Heat exchange apparatus

DOEpatents

Degtiarenko, Pavel V.

2003-08-12

A heat exchange apparatus comprising a coolant conduit or heat sink having attached to its surface a first radial array of spaced-apart parallel plate fins or needles and a second radial array of spaced-apart parallel plate fins or needles thermally coupled to a body to be cooled and meshed with, but not contacting the first radial array of spaced-apart parallel plate fins or needles.

Injecting Drug Users Retention in Needle-Exchange Program and its Determinants in Iran Prisons

PubMed Central

Shahbazi, Mohammad; Farnia, Marzieh; Moradi, Ghobad; Karamati, Mohammadreza; Paknazar, Fatemeh; Mirmohammad Khani, Majid

2015-01-01

Background: Participation and to stay in a health program depends on many factors. One of these programs is Needle Exchange Program (NEP) in prisons. Objectives: The current study aimed to evaluate the retention of injecting drug prisoners and find the related factors in Iran. Patients and Methods: This cohort study analyzed data about injecting drug male prisoners who were participated in NEP in three Iranian prisons. Data was collected from October 2009 to June 2010. A proper approach of survival analyses including Kaplan-Meier method, Log-Rank test, and Cox Proportional Hazard Model were used to evaluate Injecting Drug Users (IDUs) retention in NEP and its determinants. Results: Out of 320 prisoners, 167 were from Isfahan Central Prison, 82 from Tehran-Ghezel-Hesar Prison, and 71 from Hamadan Central Prison. Two-hundred and fifty prisoners (78.4%) had history of drug injection; and drug injection was the most common choice for 115 persons (35.9%). Participants were followed up for 29 weeks, the mean (SD) time of retention in the program was 24.1 (0.6) weeks. There was a significant relationship between age, number of used needles per week, duration of addiction, age of addiction onset, as well as imprisonment age, main method of drug use, type of main using drug, Hepatitis B Virus (HBV) infection, job status, reason of arrestment, history of involvement in harm reduction programs, and the length of retention (P < 0.05). There was also significant relationship between the history of using harm reduction services (P = 0.007), tattooing (P = 0.01), longer durations of addiction (P = 0.048), and retention. Conclusions: Tattooing and longer duration of addiction were two important factors that significantly increased retention in the program. In contrast, history of using harm reduction services was the factor that decreased persistence. The risk of quitting the program may decrease about 68% in those who did not involve in harm reduction programs. PMID:26405681

Micro-fluid exchange coupling apparatus

NASA Technical Reports Server (NTRS)

Johnson, J. E., Jr.; Swartz, P. F. (Inventor)

1980-01-01

In a macro-fluid exchange, a hollow needle, such as a syringe needle, is provided for penetrating the fluid conduit of the animal. The syringe needle is coupled to a plenum chamber having an inlet and outlet port. The plenum chamber is coupled to the syringe needle via the intermediary of a standard quick disconnect coupling fitting. The plenum chamber is carried at the end of a drive rod which is coupled to a micrometer drive head. The micrometer drive head is slidably and pivotably coupled to a pedestal for adjusting the height and angle of inclination of the needle relative to a reference base support. The needle is positioned adjacent to the incised trachea or a blood vessel of a small animal and the micrometer drive head is operated for penetrating the fluid conduit of the animal.

The New York Needle Trial: the politics of public health in the age of AIDS.

PubMed Central

Anderson, W

1991-01-01

During the past 5 years, the exchange of sterile needles and syringes for dirty injecting equipment has gained increasing acceptance outside the United States as a potential means of reducing the transmission of the human immunodeficiency virus (HIV) among intravenous drug users. This article describes the controversy over attempts to establish a needle and syringe exchange scheme in New York City between 1985 and 1991. The response to a health crisis is used as an indicator of patterns of social and institutional practice. Advocates of needle exchanges had reached a stalemate with the promoters of law enforcement, and the strategic reformulation of the policy problem in terms of the research process seemed to offer a solution. The article discusses the practical limitations on designing and carrying out a controversial health promotion policy; the use (under constraint) of a restrictive research process to constitute--rather than simply to guide or monitor--public policy; and the potential ethical hazards of health professionals' seeking a polemical recourse to the clinical trial. The efforts to establish a needle exchange in New York thus illustrate more general problems for AIDS prevention. Images p1511-a p1512-a p1513-a PMID:1951815

CO2 AND O3 ALTER PHOTOSYNTHESIS AND WATER VAPOR EXCHANGE FOR PINUS PONDEROSA NEEDLES

EPA Science Inventory

1. Effects of CO2 and O3 were determined for a key component of ecosystem carbon and water cycling: needle gas exchange (photosynthesis, conductance, transpiration and water use efficiency). The measurements were made on Pinus ponderosa seedlings grown in outdoor, sunlit, mesoc...

Police Encounters Among Needle Exchange Clients in Baltimore: Drug Law Enforcement as a Structural Determinant of Health.

PubMed

Beletsky, Leo; Cochrane, Jess; Sawyer, Anne L; Serio-Chapman, Chris; Smelyanskaya, Marina; Han, Jennifer; Robinowitz, Natanya; Sherman, Susan G

2015-09-01

We piloted a monitoring mechanism to document police encounters around programs targeting people who inject drugs (PWID), and assessed their demographic predictors at 2 Baltimore, Maryland, needle exchange program (NEP) sites. In a brief survey, 308 clients quantified, characterized, and sited recent police encounters. Multivariate linear regression determined encounter predictors, and we used geocoordinate maps to illustrate clusters. Within the past 6 months, clients reported a median of 3 stops near NEP sites (interquartile range [IQR] = 0-7.5) and a median of 1 arrest in any location (IQR = 0-2). Three respondents reported police referral to the NEP. Being younger (P = .009), being male (P = .033), and making frequent NEP visits (P = .02) were associated with reported police stops. Among clients reporting arrest or citation for syringe possession, Whites were significantly less likely than non-Whites to report being en route to or from an NEP (P < .001). Reported encounters were clustered around NEPs. Systematic surveillance of structural determinants of health for PWID proved feasible when integrated into service activities. Improved monitoring is critical to informing interventions to align policing with public health, especially among groups subject to disproportionate levels of drug law enforcement.

A spatial model for predicting effects of climate change on swiss needle cast disease severity in Pacific Northwest forests

Treesearch

Jeffrey K. Stone; Leonard B. Coop; Daniel K. Manter

2010-01-01

Swiss needle cast disease of Douglas-fir (Pseudotsuga menziesii) is caused by the ascomycete fungus Phaeocryptopus gaeumannii. Symptoms of the disease are foliage chlorosis and premature needle abscission due to occlusion of stomata by the ascocarps of the pathogen, resulting in impaired needle gas exchange. Severe defoliation...

Police Encounters Among Needle Exchange Clients in Baltimore: Drug Law Enforcement as a Structural Determinant of Health

PubMed Central

Cochrane, Jess; Sawyer, Anne L.; Serio-Chapman, Chris; Smelyanskaya, Marina; Han, Jennifer; Robinowitz, Natanya; Sherman, Susan G.

2015-01-01

Objectives. We piloted a monitoring mechanism to document police encounters around programs targeting people who inject drugs (PWID), and assessed their demographic predictors at 2 Baltimore, Maryland, needle exchange program (NEP) sites. Methods. In a brief survey, 308 clients quantified, characterized, and sited recent police encounters. Multivariate linear regression determined encounter predictors, and we used geocoordinate maps to illustrate clusters. Results. Within the past 6 months, clients reported a median of 3 stops near NEP sites (interquartile range [IQR] = 0–7.5) and a median of 1 arrest in any location (IQR = 0–2). Three respondents reported police referral to the NEP. Being younger (P = .009), being male (P = .033), and making frequent NEP visits (P = .02) were associated with reported police stops. Among clients reporting arrest or citation for syringe possession, Whites were significantly less likely than non-Whites to report being en route to or from an NEP (P < .001). Reported encounters were clustered around NEPs. Conclusions. Systematic surveillance of structural determinants of health for PWID proved feasible when integrated into service activities. Improved monitoring is critical to informing interventions to align policing with public health, especially among groups subject to disproportionate levels of drug law enforcement. PMID:26180948

Relationship between canopy structure, microclimate, and Swiss needle cast severity among different ages of Douglas-fir forests

EPA Science Inventory

Swiss needle cast (SNC) is an endemic disease of Douglas-fir caused by Phaeocryptopus gaeumannii. The fungus infects newly emerged needles between May and August. As the fungus develops, its fruiting bodies (pseudothecia) block the stomata and inhibit gas exchange, reducing the p...

Building a city wide service for exchanging needles and syringes.

PubMed Central

Gruer, L; Cameron, J; Elliott, L

1993-01-01

How best can injecting drug misusers obtain clean injecting equipment in a city where drug injecting is widespread? An exchange service for needles and syringes throughout Glasgow has been established in health centres and clinics in the evening. Over the past four years seven new exchanges have been opened and over 2700 injecting drug misusers have attended. Attendances rose from under 1000 in 1988 to 28,000 in 1992. The exchanges also provide a wide range of other health and social services. Public hostility to the exchanges has abated. During the same period equipment sharing in the city diminished and the observed prevalence of HIV among injecting drug misusers stabilised at around 1%. Images FIG 1 FIG 2 FIG 3 PMID:8518609

Predictors of needle exchange program utilization during its implementation and expansion in Tijuana, Mexico.

PubMed

Smith, Danielle M; Werb, Dan; Abramovitz, Daniela; Magis-Rodriguez, Carlos; Vera, Alicia; Patterson, Thomas L; Strathdee, Steffanie A

2016-03-01

Until the early 2000s, there was only one needle exchange program (NEP) offered in Mexico. In 2004, the second Mexican NEP opened in Tijuana, but its utilization has not been studied. We studied predictors of initiating NEP during its early expansion in Tijuana, Mexico. From April 2006 to April 2007, people who inject drugs (PWID) residing in Tijuana who had injected within the last month were recruited using respondent-driven sampling. Weighted Poisson regression incorporating generalized estimating equations was used to identify predictors of initiating NEP, while accounting for correlation between recruiter and recruits. NEP uptake increased from 20% at baseline to 59% after 6 months. Among a subsample of PWID not accessing NEP at baseline (n = 480), 83% were male and median age was 37 years (Interquartile Range: 32-43). At baseline, 4.4% were HIV-infected and 5.9% had syphilis titers >1:8. In multivariate models, factors associated with NEP initiation (p < .05) were attending shooting galleries (Adjusted Relative Risk [ARR]: 1.54); arrest for track-marks (ARR: 1.38); having a family member that ever used drugs (ARR: 1.37); and having a larger PWID network (ARR: 1.01 per 10 persons). NEP initiation was inversely associated with obtaining syringes at pharmacies (ARR: .56); earning >2500 pesos/month (ARR: .66); and reporting needle sharing (ARR: .71). Uptake of NEP expansion in Tijuana was vigorous among PWID. We identified a range of factors that influenced the likelihood of NEP initiation, including police interaction. These findings have important implications for the scale-up of NEP in Mexico. © American Academy of Addiction Psychiatry.

Measurement of backbone hydrogen-deuterium exchange in the type III secretion system needle protein PrgI by solid-state NMR

NASA Astrophysics Data System (ADS)

Chevelkov, Veniamin; Giller, Karin; Becker, Stefan; Lange, Adam

2017-10-01

In this report we present site-specific measurements of amide hydrogen-deuterium exchange rates in a protein in the solid state phase by MAS NMR. Employing perdeuteration, proton detection and a high external magnetic field we could adopt the highly efficient Relax-EXSY protocol previously developed for liquid state NMR. According to this method, we measured the contribution of hydrogen exchange on apparent 15N longitudinal relaxation rates in samples with differing D2O buffer content. Differences in the apparent T1 times allowed us to derive exchange rates for multiple residues in the type III secretion system needle protein.

Barriers and Potential Improvements for Needle and Syringe Exchange Programs (NSPs) in China: A Qualitative Study from Perspectives of Both Health and Public Security Sectors

PubMed Central

Chow, Eric P. F.; Jing, Jun; Zheng, Jun; Zhao, Junshi; Zhang, Lei

2015-01-01

This study explores the acceptability, the barriers to the implementation of needle and syringe exchange programs (NSPs) and the potential improvement strategies in China from the perspectives of governmental health and public security officials. Purposive sampling was used for recruitment of participants who had been involved in NSPs implementation. Semi-Structured individual interviews were conducted in Mandarin to address three aspects of NSPs: (1) participants’ attitudes towards NSPs, (2) participants’ opinions on the effectiveness and barriers of NSPs, and (3) suggestions for improving the program. Content analysis was used to analyse the translated interview data. A total of 68 participants from 12 Hunan counties were interviewed (34 from each of the Bureau of Health and the Narcotic Division). Both groups recognised the importance and effectiveness of NSPs in HIV prevention, but public security officials regarded NSPs as a temporary intervention in place of punitive measures. Most health officials (32/34) regarded the main barriers to its implementation as administrative and structural, whereas participants from Narcotics Division (n=24) questioned the legitimacy of NSPs and concerned about the poor management of drug users’ risk behaviours. Close cooperation between the health and public security sectors, engagement of the drug user community and an enabling policy environment were reportedly to be critical for potential improvements of NSPs in China. Misconceptions about NSPs encourage drug users’ addictive behaviour, and an unclear leadership and insufficient support de-motivate the participants from the Bureau of Health and the Narcotics Division to actively support the program implementation. PMID:26114556

Rise in needle sharing among injection drug users in Pakistan during the Afghanistan war.

PubMed

Strathdee, Steffanie A; Zafar, Tariq; Brahmbhatt, Heena; Baksh, Ahmed; ul Hassan, Salman

2003-07-20

The war in Afghanistan in 2001 may have had direct or indirect effects on drug users' behaviors in nearby Pakistan. We studied drug use patterns and correlates of needle sharing among injection drug users (IDUs) in Lahore, Pakistan, before and after the beginning of the Afghanistan war. Between August and October 2001, 244 drug users registering for needle exchange and other services underwent an interviewer-administered survey on sociodemographics, drug use and HIV/AIDS awareness. chi(2)-tests were used to compare drug use behaviors among subjects interviewed before and after October 6th, 2001, coinciding with the start of the Afghanistan war. Correlates of needle sharing among IDUs were identified using logistic regression. Comparing IDUs interviewed before and after October 6th, 2001, levels of needle sharing were significantly higher after the war (56% versus 76%, respectively; P=0.02). Factors independently associated with needle sharing included registering after the war began (adjusted odds ratio, AOR=3.76 (95% CI: 1.23-11.48)), being married (AOR=0.36), being homeless (AOR=3.91), having been arrested (AOR=6.00), and re-using syringes (AOR=6.19). Expansion of needle exchange, drug treatment and supportive services is urgently needed to avoid an explosive HIV epidemic in Pakistan.

Needle and Syringe Cleaning Practices among Injection Drug Users.

ERIC Educational Resources Information Center

Fisher, Dennis G.; Harbke, Colin R.; Canty, John R.; Reynolds, Grace L.

2002-01-01

Evaluates the effect of needle exchange on the bleach-mediated disinfection (BMD) practices of 176 needle and syringe sharing injection drug users (IDUs). Results reveal that IDUs who traded sex for money or drugs were less likely to practice BMD, and IDUs who reported a reduced number of sex partners were more likely to practice BMD. (Contains 36…

Occupational Safety in the Age of the Opioid Crisis: Needle Stick Injury among Baltimore Police.

PubMed

Cepeda, Javier A; Beletsky, Leo; Sawyer, Anne; Serio-Chapman, Chris; Smelyanskaya, Marina; Han, Jennifer; Robinowitz, Natanya; Sherman, Susan G

2017-02-01

At a time of resurgence in injection drug use and injection-attributable infections, needle stick injury (NSI) risk and its correlates among police remain understudied. In the context of occupational safety training, a convenience sample of 771 Baltimore city police officers responded to a self-administered survey. Domains included NSI experience, protective behaviors, and attitudes towards syringe exchange programs. Sixty officers (8%) reported lifetime NSI. Officers identifying as Latino or other race were almost three times more likely (aOR 2.58, 95% CI 1.12-5.96) to have experienced NSI compared to whites, after adjusting for potential confounders. Findings highlight disparate burdens of NSIs among officers of color, elevating risk of hepatitis, HIV, and trauma. Training, equipment, and other measures to improve occupational safety are critical to attracting and safeguarding police, especially minority officers.

Choosing HIV Counseling and Testing Strategies for Outreach Settings: A Randomized Trial.

PubMed

Spielberg, Freya; Branson, Bernard M; Goldbaum, Gary M; Lockhart, David; Kurth, Ann; Rossini, Anthony; Wood, Robert W

2005-03-01

In surveys, clients have expressed preferences for alternatives to traditional HIV counseling and testing. Few data exist to document how offering such alternatives affects acceptance of HIV testing and receipt of test results. This randomized controlled trial compared types of HIV tests and counseling at a needle exchange and 2 bathhouses to determine which types most effectively ensured that clients received test results. Four alternatives were offered on randomly determined days: (1) traditional test with standard counseling, (2) rapid test with standard counseling, (3) oral fluid test with standard counseling, and (4) traditional test with choice of written pretest materials or standard counseling. Of 17,010 clients offered testing, 7014 (41%) were eligible; of those eligible, 761 (11%) were tested: 324 at the needle exchange and 437 at the bathhouses. At the needle exchange, more clients accepted testing (odds ratio [OR] = 2.3; P < 0.001) and received results (OR = 2.6; P < 0.001) on days when the oral fluid test was offered compared with the traditional test. At the bathhouses, more clients accepted oral fluid testing (OR = 1.6; P < 0.001), but more clients overall received results on days when the rapid test was offered (OR = 1.9; P = 0.01). Oral fluid testing and rapid blood testing at both outreach venues resulted in significantly more people receiving test results compared with traditional HIV testing. Making counseling optional increased testing at the needle exchange but not at the bathhouses.

Relationships among foliar chemistry, foliar polyamines, and soil chemistry in red spruce trees growing across the northeastern United States

USGS Publications Warehouse

Minocha, R.; Shortle, W.C.; Lawrence, G.B.; David, M.B.; Minocha, S.C.

1997-01-01

Forest trees are constantly exposed to various types of natural and anthropogenic stressors. A major long-term goal of our research is to develop a set of early physiological and biochemical markers of stress in trees before the appearance of visual symptoms. Six red spruce (Picea rubens Sarg.) stands from the northeastern United States were selected for collection of soil and foliage samples. All of the chosen sites had soil solution pH values below 4.0 in the Oa horizon but varied in their geochemistry. Some of these sites were apparently under some form of environmental stress as indicated by a large number of dead and dying red spruce trees. Samples of soil and needles (from apparently healthy red spruce trees) were collected from these sites four times during a two-year period. The needles were analyzed for perchloric acid-soluble polyamines and exchangeable inorganic ions. Soil and soil solution samples from the Oa and B horizons were analyzed for their exchange chemistry. The data showed a strong positive correlation between Ca and Mg concentrations in the needles and in the Oa horizon of the soil. However, needles from trees growing on relatively Ca-rich soils with a low exchangeable Al concentration and a low Al:Ca soil solution ratio had significantly lower concentrations of putrescine and spermidine than those growing on Ca-poor soils with a high exchangeable Al concentration and a high Al:Ca soil solution in the Oa horizon. The magnitude of this change was several fold higher for putrescine concentrations than for spermidine concentrations. Neither putrescine nor spermidine were correlated with soil solution Ca, Mg, and Al concentrations in the B horizon. The putrescine concentrations of the needles always correlated significantly with exchangeable Al (r2=0.73, p???0.05) and still solution Al:Ca ratios (r2=0.91, p???0.01) of the Oa horizon. This suggests that in conjunction with soil chemistry, putrescine and/or spermidine may be used as a potential early indicator of Al stress before the appearance of visual symptoms in red spruce trees.

The Prison Economy of Needles and Syringes: What Opportunities Exist for Blood Borne Virus Risk Reduction When Prices Are so High?

PubMed

Treloar, Carla; McCredie, Luke; Lloyd, Andrew R

2016-01-01

A formal Needle and Syringe Program (NSP) is not provided in Australian prisons. Injecting equipment circulates in prisons as part of an informal and illegal economy. This paper examined how this economy generates blood-borne virus (BBV) risk and risk mitigation opportunities for inmates. The HITS-p cohort recruited New South Wales inmates who had reported ever injecting drugs and who had a negative HCV serological test within 12 months prior to enrolment. For this study, qualitative interviews were conducted with 30 participants enrolled in HITS-p. Participants included 10 women and were incarcerated in 12 prisons. A needle/syringe was nominated as being typically priced in the 'inside' prison economy at $100-$150, with a range of $50-$350. Purchase or hire of equipment was paid for in cash (including transactions that occurred outside prison) and in exchange for drugs and other commodities. A range of other resources was required to enable successful needle/syringe economies, especially relationships with visitors and other prisoners, and violence to ensure payment of debts. Strategies to mitigate BBV risk included retaining one needle/syringe for personal use while hiring out others, keeping drug use (and ownership of equipment) "quiet", stealing used equipment from the prison health clinic, and manufacture of syringes from other items available in the prison. The provision of prison NSP would disrupt the inside economies built around contraband needles/syringes, as well as minimise BBV risk. However, any model of prison NSP should be interrogated for any unanticipated markets that could be generated as a result of its regulatory practices.

The Prison Economy of Needles and Syringes: What Opportunities Exist for Blood Borne Virus Risk Reduction When Prices Are so High?

PubMed Central

Treloar, Carla; McCredie, Luke; Lloyd, Andrew R.

2016-01-01

Aim A formal Needle and Syringe Program (NSP) is not provided in Australian prisons. Injecting equipment circulates in prisons as part of an informal and illegal economy. This paper examined how this economy generates blood-borne virus (BBV) risk and risk mitigation opportunities for inmates. Method The HITS-p cohort recruited New South Wales inmates who had reported ever injecting drugs and who had a negative HCV serological test within 12 months prior to enrolment. For this study, qualitative interviews were conducted with 30 participants enrolled in HITS-p. Participants included 10 women and were incarcerated in 12 prisons. Results A needle/syringe was nominated as being typically priced in the ‘inside’ prison economy at $100-$150, with a range of $50-$350. Purchase or hire of equipment was paid for in cash (including transactions that occurred outside prison) and in exchange for drugs and other commodities. A range of other resources was required to enable successful needle/syringe economies, especially relationships with visitors and other prisoners, and violence to ensure payment of debts. Strategies to mitigate BBV risk included retaining one needle/syringe for personal use while hiring out others, keeping drug use (and ownership of equipment) “quiet”, stealing used equipment from the prison health clinic, and manufacture of syringes from other items available in the prison. Conclusions The provision of prison NSP would disrupt the inside economies built around contraband needles/syringes, as well as minimise BBV risk. However, any model of prison NSP should be interrogated for any unanticipated markets that could be generated as a result of its regulatory practices. PMID:27611849

Factors associated with drug-related harms related to policing in Tijuana, Mexico

PubMed Central

2011-01-01

Objective To assess factors associated with drug-related harms related to policing among injection drug users (IDUs) in Tijuana, Mexico. Methods IDUs who were over 18 years old and had injected drugs within the last six months were recruited via respondent-driven sampling and underwent questionnaires and testing for HIV (human immunodeficiency virus), syphilis and TB (tuberculosis). Random effects logistic regression was used to simultaneously model factors associated with five drug-related harms related to policing practices in the prior six months (i.e., police led them to rush injections; affected where they bought drugs; affected locations where they used drugs; feared that police will interfere with their drug use; receptive syringe sharing). Results Of 727 IDUs, 85% were male; median age was 38 years. Within the last 6 months, 231 (32%) of IDUs reported that police had led them to rush injections, affected where they bought or used drugs or were very afraid police would interfere with their drug use, or shared syringes. Factors independently associated with drug-related harms related to policing within the last six months included: recent arrest, homelessness, higher frequencies of drug injection, use of methamphetamine, using the local needle exchange program and perceiving a decrease in the purity of at least one drug. Conclusions IDUs who experienced drug-related harms related to policing were those who were most affected by other micro and macro influences in the physical risk environment. Police education programs are needed to ensure that policing practices do not exacerbate risky behaviors or discourage protective behaviors such as needle exchange program use, which undermines the right to health for people who inject drugs. PMID:21477299

The influence of fuelbed properties on moisture drying rates and timelags of longleaf pine litter

Treesearch

Ralph M. Nelson; J. Kevin Hiers

2008-01-01

Fire managers often model pine needles as 1 h timelag fuels, but fuelbed properties may significantly change the rate at which needles exchange moisture with the atmosphere. The problem of determining whether moisture loss from fine fuels is being controlled by individual particles or by the fuelbed remains unresolved. Results from this laboratory experiment indicate...

