years), referred in…

26 CFR 1.263A-9 - The avoided cost method.

Code of Federal Regulations, 2012 CFR

2012-04-01

... least four times during the taxable year (or consecutive 12-month period in the case of a short taxable... computation period with two measurement dates within each computation period. Corporation X must identify... date during the period and dividing the sum of these amounts by two. Under paragraph (c)(5)(iii)(C) of...

26 CFR 1.263A-9 - The avoided cost method.

Code of Federal Regulations, 2013 CFR

2013-04-01

... least four times during the taxable year (or consecutive 12-month period in the case of a short taxable... computation period with two measurement dates within each computation period. Corporation X must identify... date during the period and dividing the sum of these amounts by two. Under paragraph (c)(5)(iii)(C) of...

26 CFR 1.263A-9 - The avoided cost method.

Code of Federal Regulations, 2011 CFR

2011-04-01

... least four times during the taxable year (or consecutive 12-month period in the case of a short taxable... computation period with two measurement dates within each computation period. Corporation X must identify... date during the period and dividing the sum of these amounts by two. Under paragraph (c)(5)(iii)(C) of...

Theories of Mind in Transition: A Microgenetic Study of the Development of False Belief Understanding

ERIC Educational Resources Information Center

Amsterlaw, Jennifer; Wellman, Henry M.

2006-01-01

Microgenetic methods were used to document young children's (N = 36; M age = 3;5) acquisition of false belief (FB) understanding and investigate developmental mechanisms. A control group received no experience with FB; 2 other groups received microgenetic sessions designed to promote FB understanding. Over consecutive weeks, microgenetic groups…