[Risk reduction and drug use in detention: study about the detainees of Liancourt Penitentiary].

PubMed

Sannier, Olivier; Verfaillie, Florent; Lavielle, Dorothée

2012-07-01

The prison population is drug users. Recent debates around the provision of devices to reduce the risks associated with drug use (syringe exchange programs and snort kit) lead us to question local practices of the prison population. An anonymous questionnaire was offered to the prison population of the Liancourt penitentiary. The questions addressed the use of drugs before and during incarceration, knowledge of HIV and B and C hepatitis status, taking an opiate substitution treatment and advice on the implementation of syringe exchange programs and snort kit. A percentage of 54.4 of the prisoners responded to the questionnaire. An amount of 60.1 % of respondents consumed at least one drug before incarceration and 43.6 % of respondents consumed at least one drug during their incarceration. Cannabis was the most consumed drug before and during incarceration. Barely half of respondents reported knowing their HIV and hepatitis B and C status. Over 10 % of respondents said they were interesting in establishing needle exchange programs or snort kit. The prison concentrate drug users and is not a repressive tool of efficient risk reduction. The strategies implemented by the medical unit of Liancourt prison require adaptations that warrant development of health resources. Then, only new tools to reduce risks associated with drug use can be established. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Lack of photosynthetic or stomatal regulation after 9 years of elevated [CO2] and 4 years of soil warming in two conifer species at the alpine treeline.

PubMed

Streit, Kathrin; Siegwolf, Rolf T W; Hagedorn, Frank; Schaub, Marcus; Buchmann, Nina

2014-02-01

Alpine treelines are temperature-limited vegetation boundaries. Understanding the effects of elevated [CO2 ] and warming on CO2 and H2 O gas exchange may help predict responses of treelines to global change. We measured needle gas exchange of Larix decidua Mill. and Pinus mugo ssp. uncinata DC trees after 9 years of free air CO2 enrichment (575 µmol mol(-1) ) and 4 years of soil warming (+4 °C) and analysed δ(13) C and δ(18) O values of needles and tree rings. Tree needles under elevated [CO2 ] showed neither nitrogen limitation nor end-product inhibition, and no down-regulation of maximal photosynthetic rate (Amax ) was found. Both tree species showed increased net photosynthetic rates (An ) under elevated [CO2 ] (L. decidua: +39%; P. mugo: +35%). Stomatal conductance (gH2O ) was insensitive to changes in [CO2 ], thus transpiration rates remained unchanged and intrinsic water-use efficiency (iWUE) increased due to higher An . Soil warming affected neither An nor gH2O . Unresponsiveness of gH2O to [CO2 ] and warming was confirmed by δ(18) O needle and tree ring values. Consequently, under sufficient water supply, elevated [CO2 ] induced sustained enhancement in An and lead to increased C inputs into this ecosystem, while soil warming hardly affected gas exchange of L. decidua and P. mugo at the alpine treeline. © 2013 John Wiley & Sons Ltd.

Overcoming barriers to HIV testing: preferences for new strategies among clients of a needle exchange, a sexually transmitted disease clinic, and sex venues for men who have sex with men.

PubMed

Spielberg, Freya; Branson, Bernard M; Goldbaum, Gary M; Lockhart, David; Kurth, Ann; Celum, Connie L; Rossini, Anthony; Critchlow, Cathy W; Wood, Robert W

2003-03-01

To determine strategies to overcome barriers to HIV testing among persons at risk. We developed a survey that elicited testing motivators, barriers, and preferences for new strategies among 460 participants at a needle exchange, three sex venues for men who have sex with men, and a sexually transmitted disease clinic. Barriers to testing included factors influenced by individual concern (fear and discrimination); by programs, policies, and laws (named reporting and inability to afford treatment); and by counseling and testing strategies (dislike of counseling, anxiety waiting for results, and venipuncture). The largest proportions of participants preferred rapid testing strategies, including clinic-based testing (27%) and home self-testing (20%); roughly equal proportions preferred oral fluid testing (18%), urine testing (17%), and standard blood testing (17%). One percent preferred home specimen collection. Participants who had never tested before were significantly more likely to prefer home self-testing compared with other strategies. Blacks were significantly more likely to prefer urine testing. Strategies for improving acceptance of HIV counseling and testing include information about access to anonymous testing and early treatment. Expanding options for rapid testing, urine testing, and home self-testing; providing alternatives to venipuncture; making pretest counseling optional; and allowing telephone results disclosure may encourage more persons to learn their HIV status.

Mortality and causes of death among people who inject amphetamine: A long-term follow-up cohort study from a needle exchange program in Sweden.

PubMed

Åhman, Ada; Jerkeman, Anna; Blomé, Marianne Alanko; Björkman, Per; Håkansson, Anders

2018-07-01

Abuse of amphetamines is a worldwide problem with around 34 million users, and amphetamine is commonly used by people who inject drugs (PWID). Despite this, there is relatively little research on mortality and cause of death among people who use amphetamines primarily. The present study aimed to examine mortality and causes of death among people who inject amphetamine, and compare these results to the general population. This retrospective cohort study was based on data from The Malmö Needle Exchange Program in Sweden (MNEP) and on data from The Swedish National Cause of Death Register. Participants in the MNEP, between 1987 and 2011, with registered national identity number and amphetamine as their primary drug of injection use, were included in the study. Standardized mortality ratios (SMR) was calculated for overall mortality and categories of causes of death. 2019 individuals were included (mean follow-up-time 13.7 years [range 0.02-24.2 years], a total of 27,698 person-years). Of the 448 deceased, 428 had a registered cause of death. The most common causes of death were external causes (n = 162, 38%), followed by diseases of the circulatory system (n = 67, 16%). SMR were significantly elevated (8.3, 95% CI [7.5-9.1]) for the entire study population, and for every category of causes of death respectively. People injecting amphetamine as a primary drug were found to have significantly elevated mortality compared with the general population, with high rates of both external and somatic causes of death. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

"We want a living solution": views of harm reduction programs in black US Communities.

PubMed

Eversman, Michael H

2015-01-01

Illicit drug use in the US remains concerning, with injection drug use linked to transmission of blood-borne diseases as HIV/AIDS; persons of color, including Black Americans, experience disproportionately higher transmission rates. Harm reduction programs such as methadone and needle- and syringe-exchange (NEP/SEP) are empirically demonstrated to reduce HIV transmission, yet are believed largely opposed by Black communities. Using interview data from 21 service providers of substance abuse and related service organizations located in and/or serving predominantly populations of color, this study explored perceptions of harm reduction programming for illicit drugs and race in the US. Criticizing each program for unique reasons, respondents deemed them largely inadequate and inappropriate responses to community drug problems. While some believed these programs worsen Black communities, others believed they are becoming more accepted there. Views were informed by racial dynamics surrounding drugs in society, burdens borne by program host communities, and racialized stereotypes of drug use.

Options for reducing HIV transmission related to the dead space in needles and syringes.

PubMed

Zule, William A; Pande, Poonam G; Otiashvili, David; Bobashev, Georgiy V; Friedman, Samuel R; Gyarmathy, V Anna; Des Jarlais, Don C

2018-01-15

When shared by people who inject drugs, needles and syringes with different dead space may affect the probability of HIV and hepatitis C virus (HCV) transmission differently. We measured dead space in 56 needle and syringe combinations obtained from needle and syringe programs across 17 countries in Europe and Asia. We also calculated the amounts of blood and HIV that would remain in different combinations following injection and rinsing. Syringe barrel capacities ranged from 0.5 to 20 mL. Needles ranged in length from 8 to 38 mm. The average dead space was 3 μL in low dead space syringes with permanently attached needles, 13 μL in high dead space syringes with low dead space needles, 45 μL in low dead space syringes with high dead space needles, and 99 μL in high dead space syringes with high dead space needles. Among low dead space designs, calculated volumes of blood and HIV viral burden were lowest for low dead space syringes with permanently attached needles and highest for low dead space syringes with high dead space needles. The dead space in different low dead space needle and syringe combinations varied substantially. To reduce HIV transmission related to syringe sharing, needle and syringe programs need to combine this knowledge with the needs of their clients.

From West End to Eastside: The Vancouver HIV/AIDS Epidemic, 1983-2013.

PubMed

Perry, Taylor

2016-01-01

Traditional histories of AIDS have used a few major American urban centres as proxies for the North American epidemic more broadly and have tended to frame the epidemic as a quintessentially gay and American experience. A careful examination of how the epidemic unfolded in Vancouver, British Columbia, however, reveals considerable differences, including the relative absence of local gay activist traditions prior to HIV/AIDS and the relative prominence of interventions such as Insite, North America's first sanctioned needle exchange program and safe injection site. An investigation of such differences emphasizes the local character of the epidemic and adds a Canadian perspective to the existing AIDS historiography.

Irrigant flow within a prepared root canal using various flow rates: a Computational Fluid Dynamics study.

PubMed

Boutsioukis, C; Lambrianidis, T; Kastrinakis, E

2009-02-01

To study using computer simulation the effect of irrigant flow rate on the flow pattern within a prepared root canal, during final irrigation with a syringe and needle. Geometrical characteristics of a side-vented endodontic needle and clinically realistic flow rate values were obtained from previous and preliminary studies. A Computational Fluid Dynamics (CFD) model was created using FLUENT 6.2 software. Calculations were carried out for five selected flow rates (0.02-0.79 mL sec(-1)) and velocity and turbulence quantities along the domain were evaluated. Irrigant replacement was limited to 1-1.5 mm apical to the needle tip for all flow rates tested. Low-Reynolds number turbulent flow was detected near the needle outlet. Irrigant flow rate affected significantly the flow pattern within the root canal. Irrigation needles should be placed to within 1 mm from working length to ensure fluid exchange. Turbulent flow of irrigant leads to more efficient irrigant replacement. CFD represents a powerful tool for the study of irrigation.

Pelton turbine Needle erosion prediction based on 3D three- phase flow simulation

NASA Astrophysics Data System (ADS)

Chongji, Z.; Yexiang, X.; Wei, Z.; Yangyang, Y.; Lei, C.; Zhengwei, W.

2014-03-01

Pelton turbine, which applied to the high water head and small flow rate, is widely used in the mountainous area. During the operation period the sediment contained in the water does not only induce the abrasion of the buckets, but also leads to the erosion at the nozzle which may damage the needle structure. The nozzle and needle structure are mainly used to form high quality cylindrical jet and increase the efficiency of energy exchange in the runner to the most. Thus the needle erosion will lead to the deformation of jet, and then may cause the efficiency loss and cavitation. The favourable prediction of abrasion characteristic of needle can effectively guide the optimization design and maintenance of needle structure. This paper simulated the unsteady three-dimensional multi-phase flow in the nozzle and injected jet flow. As the jet containing water and sediment is injected into the free atmosphere air with high velocity, the VOF model was adopted to predict the water and air flow. The sediment is simplified into round solid particle and the discrete particle model (DPM) was employed to predict the needle abrasion characteristic. The sand particle tracks were analyzed to interpret the mechanism of sand erosion on the needle surface. And the numerical result of needle abrasion was obtained and compared with the abrasion field observation. The similarity of abrasion pattern between the numerical results and field observation illustrated the validity of the 3D multi-phase flow simulation method.

Coordination of leaf structure and gas exchange along a height gradient in a tall conifer.

PubMed

Woodruff, D R; Meinzer, F C; Lachenbruch, B; Johnson, D M

2009-02-01

The gravitational component of water potential and frictional resistance during transpiration lead to substantial reductions in leaf water potential (Psi(l)) near the tops of tall trees, which can influence both leaf growth and physiology. We examined the relationships between morphological features and gas exchange in foliage collected near the tops of Douglas-fir (Pseudotsuga menziesii (Mirb.) Franco) trees of different height classes ranging from 5 to 55 m. This sampling allowed us to investigate the effects of tree height on leaf structural characteristics in the absence of potentially confounding factors such as irradiance, temperature, relative humidity and branch length. The use of cut foliage for measurement of intrinsic gas-exchange characteristics allowed identification of height-related trends without the immediate influences of path length and gravity. Stomatal density, needle length, needle width and needle area declined with increasing tree height by 0.70 mm(-2) m(-1), 0.20 mm m(-1), 5.9 x 10(-3) mm m(-1) and 0.012 mm(2) m(-1), respectively. Needle thickness and mesophyll thickness increased with tree height by 4.8 x 10(-2) mm m(-1) and 0.74 microm m(-1), respectively. Mesophyll conductance (g(m)) and CO(2) assimilation in ambient [CO(2)] (A(amb)) decreased by 1.1 mmol m(-2) s(-1) per m and 0.082 micromol m(-2) s(-1) per m increase in height, respectively. Mean reductions in g(m) and A(amb) of foliage from 5 to 55 m were 47% and 42%, respectively. The observed trend in A(amb) was associated with g(m) and several leaf anatomic characteristics that are likely to be determined by the prevailing vertical tension gradient during foliar development. A linear increase in foliar delta(13)C values with height (0.042 per thousand m(-1)) implied that relative stomatal and mesophyll limitations of photosynthesis in intact shoots increased with height. These data suggest that increasing height leads to both fixed structural constraints on leaf gas exchange and dynamic constraints related to prevailing stomatal behavior.

Assessing the feasibility of harm reduction services for MSM: the late night breakfast buffet study

PubMed Central

Rose, Valerie J; Raymond, H Fisher; Kellogg, Timothy A; McFarland, Willi

2006-01-01

Background Despite the leveling off in new HIV infections among men who have sex with men (MSM) in San Francisco, new evidence suggests that many recent HIV infections are linked with the use of Methamphetamine (MA). Among anonymous HIV testers in San Francisco, HIV incidence among MA users was 6.3% compared to 2.1% among non-MA users. Of particular concern for prevention programs are frequent users and HIV positive men who use MA. These MSM pose a particular challenge to HIV prevention efforts due to the need to reach them during very late night hours. Methods The purpose of the Late Night Breakfast Buffet (LNBB) was to determine the feasibility and uptake of harm reduction services by a late night population of MSM. The "buffet" of services included: needle exchange, harm reduction information, oral HIV testing, and urine based sexually transmitted infection (STI) testing accompanied by counseling and consent procedures. The study had two components: harm reduction outreach and a behavioral survey. For 4 months during 2004, we provided van-based harm reduction services in three neighborhoods in San Francisco from 1 – 5 a.m. for anyone out late at night. We also administered a behavioral risk and service utilization survey among MSM. Results We exchanged 2000 needles in 233 needle exchange visits, distributed 4500 condoms/lubricants and provided 21 HIV tests and 12 STI tests. Fifty-five MSM enrolled in the study component. The study population of MSM was characterized by low levels of income and education whose ages ranged from 18 – 55. Seventy-eight percent used MA in the last 3 months; almost 25% used MA every day in the same time frame. Of the 65% who ever injected, 97% injected MA and 13% injected it several times a day. MA and alcohol were strong influences in the majority of unprotected sexual encounters among both HIV negative and HIV positive MSM. Conclusion We reached a disenfranchised population of MA-using MSM who are at risk for acquiring or transmitting HIV infection through multiple high risk behaviors, and we established the feasibility and acceptability of late night harm reduction for MSM and MSM who inject drugs. PMID:17018154

Recovery of photosynthesis in 1-year-old needles of unfertilized and fertilized Norway spruce (Picea abies (L.) Karst.) during spring.

PubMed

Strand, M; Lundmark, T

1995-03-01

Photosynthetic O(2) evolution and chlorophyll a fluorescence were measured in 1-year-old needles of unfertilized and fertilized trees of Norway spruce (Picea abies (L.) Karst.) during recovery of photosynthesis from winter inhibition in northern Sweden. Measurements were made under laboratory conditions at 20 degrees C. In general, the CO(2)-saturated rate of O(2) evolution was higher in needles of fertilized trees than in needles of unfertilized trees over a wide range of incident photon flux densities. Furthermore, the maximum photochemical efficiency of photosystem (PS) II, as indicated by the ratio of variable to maximum fluorescence (F(V)/F(M)) was higher in needles of fertilized trees than in needles of unfertilized trees. The largest differences in F(V)/F(M) between the two treatments occurred before the main recovery of photosynthesis from winter inhibition in late May. The rate of O(2) evolution was higher in needles of north-facing branches than in needles of south-facing branches in the middle of May. Simultaneous measurements of O(2) exchange and chlorophyll fluorescence indicated that differences in the rate of O(2) evolution between the two treatments were paralleled by differences in the rate of PS II electron transport determined by chlorophyll fluorescence. We suggest that, during recovery of photosynthesis from winter inhibition, the balance between carbon assimilation and PS II electron transport was maintained largely by adjustments in the nonphotochemical dissipation of excitation energy within PS II.

[Needle-free injection--science fiction or comeback of an almost forgotten drug delivery system?].

PubMed

Ziegler, Andreas

2007-08-01

The first to create a "needle-free injector" was the American anesthetist Robert A. Hingson, 65 year ago. Since that time those devices underwent a changeful history. In 1986 an outbreak of hepatitis B among patients receiving injections from a needle-free multiple-use-nozzle injector was documented and related to the use of the injector device. Due to such risk of transmission of infection with these reusable devices, their application has been restricted. In 1998 the WHO recommended that only conventional needles and syringes should be used for immunization until safe needle-free injectors are identified through independent safety testing. Since needle-free injection has shown numerous advantages in comparison to conventional injection, new systems were developed that combine the advantages of needle-free injection with sufficient safety in mass vaccination programs. As an alternative to this early injector type, the disposable-cartridge injectors were developed. The newest research field in the area of the needle-free injection systems opened with the development of powder injectors, in which the drug preparation is no longer a suspension or solution, but a powdered solid. This injector type using powder formulations shows a number of advantages in comparison with the conventional needle/syringe injection technique as well as towards the liquid jet injectors. Due to this new kind of injectors the comeback of the needle-free injection technique in large-scale vaccination programs of the WHO seems reasonable and within reach.

Impacts of seasonal air and soil temperatures on photosynthesis in Scots pine trees.

PubMed

Strand, Martin; Lundmark, Tomas; Söderbergh, Ingrid; Mellander, Per-Erik

2002-08-01

Seasonal courses of light-saturated rate of net photosynthesis (A360) and stomatal conductance (gs) were examined in detached 1-year-old needles of Scots pine (Pinus sylvestris L.) from early April to mid-November. To evaluate the effects of soil frost and low soil temperatures on gas exchange, the extent and duration of soil frost, as well as the onset of soil warming, were manipulated in the field. During spring, early summer and autumn, the patterns of A360 and gs in needles from the control and warm-soil plots were generally strongly related to daily mean air temperatures and the frequency of severe frost. The warm-soil treatment had little effect on gas exchange, although mean soil temperature in the warm-soil plot was 3.8 degrees C higher than in the control plot during spring and summer, indicating that A360 and gs in needles from control trees were not limited by low soil temperature alone. In contrast, prolonged exposure to soil temperatures slightly above 0 degrees C severely restricted recovery of A360 and especially gs in needles from the cold-soil treatment during spring and early summer; however, full recovery of both A360 and gs occurred in late summer. We conclude that inhibition of A360 by low soil temperatures is related to both stomatal closure and effects on the biochemistry of photosynthesis, the relative importance of which appeared to vary during spring and early summer. During the autumn, soil temperatures as low as 8 degrees C did not affect either A360 or gs.

AIDS bills remain in limbo as lawmakers ponder Clinton's fate.

PubMed

1998-10-02

Due to the distractions caused by the possible presidential impeachment and by the upcoming re-election campaigns of current lawmakers, Congress may postpone the approval of funding for key legislation that affects a number of HIV prevention, research, and care programs. The current status of several bills is presented. The House and Senate versions of the Labor/Health and Human Services bill show discrepancies regarding the amount of money that should be allocated to the Ryan White CARE Act, to the Centers for Disease Control and Prevention (CDC) programs, and to research at the National Institutes of Health. Another bill debates whether there should be an increase in funding for the Housing Opportunities for People with AIDS program, which is part of the Veterans Affairs/Housing and Urban Development appropriations bill. Two other bills that are being discussed include a bill that may bar the use of government funds for needle-exchange programs (H.R. 3717 and H.R. 4380) and the Ricky Ray Hemophilia Relief Fund Act, which may allow compensation for hemophiliacs that contracted HIV through contaminated blood-clotting medicines.

Piezoelectrically Actuated Robotic System for MRI-Guided Prostate Percutaneous Therapy

PubMed Central

Su, Hao; Shang, Weijian; Cole, Gregory; Li, Gang; Harrington, Kevin; Camilo, Alexander; Tokuda, Junichi; Tempany, Clare M.; Hata, Nobuhiko; Fischer, Gregory S.

2014-01-01

This paper presents a fully-actuated robotic system for percutaneous prostate therapy under continuously acquired live magnetic resonance imaging (MRI) guidance. The system is composed of modular hardware and software to support the surgical workflow of intra-operative MRI-guided surgical procedures. We present the development of a 6-degree-of-freedom (DOF) needle placement robot for transperineal prostate interventions. The robot consists of a 3-DOF needle driver module and a 3-DOF Cartesian motion module. The needle driver provides needle cannula translation and rotation (2-DOF) and stylet translation (1-DOF). A custom robot controller consisting of multiple piezoelectric motor drivers provides precision closed-loop control of piezoelectric motors and enables simultaneous robot motion and MR imaging. The developed modular robot control interface software performs image-based registration, kinematics calculation, and exchanges robot commands and coordinates between the navigation software and the robot controller with a new implementation of the open network communication protocol OpenIGTLink. Comprehensive compatibility of the robot is evaluated inside a 3-Tesla MRI scanner using standard imaging sequences and the signal-to-noise ratio (SNR) loss is limited to 15%. The image deterioration due to the present and motion of robot demonstrates unobservable image interference. Twenty-five targeted needle placements inside gelatin phantoms utilizing an 18-gauge ceramic needle demonstrated 0.87 mm root mean square (RMS) error in 3D Euclidean distance based on MRI volume segmentation of the image-guided robotic needle placement procedure. PMID:26412962

Needle and syringe sharing practices of injecting drug users participating in an outreach HIV prevention program in Tehran, Iran: A cross-sectional study

PubMed Central

Vazirian, Mohsen; Nassirimanesh, Bijan; Zamani, Saman; Ono-Kihara, Masako; Kihara, Masahiro; Mortazavi Ravari, Shahrzad; Gouya, Mohammad Mehdi

2005-01-01

HIV infection rates have reached epidemic proportions amongst injecting drug users (IDUs) in Iran. Although a number of community-based interventions have being implemented in the country, there is little information on the risk behaviors of IDU participants in these programs. This cross-sectional report aimed to compare the risk behaviors of injecting drug users with differential exposure rates to an HIV outreach program in Tehran, Iran. Results indicated that shared use of needle/syringe in the past month was significantly lower among IDUs who received estimated ≥ 7 syringes per week than those who did not [adjusted odds ratio (OR) = 14.36, 95% confidence interval (CI) 2.30–89.56]. While the effectiveness of this outreach program needs further evaluation through a longitudinal investigation, our preliminary findings suggest that the outreach program in Tehran may have been beneficial in reducing direct sharing among those who received more than several needles/syringes from the program. PMID:16212655

Needle metabolome, freezing tolerance and gas exchange in Norway spruce seedlings exposed to elevated temperature and ozone concentration.

PubMed

Riikonen, Johanna; Kontunen-Soppela, Sari; Ossipov, Vladimir; Tervahauta, Arja; Tuomainen, Marjo; Oksanen, Elina; Vapaavuori, Elina; Heinonen, Jaakko; Kivimäenpää, Minna

2012-09-01

Northern forests are currently experiencing increasing mean temperatures, especially during autumn and spring. Consequently, alterations in carbon sequestration, leaf biochemical quality and freezing tolerance (FT) are likely to occur. The interactive effects of elevated temperature and ozone (O(3)), the most harmful phytotoxic air pollutant, on Norway spruce (Picea abies (L.) Karst.) seedlings were studied by analysing phenology, metabolite concentrations in the needles, FT and gas exchange. Sampling was performed in September and May. The seedlings were exposed to a year-round elevated temperature (+1.3 °C), and to 1.4× ambient O(3) concentration during the growing season in the field. Elevated temperature increased the concentrations of amino acids, organic acids of the citric acid cycle and some carbohydrates, and reduced the concentrations of phenolic compounds, some organic acids of the shikimic acid pathway, sucrose, cyclitols and steroids, depending on the timing of the sampling. Although growth onset occurred earlier at elevated temperature, the temperature of 50% lethality (LT(50)) was similar in the treatments. Photosynthesis and the ratio of photosynthesis to dark respiration were reduced by elevated temperature. Elevated concentrations of O(3) reduced the total concentration of soluble sugars, and tended to reduce LT(50) of the needles in September. These results show that alterations in needle chemical quality can be expected at elevated temperatures, but the seedlings' sensitivity to autumn and spring frosts is not altered. Elevated O(3) has the potential to disturb cold hardening of Norway spruce seedlings in autumn, and to alter the water balance of the seedling through changes in stomatal conductance (g(s)), while elevated temperature is likely to reduce g(s) and consequently reduce the O(3)-flux inside the leaves.

Biogeographic variation in evergreen conifer needle longevity and impacts on boreal forest carbon cycle projections

PubMed Central

Reich, Peter B.; Rich, Roy L.; Lu, Xingjie; Wang, Ying-Ping; Oleksyn, Jacek

2014-01-01

Leaf life span is an important plant trait associated with interspecific variation in leaf, organismal, and ecosystem processes. We hypothesized that intraspecific variation in gymnosperm needle traits with latitude reflects both selection and acclimation for traits adaptive to the associated temperature and moisture gradient. This hypothesis was supported, because across 127 sites along a 2,160-km gradient in North America individuals of Picea glauca, Picea mariana, Pinus banksiana, and Abies balsamea had longer needle life span and lower tissue nitrogen concentration with decreasing mean annual temperature. Similar patterns were noted for Pinus sylvestris across a north–south gradient in Europe. These differences highlight needle longevity as an adaptive feature important to ecological success of boreal conifers across broad climatic ranges. Additionally, differences in leaf life span directly affect annual foliage turnover rate, which along with needle physiology partially regulates carbon cycling through effects on gross primary production and net canopy carbon export. However, most, if not all, global land surface models parameterize needle longevity of boreal evergreen forests as if it were a constant. We incorporated temperature-dependent needle longevity and %nitrogen, and biomass allocation, into a land surface model, Community Atmosphere Biosphere Land Exchange, to assess their impacts on carbon cycling processes. Incorporating realistic parameterization of these variables improved predictions of canopy leaf area index and gross primary production compared with observations from flux sites. Finally, increasingly low foliage turnover and biomass fraction toward the cold far north indicate that a surprisingly small fraction of new biomass is allocated to foliage under such conditions. PMID:25225397

Effectiveness of dry needling versus a classical physiotherapy program in patients with chronic low-back pain: a single-blind, randomized, controlled trial.

PubMed

Tüzün, Emİne Handan; Gıldır, Sıla; Angın, Ender; Tecer, Büşra Hande; Dana, Kezban Öztürk; Malkoç, Mehtap

2017-09-01

[Purpose] We compared the effectiveness of dry needling with a classical physiotherapy program in patients with chronic low-back pain caused by lumbar disc hernia (LHNP). [Subjects and Methods] In total, 34 subjects were allocated randomly to the study (n=18) and control groups (n=16). In the study group, dry needling was applied using acupuncture needles. The control group performed a home exercise program in addition to hot pack, TENS, and ultrasound applications. Pain was assessed with the short form of the McGill Pain Questionnaire. The number of trigger points and their pressure sensitivity were evaluated with a physical examination (palpation). The Beck Depression Inventory was used to assess depression. The Tampa Kinesiophobia Scale was used to assess fear of movement. [Results] In the study group, the calculated Cohen's effect sizes were bigger than those in the control group in terms of pain, trigger point-related variables, and fear of movement. Effect sizes for reducing depressive symptoms were similar in both groups. [Conclusion] These results suggest that dry needling can be an effective treatment for reducing pain, number of trigger points, sensitivity, and kinesiophobia in patients with chronic low-back pain caused by lumbar disc hernia.

Injecting drug users and their health seeking behavior: a cross-sectional study in dhaka, bangladesh.

PubMed

Shariful Islam, Sheikh Mohammed; Biswas, Tuhin; Bhuiyan, Faiz Ahmed; Islam, Md Serajul; Rahman, Mohammad Mizanur; Nessa, Hurun

2015-01-01

Introduction and Aim. Injecting drug users (IDUs) are amongst the most vulnerable people to acquisition of HIV/AIDS. This study aims to collect information on IDUs and their health seeking behavior in Bangladesh. Design and Methods. A cross-sectional study was conducted among 120 IDUs attending a drug rehabilitation center in Dhaka, Bangladesh. Data were collected on sociodemographics, drug use, health seeking behavior, knowledge of injecting drugs, and sexual behavior. Results. The mean ± SD and median (IQR) age of the participants were 32.5 ± 21.3 and 33 (27-38) years, respectively, with only 9.2% females. Injection buprenorphine was the drug of choice for 40% of participants, and 58% of the participants first started drug use with smoking cannabis. 73.3% of participants shared needles sometimes and 57.5% were willing to use the needle exchange programs. 60% of the participants had no knowledge about the diseases spread by injection. Condom use during the last intercourse with regular partners was 11.7% and with any partners 15.8%. Conclusion. IDUs in Bangladesh are a high-risk group for HIV/AIDS due to lack of knowledge and risky behaviors. Education and interventions specifically aimed at IDUs are needed, because traditional education may not reach IDUs or influence their behavior.

Injecting Drug Users and Their Health Seeking Behavior: A Cross-Sectional Study in Dhaka, Bangladesh

PubMed Central

Biswas, Tuhin; Bhuiyan, Faiz Ahmed; Islam, Md. Serajul; Rahman, Mohammad Mizanur; Nessa, Hurun

2015-01-01

Introduction and Aim. Injecting drug users (IDUs) are amongst the most vulnerable people to acquisition of HIV/AIDS. This study aims to collect information on IDUs and their health seeking behavior in Bangladesh. Design and Methods. A cross-sectional study was conducted among 120 IDUs attending a drug rehabilitation center in Dhaka, Bangladesh. Data were collected on sociodemographics, drug use, health seeking behavior, knowledge of injecting drugs, and sexual behavior. Results. The mean ± SD and median (IQR) age of the participants were 32.5 ± 21.3 and 33 (27–38) years, respectively, with only 9.2% females. Injection buprenorphine was the drug of choice for 40% of participants, and 58% of the participants first started drug use with smoking cannabis. 73.3% of participants shared needles sometimes and 57.5% were willing to use the needle exchange programs. 60% of the participants had no knowledge about the diseases spread by injection. Condom use during the last intercourse with regular partners was 11.7% and with any partners 15.8%. Conclusion. IDUs in Bangladesh are a high-risk group for HIV/AIDS due to lack of knowledge and risky behaviors. Education and interventions specifically aimed at IDUs are needed, because traditional education may not reach IDUs or influence their behavior. PMID:25692067

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

Siauw, Timmy; Cunha, Adam; Berenson, Dmitry

Purpose: In this study, the authors introduce skew line needle configurations for high dose rate (HDR) brachytherapy and needle planning by integer program (NPIP), a computational method for generating these configurations. NPIP generates needle configurations that are specific to the anatomy of the patient, avoid critical structures near the penile bulb and other healthy structures, and avoid needle collisions inside the body. Methods: NPIP consisted of three major components: a method for generating a set of candidate needles, a needle selection component that chose a candidate needle subset to be inserted, and a dose planner for verifying that the finalmore » needle configuration could meet dose objectives. NPIP was used to compute needle configurations for prostate cancer data sets from patients previously treated at our clinic. NPIP took two user-parameters: a number of candidate needles, and needle coverage radius, {delta}. The candidate needle set consisted of 5000 needles, and a range of {delta} values was used to compute different needle configurations for each patient. Dose plans were computed for each needle configuration. The number of needles generated and dosimetry were analyzed and compared to the physician implant. Results: NPIP computed at least one needle configuration for every patient that met dose objectives, avoided healthy structures and needle collisions, and used as many or fewer needles than standard practice. These needle configurations corresponded to a narrow range of {delta} values, which could be used as default values if this system is used in practice. The average end-to-end runtime for this implementation of NPIP was 286 s, but there was a wide variation from case to case. Conclusions: The authors have shown that NPIP can automatically generate skew line needle configurations with the aforementioned properties, and that given the correct input parameters, NPIP can generate needle configurations which meet dose objectives and use as many or fewer needles than the current HDR brachytherapy workflow. Combined with robot assisted brachytherapy, this system has the potential to reduce side effects associated with treatment. A physical trial should be done to test the implant feasibility of NPIP needle configurations.« less

Health Outcomes for Clients of Needle and Syringe Programs in Prisons.

PubMed

Lazarus, Jeffrey V; Safreed-Harmon, Kelly; Hetherington, Kristina L; Bromberg, Daniel J; Ocampo, Denise; Graf, Niels; Dichtl, Anna; Stöver, Heino; Wolff, Hans

2018-04-12

High levels of drug dependence have been observed in the prison population globally, and the sharing of injecting drug equipment in prisons has contributed to higher prevalence of bloodborne diseases in prisoners than in the general population. Few prison needle and syringe programs (PNSPs) exist. We conducted a systematic review to assess evidence regarding health outcomes of PNSPs. We searched peer-reviewed databases for data relating to needle and syringe programs in prisons. The search methodology was conducted in accordance with accepted guidelines. Five studies met review inclusion criteria, and all presented evidence associating PNSPs with one or more health benefits, but the strength of the evidence was low. The outcomes for which the studies collectively demonstrated the strongest evidence were prevention of human immunodeficiency virus and viral hepatitis. Few negative consequences from PNSPs were observed, consistent with previous evidence assessments. More research is needed on PNSP effectiveness, and innovative study designs are needed to overcome methodological limitations of previous research. Until stronger evidence becomes available, policymakers are urged to recognize that not implementing PNSPs has the potential to cause considerable harm, in light of what is currently known about the risks and benefits of needle and syringe programs and PNSPs and about the high prevalence of human immunodeficiency virus and viral hepatitis in prisons.

Relationships between needle and syringe programs and police: An exploratory analysis of the potential role of in-service training.

PubMed

Strike, Carol; Watson, Tara Marie

2017-06-01

Training police on the public health benefits of needle and syringe programs (NSPs) is viewed as a best practice to facilitate more collaborative relationships between police and these programs. To date, while the limited published literature contains promising cases of harm reduction in-service training for police, evaluative evidence is preliminary. Using an online survey, we asked NSP managers across Canada about their programs and the quality of their NSP-police relationships. We analyzed data from the responses of 75 program managers among whom 69% reported that their program had a "positive" or "mostly positive" relationship with the police. In-service training about topics such as needle-stick injury prevention and NSP effectiveness was provided by less than 50% of the programs surveyed. Seventy-five percent reported no established protocols to resolve conflicts between NSP staff and police. Four variables, all related to in-service training, were significantly related to positive NSP-police relationships, including training about: NSP program goals (OR 7.7; 95% CI 2.0, 33.1); needle-stick injury prevention and basics of blood-borne virus transmission (OR 4.0; 95% CI 1.1, 15.34); the health and social concerns of people who use drugs (OR 3.9; 95% CI 1.1, 13.5); and evidence about the impact of injection equipment distribution (OR 3.9; 95% CI 1.1, 13.5). Development of in-service training for police that is focused on harm reduction goals and initiatives is a new and evolving area. We highly encourage NSPs to offer and evaluate any such in-service training programs. Copyright © 2017 Elsevier B.V. All rights reserved.

[Prevalence of indirect sharing of drug-injecting paraphernalia in Galicia, Madrid, Seville and Valencia [Spain

PubMed

Bravo, María J; Royuela, Luis; Barrio, Gregorio; Rodríguez-Arenas, María A; de la Fuente, Luis

2004-01-01

To study drug-injecting practices, particularly indirect sharing of injecting paraphernalia (ISIP), and sexual risk behavior. We performed a cross-sectional study of 1638 users of needle exchange programs (NEPs). Different types of ISIP were studied: taking diluted drugs in a syringe used by others, placing the needle in a recipient with other used needles, and reusing cleaning liquid previously used by others. The prevalence of injecting with syringes already used by others was 16% in Galicia, 4.7% in Madrid, 17.6% in Seville and 13.2% in Valencia (p < 0.001). With geographical variations, other types of ISIP (Galicia: 32.4%; Madrid: 28.5%; Seville: 42.6%; Valencia: 27.4% -p < 0.001-) were more frequent than injecting with syringes already used by others (Galicia: 32.4%; Madrid: 28.5%; Seville: 42.6%; Valencia: 27.4% -p < 0.001-). The percentage not injecting with syringes used by others but performing ISIP was 21.7%, 25.3%, 28.2% and 18.1% (p < 0.01) respectively. In all geographical areas, sexual risk practices were more prevalent with steady sex partners (68.6%, 72.0%, 77.8%, 72.8% [NS]) than with casual partners (36.6%, 40.9%, 37.9%, 23.9% [NS]). Among injectors with a stable partner, 81.3% in Galicia, 75.9% in Madrid, 86.1% in Seville and 79.7% in Valencia reported that his/her serological status was negative for HIV or was unknown (p < 0.001). ISIP is more prevalent than injection with syringes already used by others. For a substantial percentage of injectors, ISIP is the only risk practice. ISIP and the low use of condoms, particularly with steady partners, could be a contributory factor to the spread of HIV, hepatitis C virus, and hepatitis B virus infection.

Turkish nurses' level of knowledge regarding implantable port catheter care.

PubMed

Özden, Dilek; Çalişkan, Nurcan

2012-06-01

The aim of this study was to determine the knowledge levels of Turkish nurses regarding implantable port catheter care. A descriptive method was used inside a university hospital that was located in a Turkish metropolis. The data were collected via a questionnaire that was given to a total of 45 nurses who were employed in the internal medicine clinics where the oncology patients were treated. In this study, 42.2% of the nurses received in-service training about the implantable port catheter. It was determined that the mean knowledge point was 15.13 ± 4.78. The difference between the knowledge points of the nurses regarding implantable port catheter care, based on whether or not the nurses had received in-service training, was statistically significant. Moreover, it was determined that the majority of the nurses did not know where the implantable port catheter is placed, its period of use following implantation, the amount of normal saline to be used for washing the catheter, the special port (Huber) needle, the number of the needle, and the exchange time of these needles. In this study, there existed significant differences between the scores of the nurses who received in-service training about the implantable port catheter and the scores of those who did not receive in-service training. The majority of the nurses who participated in the study were willing to receive in-service training regarding this subject. Thus, the organization of in-service training programs and the implementation of care, according to the developed standards and guidelines, are considered as significant for reducing the occurrence of the complications that are related to the use of the implantable port catheter. © 2011 The Authors. Japan Journal of Nursing Science © 2011 Japan Academy of Nursing Science.

Occupational Clothing Curriculum.

ERIC Educational Resources Information Center

Fraser, Annette J.

Designed to provide individualized, hands-on experience for secondary or postsecondary students in gainful homemaking programs, this occupational clothing curriculum contains eight learning modules. The following topics are covered in the modules: plant production for the needle trades (needle trade structure and operation, terminology, history,…

Is point of access to needles and syringes related to needle sharing? Comparing data collected from pharmacies and needle and syringe programs in south-east Sydney.

PubMed

Bryant, Joanne; Topp, Libby; Hopwood, Max; Iversen, Jenny; Treloar, Carla; Maher, Lisa

2010-07-01

The comprehensive needle and syringe distribution system in New South Wales is partly based on the premise that different points of access to injecting equipment may attract different groups of injecting drug users. This paper examines patterns of equipment acquisition and risk for blood-borne virus transmission among injecting drug users who use pharmacies and needle and syringe programs (NSP) in south-east Sydney. Clients obtaining injecting equipment from four NSP (n = 147) and eight pharmacies (n = 227) in 2006 voluntarily completed a self-administered questionnaire. Respondents were grouped into three categories based on their needle and syringe acquisition patterns: exclusive use of NSP, exclusive use of pharmacies and use of both. Although it was common for respondents to report using both pharmacies and NSP to obtain needles and syringes (57%), a proportion reported exclusive use of pharmacies (17%) and NSP (14%). Exclusive pharmacy users were more likely to have never received treatment for their drug use and the least likely to have had a recent test for hepatitis C. Compared with respondents who exclusively used NSP, respondents who exclusively used pharmacies were more likely to report receptive sharing of injecting equipment (adjusted odds ratio 5.9, 95% confidence interval 2.02-17.14), as were respondents who reported using both sources (adjusted odds ratio 5.8, 95% confidence interval 2.35-14.40). The high prevalence of receptive equipment sharing among pharmacy clients indicates a need to improve access to needles and syringes and ancillary equipment, possibly by including ancillary equipment at no cost in existing pre-packaged pharmacy products.

Genotoxicity of dill (Anethum graveolens L.), peppermint (Menthaxpiperita L.) and pine (Pinus sylvestris L.) essential oils in human lymphocytes and Drosophila melanogaster.

PubMed

Lazutka, J R; Mierauskiene, J; Slapsyte, G; Dedonyte, V

2001-05-01

Genotoxic properties of the essential oils extracted from dill (Anethum graveolens L.) herb and seeds, peppermint (Menthaxpiperita L.) herb and pine (Pinus sylvestris L.) needles were studied using chromosome aberration (CA) and sister chromatid exchange (SCE) tests in human lymphocytes in vitro, and Drosophila melanogaster somatic mutation and recombination test (SMART) in vivo. In the CA test, the most active essential oil was from dill seeds, then followed essential oils from dill herb, peppermint herb and pine needles, respectively. In the SCE test, the most active essential oils were from dill herb and seeds followed by essential oils from pine needles and peppermint herb. Essential oils from dill herb and seeds and pine needles induced CA and SCE in a clear dose-dependent manner, while peppermint essential oil induced SCE in a dose-independent manner. All essential oils were cytotoxic for human lymphocytes. In the SMART test, a dose-dependent increase in mutation frequency was observed for essential oils from pine and dill herb. Peppermint essential oil induced mutations in a dose-independent manner. Essential oil from dill seeds was almost inactive in the SMART test.

EFFECTS OF ELEVATED CO2 AND TEMPERATURE ON GROWTH, BIOCHEMISTRY AND PHYSIOLOGY OF DOUGLAS-FIR

EPA Science Inventory

We examined the interactive effects of CO2 concentration and mean annual temperature on physiology, biochemistry and growth of Douglas fir seedlings. Seedlings were grown at ambient CO2 or ambient + 200 ppm CO2 and at ambient temperature or ambient + 4 ?C. Needle gas exchange m...

The efficacy of fluid-gas exchange for the treatment of postvitrectomy retinal detachment.

PubMed

Jang, Ji Hye; Kim, Yu Cheol; Kim, Kwang Soo

2009-12-01

This study was designed to evaluate the efficacy of fluid-gas exchange for the treatment of postvitrectomy retinal detachment. We retrospectively reviewed the records of 33 consecutive patients (35 eyes) who underwent fluid-gas exchange treatment for postvitrectomy retinal detachment using the two-needle pars plana approach technique. The retinal reattachment rate was 80.0% after complete intravitreal gas disappearance following the fluid-gas exchange; the overall success rate was 65.7%. Visual acuity was improved or stable in 80.0% of cases; a two-line or greater vision improvement or a best-corrected visual acuity of 0.4 or better occurred in 62.9% of cases. The success rates for superior retinal detachments and posterior pole retinal detachments were 76.5% and 85.7%, respectively. Fluid-gas exchange represents a simple and cost-effective alternative outpatient procedure for retinal reattachment without reoperation for the treatment of superior and posterior pole retinal detachments.

Low knowledge and perceived Hepatitis C risk despite high risk behaviour among injection drug users in Kathmandu, Nepal.

PubMed

Loewinger, Gabriel; Sharma, Bishnu; Karki, Deepak Kumar; Khatiwoda, Prasana; Kainee, Sher; Poudel, Krishna C

2016-07-01

In Nepal, prevalence of Hepatitis C (HCV) among injecting drug users (IDUs) has been measured at 50% and knowledge of the virus is low. Rehabilitation and harm reduction attendees constitute populations to whom health care providers can deliver services. As such, characterizing their drug use and risk profiles is important for developing targeted service delivery. We measured drug use and risk patterns of IDUs participating in residential rehabilitation as well as those contacted through needle exchanges to identify correlates of drug use frequency, risky injection practices as well as HCV testing, knowledge and perceived risk. We collected cross-sectional data from one-on-one structured interviews of IDUs contacted through needle-exchange outreach workers (n=202) and those attending rehabilitation centres (behaviour immediately prior to joining rehabilitation) (n=167). Roughly half of participants reported injecting at least 30 times in the past 30 days and individuals with previous residential rehabilitation experience reported frequent injection far more than those without it. About one in fourteen respondents reported past week risky injection practices. Participants were over three times as likely to report risky injection if they consumed alcohol daily (17.2%) than if they did not (5.0%) (p=0.002). Those who reported injecting daily reported risky injection practices (11.9%) significantly more than non-daily injectors (1.8%) (p<0.001). Respondents reported high HCV infection rates, low perceived risk, testing history and knowledge. HCV knowledge was not associated with differences in risky injecting. Treatment centres should highlight the link between heavy drinking, frequent injection and risky injecting practices. The link between rehabilitation attendance and frequent injection may suggest IDUs with more severe use patterns are more likely to attend rehabilitation. Rehabilitation centres and needle exchanges should provide testing and education for HCV. Education alone may not be sufficient to initiate change since knowledge did not predict lower risk. Copyright © 2016 Elsevier B.V. All rights reserved.

Enterobacter aerogenes Needle Stick Leads to Improved Biological Management System

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

Johanson, Richard E.

2004-08-01

A laboratory worker who received a needle stick from a contaminated needle while working with a culture containing Enterobactor aerogenes developed a laboratory acquired infection. Although this organism has been shown to cause community and nosocomial infections, there have been no documented cases of a laboratory acquired infections. Lessons learned from the event led to corrective actions which included modification of lab procedures, development of a biological inventory tracking and risk identification system and the establishment of an effective biological safety program.

The Matchmaker Exchange: a platform for rare disease gene discovery.

PubMed

Philippakis, Anthony A; Azzariti, Danielle R; Beltran, Sergi; Brookes, Anthony J; Brownstein, Catherine A; Brudno, Michael; Brunner, Han G; Buske, Orion J; Carey, Knox; Doll, Cassie; Dumitriu, Sergiu; Dyke, Stephanie O M; den Dunnen, Johan T; Firth, Helen V; Gibbs, Richard A; Girdea, Marta; Gonzalez, Michael; Haendel, Melissa A; Hamosh, Ada; Holm, Ingrid A; Huang, Lijia; Hurles, Matthew E; Hutton, Ben; Krier, Joel B; Misyura, Andriy; Mungall, Christopher J; Paschall, Justin; Paten, Benedict; Robinson, Peter N; Schiettecatte, François; Sobreira, Nara L; Swaminathan, Ganesh J; Taschner, Peter E; Terry, Sharon F; Washington, Nicole L; Züchner, Stephan; Boycott, Kym M; Rehm, Heidi L

2015-10-01

There are few better examples of the need for data sharing than in the rare disease community, where patients, physicians, and researchers must search for "the needle in a haystack" to uncover rare, novel causes of disease within the genome. Impeding the pace of discovery has been the existence of many small siloed datasets within individual research or clinical laboratory databases and/or disease-specific organizations, hoping for serendipitous occasions when two distant investigators happen to learn they have a rare phenotype in common and can "match" these cases to build evidence for causality. However, serendipity has never proven to be a reliable or scalable approach in science. As such, the Matchmaker Exchange (MME) was launched to provide a robust and systematic approach to rare disease gene discovery through the creation of a federated network connecting databases of genotypes and rare phenotypes using a common application programming interface (API). The core building blocks of the MME have been defined and assembled. Three MME services have now been connected through the API and are available for community use. Additional databases that support internal matching are anticipated to join the MME network as it continues to grow. © 2015 WILEY PERIODICALS, INC.

The Matchmaker Exchange: A Platform for Rare Disease Gene Discovery

PubMed Central

Philippakis, Anthony A.; Azzariti, Danielle R.; Beltran, Sergi; Brookes, Anthony J.; Brownstein, Catherine A.; Brudno, Michael; Brunner, Han G.; Buske, Orion J.; Carey, Knox; Doll, Cassie; Dumitriu, Sergiu; Dyke, Stephanie O.M.; den Dunnen, Johan T.; Firth, Helen V.; Gibbs, Richard A.; Girdea, Marta; Gonzalez, Michael; Haendel, Melissa A.; Hamosh, Ada; Holm, Ingrid A.; Huang, Lijia; Hurles, Matthew E.; Hutton, Ben; Krier, Joel B.; Misyura, Andriy; Mungall, Christopher J.; Paschall, Justin; Paten, Benedict; Robinson, Peter N.; Schiettecatte, François; Sobreira, Nara L.; Swaminathan, Ganesh J.; Taschner, Peter E.; Terry, Sharon F.; Washington, Nicole L.; Züchner, Stephan; Boycott, Kym M.; Rehm, Heidi L.

2015-01-01

There are few better examples of the need for data sharing than in the rare disease community, where patients, physicians, and researchers must search for “the needle in a haystack” to uncover rare, novel causes of disease within the genome. Impeding the pace of discovery has been the existence of many small siloed datasets within individual research or clinical laboratory databases and/or disease-specific organizations, hoping for serendipitous occasions when two distant investigators happen to learn they have a rare phenotype in common and can “match” these cases to build evidence for causality. However, serendipity has never proven to be a reliable or scalable approach in science. As such, the Matchmaker Exchange (MME) was launched to provide a robust and systematic approach to rare disease gene discovery through the creation of a federated network connecting databases of genotypes and rare phenotypes using a common application programming interface (API). The core building blocks of the MME have been defined and assembled. Three MME services have now been connected through the API and are available for community use. Additional databases that support internal matching are anticipated to join the MME network as it continues to grow. PMID:26295439

The Matchmaker Exchange: A Platform for Rare Disease Gene Discovery

DOE PAGES

Philippakis, Anthony A.; Azzariti, Danielle R.; Beltran, Sergi; ...

2015-09-17

There are few better examples of the need for data sharing than in the rare disease community, where patients, physicians, and researchers must search for "the needle in a haystack" to uncover rare, novel causes of disease within the genome. Impeding the pace of discovery has been the existence of many small siloed datasets within individual research or clinical laboratory databases and/or disease-specific organizations, hoping for serendipitous occasions when two distant investigators happen to learn they have a rare phenotype in common and can "match" these cases to build evidence for causality. However, serendipity has never proven to be amore » reliable or scalable approach in science. As such, the Matchmaker Exchange (MME) was launched to provide a robust and systematic approach to rare disease gene discovery through the creation of a federated network connecting databases of genotypes and rare phenotypes using a common application programming interface (API). The core building blocks of the MME have been defined and assembled. In conclusion, three MME services have now been connected through the API and are available for community use. Additional databases that support internal matching are anticipated to join the MME network as it continues to grow.« less

The Matchmaker Exchange: A Platform for Rare Disease Gene Discovery

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

Philippakis, Anthony A.; Azzariti, Danielle R.; Beltran, Sergi

There are few better examples of the need for data sharing than in the rare disease community, where patients, physicians, and researchers must search for "the needle in a haystack" to uncover rare, novel causes of disease within the genome. Impeding the pace of discovery has been the existence of many small siloed datasets within individual research or clinical laboratory databases and/or disease-specific organizations, hoping for serendipitous occasions when two distant investigators happen to learn they have a rare phenotype in common and can "match" these cases to build evidence for causality. However, serendipity has never proven to be amore » reliable or scalable approach in science. As such, the Matchmaker Exchange (MME) was launched to provide a robust and systematic approach to rare disease gene discovery through the creation of a federated network connecting databases of genotypes and rare phenotypes using a common application programming interface (API). The core building blocks of the MME have been defined and assembled. In conclusion, three MME services have now been connected through the API and are available for community use. Additional databases that support internal matching are anticipated to join the MME network as it continues to grow.« less

Reapplication of Silvicultural Treatments Impacts Phenology and Photosynthetic Gas Exchange of Loblolly Pine

Treesearch

Zhenmin Tang; Jim L. Chambers; Mary A. Sword; Shufang Yu; James P. Barnett

2004-01-01

A loblolly pine (Pinus taeda L.) plantation, established in 1981, was thinned and fertilized in 1988. Thinning and fertilization treatments were applied again in early 1995. The morphology of current flushes and needles were measured between March and October in 1995 through 1997. Physiological responses were monitored in the upper and lower crowns....

Teddy and I Get a Check-Up: A Pilot Educational Intervention Teaching Children Coping Strategies for Managing Procedure-Related Pain and Fear.

PubMed

Dalley, Jessica S; McMurtry, C Meghan

2016-01-01

Background. Pediatric medical information provision literature focuses on hospitalization and surgical procedures, but children would also benefit from an educational program regarding more commonly experienced medical procedures (e.g., needles, general check-up). Objective. To determine whether an evidence-based educational program reduced children's ratings of fear of and expected pain from medical stimuli and increased their knowledge of procedural coping strategies. Methods. An educational, interactive, developmentally appropriate Teddy Bear Clinic Tour was developed and delivered at a veterinary clinic. During this tour, 71 5-10-year-old children (Mage = 6.62 years, SD = 1.19) were taught about medical equipment, procedures, and coping strategies through modelling and rehearsal. In a single-group, pretest posttest design, participants reported their fear of and expected pain from medical and nonmedical stimuli. Children were also asked to report strategies they would use to cope with procedural fear. Results. Children's ratings for expected pain during a needle procedure were reduced following the intervention. No significant change occurred in children's fear of needles. Children reported more intervention-taught coping strategies at Time 2. Conclusions. The results of this study suggest that an evidence-based, interactive educational program can reduce young children's expectations of needle pain and may help teach them procedural coping strategies.

Injection drug use and HIV/AIDS in China: Review of current situation, prevention and policy implications

PubMed Central

Qian, Han-Zhu; Schumacher, Joseph E; Chen, Huey T; Ruan, Yu-Hua

2006-01-01

Illicit drug abuse and HIV/AIDS have increased rapidly in the past 10 to 20 years in China. This paper reviews drug abuse in China, the HIV/AIDS epidemic and its association with injection drug use (IDU), and Chinese policies on illicit drug abuse and prevention of HIV/AIDS based on published literature and unpublished official data. As a major drug trans-shipment country with source drugs from the "Golden Triangle" and "Gold Crescent" areas in Asia, China has also become an increasingly important drug consuming market. About half of China's 1.14 million documented drug users inject, and many share needles. IDU has contributed to 42% of cumulatively reported HIV/AIDS cases thus far. Drug trafficking is illegal in China and can lead to the death penalty. The public security departments adopt "zero tolerance" approach to drug use, which conflict with harm reduction policies of the public health departments. Past experience in China suggests that cracking down on drug smuggling and prohibiting drug use alone can not prevent or solve all illicit drug related problems in the era of globalization. In recent years, the central government has outlined a series of pragmatic policies to encourage harm reduction programs; meanwhile, some local governments have not fully mobilized to deal with drug abuse and HIV/AIDS problems seriously. Strengthening government leadership at both central and local levels; scaling up methadone substitution and needle exchange programs; making HIV voluntary counseling and testing available and affordable to both urban and rural drug users; and increasing utilization of outreach and nongovernmental organizations are offered as additional strategies to help cope with China's HIV and drug abuse problem. PMID:16451717

Harm reduction in the US: a movement for change.

PubMed

Greig, A

The War on Drugs in the United States has polarized the debate on how to deal effectively with drug use and prevention and makes it difficult to form an agenda to address the harm of drug use. Harm-reduction activists and drug-user groups need to establish common ground to develop programs acceptable to all parties. The harm-reduction approach is based on the premise that adverse consequences of a harmful act, drug use in this case, can be mitigated without necessarily reducing consumption. Needle exchange programs are a good example of this approach. There are 100 such programs in the United States, and the programs are seen as an effective means of reducing HIV transmission. However, the programs remain politically sensitive and Federal funding is outlawed. The War on Drugs programs can conflict with HIV prevention programs; programs that might reduce the incidence of HIV infection but do not criminalize or stigmatize drug use are rarely socially acceptable. In the U.S., about half of all new HIV cases can be attributed to drug use. One-third of the increase in prison populations since 1980 is a consequence of the number of drug-law violators in the prison system. The impact of moral conservatism and how the drug laws are affected by class, race, and gender are discussed. Groups involved with combating drug use and preventing HIV transmission will need to form alliances to develop programs mutually beneficial to their audiences.

A successful strategy for estimating the consumption of needles and syringes by injecting drug users in the Czech Republic.

PubMed

Gabrhelík, Roman; Vacek, Jaroslav; Mista, Jan

2014-01-01

The objectives were to: (i) estimate the extent of the injecting equipment (IE) provided by needle exchange programs (NEPs) to injecting drug users (IDUs) in the Czech Republic in 2010; (ii) subsequently validate the recent methodology used for data collection by the Czech National Monitoring Centre for Drugs and Drug Addiction (CMC), and (iii) estimate the number of syringes provided to Czech IDUs. A simple document analysis was performed in order to collect data on the production, sale, and consumption of injecting equipment in the Czech Republic in combination with questionnaire screening in the NEPs and 21 brief interviews with key informants. Ten types of IE most commonly used for drug injecting by the Czech drug users were identified. Approximately 5,038,000 pieces of sterile IE were marketed in the Czech Republic in 2010. According to four manufacturers (with a market share of 96%) and with reference to the year 2010, 5,430,694 pieces of sterile IE were provided to Czech injecting drug users (487,694 pieces of IE were sold to IDUs in pharmacies and 5,038,000 pieces of IE were distributed by NEPs in 2010). We compared the amount of IE provided to IDUs as reported to the CMC National registry by NEPs (4,943,000) with that of IE distributed by manufacturers and distributors (5,038,000) in the country in 2010 and found a difference of less than two percent using two different methodologies. This study confirms the accuracy of the data on the amount of IE exchanged as collected by the CMC monitoring system. This study opens up important public health practice and policy-making issues. The methodology of this study may be used in regions where no data collection system is present or where confirmation of the data related to IE is needed.

Forest Watch: a K-12 Outreach Program to Engage Young Students in Authentic, Hands-On Science

NASA Astrophysics Data System (ADS)

Rock, B. N.; Gagnon, M.

2008-12-01

The Forest Watch Program is a K-12 science outreach program developed at the University of New Hampshire (UNH) in 1991. The program engages pre-college teachers and their students in assisting researchers at UNH in the assessment of the state-of-health of white pine (Pinus strobus), a known bio- indicator species for exposure to elevated levels of ground-level ozone. Students participate in three types of activities: 1. selection, collection, and analysis of needle samples from five permanently tagged white pine trees near their school; 2. Study of needles in their classroom and sending a set of needles to UNH for spectral analysis; and 3. analysis of remote sensing data (Landsat TM) provided of their local area using freeware software (MultiSpec). Student-derived foliar symptomology, needle length, needle retention, and tree biometrics, plus the spectral indices, allow UNH researchers to characterize annual variations in tree state-of-health, and to correlate that state-of-health with annual summer ozone levels collected by the EPA and state environmental monitoring networks. The results suggest that regional air quality and state- of-health of trees has improved since 1991. Annual student data and the yearly spectral variations, for the same trees, suggest that white pine health has improved dramatically since 1997/8. This improvement in tree health corresponds with improved regional air quality. An evaluation of student data reliability has been conducted and suggests that the DBH measurements are a most reliable indicator of tree growth. Student data are more reliable if multiple sets of measurements are made and averaged together, compared with single sets of measurements. Based on both student data and spectral analysis of student-provided branch samples, the greatest damage (chlorosis) occurs in trees located along the seacoast areas. Participation in Forest Watch introduces students to the scientific method via an authentic research program. The program is designed in partnership with participating teachers, and thus meets New England state science and mathematics curricula for K-12 education. Student participation in Forest Watch has resulted in an improved understanding of inter-annual white pine state-of-health response to improved air quality across the New England region.

Emerging HIV epidemics in Muslim countries: assessment of different cultural responses to harm reduction and implications for HIV control.

PubMed

Todd, Catherine S; Nassiramanesh, Bijan; Stanekzai, Mohammad Raza; Kamarulzaman, Adeeba

2007-12-01

Harm reduction, including needle exchange and opioid substitution therapy, has been demonstrated to reduce high-risk behavior and HIV infection among injection drug users. An increasing number of countries in the Middle East, North Africa, and Asia, including those with Muslim majorities, have experienced or are at risk for HIV epidemics initiated by burgeoning injection drug use. Although use of intoxicants is expressly forbidden within Islam, the local culture impacts the interpretation of Islamic law and influences the response to drug misuse, whether punitive or therapeutic. Harm reduction programming has received varying acceptance within this global region, which may be reflected by national trends in HIV prevalence. The purpose of this paper is to examine cultural and religious response to injecting drug use and associated HIV prevalence trends in Malaysia and Iran, with possible application of lessons learned to an emerging situation in Afghanistan.

Disturbance ecology of high-elevation five-needle pine ecosystems in western North America

Treesearch

Elizabeth M. Campbell; Robert E. Keane; Evan R. Larson; Michael P. Murray; Anna W. Schoettle; Carmen Wong

2011-01-01

This paper synthesizes existing information about the disturbance ecology of high-elevation five-needle pine ecosystems, describing disturbances regimes, how they are changing or are expected to change, and the implications for ecosystem persistence. As it provides the context for ecosystem conservation/restoration programs, we devote particular attention to wildfire...

Seasonal photosynthesis and water relations of juvenile loblolly pine relative to stand density and canopy position

Treesearch

Zhenmin Tang; Jim L. Chambers; Mary A. Sword Sayer; James P. Barnett

2003-01-01

To assess the effects of stand density and canopy environment on tree physiology, we measured gas exchange responses of the same needle age class of 16-year-old loblolly pines (Pinus taeda L.) in thinned (512 trees ha-1) and non-thinned treatment plots (2,863 trees ha-1) in central Louisiana....

The magnificent high-elevation five-needle white pines: Ecological roles and future outlook

Treesearch

Diana F. Tomback; Peter Achuff; Anna W. Schoettle; John W. Schwandt; Ron J. Mastrogiuseppe

2011-01-01

The High Five symposium is devoted to exchanging information about a small group of pines with little commercial value but great importance to the ecology of high-mountain ecosystems of the West. These High Five pines include the subalpine and treeline species - whitebark (Pinus albicaulis), Rocky Mountain bristlecone (P. aristata), Great Basin bristlecone (P. longaeva...

Design and investigation of potential Sn-Te-P and Zr-Te-P class of Dirac materials

NASA Astrophysics Data System (ADS)

Sarswat, Prashant; Sarkar, Sayan; Free, Michael

A motivation of new Dirac materials design and synthesis by perturbing the symmetry, was explored by substitution of a Sn vacancy by P that maintains the intrinsic band inversion at the L point but also the direct bandgap shrinkage upon the incorporation of spin-orbit coupling. In a similar line of investigation, Zr-Te-P was also systematically studied. The synthesis of both Sn-Te-P and Zr-Te-P system of compounds resulted in the formation of long needles type crystals and the bulk porous deposits. The exotic morphology of the P-doped SnTe needles possesses the pierced surface throughout its extension. First principle based calculations were also carried out for these sets of compounds using General Gradient Approximation (GGA) with Perdew-Burke-Ernzerhof (PBE) exchange-correlation functional. In order to ensure structural optimization, a limited memory Broyden-Fletcher-Goldfarb-Shanno (LBFGS) algorithm was employed and the total energy in PBE exchange-correlation functional was considered for the calculation of the formation energy per atom. The new modifications have a potential to establish the new class of Dirac materials ushering upon new frontiers of interest.

The Emerging HIV Epidemic on the Mexico-US Border: An International Case Study Characterizing the Role of Epidemiology in Surveillance and Response

PubMed Central

Strathdee, Steffanie A.; Magis-Rodriguez, Carlos; Mays, Vickie M.; Jimenez, Richard; Patterson, Thomas L.

2012-01-01

Purpose HIV/AIDS surveillance data are critical for monitoring epidemic trends, but can mask dynamic sub-epidemics, especially in vulnerable populations that under-utilize HIV testing. In this case study, we describe community-based epidemiologic data among injection drug users (IDU) and female sex workers (FSWs) in two northern Mexico-US Border States that identified an emerging HIV epidemic and generated a policy response. Methods We draw from quantitative and qualitative cross-sectional and prospective epidemiologic studies and behavioral intervention studies among IDUs and FSWs in Tijuana, Baja California and Ciudad Juarez, Chihuahua. Results Recognition that the HIV epidemic on Mexico’s northern border was already well established in subgroups where it had been presumed to be insignificant was met with calls for action and enhanced prevention efforts from researchers, NGOs and policy makers. Conclusions Successful policies and program outcomes included expansion of needle exchange programs, a nation-wide mobile HIV prevention program targeting marginalized populations, a successful funding bid from the Global Fund for HIV, TB and Malaria to scale up targeted HIV prevention programs and the establishment of binational training programs on prevention of HIV and substance use. We discuss how epidemiologic data informed HIV prevention policies and suggest how other countries may learn from Mexico’s experience. PMID:22626001

Drug-related deaths and the sales of needles through pharmacies

PubMed Central

Davidson, Peter J.; Martinez, Alexis; Lutnick, Alexandra; Kral, Alex H.; Bluthenthal, Ricky N.

2014-01-01

Background Providing needles to people who inject drugs is a well-proven public health response to the transmission of HIV and other blood borne viruses. Despite over a quarter of a century of research, new concerns about potential unintended negative consequences of needle distribution continue to emerge. Specifically, a claim was recently made that the introduction of pharmacy sales of needles was followed by an increase in overdoses in pharmacy parking lots. If true, this would have serious implications for the design of needle access programs, particularly those involving pharmacy sales of needles. Methods We examine spatial relationships between drug-related deaths and pharmacies in Los Angeles County (population 9·8 million) before and after the 2007 enactment of a California law allowing pharmacy sales of needles without a prescription. 7,049 drug related deaths occurred in Los Angeles county from 2000-2009 inclusive. 4,275 of these deaths could be geocoded, and were found to be clustered at the census tract level. Results We used three methods to examine spatial relationships between overdose death locations and pharmacy locations for two years on either side of the enactment of the pharmacy sales law, and found no statistically significant changes. Among the 711 geocodable deaths occurring in the two years following the change in law, no death was found to occur within 50 meters of a pharmacy which sold needles. Conclusion These results are consistent with prior studies which suggest pharmacy sales of needles improve access to needles without causing increased harms to the surrounding community. PMID:25499730

Drug-related deaths and the sales of needles through pharmacies.

PubMed

Davidson, Peter J; Martinez, Alexis; Lutnick, Alexandra; Kral, Alex H; Bluthenthal, Ricky N

2015-02-01

Providing needles to people who inject drugs is a well-proven public health response to the transmission of HIV and other blood borne viruses. Despite over a quarter of a century of research, new concerns about potential unintended negative consequences of needle distribution continue to emerge. Specifically, a claim was recently made that the introduction of pharmacy sales of needles was followed by an increase in overdoses in pharmacy parking lots. If true, this would have serious implications for the design of needle access programs, particularly those involving pharmacy sales of needles. We examine spatial relationships between drug-related deaths and pharmacies in Los Angeles County (population 9.8 million) before and after the 2007 enactment of a California law allowing pharmacy sales of needles without a prescription. Seven thousand and forty-nine drugs related deaths occurred in Los Angeles county from 2000 to 2009 inclusive. Four thousand two hundred and seventy-five of these deaths could be geocoded, and were found to be clustered at the census tract level. We used three methods to examine spatial relationships between overdose death locations and pharmacy locations for two years on either side of the enactment of the pharmacy sales law, and found no statistically significant changes. Among the 711 geocodable deaths occurring in the two years following the change in law, no death was found to occur within 50m of a pharmacy which sold needles. These results are consistent with prior studies which suggest pharmacy sales of needles improve access to needles without causing increased harms to the surrounding community. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Teddy and I Get a Check-Up: A Pilot Educational Intervention Teaching Children Coping Strategies for Managing Procedure-Related Pain and Fear

PubMed Central

Dalley, Jessica S.; McMurtry, C. Meghan

2016-01-01

Background. Pediatric medical information provision literature focuses on hospitalization and surgical procedures, but children would also benefit from an educational program regarding more commonly experienced medical procedures (e.g., needles, general check-up). Objective. To determine whether an evidence-based educational program reduced children's ratings of fear of and expected pain from medical stimuli and increased their knowledge of procedural coping strategies. Methods. An educational, interactive, developmentally appropriate Teddy Bear Clinic Tour was developed and delivered at a veterinary clinic. During this tour, 71 5–10-year-old children (Mage = 6.62 years, SD = 1.19) were taught about medical equipment, procedures, and coping strategies through modelling and rehearsal. In a single-group, pretest posttest design, participants reported their fear of and expected pain from medical and nonmedical stimuli. Children were also asked to report strategies they would use to cope with procedural fear. Results. Children's ratings for expected pain during a needle procedure were reduced following the intervention. No significant change occurred in children's fear of needles. Children reported more intervention-taught coping strategies at Time 2. Conclusions. The results of this study suggest that an evidence-based, interactive educational program can reduce young children's expectations of needle pain and may help teach them procedural coping strategies. PMID:27445612

Injecting drugs in tight spaces: HIV, cocaine and collinearity in the Downtown Eastside, Vancouver, Canada.

PubMed

Ciccarone, Daniel; Bourgois, Philippe

2016-07-01

This commentary revisits the political turmoil and scientific controversy over epidemiological study findings linking high HIV seroincidence to syringe exchange attendance in Vancouver in the mid-1990s. The association was mobilized polemically by US politicians and hard-line drug warriors to attack needle exchange policies and funding. In turn, program restrictions limiting access to syringes at the Vancouver exchange may have interfaced with a complex conjunction of historical, geographic, political economic and cultural forces and physiological vulnerabilities to create an extraordinary HIV risk environment: (1) ghettoization of services for indigent populations in a rapidly gentrifying, post-industrial city; (2) rural-urban migration of vulnerable populations subject to historical colonization and current patterns of racism; and (3) the flooding of North America with inexpensive powder cocaine and heroin, and the popularity of crack. In fact, we will never know with certainty the precise cause for the extreme seroincidence rates in Vancouver in the early to mid-1990s. The tendency for modern social epidemiology to decontextualize research subjects and assign excessive importance to discrete, "magic bullet" variables resulted in a counterproductive scientific and political debate in the late 1990s that has obfuscated potentially useful practical lessons for organizing the logistics of harm reduction services - especially syringe exchange - to better serve the needs of vulnerable populations and to mitigate the effects of political-economically imposed HIV risk environments. We would benefit from humbly acknowledging the limits of public health science and learn to recognize the unintended consequences of well-intentioned interventions rather than sweep embarrassing histories under the rug. Copyright © 2016 Elsevier B.V. All rights reserved.

The enigma of effective path length for (18) O enrichment in leaf water of conifers.

PubMed

Roden, John; Kahmen, Ansgar; Buchmann, Nina; Siegwolf, Rolf

2015-12-01

The Péclet correction is often used to predict leaf evaporative enrichment and requires an estimate of effective path length (L). Studies to estimate L in conifer needles have produced unexpected patterns based on Péclet theory and leaf anatomy. We exposed seedlings of six conifer species to different vapour pressure deficits (VPD) in controlled climate chambers to produce steady-state leaf water enrichment (in (18) O). We measured leaf gas exchange, stable oxygen isotopic composition (δ(18) O) of input and plant waters as well as leaf anatomical characteristics. Variation in bulk needle water δ(18) O was strongly related to VPD. Conifer needles had large amounts of water within the vascular strand that was potentially unenriched (up to 40%). Both standard Craig-Gordon and Péclet models failed to accurately predict conifer leaf water δ(18) O without taking into consideration the unenriched water in the vascular strand and variable L. Although L was linearly related to mesophyll thickness, large within-species variation prevented the development of generalizations that could allow a broader use of the Péclet effect in predictive models. Our results point to the importance of within needle water pools and isolating mechanisms that need further investigation in order to integrate Péclet corrections with 'two compartment' leaf water concepts. © 2015 John Wiley & Sons Ltd.

Needle echogenicity in ultrasound-guided lumbar spine injections: a cadaveric study.

PubMed

Gofeld, Michael; Krashin, Daniel L; Ahn, Sangmin

2013-01-01

Echogenicity of regional anesthesia needles has been tested on different preclinical models; however, previous studies were done in an ideal experimental setting utilizing high-frequency insonation and superficially located targets. Because steep-angle deep injections are typically required for spinal and other chronic pain procedures, and low-frequency transducers are used, further feasibility study is warranted. To determine effectiveness of steep-angle deep injections, typically required for spinal and other chronic pain procedures. Experimental laboratory study. Willed Body Program, University of Washington. In-plane lumbar spine procedures with 50° and 70° angles were performed on a human cadaver. The images and video clips of a non-echogenic (Quincke-type) and echogenic (SonoPlex, StimuQuick, and EchoStim) needle placements were presented to 3 blinded assessors who rated the needle visibility on a 4-point scale. The data was statistically analyzed to determine the differences in visibility between the needles with and without the digital image enhancement, and to compare the video clips to captured images. ANOVA analysis demonstrated that overall SonoPlex was significantly better (P = 0.02) than other needles. SonoPlex maintained its superiority in the subset of facet joint injections (P = 0.02), followed by Quincke-type, then the StimuQuik, and EchoStim needles. In deep procedures, EchoStim was comparable with SonoPlex (P = 0.03), and they both were better than the other 2 needles. The enhanced images received higher rates, with a 0.6 point mean improved rating (P = 0). This study is limited by choice of needles, number of experiments performed, and potential postmortem changes of echogenicity. The SonoPlex needle appeared to have better echogenicity in this study. While non-echogenic Quincke-type needle visibility was adequate in superficial placements, it was limited in deep injections. An imaging enhancement is effective in improving needle visibility and should be used whenever possible.

Safe injection practice among health care workers, Gharbiya, Egypt.

PubMed

Ismail, Nanees A; Aboul Ftouh, Aisha M; El Shoubary, Waleed H

2005-01-01

A cross-sectional study was conducted in 25 health care facilities in Gharbiya governorate to assess safe injection practices among health care workers (HCWs). Two questionnaires, one to collect information about administrative issues related to safe injection and the other to collect data about giving injections, exposure to needle stick injuries, hepatitis B vaccination status and safe injection training. Practices of injections were observed using a standardized checklist. The study revealed that there was lack of both national and local infection control policies and lack of most of the supplies needed for safe injection practices. Many safe practices were infrequent as proper needle manipulation before disposal (41%), safe needle disposal (47.5%), reuse of used syringe & needle (13.2%) and safe syringe disposal (0%). Exposure to needle stick injuries were common among the interviewed HCWs (66.2%) and hand washing was the common post exposure prophylaxis measure (63.4%). Only 11.3% of HCWs had full course hepatitis B vaccination. Infection control -including safe injections- training programs should be afforded to all HCWs.

Optimal Investment in HIV Prevention Programs: More Is Not Always Better

PubMed Central

Brandeau, Margaret L.; Zaric, Gregory S.

2008-01-01

This paper develops a mathematical/economic framework to address the following question: Given a particular population, a specific HIV prevention program, and a fixed amount of funds that could be invested in the program, how much money should be invested? We consider the impact of investment in a prevention program on the HIV sufficient contact rate (defined via production functions that describe the change in the sufficient contact rate as a function of expenditure on a prevention program), and the impact of changes in the sufficient contact rate on the spread of HIV (via an epidemic model). In general, the cost per HIV infection averted is not constant as the level of investment changes, so the fact that some investment in a program is cost effective does not mean that more investment in the program is cost effective. Our framework provides a formal means for determining how the cost per infection averted changes with the level of expenditure. We can use this information as follows: When the program has decreasing marginal cost per infection averted (which occurs, for example, with a growing epidemic and a prevention program with increasing returns to scale), it is optimal either to spend nothing on the program or to spend the entire budget. When the program has increasing marginal cost per infection averted (which occurs, for example, with a shrinking epidemic and a prevention program with decreasing returns to scale), it may be optimal to spend some but not all of the budget. The amount that should be spent depends on both the rate of disease spread and the production function for the prevention program. We illustrate our ideas with two examples: that of a needle exchange program, and that of a methadone maintenance program. PMID:19938440

Seasonal variability in foliar characteristics and physiology for boreal forest species at the five Saskatchewan tower sites during the 1994 Boreal Ecosystem-Atmosphere Study

NASA Astrophysics Data System (ADS)

Middleton, E. M.; Sullivan, J. H.; Bovard, B. D.; Deluca, A. J.; Chan, S. S.; Cannon, T. A.

1997-12-01

Leaf-level measurements of gas exchange, chemistry, morphology, and spectral optical properties were acquired at the five instrumented tower sites during the three 1994 growing season intensive field campaigns (IFCs) conducted near Prince Albert, Saskatchewan, as part of the Boreal Ecosystem-Atmosphere Study (BOREAS). Stands included old and young aspen (OA, YA) associated with the hazelnut shrub, old and young jack pine (OJP, YJP) stands, and an old black spruce (OBS) stand; white spruce (at YA) and an understory herb (dogbane, at OJP) were also examined. Midsummer peak photosynthesis for aspen leaves in the field (A, light saturated) and laboratory (Amax light and CO2 saturated) was ˜12.6 and 33-41 μmol CO2 m-2 s-1. Black spruce exhibited the lowest A, 3 μmol CO2 m-2 s-1. Jack pine and black spruce attained their highest Amax (17-20 μmol CO2 m-2 s-1) in late summer/early fall. Gas exchange by white spruce was significantly higher and stomatal limitation lower than for other conifers, at levels comparable to broadleaf responses. White spruce foliage had the highest chlorophyll content in fall (˜41 μg cm-2), followed by aspen (OA) and hazelnut (YA) in midsummer (˜31 μg cm-2). Specific leaf mass of aspen, hazelnut, and conifer foliage was 86, ˜47, and ˜174 g m-2, respectively. Leaf nitrogen content of broadleaves (18-40 g N g-1 dry wt) was 2-3 times greater than conifer needles (8-12 g N g-1). Significantly larger needles were produced at OJP versus YJP, but needle number per age class was greater at YJP. The absorbed photosynthetically active radiation fraction (fAPAR) in June/July averaged ˜80% for broadleaves and ˜83% in conifer needles. The simple ratio (SR, near-infrared/red ratio) calculated from foliar transmittances was more strongly related to fAPAR than SR calculated from reflectances, with stronger correlation for broadleaves (r=0.92) than for conifers (r=0.78).

Associations Between Availability and Coverage of HIV-Prevention Measures and Subsequent Incidence of Diagnosed HIV Infection Among Injection Drug Users

PubMed Central

Likatavičius, Giedrius; Klempová, Danica; Hedrich, Dagmar; Nardone, Anthony; Griffiths, Paul

2009-01-01

HIV-prevention measures specific to injection drug users (IDUs), such as opioid substitution treatment and needle-and-syringe programs, are not provided in many countries where injection drug use is endemic. We describe the incidence of diagnosed HIV infection in IDUs and the availability and coverage of opioid substitution and needle-and-syringe programs in the European Union and 5 middle- and high-income countries. Countries with greater provision of both prevention measures in 2000 to 2004 had lower incidence of diagnosed HIV infection in 2005 and 2006. PMID:19372511

A qualitative assessment of stakeholder perceptions and socio-cultural influences on the acceptability of harm reduction programs in Tijuana, Mexico

PubMed Central

Philbin, Morgan M; Lozada, Remedios; Zúñiga, María Luisa; Mantsios, Andrea; Case, Patricia; Magis-Rodriguez, Carlos; Latkin, Carl A; Strathdee, Steffanie A

2008-01-01

Background The Mexico-U.S. border region is experiencing rising rates of blood-borne infections among injection drug users (IDUs), emphasizing the need for harm reduction interventions. Methods We assessed the religious and cultural factors affecting the acceptability and feasibility of three harm reduction interventions – Needle exchange programs (NEPs), syringe vending machines, and safer injection facilities (SIFs) – in Tijuana, Mexico. In-depth qualitative interviews were conducted with 40 community stakeholders to explore cultural and societal-related themes. Results Themes that emerged included Tijuana's location as a border city, family values, and culture as a mediator of social stigma and empathy towards IDUs. Perception of low levels of both awareness and socio-cultural readiness for harm reduction interventions was noted. Religious culture emerged as a theme, highlighting the important role religious leaders play in determining community responses to harm reduction and rehabilitation strategies for IDUs. The influence of religious culture on stakeholders' opinions concerning harm reduction interventions was evidenced by discussions of family and social values, stigma, and resulting policies. Conclusion Religion and politics were described as both a perceived benefit and deterrent, highlighting the need to further explore the overall influences of culture on the acceptability and implementation of harm reduction programs for drug users. PMID:19021899

The Hydrodynamics of Needle-Free Intradermal Jet Injection

NASA Astrophysics Data System (ADS)

Simmons, Jonathan; Marston, Jeremy; Fisher, Paul; Broderick, Kate

2017-11-01

Needle-free methods of drug delivery circumvent the drawbacks associated with the use of hypodermic needles such as needle-stick injuries, needle-phobia, cross contamination and disposal. Furthermore, pioneering DNA-based vaccines that aim to treat cancer and fight infectious diseases, such as HIV, Ebola and Zika, require precise deposition into the skin to target the immune response producing cells found only in the epidermis and dermis. Intradermal (ID) delivery can be achieved using a needle and the Mantoux technique but this requires a highly skilled technician and so extensive use of DNA vaccines calls for an alternative method of delivery. One option is jet injection which has been employed in mass vaccination programs for intramuscular or subcutaneous delivery and is used by some diabetic patients to inject insulin. In this talk I will present results from our ongoing ex-vivo experimental study into ID jet injection. Ultra-high-speed imaging is used to visualize the process of the jet exiting the nozzle and striking excised skin. A skin bleb grows as liquid is deposited within the skin. I will discuss how the control parameters, such as the rheological profile of the liquid and the stand-off distance, influence the volume of liquid successfully delivered intradermally.

A method of determining the presence of blood in and on a dental needle after the administration of local anesthetic.

PubMed

Kotze, Marthinus J; Labuschagne, Willemien

2014-06-01

In the study reported in this article, the authors aimed to demonstrate the presence of blood on the surface and in the lumen of two gauges of dental needles after administration of local anesthetic (LA) by using three LA-administering techniques normally used for the extraction of teeth. The authors obtained standardized photographs of 200 urine dipsticks after moistening the dipstick's chemical pads for blood with the first drop of liquid discharged from the needle lumen after LA administration. Using the histogram function of a software program, the authors analyzed differences in gray-scale values of the different blood parameters for the presence of blood. They used luminol spray to expose small quantities of blood on the surface of the needle after LA administration. Blood was identified at 39 percent in the lumen and at 16 percent on the surface of the needles when analyzed after LA administration. With the method used, it was possible to demonstrate and quantify the percentage of blood present in the lumen of needles (39 percent) after the administration of dental LA. Furthermore, the technique was adequately sensitive for demonstrating the quantity of blood in two needles of different diameters. By demonstrating the presence, as well as quantifying the percentage, of blood on two dental needles of different gauges after the administration of LA, dental health care workers can be motivated to report needlestick injuries and to follow the approved protocols recommended by their institutions.

New foliage growth is a significant, unaccounted source for volatiles in boreal evergreen forests

NASA Astrophysics Data System (ADS)

Aalto, J.; Kolari, P.; Hari, P.; Kerminen, V.-M.; Schiestl-Aalto, P.; Aaltonen, H.; Levula, J.; Siivola, E.; Kulmala, M.; Bäck, J.

2014-03-01

Estimates of volatile organic compound (VOC) emissions from forests are based on the assumption that foliage has a steady emission potential over its lifetime, and that emissions are mainly modified by short-term variations in light and temperature. However, in many field studies this has been challenged, and high emissions and atmospheric concentrations have been measured during periods of low biological activity, such as in springtime. We conducted measurements during three years, using an online gas-exchange monitoring system to observe volatile organic emissions from a mature (1 year-old) and a growing Scots pine shoot. The emission rates of organic vapors from vegetative buds of Scots pine during the dehardening and rapid shoot growth stages were one to two orders of magnitude higher than those from mature foliage; this difference decreased and finally disappeared when the new shoot was maturing in late summer. On average, the springtime monoterpene emission rate of the bud was about 500 times higher than that of the mature needles; during the most intensive needle elongation period, the monoterpene emission rate of the growing needles was 3.5 higher than that of the mature needles, and in September the monoterpene emission rate of the same years' needles was even lower (50%) than that of the previous years' needles. For other measured compounds (methanol, acetone and methylbutenol) the values were of the same order of magnitude, except before bud break in spring, when the emission rates of buds for those compounds were on average about 20-30 times higher than that of mature needles. During spring and early summer the buds and growing shoots are a strong source of several VOCs, and if they are not accounted for in emission modeling a significant proportion of the emissions - from a few percent to even half of the annual cumulative emissions - will remain concealed. The diurnal emission pattern of growing shoots differed from the diurnal cycle in temperature as well as from the diurnal emission pattern of mature shoots, which may be related to processes involved in shoot or needle elongation. Our findings imply that global estimations of monoterpene emission rates from forests are in need of revision, and that the physiological state of the plants should be taken into account when emissions of the reactive gases such as monoterpenes are estimated.

Seroprevalence of HCV and HIV infection among clients of the nation's longest-standing statewide syringe exchange program: A cross-sectional study of Community Health Outreach Work to Prevent AIDS (CHOW).

PubMed

Salek, Thomas P; Katz, Alan R; Lenze, Stacy M; Lusk, Heather M; Li, Dongmei; Des Jarlais, Don C

2017-10-01

The Community Health Outreach Work to Prevent AIDS (CHOW) Project is the first and longest-standing statewide integrated and funded needle and syringe exchange program (SEP) in the US. Initiated on O'ahu in 1990, CHOW expanded statewide in 1993. The purpose of this study is to estimate the prevalences of hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infection, and to characterize risk behaviors associated with infection among clients of a long-standing SEP through the analysis of the 2012 CHOW evaluation data. A cross-sectional sample of 130 CHOW Project clients was selected from January 1, 2012 through December 31, 2012. Questionnaires captured self-reported exposure information. HIV and HCV antibodies were detected via rapid, point-of-care FDA-approved tests. Log-binomial regressions were used to estimate prevalence proportion ratios (PPRs). A piecewise linear log-binomial regression model containing 1 spline knot was used to fit the age-HCV relationship. The estimated seroprevalence of HCV was 67.7% (95% confidence interval [CI]=59.5-75.8%). HIV seroprevalence was 2.3% (95% CI=0-4.9%). Anti-HCV prevalence demonstrated age-specific patterns, ranging from 31.6% through 90.9% in people who inject drugs (PWID) <30 to ≥60 years respectively. Age (continuous/year) prior to spline knot at 51.5 years (adjusted PPR [APPR]=1.03; 95% CI=1.02-1.05) and months exchanging syringes (quartiles) (APPR=1.92; 95% CI=1.3-3.29) were independently associated with anti-HCV prevalence. In Hawai'i, HCV prevalence among PWID is hyperendemic demonstrating age- and SEP duration-specific trends. Relatively low HIV prevalence compared with HCV prevalence reflects differences in transmissibility of these 2 blood-borne pathogens and suggests much greater efficacy of SEP for HIV prevention. Copyright © 2017 Elsevier B.V. All rights reserved.

Short-term effects of fertilization on photosynthesis and leaf morphology of field-grown loblolly pine following long-term exposure to elevated CO2 concentration

Treesearch

Chris A. Maier; Sari Palmroth; Eric Ward

2008-01-01

We examined effects of a first nitrogen (N) fertilizer application on upper-canopy needle morphology and gas exchange in ~20-m-tall loblolly pine (Pinus taeda L.) exposed to elevated carbon dioxide concentration ([CO2]) for 9 years. Duke Forest free-air CO2 enrichment (FACE) plots were split and half of...

Monovalve with integrated fuel injector and port control valve, and engine using same

DOEpatents

Milam, David M.

2001-11-06

An engine includes an engine casing that defines a hollow piston cavity separated from an exhaust passage and an intake passage by a valve seat. A gas exchange valve member is positioned adjacent the valve seat and is moveable between an open position and a closed position. The gas exchange valve member also defines an opening that opens into the hollow piston cavity. A needle valve member is positioned in the gas exchange valve member adjacent a nozzle outlet and is moveable between an inject position and a blocked position. A port control valve member, which has a hydraulic surface, is mounted around the gas exchange valve member and moveable between an intake position and an exhaust position. A pilot valve is moveable between a first position at which the port control hydraulic surface is exposed to a source of high pressure fluid, and a second position at which the port control hydraulic surface is exposed to a source of low pressure fluid.

Space shuttle galley water system test program

NASA Technical Reports Server (NTRS)

1975-01-01

A water system for food rehydration was tested to determine the requirements for a space shuttle gallery flight system. A new food package concept had been previously developed in which water was introduced into the sealed package by means of a needle and septum. The needle configuration was developed and the flow characteristics measured. The interface between the food package and the water system, oven, and food tray was determined.

How far will they go? Assessing the travel distance of current and former drug users to access harm reduction services.

PubMed

Allen, Sean; Ruiz, Monica; O'Rourke, Allison

2015-03-01

Prior research has explored spatial access to syringe exchange programs (SEPs) among people who inject drugs (PWID), but little is known about service utilization by former PWID who continue to access services (e.g., HIV screenings and referrals for social services) at harm reduction providers. The purpose of this research is to examine differences in access to SEPs between current and former PWID seeking services at a mobile SEP in Washington, DC. A geometric point distance estimation technique was applied to data collected as part of a PWID population estimation study that took place in Washington, DC, in March and April 2014. We calculated the walking distance from the centroid point of home residence zip code to the mobile exchange site where PWID presented for services. An independent samples t-test was used to examine differences in walking distance measures between current and former PWID. Differences in mean walking distance were statistically significant with current and former PWID having mean walking distances of 2.75 and 1.80 miles, respectively. The results of this study suggest that former PWID who are engaging with SEPs primarily for non-needle exchange services (e.g., medical or social services) may have decreased access to SEPs than their counterparts who are active injectors. This research provides support for expanding SEP operations such that both active and former PWID have increased access to harm reduction providers and associated health and social services. Increasing service accessibility may help resolve unmet needs among current and former PWID.

Injecting Drugs in Tight Spaces: HIV, Cocaine and Collinearity in the Downtown Eastside, Vancouver, BC

PubMed Central

Ciccarone, Daniel; Bourgois, Philippe

2016-01-01

This commentary revisits the political turmoil and scientific controversy over epidemiological study findings linking high HIV seroincidence to syringe exchange attendance in Vancouver in the mid-1990s. The association was mobilized polemically by US politicians and hard-line drug warriors to attack needle exchange policies and funding. In turn, program restrictions limiting access to syringes at the Vancouver exchange may have interfaced with a complex conjunction of historical, geographic, political economic and cultural forces and physiological vulnerabilities to create an extraordinary HIV risk environment: 1) ghettoization of services for indigent populations in a rapidly gentrifying, post-industrial city; 2) rural-urban migration of vulnerable populations subject to historical colonization and current patterns of racism; and 3) the flooding of North America with inexpensive powder cocaine and heroin, and the popularity of crack. In fact, we will never know with certainty the precise cause for the extreme seroincidence rates in Vancouver in the early to mid-1990s. The tendency for modern social epidemiology to decontextualize research subjects and assign excessive importance to discrete, “magic bullet” variables resulted in a counterproductive scientific and political debate in the late 1990s that has obfuscated potentially useful practical lessons for organizing the logistics of harm reduction services–especially syringe exchange–to better serve the needs of vulnerable populations and to mitigate the effects of political-economically imposed HIV risk environments. We would benefit from humbly acknowledging the limits of public health science and learn to recognize the unintended consequences of well-intentioned interventions rather than sweep embarrassing histories under the rug. PMID:27117187

Automating fruit fly Drosophila embryo injection for high throughput transgenic studies

NASA Astrophysics Data System (ADS)

Cornell, E.; Fisher, W. W.; Nordmeyer, R.; Yegian, D.; Dong, M.; Biggin, M. D.; Celniker, S. E.; Jin, J.

2008-01-01

To decipher and manipulate the 14 000 identified Drosophila genes, there is a need to inject a large number of embryos with transgenes. We have developed an automated instrument for high throughput injection of Drosophila embryos. It was built on an inverted microscope, equipped with a motorized xy stage, autofocus, a charge coupled device camera, and an injection needle mounted on a high speed vertical stage. A novel, micromachined embryo alignment device was developed to facilitate the arrangement of a large number of eggs. The control system included intelligent and dynamic imaging and analysis software and an embryo injection algorithm imitating a human operator. Once the injection needle and embryo slide are loaded, the software automatically images and characterizes each embryo and subsequently injects DNA into all suitable embryos. The ability to program needle flushing and monitor needle status after each injection ensures reliable delivery of biomaterials. Using this instrument, we performed a set of transformation injection experiments. The robot achieved injection speeds and transformation efficiencies comparable to those of a skilled human injector. Because it can be programed to allow injection at various locations in the embryo, such as the anterior pole or along the dorsal or ventral axes, this system is also suitable for injection of general biochemicals, including drugs and RNAi.

Effect of Needle Size in Ultrasound-guided Core Needle Breast Biopsy: Comparison of 14-, 16-, and 18-Gauge Needles.

PubMed

Giuliani, Michela; Rinaldi, Pierluigi; Rella, Rossella; Fabrizi, Gina; Petta, Federica; Carlino, Giorgio; Di Leone, Alba; Mulè, Antonino; Bufi, Enida; Romani, Maurizio; Belli, Paolo; Bonomo, Lorenzo

2017-11-01

The aim of the present study was to assess the diagnostic accuracy of ultrasound-guided core needle biopsy (US-CNB) of breast lesions, comparing smaller needles (16- and 18-gauge) with the 14-gauge needle, and to analyze the lesion characteristics influencing US-CNB diagnostic performance. All the patients provided informed consent before the biopsy procedure. The data from breast lesions that had undergone US-CNB in our institution from January 2011 to January 2015 were retrospectively reviewed. The inclusion criterion was the surgical histopathologic examination findings of the entire lesion or radiologic follow-up data for ≥ 24 months. The exclusion criterion was the use of preoperative neoadjuvant therapy. The US-CNB results were compared with the surgical pathologic results or with the follow-up findings in the 3 needle size groups (14-, 16-, and 18-gauge). The needle size- and lesion characteristic-specific diagnostic accuracy parameters were evaluated. Statistical analysis was performed using a dedicated software program, and P ≤ .01 was considered significant. A total of 1118 US-CNB cases (1042 patients) were included. Of the 1118 cases, 630 (56.3%) were in the 14-gauge group, 136 (12.2%) in the 16-gauge, and 352 (31.5%) in the 18-gauge needle group. Surgery was performed on 800 lesions (71.6%). Of these, 619 were malignant, 77 were high risk, and 104 were benign. The remaining 318 lesions (28.4%) underwent follow-up imaging studies. All the lesions were stable and, therefore, were considered benign. No differences were observed in the diagnostic accuracy parameters among the 3 needle size groups (P > .01). The false-negative rate was greater for lesions < 10 mm (7.2%) (P < .01) but without statistically significant differences among the 3 gauges (P > .01). US-CNB performed with small needles (16 and 18 gauge) had the same diagnostic accuracy as that performed with 14-gauge needles, regardless of the lesion characteristics. Copyright © 2017 Elsevier Inc. All rights reserved.

[Evaluation of needle exchange program at Pereiro de Aguiar prison (Ourense, Spain): ten years of experience].

PubMed

Ferrer-Castro, V; Crespo-Leiro, M R; García-Marcos, L S; Pérez-Rivas, M; Alonso-Conde, A; García-Fernández, I; Lorenzo-Guisado, A; Sánchez-Fernández, J L; Seara-Selas, M; Sanjosé-Vallejo, R

2012-01-01

To evaluate the effectiveness of NEPs in prison to reduce the prevalence of infections associated with intravenous drug use and to know more about acceptance of the program by inmates and staff. cross-sectional observational study at baseline, 6 and 12 months and 10 years of program development. Interviews were conducted with program users, as well as random sample surveys of officials at the various cuts, and a random sample of inmates from the centre after10 years. Activity indicators of the program were recorded continuously, and the prevalence of HIV, HBV and HCV at baseline and after 10 years was evaluated. For the statistical analysis, the chi-square test was used with the Yates correction when necessary. In ten years we have supplied a total of 15,962 syringes to 429 users, (average 20.2 users/month), and 11,327 (70.9%) were returned. The prevalence of HIV infection decreased from 21% in 1999 to 8.5% in 2009, HCV prevalence from 40% to 26.1% (p <0.01), finding no significant differences in the prevalence of HBsAg +. Most of the inmates and civil servants believe that the program did not increase intravenous drug use and improves hygienic living conditions in prison. After ten years of development of the NEP, there was a significant decrease in the prevalence of HIV and HCV in the prison population at the centre, and the program is accepted as beneficial by most of the inmates and staff participating in the survey.

Syringe access for the prevention of blood borne infections among injection drug users

PubMed Central

Stancliff, Sharon; Agins, Bruce; Rich, Josiah D; Burris, Scott

2003-01-01

Background Approximately one-third of acquired immunodeficiency syndrome cases in the United States are associated with the practice of sharing of injection equipment and are preventable through the once-only use of syringes, needles and other injection equipment. Discussion Sterile syringes may be obtained legally by 4 methods depending on the state. They may be purchased over the counter, prescribed, obtained at syringe exchange programs or furnished by authorized agencies. Each of these avenues has advantages and disadvantages; therefore, legal access through all means is the most likely way to promote the use of sterile syringes. Summary By assisting illicit drug injectors to obtain sterile syringes the primary care provider is able to reduce the incidence of blood borne infections, and educate patients about safe syringe disposal. The provider is also able to initiate discussion about drug use in a nonjudgmental manner and to offer care to patients who are not yet ready to consider drug treatment. PMID:14633286

A randomized trial to evaluate the efficacy of a computer-tailored intervention to promote safer injection practices among drug users.

PubMed

Gagnon, Hélène; Godin, Gaston; Alary, Michel; Bruneau, Julie; Otis, Joanne

2010-06-01

The aim of this study was to evaluate the efficacy of a theory-based intervention to increase the use of a new syringe for each injection among injection drug users (IDUs). Users of two needle exchange programs (NEPs) were involved. At both sites, participants were assigned at random to either the experimental or the control group. Once a week for four weeks, users reported to the NEPs where they logged onto a computer and received an audiovisual message. A total of 260 IDUs were recruited. At baseline, 52.3% of participants reported that they had not always used new syringes in the previous week. The results indicate that it is possible for IDUs to adopt safer injection practices. One month after the intervention began, participants in the experimental group were using fewer dirty syringes compared to the control group (RR: 0.47 CI(95%) 0.28-0.79; P = .004). This short-term effect was no longer present 3 months later.

Behavior of healthcare workers after injuries from sharp instruments.

PubMed

Adib-Hajbaghery, Mohsen; Lotfi, Mohammad Sajjad

2013-09-01

Injuries with sharps are common occupational hazards for healthcare workers. Such injuries predispose the staff to dangerous infections such as hepatitis B, C and HIV. The present study was conducted to investigate the behaviors of healthcare workers in Kashan healthcare centers after needle sticks and injuries with sharps in 2012. A cross-sectional study was conducted on 298 healthcare workers of medical centers governed by Kashan University of Medical Sciences. A questionnaire was used in this study. The first part included questions about demographic characteristics. The second part of the questionnaire consisted of 16 items related to the sharp instrument injuries. For data analysis, descriptive and analytical statistics (chi-square, ANOVA and Pearson correlation coefficient) SPSS version 16.0 software was used. From a total of 298 healthcare workers, 114 (38.3%) had a history of injury from needles and sharp instruments in the last six months. Most needle stick and sharp instrument injuries had occurred among the operating room nurses and midwifes; 32.5% of injuries from sharp instruments occurred in the morning shift. Needles were responsible for 46.5% of injuries. The most common actions taken after needle stick injuries were compression (27.2%) and washing the area with soap and water (15.8%). Only 44.6% of the injured personnel pursued follow-up measures after a needle stick or sharp instrument injury. More than a half of the healthcare workers with needle stick or sharp instrument injury had refused follow-up for various reasons. The authorities should implement education programs along with protocols to be implemented after needle stick injuries or sharps.

Periosteal Electrical Dry Needling as an Adjunct to Exercise and Manual Therapy for Knee Osteoarthritis: A Multi-Center Randomized Clinical Trial.

PubMed

Dunning, James; Butts, Raymond; Young, Ian; Mourad, Firas; Galante, Victoria; Bliton, Paul; Tanner, Michelle; Fernández-de-Las-Peñas, César

2018-05-28

To compare the effects of adding electrical dry needling into a manual therapy and exercise program on pain, stiffness, function, and disability in individuals with painful knee osteoarthritis (OA). Two hundred and forty-two participants (n=242) with painful knee OA were randomized to receive 6 weeks of electrical dry needling, manual therapy and exercise (n=121) or manual therapy and exercise (n=121). The primary outcome was related-disability as assessed by the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index at 3 months. Individuals receiving the combination of electrical dry needling, manual therapy and exercise experienced significantly greater improvements in related-disability (WOMAC: F=35.504; P<0.001) than those receiving manual therapy and exercise alone at 6 weeks and 3 months. Patients receiving electrical dry needling were 1.7 times more likely to have completely stopped taking medication for their pain at 3 months than individuals receiving manual therapy and exercise (OR: 1.6; 95%CI: 1.24-2.01; P=0.001). Based on the cutoff score of +5 on the Global Rating of Change (GROC), significantly (X =14.887; P<0.001) more patients (n=91, 75%) within the dry needling group achieved a successful outcome compared to the manual therapy and exercise group (n=22, 18%) at 3 months. Effect sizes were large (SMD>0.82) for all outcome measures in favor of the electrical dry needling group at 3 months. The inclusion of electrical dry needling into a manual therapy and exercise program was more effective for improving pain, function and related-disability than the application of manual therapy and exercise alone in individuals with painful knee OA. Therapy, Level 1b. Prospectively registered February 10, 2015 on http://www.clinicaltrials.gov (NCT02373631)This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/.

Effects of nonlocal hydromechanics in a flow in thin channels

NASA Astrophysics Data System (ADS)

Aydagulov, R. R.; Ganiev, O. R.

2017-04-01

An approach to viscous friction is described as nonlocal momentum exchange between different layers of a fluid. The Navier-Stokes equations are replaced by pseudo-differential equations hyperbolic in time. In this case, instead of zero velocity on the boundary, a nonlocal nonlinear boundary condition is set in the form of the velocity dependence of the coefficient before the intensity of the momentum exchange with the boundary. The non-newtonian character of the viscosity of water is shown in experiments with thin insulin needles and explained by the nonlinear character of the momentum exchange of water with the boundary. The calculations agree very well both with our experiments and with the experiments of other authors. Calculations show that the flow decreases more than one-and-a-half times in comparison with the Poiseuille flow for channels with a diameter of 360-390 μm, which is confirmed in experiments.

Australia's role in HIV prevention in the developing world.

PubMed

Cooper, D A

1995-12-01

A scientist with the National Centre in HIV Epidemiology and Clinical Research at the University of New South Wales in Sydney, Australia, addresses the fact that Australians working in the area of HIV infection have been very successful in prevention, treatment, and care. In the early 1980s, a bipartisan political decision was made to foster an effective partnership between HIV-infected communities, health care providers, and governments. HIV-infected communities included sex workers, prisoners, Aboriginal people, and high profile gay community activists. These three different groups succeeded in forming such a partnership, as reflected in the fact that the annual number of new HIV cases is down to 500 from a peak of 3000 in 1984. A key method used to contain HIV infection was needle-and-syringe exchange programs and continuing access to needles to prevent HIV transmission in the injecting drug community. Even though Australia has all this experience and success, it had a backseat role in ushering in the UNAIDS program because Australia did not contribute a significant share of the agency's relatively small budget (US$100 million/year). If Australia were to give just 10%, it would acquire a front row seat along with the Netherlands, Sweden, Belgium, France, and the UK. These nations have the greatest say as to where UNAIDS funds go. The Australian international aid organization has recently received an increase in funds, $110 million for 4 years to spend on four areas, one of which is HIV/AIDS. Australia has just allocated $25 million for a 5-year program for HIV/STD (sexually transmitted disease) prevention in Indonesia. This money would have been able to buy Australia a leading role in UNAIDS. Australians need to reassess their priorities. Australians can help their neighbors in the Asia-Pacific region move away from their denial of HIV to HIV prevention and care. They can conduct clinical trials of shorter and more user-friendly regimens of antiviral drugs that may lead to reduced perinatal transmission and research on microbicides. They can prevent tuberculosis and introduce manageable methods of securing safe blood supplies and mass screening.

Robot-assisted antegrade in-situ fenestrated stent grafting.

PubMed

Riga, Celia V; Bicknell, Colin D; Wallace, Daniel; Hamady, Mohamad; Cheshire, Nicholas

2009-05-01

To determine the technical feasibility of a novel approach of in-situ fenestration of aortic stent grafts by using a remotely controlled robotic steerable catheter system in the porcine model. A 65-kg pig underwent robot-assisted bilateral antegrade in-situ renal fenestration of an abdominal aortic stent graft with subsequent successful deployment of a bare metal stent into the right renal artery. A 16-mm iliac extension covered stent served as the porcine aortic endograft. Under fluoroscopic guidance, the graft was punctured with a 20-G customized diathermy needle that was introduced and kept in place by the robotic arm. The needle was exchanged for a 4 x 20 mm cutting balloon before successful deployment of the renal stent. Robot-assisted antegrade in-situ fenestration is technically feasible in a large mammalian model. The robotic system enables precise manipulation, stable positioning, and minimum instrumentation of the aorta and its branches while minimizing radiation exposure.

Needle and syringe sharing among Iranian drug injectors

PubMed Central

Rafiey, Hassan; Narenjiha, Hooman; Shirinbayan, Peymaneh; Noori, Roya; Javadipour, Morteza; Roshanpajouh, Mohsen; Samiei, Mercedeh; Assari, Shervin

2009-01-01

Objective The role of needle and syringe sharing behavior of injection drug users (IDUs) in spreading of blood-borne infections – specially HIV/AIDS – is well known. However, very little is known in this regard from Iran. The aim of our study was to determine the prevalence and associates of needle and syringe sharing among Iranian IDUs. Methods In a secondary analysis of a sample of drug dependents who were sampled from medical centers, prisons and streets of the capitals of 29 provinces in the Iran in 2007, 2091 male IDUs entered. Socio-demographic data, drug use data and high risk behaviors entered to a logistic regression to determine independent predictors of lifetime needle and syringe sharing. Results 749(35.8%) reported lifetime experience of needle and syringe sharing. The likelihood of lifetime needle and syringe sharing was increased by female gender, being jobless, having illegal income, drug use by family members, pleasure/enjoyment as causes of first injection, first injection in roofless and roofed public places, usual injection at groin, usual injection at scrotum, lifetime experience of nonfatal overdose, and history of arrest in past year and was decreased by being alone at most injections. Conclusion However this data has been extracted from cross-sectional design and we can not conclude causation, some of the introduced variables with association with needle and syringe sharing may be used in HIV prevention programs which target reducing syringe sharing among IDUs. PMID:19643014

Frequent food insecurity among injection drug users: correlates and concerns.

PubMed

Strike, Carol; Rudzinski, Katherine; Patterson, Jessica; Millson, Margaret

2012-12-08

Food insecurity and nutrition are two topics that are under-researched among injection drug users (IDUs). Our study examined the extent and correlates of food insecurity among a sample of IDUs and explored whether there is an association between food insecurity and injection-related HIV risk. A cross-sectional survey was conducted using interviewer-administered questionnaires. Data were collected at a needle exchange program in London, Ontario, Canada between September 2006 and January 2007. Participants included 144 English-speaking IDUs who had injected drugs in the past 30 days. Participants were asked about their socio-demographic characteristics, HIV risk behaviours, food insecurity, and health/social service use. In the past 6 months, 54.5% of participants reported that on a daily/weekly basis they did not have enough to eat because of a lack of money, while 22.1% reported this type of food insecurity on a monthly basis. Moreover, 60.4% and 24.3% reported that they did not eat the quality or quantity of food they wanted on a daily/weekly or a monthly basis, respectively. Participants reported re-using someone else's injection equipment: 21% re-used a needle, 19% re-used water, and 37.3% re-used a cooker. The odds of sharing injection equipment were increased for food insecure individuals. Findings show that IDUs have frequent and variable experiences of food insecurity and these experiences are strongly correlated with sharing of injection-related equipment. Such behaviours may increase the likelihood of HIV and HCV transmission in this population. Addressing food-related needs among IDUs is urgently needed.

Fine Needle Aspiration

MedlinePlus

... Programs Professional Development Home AcademyU Home Study Course Maintenance of Certification Conferences & Events Practice Management Home Resources Quality Clinical Data Registry Research Reimbursement ...

Optimal investment in a portfolio of HIV prevention programs.

PubMed

Zaric, G S; Brandeau, M L

2001-01-01

In this article, the authors determine the optimal allocation of HIV prevention funds and investigate the impact of different allocation methods on health outcomes. The authors present a resource allocation model that can be used to determine the allocation of HIV prevention funds that maximizes quality-adjusted life years (or life years) gained or HIV infections averted in a population over a specified time horizon. They apply the model to determine the allocation of a limited budget among 3 types of HIV prevention programs in a population of injection drug users and nonusers: needle exchange programs, methadone maintenance treatment, and condom availability programs. For each prevention program, the authors estimate a production function that relates the amount invested to the associated change in risky behavior. The authors determine the optimal allocation of funds for both objective functions for a high-prevalence population and a low-prevalence population. They also consider the allocation of funds under several common rules of thumb that are used to allocate HIV prevention resources. It is shown that simpler allocation methods (e.g., allocation based on HIV incidence or notions of equity among population groups) may lead to alloctions that do not yield the maximum health benefit. The optimal allocation of HIV prevention funds in a population depends on HIV prevalence and incidence, the objective function, the production functions for the prevention programs, and other factors. Consideration of cost, equity, and social and political norms may be important when allocating HIV prevention funds. The model presented in this article can help decision makers determine the health consequences of different allocations of funds.

Moving the Needle on Program Quality: An Examination of the Organizational Characteristics That Drive Improvement in Expanded Learning Programs

ERIC Educational Resources Information Center

McCormick, Silvana

2017-01-01

Program evaluation can play a critical role in supporting high quality implementation of social programs to help them achieve their goal of social impact. Evaluation scholars have developed a wide range of strategies to help build programs' internal evaluation capacity in an effort to support meaningful use of evaluation. However, the evaluation…

Belowground Carbon Allocation to Ectomycorrhizal Fungi Links Biogeochemical Cycles of Boron and Nitrogen

NASA Astrophysics Data System (ADS)

Lucas, R. W.; Högberg, P.; Ingri, J. N.

2011-12-01

Boron (B) is an essential micronutrient to most trees and represents an important limiting resource in some regions, deficient trees experiencing the loss of apical dominance, altered stem growth, and even tree death in extreme cases. Similar to the acquisition of most soil nutrients, B is likely supplied to host trees by mycorrhizal symbionts in exchange for recently fixed carbohydrates. In this way, belowground allocation of photosynthate, which drives the majority of biological processes belowground, links the biogeochemical cycles of B and nitrogen (N). Using a long-term N addition experiment in a Pinus sylvestris forest that has been ongoing for 41 years, we examined how the availability of inorganic N mediates the response of B isotopes in the tree needles, organic soil, and fungal pools in a boreal forest in northern Sweden. Using archived needle samples collected annually from the current year's needle crop, we observed δ11B to increase from 30.8 (0.5 se) to 41.8 (0.7 se)% in N fertilized plots from 1970 to 1979, a period of increasing B deficiency stress induced by N fertilization; the concentration of B in tree needles during 1979 dropping as low as 3.0 μg g-2. During the same period, B concentrations in tree needles from control plots remained relatively unchanged and δ11B remained at a steady state value of 34.1 (1.0 se)%. Following a distinct, large-scale, pulse labeling event in 1980 in which 2.5 kg ha-1 of isotopically distinct B was applied to all treatment and control plots to alleviate the N-induced B deficiency, concentrations of B in current needles increased immediately in all treatments, the magnitude of the response being dependent upon the N treatment. But unlike other pool dilution studies, δ11B of current tree needles did not return to pre-addition, steady-state levels. Instead, δ11B continued to decrease over time in both N addition and control treatments. This unexpected pattern has not been previously described but can be explained by the preferential translocation of 10B to their host trees by ectomycorrhizal fungi, while the fungal partner retains the heavier 11B. Repeated fractionation over time leads to progressively larger differences in δ11B in both current tree needles and also fungal tissue, analogous to the repeated fractionation of N isotopes by ectomycorrhizal fungi.

Racial differences in acquisition of syringes from pharmacies under conditions of legal but restricted sales.

PubMed

Costenbader, Elizabeth C; Zule, William A; Coomes, Curtis C

2010-09-01

Injecting drug users (IDUs) are at increased risk of acquiring and transmitting HIV and other bloodborne pathogens through the multi-person use of syringes. Although research has shown that increased access to syringes through syringe exchange programs (SEPs) is an effective strategy to reduce risky injection practices many areas of the United States still do not have SEPs. In the absence of SEPs, legislation allowing pharmacies over-the-counter sales of syringes has also been shown to reduce syringe sharing. The success of pharmacy sales however is limited by other legal stipulations, such as drug paraphernalia laws, which in turn may contribute to fear among IDUs about being caught purchasing and carrying syringes. Between 2003 and 2006, 851 out-of-treatment IDUs were recruited using street outreach in the Raleigh-Durham (North Carolina) area. Data were collected using audio-computer assisted interview (ACASI) technology. Multiple logistic regression analyses were performed to assess factors associated with purchasing syringes from pharmacies. In our study sample, African-American IDUs were one-fifth as likely as white IDUs to report pharmacies as their primary source of syringes. Given the absence of syringe exchange programs and the relatively high prevalence of HCV and HIV among IDUs in the Raleigh-Durham area, the limited use of pharmacies as a source of syringes among African-American IDUs in this study sample is problematic. The study findings support the need for effective multilevel interventions to increase access to clean needles in this population, as well as for policy interventions, such as legalization of SEPs and elimination of penalties for carrying syringes, to reduce harm and eliminate the health threats posed by receptive syringe sharing. Copyright 2010 Elsevier B.V. All rights reserved.

Effects of elevated CO(2) concentration and nutrition on net photosynthesis, stomatal conductance and needle respiration of field-grown Norway spruce trees.

PubMed

Roberntz, Peter; Stockfors, Jan

1998-04-01

To study the effects of elevated CO(2) on gas exchange, nonstructural carbohydrate and nutrient concentrations in current-year foliage of 30-year-old Norway spruce (Picea abies (L.) Karst.) trees, branches were enclosed in ventilated, transparent plastic bags and flushed with ambient air (mean 370 &mgr;mol CO(2) mol(-1); control) or ambient air + 340 &mgr;mol CO(2) mol(-1) (elevated CO(2)) during two growing seasons. One branch bag was installed on each of 24 selected trees from control and fertilized plots. To reduce the effect of variation among trees, results from each treated branch were compared with those from a control branch on the same whorl of the same tree. Elevated CO(2) increased rates of light-saturated photosynthesis on average by 55% when measured at the treatment CO(2) concentration. The increase was larger in shoots with high needle nitrogen concentrations than in shoots with low needle nitrogen concentrations. However, shoots grown in elevated CO(2) showed a decrease in photosynthetic capacity compared with shoots grown in ambient CO(2). When measured at the internal CO(2) concentration of 200 &mgr;mol CO(2) mol(-1), photosynthetic rates of branches in the elevated CO(2) treatments were reduced by 8 to 32%. The elevated CO(2) treatment caused a 9 to 20% reduction in carboxylation efficiency and an 18% increase in respiration rates. In response to elevated CO(2), starch, fructose and glucose concentrations in the needles increased on average 33%, whereas concentrations of potassium, nitrogen, phosphorus, magnesium and boron decreased. Needle nitrogen concentrations explained 50-60% of the variation in photosynthesis and CO(2) acclimation was greater at low nitrogen concentrations than at high nitrogen concentrations. We conclude that the enhanced photosynthetic rates found in shoots exposed to elevated CO(2) increased carbohydrate concentrations, which may have a negative feedback on the photosynthetic apparatus and stimulate cyanide-resistant respiration. We also infer that the decrease in nutrient concentrations of needles exposed to elevated CO(2) was the result of retranslocation of nutrients to other parts of the branch or tree.

SU-F-T-44: A Comparison of the Pre-Plan, Intra-Operative Plan, and Post-Implant Dosimetry for a Prostate Implant Case Using Prefabricated Linear Polymer-Encapsulated Pd-103

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

Sheu, R; Powers, A; McGee, H

Purpose: To investigate the reproducibility and limitations of Pd-103 prostate brachytherapy using fixed length linear sources (CivaString). Methods: An LDR prostate brachytherapy case which was preplanned on MR images with prefabricated linear polymer-encapsulated Pd-103 sources (CivaString) was studied and compared with ultrasound based intra-operative planning and CT based post-implant dosimetry. We evaluated the following parameters among the three studies: prostate geometry (volume and cross sectional area), needle position and alignment deviations, and dosimetry parameters (D90). Results: The prostate volumes and axial cross sectional areas at center of prostate were measured as 41.8, 39.3 and 36.8 cc, and 14.9, 14.3, andmore » 11.3 respectively on pre-plan MR, inter-op US, and post-implant CT studies. The deviation of prostate volumes and axial cross sectional areas measured on pre-planning MR and intra-operative US were within 5%. 17 out of 19 pre-planned needles were positioned within 5mm (the template grid size). One needle location was adjusted intra-operatively and another needle was removed due to proximity to urethra. The needle pathways were not always parallel to the trans-rectal probe due to the flexibility of CivaString. The angle of deviation was up to 10 degrees. Two pairs of needles were exchanged to better fit the length of prostate at the time of implant. This resulted in a prostate D90 of 153.8 Gy (124%) and 131.4 Gy (106.7%) for intra-op and PID respectively. Conclusion: Preplanning is a necessary part of implants performed with prefabricated linear polymer sources. However, as is often the case, there were real-time deviations from the pre-plan. Intra-op planning provides the ability conform to anatomy at the time of implant. Therefore, we propose to develop a systematic way to order extra strings of different length to provide the flexibility to perform intra-operative planning with fixed length strands.« less

Plant Gas Exchange at High Wind Speeds 1

PubMed Central

Caldwell, Martyn M.

1970-01-01

High altitude Rhododendron ferrugineum L. and Pinus cembra L. seedlings were exposed to winds at 15 meters per second for 24-hour periods. Wind-sensitive stomata of Rhododendron seedlings immediately initiated a closing response which resulted in decreased photosynthesis and an even greater reduction in transpiration. Stomatal aperture and transpiration rates of P. cembra were only slightly reduced by high speed winds. However, photosynthesis was substantially reduced because of changes in needle display to available irradiation. PMID:16657501

The rise of injecting drug use in east Africa: a case study from Kenya

PubMed Central

Beckerleg, Susan; Telfer, Maggie; Hundt, Gillian Lewando

2005-01-01

Studies on injecting drug use in East Africa are reviewed. The existingstudies document the spread of heroin injection in Kenya and Tanzania, both countries where HIV rates are high. No data from Uganda on injecting drug use was found by the authors. A case study of the growth of heroin injection in a Kenyan coastal town is presented. The need for needle-exchange programmes and other prevention services is discussed. PMID:16122382

Exploring stakeholder perceptions of acceptability and feasibility of needle exchange programmes, syringe vending machines and safer injection facilities in Tijuana, Mexico.

PubMed

Philbin, Morgan M; Mantsios, Andrea; Lozada, Remedios; Case, Patricia; Pollini, Robin A; Alvelais, Jorge; Latkin, Carl A; Magis-Rodriguez, Carlos; Strathdee, Steffanie A

2009-07-01

Injection drug use is a growing public health crisis along the U.S.-Mexican border and rising rates of blood-borne infections highlight the pressing need for harm reduction interventions. We explored the acceptability and feasibility of such interventions in Tijuana, a city adjacent to San Diego, California. Using in-depth qualitative interviews conducted from August 2006-March 2007 with 40 key stakeholders - pharmacists, legal professionals, health officials, religious officials, drug treatment providers, and law enforcement personnel - we explored the acceptability and feasibility of interventions to reduce drug-related harm in Tijuana, Mexico. Interviews were taped with consent, transcribed verbatim, and translated. Content analysis was conducted to identify themes which included barriers, structural limitations, and suggestions for implementation. Topics included acceptance and feasibility of needle exchange programmes (NEPs), syringe vending machines, and safer injection facilities (SIFs), structural barriers and suggestions for implementation. Of these interventions, NEPs were deemed the most acceptable (75%); however, only half believed these could be feasibly implemented, citing barriers involving religion, police, and lack of political will, public awareness, and funding. Increasing HIV infection rates among injection drug users in Tijuana have prompted interest in public health responses. Our results may assist policy strategists in implementing social-structural interventions that will help create enabling environments that facilitate the scale-up and implementation of harm reduction in Tijuana.

Fine Needle Aspiration

MedlinePlus

... Humanitarian Efforts International Outreach Advocacy Board of Governors Industry Programs Professional Development Home AcademyU Home Study Course Maintenance of Certification Conferences & Events Practice Management Home Resources ...

OSHA to inspect hospitals, medical clinics for use of safer needles. Occupational Safety and Health Administration.

PubMed

1999-11-26

The Occupational Safety and Health Administration (OSHA) has notified compliance officers of its intention to start imposing sanctions against health care facilities that do not use safe-needle devices. OSHA also said that facilities need to conduct yearly audits of their bloodborne pathogen programs, and must integrate new technologies wherever possible to protect their employees from exposure. Facilities affected include hospitals, home health service organizations, employment agencies, independent health care professionals, and independent contractors. About 800,000 hospital workers are accidentally punctured by needles each year. HIV is present in about 2 percent of those cases, but only a small number of workers actually contract the virus. The directive is available on the OSHA web site, and contact information is provided.

Social Network Analysis of the Farabi Exchange Program: Student Mobility

ERIC Educational Resources Information Center

Ugurlu, Zeynep

2016-01-01

Problem Statement: Exchange programs offer communication channels created through student and instructor exchanges; a flow of information takes place through these channels. The Farabi Exchange Program (FEP) is a student and instructor exchange program between institutions of higher education. Through the use of social network analysis and…

Reconciling incongruous qualitative and quantitative findings in mixed methods research: exemplars from research with drug using populations.

PubMed

Wagner, Karla D; Davidson, Peter J; Pollini, Robin A; Strathdee, Steffanie A; Washburn, Rachel; Palinkas, Lawrence A

2012-01-01

Mixed methods research is increasingly being promoted in the health sciences as a way to gain more comprehensive understandings of how social processes and individual behaviours shape human health. Mixed methods research most commonly combines qualitative and quantitative data collection and analysis strategies. Often, integrating findings from multiple methods is assumed to confirm or validate the findings from one method with the findings from another, seeking convergence or agreement between methods. Cases in which findings from different methods are congruous are generally thought of as ideal, whilst conflicting findings may, at first glance, appear problematic. However, the latter situation provides the opportunity for a process through which apparently discordant results are reconciled, potentially leading to new emergent understandings of complex social phenomena. This paper presents three case studies drawn from the authors' research on HIV risk amongst injection drug users in which mixed methods studies yielded apparently discrepant results. We use these case studies (involving injection drug users [IDUs] using a Needle/Syringe Exchange Program in Los Angeles, CA, USA; IDUs seeking to purchase needle/syringes at pharmacies in Tijuana, Mexico; and young street-based IDUs in San Francisco, CA, USA) to identify challenges associated with integrating findings from mixed methods projects, summarize lessons learned, and make recommendations for how to more successfully anticipate and manage the integration of findings. Despite the challenges inherent in reconciling apparently conflicting findings from qualitative and quantitative approaches, in keeping with others who have argued in favour of integrating mixed methods findings, we contend that such an undertaking has the potential to yield benefits that emerge only through the struggle to reconcile discrepant results and may provide a sum that is greater than the individual qualitative and quantitative parts. Copyright © 2011 Elsevier B.V. All rights reserved.

Reconciling incongruous qualitative and quantitative findings in mixed methods research: exemplars from research with drug using populations

PubMed Central

Wagner, Karla D.; Davidson, Peter J.; Pollini, Robin A.; Strathdee, Steffanie A.; Washburn, Rachel; Palinkas, Lawrence A.

2011-01-01

Mixed methods research is increasingly being promoted in the health sciences as a way to gain more comprehensive understandings of how social processes and individual behaviours shape human health. Mixed methods research most commonly combines qualitative and quantitative data collection and analysis strategies. Often, integrating findings from multiple methods is assumed to confirm or validate the findings from one method with the findings from another, seeking convergence or agreement between methods. Cases in which findings from different methods are congruous are generally thought of as ideal, while conflicting findings may, at first glance, appear problematic. However, the latter situation provides the opportunity for a process through which apparently discordant results are reconciled, potentially leading to new emergent understandings of complex social phenomena. This paper presents three case studies drawn from the authors’ research on HIV risk among injection drug users in which mixed methods studies yielded apparently discrepant results. We use these case studies (involving injection drug users [IDUs] using a needle/syringe exchange program in Los Angeles, California, USA; IDUs seeking to purchase needle/syringes at pharmacies in Tijuana, Mexico; and young street-based IDUs in San Francisco, CA, USA) to identify challenges associated with integrating findings from mixed methods projects, summarize lessons learned, and make recommendations for how to more successfully anticipate and manage the integration of findings. Despite the challenges inherent in reconciling apparently conflicting findings from qualitative and quantitative approaches, in keeping with others who have argued in favour of integrating mixed methods findings, we contend that such an undertaking has the potential to yield benefits that emerge only through the struggle to reconcile discrepant results and may provide a sum that is greater than the individual qualitative and quantitative parts. PMID:21680168

Mannitol can mitigate negative effects of simulated acid mist and fluoranthene in juvenile Japanese red pine (P. densiflora Sieb. et Zucc.).

PubMed

Oguntimehin, Ilemobayo; Bandai, Sayuri; Sakugawa, Hiroshi

2013-03-01

The negative health effects of simulated acid mists and fluoranthene on juvenile Japanese red pine were investigated, and the methods of protection from these pollutants were examined. The needle gas exchange, chlorophyll fluorescence, chemical contents and visual damage to needles caused by acid mist applied alone or its conjunction with fluoranthene were investigated over 60 d and 20 d, respectively. Acid mist at pH 2 and 3 caused physiological and visual damage, which was enhanced by the addition of fluoranthene to the mist. However, fluoranthene and acid mist at pH 4 and 5 showed only minor effects. These findings indicate that acid mist may be more harmful to pine trees if it occurs in conjunction with polycyclic aromatic hydrocarbons. Moreover, suppression of the singular and additive effects of these compounds was achieved using mannitol, which may be widely applicable to suppression of reactive oxygen species-mediated plant damage. Copyright © 2012 Elsevier Ltd. All rights reserved.

Robot-Assisted Antegrade In-Situ Fenestrated Stent Grafting

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

Riga, Celia V., E-mail: c.riga@imperial.ac.uk; Bicknell, Colin D.; Wallace, Daniel

2009-05-15

To determine the technical feasibility of a novel approach of in-situ fenestration of aortic stent grafts by using a remotely controlled robotic steerable catheter system in the porcine model. A 65-kg pig underwent robot-assisted bilateral antegrade in-situ renal fenestration of an abdominal aortic stent graft with subsequent successful deployment of a bare metal stent into the right renal artery. A 16-mm iliac extension covered stent served as the porcine aortic endograft. Under fluoroscopic guidance, the graft was punctured with a 20-G customized diathermy needle that was introduced and kept in place by the robotic arm. The needle was exchanged formore » a 4 x 20 mm cutting balloon before successful deployment of the renal stent. Robot-assisted antegrade in-situ fenestration is technically feasible in a large mammalian model. The robotic system enables precise manipulation, stable positioning, and minimum instrumentation of the aorta and its branches while minimizing radiation exposure.« less

Air Force Operational Medicine: Using the Enterprise Estimating Supplies Program to Develop Materiel Solutions for the Operational Requirements of the Air Force Otorhinolaryngology Augmentation Team (FFENT)

DTIC Science & Technology

2010-10-11

6515NCM040920 MONITOR NERVE INTEGRITY RESPOSE 2.0 EA 1 0 0.1 0.1 25500 0 0 0 A 6515014975058 MONOCULAR ASSISTANT PACKAGE WELSH EA 2 2 2 0.03 4200 2 0.03...6515001817404 NEEDLE HYPO DENTAL 25GA SELF -THREAD 100S PG 1 0 0.75 0.034 8.12 0 0 0 D 6515015261730 NEEDLE HYPO GP 25GA X1IN SAFETY SHIELD 50S PG 2 0 11.1

Exploring stakeholder perceptions of acceptability and feasibility of needle exchange programmes, syringe vending machines and safer injection facilities in Tijuana, Mexico

PubMed Central

Philbin, Morgan M.; Mantsios, Andrea; Lozada, Remedios; Case, Patricia; Pollini, Robin A.; Alvelais, Jorge; Latkin, Carl A.; Magis-Rodriguez, Carlos; Strathdee, Steffanie A.

2009-01-01

Background Injection drug use is a growing public health crisis along the U.S.–Mexican border and rising rates of blood-borne infections highlight the pressing need for harm reduction interventions. We explored the acceptability and feasibility of such interventions in Tijuana, a city adjacent to San Diego, California. Methods Using in-depth qualitative interviews conducted from August 2006–March 2007 with 40 key stakeholders – pharmacists, legal professionals, health officials, religious officials, drug treatment providers, and law enforcement personnel – we explored the acceptability and feasibility of interventions to reduce drug-related harm in Tijuana, Mexico. Interviews were taped with consent, transcribed verbatim, and translated. Content analysis was conducted to identify themes which included barriers, structural limitations, and suggestions for implementation. Results Topics included acceptance and feasibility of needle exchange programmes (NEPs), syringe vending machines, and safer injection facilities (SIFs), structural barriers and suggestions for implementation. Of these interventions, NEPs were deemed the most acceptable (75%); however, only half believed these could be feasibly implemented, citing barriers involving religion, police, and lack of political will, public awareness, and funding. Conclusions Increasing HIV infection rates among injection drug users in Tijuana have prompted interest in public health responses. Our results may assist policy strategists in implementing social-structural interventions that will help create enabling environments that facilitate the scale-up and implementation of harm reduction in Tijuana. PMID:18963906

Drug-related stigma and access to care among people who inject drugs in Vietnam.

PubMed

Lan, Chiao-Wen; Lin, Chunqing; Thanh, Duong Cong; Li, Li

2018-03-01

There are considerable challenges faced by people with a history of injecting drug use (PWID) in Vietnam, including drug-related stigma and lack of access to healthcare. Seeking and utilising healthcare, as well as harm reduction programs for PWID, are often hampered by drug-related stigma. This study aimed to examine the impacts of drug-related stigma on access to care and utilisation of harm reduction programs among PWID in Vietnam. A cross-sectional study was conducted in two provinces in Vietnam, Phú Thọ and Vinh Phúc. The study participants completed the survey by using Audio Computer-Assisted Self-Interview between late 2014 and early 2015. Linear multiple regression models and logistic regression models were used to assess the relationship among drug-related stigma, access to care and utilisation of harm reduction programs, including methadone maintenance treatment (MMT) and needle exchange programs (NEP). A total of 900 PWID participated in this study. Drug-related stigma was significantly associated with lower level of access to care, but not with utilisation of MMT or NEP. Older age was positively associated with higher levels of access to care. Levels of education were positively correlated with access to care, as well as utilisation of MMT and NEP. This study underscores the need for future interventions to reduce drug-related stigma in society and in health-care settings to improve PWID's utilisation of care services. Special attention should be paid to younger PWID and those with lower levels of education. © 2017 Australasian Professional Society on Alcohol and other Drugs.

77 FR 58198 - Self-Regulatory Organizations; BATS Exchange, Inc.; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-19

... Change Related to Fees Applicable to the Exchange's Competitive Liquidity Provider Program. September 13... Competitive Liquidity Providers (``CLPs'') to enhance liquidity on the Exchange in Exchange- listed securities (``Competitive Liquidity Provider Program'' or ``CLP Program'').\\6\\ The Exchange subsequently adopted financial...

Constructing seasonal LAI trajectory by data-model fusion for global evergreen needle-leaf forests

NASA Astrophysics Data System (ADS)

Wang, R.; Chen, J.; Mo, G.

2010-12-01

For decades, advancements in optical remote sensors made it possible to produce maps of a biophysical parameter--the Leaf Area Index (LAI), which is critically necessary in regional and global modeling of exchanges of carbon, water, energy and other substances, across large areas in a fast way. Quite a few global LAI products have been generated since 2000, e.g. GLOBCARBON (Deng et al., 2006), MODIS Collection 5 (Shabanov et al., 2007), CYCLOPES (Baret et al., 2007), etc. Albeit these progresses, the basic physics behind the technology restrains it from accurate estimation of LAI in winter, especially for northern high-latitude evergreen needle-leaf forests. Underestimation of winter LAI in these regions has been reported in literature (Yang et al., 2000; Cohen et al., 2003; Tian et al., 2004; Weiss et al., 2007; Pisek et al., 2007), and the distortion is usually attributed to the variations of canopy reflectance caused by understory change (Weiss et al., 2007) as well as by the presence of ice and snow on leaves and ground (Cohen, 2003; Tian et al., 2004). Seasonal changes in leaf pigments can also be another reason for low LAI retrieved in winter. Low conifer LAI values in winter retrieved from remote sensing make them unusable for surface energy budget calculations. To avoid these drawbacks of remote sensing approaches, we attempt to reconstruct the seasonal LAI trajectory through model-data fusion. A 1-degree LAI map of global evergreen needle-leaf forests at 10-day interval is produced based on the carbon allocation principle in trees. With net primary productivity (NPP) calculated by the Boreal Ecosystems Productivity Simulator (BEPS) (Chen et al., 1999), carbon allocated to needles is quantitatively evaluated and then can be further transformed into LAI using the specific leaf area (SLA). A leaf-fall scheme is developed to mimic the carbon loss caused by falling needles throughout the year. The seasonally maximum LAI from remote sensing data for each pixel is used as an anchor point of the LAI trajectory. Ground data are used for validation. The resulting LAI does not show strong seasonality within a year, which is reasonable for evergreen needle-leaf forests with known leaf longevity.

Community pharmacy services for people with drug problems over two decades in Scotland: Implications for future development.

PubMed

Matheson, Catriona; Thiruvothiyur, Manimekalai; Robertson, Helen; Bond, Christine

2016-01-01

In Scotland community pharmacies are heavily involved in service delivery for people with drug problems (PWDP) as documented through surveys of all community pharmacies in 1995, 2000 and 2006. A further survey in 2014 enabled trends in service demand/provision to be analysed and provides insight into future development. The lead pharmacist in every Scottish pharmacy (n=1246) was invited to complete a postal questionnaire covering attitudes towards PWDP and service provision and level of involvement in services (needle exchange, dispensing for PWDP and methadone supervision). Additional questions covered new services of take-home naloxone (THN) and pharmacist prescribing for opioid dependence. Telephone follow-up of non-responders covered key variables. A comparative analysis of four cross-sectional population surveys of the community pharmacy workforce (1995, 2000, 2006 and 2014) was undertaken. Completed questionnaires were returned by 709 (57%) pharmacists in 2014. Key variables (questionnaire or telephone follow-up) were available from 873 (70%). The proportion of pharmacies providing needle exchange significantly increased from 1995 to 2014 (8.6%, 9.5%, 12.2%, 17.8%, p<0.001) as did the proportion of pharmacies dispensing for the treatment of drug misuse (58.9%, 73.4%, 82.6% and 88%, p<0.001). Methadone was dispensed to 16,406 individuals and buprenorphine to 1777 individuals (increased from 12,400 and 192 respectively in 2006). Attitudes improved significantly from 1995 to 2014 (p<0.001). Being male and past training in drug misuse significantly predicted higher attitude scores (p<0.05) in all four years. Attitude score was a consistently significant predictor in all four years for dispensing for the treatment of drug misuse [OR=1.1 (1995 and 2006, CI 1.1-1.3, and 2014 CI 1.1-1.4) and 1.2 (2000), CI 1.3-1.5] and providing needle exchange [OR=1.1 (1995 and 2006), CI 1.1-1.2, 1.1-1.3 and 1.2 (2000 and 2014), CI 1.1-1.3 and 1.1-1.5]. In 2014, 53% of pharmacists felt part of the addiction team and 27.7% did not feel their role was valued by them. Nine pharmacists prescribed for opioid dependence. It is possible for pharmacy workforce attitudes and service engagement to improve over time. Training was key to these positive trends. Communication with the wider addiction team could be further developed. Copyright © 2015. Published by Elsevier B.V.

Inheriting the Learner's View: A Google Glass-Based Wearable Computing Platform for Improving Surgical Trainee Performance.

PubMed

Brewer, Zachary E; Fann, Hutchinson C; Ogden, W David; Burdon, Thomas A; Sheikh, Ahmad Y

2016-01-01

It is speculated that, in operative environments, real-time visualization of the trainee's viewpoint by the instructor may improve performance and teaching efficacy. We hypothesized that introduction of a wearable surgical visualization system allowing the instructor to visualize otherwise "blind" areas in the operative field could improve trainee performance in a simulated operative setting. A total of 11 surgery residents (4 in general surgery training and 7 in an integrated 6-year cardiothoracic surgery program) participated in the study. Google (Mountain View, CA) Glass hardware running proprietary software from CrowdOptic (San Francisco, CA) was utilized for creation of the wearable surgical visualization system. Both the learner and trainer wore the system, and video was streamed from the learner's system in real time to the trainer, who directed the learner to place needles in a simulated operative field. Subjects placed a total of 5 needles in each of 4 quadrants. A composite error score was calculated based on the accuracy of needle placement in relation to the intended needle trajectories as described by the trainer. Time to task completion (TTC) was also measured and participants completed an exit questionnaire. All residents completed the protocol tasks and the survey. Introduction of the wearable surgical visualization system did not affect mean time to task completion (278 ± 50 vs. 282 ± 69 seconds, p = NS). However, mean composite error score fell significantly once the wearable system was deployed (18 ± 5 vs. 15 ± 4, p < 0.05), demonstrating improved accuracy of needle placement. Most of the participants deemed the device unobtrusive, easy to operate, and useful for communication and instruction. This study suggests that wearable surgical visualization systems allowing for adoption of the learner's perspective may be a useful educational adjunct in the training of surgeons. Further evaluations of the efficacy of wearable technology in the operating room environment are warranted. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

SU-F-J-10: Sliding Mode Control of a SMA Actuated Active Flexible Needle for Medical Procedures

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

Podder, T

Purpose: In medical interventional procedures such as brachytherapy, ablative therapies and biopsy precise steering and accurate placement of needles are very important for anatomical obstacle avoidance and accurate targeting. This study presents the efficacy of a sliding mode controller for Shape Memory Alloy (SMA) actuated flexible needle for medical procedures. Methods: Second order system dynamics of the SMA actuated active flexible needle was used for deriving the sliding mode control equations. Both proportional-integral-derivative (PID) and adaptive PID sliding mode control (APIDSMC) algorithms were developed and implemented. The flexible needle was attached at the end of a 6 DOF robotic system.more » Through LabView programming environment, the control commands were generated using the PID and APIDSMC algorithms. Experiments with artificial tissue mimicking phantom were performed to evaluate the performance of the controller. The actual needle tip position was obtained using an electromagnetic (EM) tracking sensor (Aurora, NDI, waterloo, Canada) at a sampling period of 1ms. During experiment, external disturbances were created applying force and thermal shock to investigate the robustness of the controllers. Results: The root mean square error (RMSE) values for APIDSMC and PID controllers were 0.75 mm and 0.92 mm, respectively, for sinusoidal reference input. In the presence of external disturbances, the APIDSMC controller showed much smoother and less overshooting response compared to that of the PID controller. Conclusion: Performance of the APIDSMC was superior to the PID controller. The APIDSMC was proved to be more effective controller in compensating the SMA uncertainties and external disturbances with clinically acceptable thresholds.« less

The rights of drug treatment patients: Experience of addiction treatment in Poland from a human rights perspective.

PubMed

Klingemann, Justyna

2017-05-01

Drug dependence is a recognized medical condition and therefore, right to health applies in the same way to drug dependence as it does to any other health condition. The human rights in patient care framework - which refers to the application of basic human rights principles in the delivery of health care services - was used to explore the experiences of equality in the dignity and rights protected by Polish law within four different specialist drug treatment settings in Poland. The views of patients and staff were examined and compared. Focus group interviews were conducted in 12 drug treatment facilities: three inpatient therapeutic communities, three outpatient programs, three opioid substitution programs and three harm reduction programs (drop-in/needle exchange/support). Interviews were conducted with a total of 43 staff and 73 patients. All interviews were audio-recorded with participants' prior consent and transcribed verbatim. Data were analysed according to the problem-centred interview methodology, using CAQDA. Patients described instances of abuse of their rights regarding dignity, privacy, confidentiality, personalized treatment, and respect of patient's time, right to information and to complain. Those accounts were complemented by the perspective of professionals working in drug treatment. Patients of Polish opioid substitution programs reported experiencing more humiliation and disenfranchisement than patients in other drug treatment settings. Drug testing and control, fuelled by prejudices of health professionals, are leading to discriminatory practices in substitution treatment and damaging the chances of therapeutic success. The concept of epistemic injustice illuminates the reasons behind discrimination against patients on opioid substitution programs, who are seen as continuously sick and their illness perceived as a mark of moral, social and epistemic failure. Copyright © 2017 Elsevier B.V. All rights reserved.

78 FR 48520 - Self-Regulatory Organizations; New York Stock Exchange LLC; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-08

... Proposed Rule Change Extending the Pilot Period for the Exchange's Retail Liquidity Program for an... The Exchange proposes to extend the pilot period for the Exchange's Retail Liquidity Program (the ``Retail Liquidity Program'' or the ``Program''), which is currently scheduled to expire on July 31, 2013...

Spontaneous Pneumothorax in the USAF Aircrew Population: A Retrospective Study.

DTIC Science & Technology

1986-10-01

PROGRAM PROjECT ITASK WORK UNIT i oroc Is Ai r Force Base, TFX 78235-530Dl ELEMENT NO No NO ACCESSiON NO ITiTLE (include Security Classification) incrat...Needle aspiration plus surgery Chsest tube. oxygen, and sufer ’ program. there are no firm guidelines regarding aviation rates were lower than those

Popularity of suture materials among residents and faculty members of a postdoctoral periodontology program.

PubMed

Maksoud, Mohamed; Koo, Samuel; Barouch, Kasumi; Karimbux, Nadeem

2014-02-01

The aim of the present study was to determine the favoritism of suture materials among a group of clinicians at a teaching institution. The surveys included 11 absorbable and nine non-absorbable sutures. The surveyor was asked to select his or her suture preferences when it comes to using it in 13 different, commonly-performed surgical procedures. The surveys showed overall preferences for non-absorbable versus absorbable sutures. Chromic Gut with a 4-0 diameter thread reverse cutting FS2 needle was the most favored suture. For periodontal bone grafts and hard tissue ridge augmentation, polytetrafluoroethylene with a 4-0 thread and FS2 needle was preferred. For autogenous gingival grafts, gingival allografts, connective tissue grafts, frenectomy and frenoplasty, Chromic Gut with 5-0 diameter thread reverse cutting P3 needle was favored. For extraction socket preservation, soft tissue canine exposure, ridge augmentation, and dental implants, Chromic Gut with 4-0 diameter thread reverse cutting FS2 needle was preferred, and for sinus augmentation, Vicryl with a 4-0 diameter thread reverse cutting FS2 needle was favored. Absorbable sutures were preferred in the majority of periodontal procedures; however, non-absorbable sutures were favored in procedures that required longer healing or better stability of the flap edges in cases of periodontal and ridge augmentation. © 2013 Wiley Publishing Asia Pty Ltd.

Cost-effectiveness Evaluation of the Inclusion of Dry Needling into an Exercise Program for Subacromial Pain Syndrome: Evidence from a Randomized Clinical Trial.

PubMed

Arias-Buría, José L; Martín-Saborido, Carlos; Cleland, Joshua; Koppenhaver, Shane L; Plaza-Manzano, Gustavo; Fernández-de-Las-Peñas, César

2018-02-22

To evaluate the cost-effectiveness of the inclusion of trigger point-dry needling (TrP-DN) into an exercise program for the management of subacromial pain syndrome. Fifty patients with unilateral subacromial pain syndrome were randomized with concealed allocation to exercise alone or exercise plus TrP-DN. Both groups were asked to perform an exercise program targeting the rotator cuff musculature twice daily for five weeks. Patients allocated to the exercise plus TrP-DN group also received dry needling during the second and fourth sessions. Societal costs and health-related quality of life (estimated by EuroQol-5D-5L) over a one-year follow-up were used to generate incremental cost per quality-adjusted life-year (QALY) ratios for each intervention.  Intention-to-treat analysis was possible for 48 (96%) of the participants. Those in the exercise group made more visits to medical doctors and received a greater number of other treatments (P < 0.001). The major contributor to societal costs (77%) was the absenteeism paid labor in favor of the exercise plus TrP-DN group (P = 0.03). The combination of exercise plus TrP-DN was less costly (mean difference cost/patient = €517.34, P = 0.003) than exercise alone. Incremental QALYs showed greater benefit for exercise plus TrP-DN (difference = 2.87, 95% confidence interval = 2.85-2.89). Therefore, the inclusion of TrP-DN into an exercise program was more likely to be cost-effective than an exercise program alone, with 99.5% of the iterations falling in the dominant area. The inclusion of TrP-DN into an exercise program was more cost-effective for individuals with subacromial pain syndrome than exercise alone. From a cost-benefit perspective, the inclusion of TrP-DN into multimodal management of patients with subacromial pain syndrome should be considered.

Long-Term Effects of Liming on Health and Growth of a Masson Pine Stand Damaged by Soil Acidification in Chongqing, China

PubMed Central

Li, Zhiyong; Wang, Yanhui; Liu, Yuan; Guo, Hao; Li, Tao; Li, Zhen-Hua; Shi, Guoan

2014-01-01

In the last decades, the Masson pine (Pinus massoniana) forests in Chongqing, southwest China, have increasingly declined. Soil acidification was believed to be an important cause. Liming is widely used as a measure to alleviate soil acidification and its damage to trees, but little is known about long-term effects of liming on the health and growth of declining Masson pine forests. Soil chemical properties, health condition (defoliation and discoloration), and growth were evaluated following application of limestone powder (0 (unlimed control), 1, 2, 3, and 4 t ha−1) in an acidified and declining Masson pine stand at Tieshanping (TSP) of Chongqing. Eight years after liming, in the 0–20 cm and 20–40 cm mineral soil layers, soil pH values, exchangeable calcium (Ca) contents, and Ca/Al molar ratios increased, but exchangeable aluminum (Al) levels decreased, and as a result, length densities of living fine roots of Masson pine increased, with increasing dose. Mean crown defoliation of Masson pines (dominant, codominant and subdominant pines, according to Kraft classes 1–3) decreased with increasing dose, and it linearly decreased with length densities of living fine roots. However, Masson pines (Kraft classes 1–3) in all treatments showed no symptoms of discoloration. Mean current-year twig length, twig dry weight, needle number per twig, needle length per twig, and needle dry weight per twig increased with increasing dose. Over 8 years, mean height increment of Masson pines (Kraft classes 1–3) increased from 5.5 m in the control to 5.8, 6.9, 8.3, and 9.5 m in the 1, 2, 3, and 4 t ha−1 lime treatments, and their mean DBH (diameter at breast height) increment increased from 3.1 to 3.2, 3.8, 4.9, and 6.2 cm, respectively. The values of all aboveground growth parameters linearly increased with length densities of living fine roots. Our results show that liming improved tree health and growth, and these effects increased with increasing dose. PMID:24728089

Long-term effects of liming on health and growth of a Masson pine stand damaged by soil acidification in Chongqing, China.

PubMed

Li, Zhiyong; Wang, Yanhui; Liu, Yuan; Guo, Hao; Li, Tao; Li, Zhen-Hua; Shi, Guoan

2014-01-01

In the last decades, the Masson pine (Pinus massoniana) forests in Chongqing, southwest China, have increasingly declined. Soil acidification was believed to be an important cause. Liming is widely used as a measure to alleviate soil acidification and its damage to trees, but little is known about long-term effects of liming on the health and growth of declining Masson pine forests. Soil chemical properties, health condition (defoliation and discoloration), and growth were evaluated following application of limestone powder (0 (unlimed control), 1, 2, 3, and 4 t ha(-1)) in an acidified and declining Masson pine stand at Tieshanping (TSP) of Chongqing. Eight years after liming, in the 0-20 cm and 20-40 cm mineral soil layers, soil pH values, exchangeable calcium (Ca) contents, and Ca/Al molar ratios increased, but exchangeable aluminum (Al) levels decreased, and as a result, length densities of living fine roots of Masson pine increased, with increasing dose. Mean crown defoliation of Masson pines (dominant, codominant and subdominant pines, according to Kraft classes 1-3) decreased with increasing dose, and it linearly decreased with length densities of living fine roots. However, Masson pines (Kraft classes 1-3) in all treatments showed no symptoms of discoloration. Mean current-year twig length, twig dry weight, needle number per twig, needle length per twig, and needle dry weight per twig increased with increasing dose. Over 8 years, mean height increment of Masson pines (Kraft classes 1-3) increased from 5.5 m in the control to 5.8, 6.9, 8.3, and 9.5 m in the 1, 2, 3, and 4 t ha(-1) lime treatments, and their mean DBH (diameter at breast height) increment increased from 3.1 to 3.2, 3.8, 4.9, and 6.2 cm, respectively. The values of all aboveground growth parameters linearly increased with length densities of living fine roots. Our results show that liming improved tree health and growth, and these effects increased with increasing dose.

Client-Level Coverage of Needle and Syringe Program and High-Risk Injection Behaviors: A Case Study of People Who Inject Drugs in Kermanshah, Iran.

PubMed

Noroozi, Mehdi; Mirzazadeh, Ali; Noroozi, Alireza; Mehrabi, Yadoallah; Hajebi, Ahmad; Zamani, Saman; Sharifi, Hamid; Higgs, Peter; Soori, Hamid

2015-01-01

Needle-syringe programs (NSP) have been running in Iran since 2002. However, the coverage of such program among the NSP clients at the individual level was not studies yet. This study aimed to determine the client coverage of NSP and its correlation with high injection-related risk behaviors. A cross-sectional survey was conducted in Kermanshah province, Iran, in 2014. 230 people who inject drugs (PWID) recruited from two drop-in centers (DICs) from April to September 2014, participated in a face-to-face interview to provide information related individual coverage of NSP, demographic characteristics, and injecting behaviors 30 days prior to the interview. Overall, the average of syringe coverage was 158% [95% confidence interval (CI) = 65.7-205.5], while 56% (95% CI = 40-97) have individual converge less than 100%. Needle/syringe sharing was significantly higher among individual with low NSP coverage [adjusted odds ratio (AOR) = 2.6, 95% CI = 1.3-6.2]. About 85% participants with coverage of less than 100% reported reuse of syringe within the last 30 days (AOR = 3.2, 95% CI = 1.4-7.7). PWID are different regarding their NSP individual-level converges. There are certain clusters of PWID, who do not receive sufficient number of syringes. Given that insufficient individual syringe coverage level is highly associated with injection risk behaviors, reasons for such low converge need to be assessed and addressed carefully.

Client-Level Coverage of Needle and Syringe Program and High-Risk Injection Behaviors: A Case Study of People Who Inject Drugs in Kermanshah, Iran

PubMed Central

Noroozi, Mehdi; Mirzazadeh, Ali; Noroozi, Alireza; Mehrabi, Yadoallah; Hajebi, Ahmad; Zamani, Saman; Sharifi, Hamid; Higgs, Peter; Soori, Hamid

2015-01-01

Background Needle-syringe programs (NSP) have been running in Iran since 2002. However, the coverage of such program among the NSP clients at the individual level was not studies yet. This study aimed to determine the client coverage of NSP and its correlation with high injection-related risk behaviors. Methods A cross-sectional survey was conducted in Kermanshah province, Iran, in 2014. 230 people who inject drugs (PWID) recruited from two drop-in centers (DICs) from April to September 2014, participated in a face-to-face interview to provide information related individual coverage of NSP, demographic characteristics, and injecting behaviors 30 days prior to the interview. Findings Overall, the average of syringe coverage was 158% [95% confidence interval (CI) = 65.7-205.5], while 56% (95% CI = 40-97) have individual converge less than 100%. Needle/syringe sharing was significantly higher among individual with low NSP coverage [adjusted odds ratio (AOR) = 2.6, 95% CI = 1.3-6.2]. About 85% participants with coverage of less than 100% reported reuse of syringe within the last 30 days (AOR = 3.2, 95% CI = 1.4-7.7). Conclusion PWID are different regarding their NSP individual-level converges. There are certain clusters of PWID, who do not receive sufficient number of syringes. Given that insufficient individual syringe coverage level is highly associated with injection risk behaviors, reasons for such low converge need to be assessed and addressed carefully. PMID:26885353

22 CFR 62.45 - Reinstatement to valid program status.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Section 62.45 Foreign Relations DEPARTMENT OF STATE PUBLIC DIPLOMACY AND EXCHANGES EXCHANGE VISITOR PROGRAM Status of Exchange Visitors § 62.45 Reinstatement to valid program status. (a) Definitions. For purpose of this section— You means the Responsible Officer or Alternate Responsible Officer; Exchange...

Faculty-Exchange Programs Promoting Change: Motivations, Experiences, and Influence of Participants in the Carnegie Mellon University-Portugal Faculty Exchange Program

ERIC Educational Resources Information Center

Patrício, Maria Teresa; Santos, Patrícia; Loureiro, Paulo Maia; Horta, Hugo

2018-01-01

The international mobility of faculty is increasing worldwide. Although studies have considered the experiences of academics abroad, less is known about faculty-exchange programs with policy objectives. This study helps to fill this gap by analyzing a nationwide structured faculty exchange program established by Carnegie Mellon University and…

Integration of soft tissue model and open haptic device for medical training simulator

NASA Astrophysics Data System (ADS)

Akasum, G. F.; Ramdhania, L. N.; Suprijanto; Widyotriatmo, A.

2016-03-01

Minimally Invasive Surgery (MIS) has been widely used to perform any surgical procedures nowadays. Currently, MIS has been applied in some cases in Indonesia. Needle insertion is one of simple MIS procedure that can be used for some purposes. Before the needle insertion technique used in the real situation, it essential to train this type of medical student skills. The research has developed an open platform of needle insertion simulator with haptic feedback that providing the medical student a realistic feel encountered during the actual procedures. There are three main steps in build the training simulator, which are configure hardware system, develop a program to create soft tissue model and the integration of hardware and software. For evaluating its performance, haptic simulator was tested by 24 volunteers on a scenario of soft tissue model. Each volunteer must insert the needle on simulator until rearch the target point with visual feedback that visualized on the monitor. From the result it can concluded that the soft tissue model can bring the sensation of touch through the perceived force feedback on haptic actuator by looking at the different force in accordance with different stiffness in each layer.

Partners in Progress. A Monograph on the Worker Education Program of Northeastern Illinois University.

ERIC Educational Resources Information Center

Estes, Florence

The Worker Education Program (WEP) of Northeastern Illinois University (NIU) is a partnership among NIU; the Union of Needle Trades, Industrial, and Textile Employees (UNITE); and companies whose employees are represented by UNITE. Now in its fourth year, the WEP operates in 13 diverse types of workplaces in three states: Illinois, Ohio, and…

Accelerated Learning Options: Moving the Needle on Access and Success. A Study of State and Institutional Policies and Practices

ERIC Educational Resources Information Center

Western Interstate Commission for Higher Education, 2006

2006-01-01

This document was designed to inform members of the policy, education, and research communities about existing state and institutional policies and practices associated with four accelerated learning programs: Advanced Placement (AP), dual/concurrent enrollment, the International Baccalaureate (IB) Diploma Program, and Tech-Prep. This effort was…

78 FR 76187 - 30-Day Notice of Proposed Information Collection: Exchange Programs Alumni Web Site Registration

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-16

...: Exchange Programs Alumni Web Site Registration ACTION: Notice of request for public comment and submission... Information Collection: Exchange Programs Alumni Web site Registration. OMB Control Number: 1405-0192. Type of... proposed collection: The International Exchange Alumni Web site requires information to process users...

Modified Perfluorocarbon Tracer Method for Measuring Effective Multizone Air Exchange Rates

PubMed Central

Shinohara, Naohide; Kataoka, Toshiyuki; Takamine, Koichi; Butsugan, Michio; Nishijima, Hirokazu; Gamo, Masashi

2010-01-01

A modified procedure was developed for the measurement of the effective air exchange rate, which represents the relationship between the pollutants emitted from indoor sources and the residents’ level of exposure, by placing the dosers of tracer gas at locations that resemble indoor emission sources. To measure the 24-h-average effective air exchange rates in future surveys based on this procedure, a low-cost, easy-to-use perfluorocarbon tracer (PFT) doser with a stable dosing rate was developed by using double glass vials, a needle, a polyethylene-sintered filter, and a diffusion tube. Carbon molecular sieve cartridges and carbon disulfide (CS2) were used for passive sampling and extraction of the tracer gas, respectively. Recovery efficiencies, sampling rates, and lower detection limits for 24-h sampling of hexafluorobenzene, octafluorotoluene, and perfluoroallylbenzene were 40% ± 3%, 72% ± 5%, and 84% ± 6%; 10.5 ± 1.1, 14.4 ± 1.4, and 12.2 ± 0.49 mL min−1; and 0.20, 0.17, and 0.26 μg m−3, respectively. PMID:20948928

Modified perfluorocarbon tracer method for measuring effective multizone air exchange rates.

PubMed

Shinohara, Naohide; Kataoka, Toshiyuki; Takamine, Koichi; Butsugan, Michio; Nishijima, Hirokazu; Gamo, Masashi

2010-09-01

A modified procedure was developed for the measurement of the effective air exchange rate, which represents the relationship between the pollutants emitted from indoor sources and the residents' level of exposure, by placing the dosers of tracer gas at locations that resemble indoor emission sources. To measure the 24-h-average effective air exchange rates in future surveys based on this procedure, a low-cost, easy-to-use perfluorocarbon tracer (PFT) doser with a stable dosing rate was developed by using double glass vials, a needle, a polyethylene-sintered filter, and a diffusion tube. Carbon molecular sieve cartridges and carbon disulfide (CS₂) were used for passive sampling and extraction of the tracer gas, respectively. Recovery efficiencies, sampling rates, and lower detection limits for 24-h sampling of hexafluorobenzene, octafluorotoluene, and perfluoroallylbenzene were 40% ± 3%, 72% ± 5%, and 84% ± 6%; 10.5 ± 1.1, 14.4 ± 1.4, and 12.2 ± 0.49 mL min⁻¹; and 0.20, 0.17, and 0.26 μg m⁻³, respectively.

Impact of increased syringe access: preliminary findings on injection drug user syringe source, disposal, and pharmacy sales in Harlem, New York.

PubMed

Fuller, Crystal M; Ahern, Jennifer; Vadnai, Liza; Coffin, Phillip O; Galea, Sandro; Factor, Stephanie H; Vlahov, David

2002-01-01

To evaluate the New York State Expanded Syringe Access Demonstration Program (ESAP) through injection drug user (IDU) surveys, discarded needles and syringes studies, and pharmacy sales and experiences surveys. Pre-post comparison. In Harlem, New York City, risk surveys among street-recruited IDUs, needle/syringe street counts on 27 systematically sampled city blocks, and Harlem pharmacist reports of sales and experiences. Number and types of IDU syringe sources, block mean counts of discarded needles and syringes, level of pharmacy nonprescription syringe sales (NPSS), and pharmacists' experiences. Comparing 209 pre-ESAP with 396 post-ESAP IDUs, pharmacies as a primary syringe source increased: 3.4% to 5.3% (P < .001, and ever pharmacy use increased: 4.9% to 12.5% (P < .001), respectively. Compared with pre-ESAP IDUs, post-ESAP IDUs tended to be younger and more often black. Harlem pharmacy participation in ESAP increased considerably from March 1, 2001, to March 1, 2002, 49% to 79%, respectively. Among three Harlem pharmacies, there was a modest increase in NPSS; pharmacists reported no problems, and no discarded needles and syringes were observed in pharmacy areas. In the three pharmacies, the proportion of syringe sales that were NPSS was 46% (110 to 240 NPSS/month), 3% (25 to 90 NPSS/month), and 0%. The mean ratios of needles/syringes to background trash have not increased in Harlem since ESAP began. To date, no evidence of harmful effects discarded needles/syringes, pharmacy altercations) resulting from ESAP were observed. While NPSS have increased in Harlem, pharmacy use among IDUs remains low. In Harlem, efforts are underway to increase ESAP awareness and reduce socioenvironmental barriers to ESAP.

Fostering internationalization: an American-Danish semester-long undergraduate nursing student exchange program.

PubMed

Baernholdt, M; Drake, E; Maron, F; Neymark, K

2013-06-01

This paper describes the development, implementation and evaluation of a semester-long exchange program between two Bachelor of Science in Nursing programs in the USA and Denmark. Nurses globally need to provide culturally sensitive care for an ethnically diverse population. Competencies on how to do so should start in basic nursing programs. A useful strategy is through immersion into another culture through an exchange program. Little is known about successful strategies for two-way or 360° exchange programs between schools from different countries. Guided by experiential learning theory, we developed an exchange program with the objective of enhancing nursing students' cultural competence through knowledge building, attitudes and behaviour development. Lessons learned and implications for educational institutions and policy are discussed. In internationalization of nursing education, an awareness of underlying cultural values regarding nursing competence and taking appropriate action are important for success. Other areas for a successful exchange program include matching of courses or content across schools, clear objectives and evaluation plans. Finally, flexibility and open communication are key components when setting up a 360° exchange program. © 2013 The Authors. International Nursing Review © 2013 International Council of Nurses.

Subxyphoid access of the normal pericardium: a novel drug delivery technique.

PubMed

Laham, R J; Simons, M; Hung, D

1999-05-01

The pericardial space may potentially serve as a drug delivery reservoir that might be used to deliver therapeutic substances to the heart. This study describes a novel delivery technique that enables safe and rapid percutaneous subxyphoid access of the normal pericardium in a large animal model (49 Yorkshire pigs). An epidural introducer needle (Tuohy-17) is advanced gently under fluoroscopic guidance with a continuous positive pressure of 20-30 mm Hg (achieved by saline infusion using an intraflow system). The positive pressure is intended to push the right ventricle (with a lower pressure) away from the needle's path. Entry of the pericardial space is suspected after an increase in the saline flow through the intraflow system. Access to the pericardial space is confirmed by the injection of 1 ml of diluted contrast under fluoroscopy. A soft floppy-tip 0.025" guidewire is then advanced to the pericardial space and the needle is exchanged for an infusion catheter. Access of the pericardial space was achieved in all animals without any adverse events and without any hemodynamic compromise even with the delivery of fluid volumes as large as 50 ml. Histologic examination in 15 animals 4 weeks after pericardial access did not reveal any delivery-related myocardial damage. The safety, ease, and absence of hemodynamic compromise make this technique a potentially useful method for intrapericardial drug delivery and a good alternative to standard pericardiocentesis in patients with small pericardial effusions at higher risk for complications.

Global Temperature and Salinity Pilot Project

NASA Technical Reports Server (NTRS)

Searle, Ben

1992-01-01

Data exchange and data management programs have been evolving over many years. Within the international community there are two main programs to support the exchange, management and processing of real time and delayed mode data. The Intergovernmental Oceanographic Commission (IOC) operate the International Oceanographic Data and Information Exchange (IODE) program which coordinates the exchange of delayed mode data between national oceanographic data centers, World Data Centers and the user community. The Integrated Global Ocean Services System is a joint IOC/World Meteorological Organization (WMO) program for the exchange and management of real-time data. These two programs are complemented by mechanisms that have been established within scientific programs to exchange and manage project data sets. In particular TOGA and WOCE have identified a data management requirement and established the appropriate infrastructure to achieve this. Where GTSPP fits into this existing framework is discussed.

Educators Exchange: A Program Evaluation.

ERIC Educational Resources Information Center

Armstrong, William B.

The Educators Exchange Program (EEP) was established under a training and educational exchange agreement reached by California's San Diego Community College District (SDCCD) and the republic of Mexico. In the program, the District provided a 4-week technological training program to faculty at Centros de Capacitacion Tecnologica Industrial…

Needle Biopsy

MedlinePlus

... needle biopsy procedures include fine-needle aspiration and core needle biopsy. Needle biopsy may be used to ... hollow needle to draw cells from your body. Core needle biopsy. This type of needle biopsy uses ...

22 CFR Appendix C to Part 62 - Update of Information on Exchange-Visitor Program Sponsor

Code of Federal Regulations, 2010 CFR

2010-04-01

... assigned to ________ as follows: (Name of institution/organization) 1. Change the name of the Program... Cultural Exchange. 9. ( ) Cancel the above named Exchange Visitor Program. (Signature of Responsible or...

Determinants of Participating in Australian University Student Exchange Programs

ERIC Educational Resources Information Center

Daly, Amanda

2011-01-01

Outbound mobility programs such as exchange programs are one of the many strategies implemented at universities to develop graduates' intercultural skills and international knowledge. Few Australian students participate in exchange programs. This article presents a literature review and proposes a model of the contextual and individual factors…

78 FR 13141 - 30-Day Notice of Proposed Information Collection: Exchange Visitor Program Participant Survey...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-26

...: Exchange Visitor Program Participant Survey--Summer Work Travel ACTION: Notice of request for public... of Information Collection: Exchange Visitor Program Participant Survey--Summer Work Travel Program... participants in the Summer Work Travel category. Estimated Number of Respondents: 109,000. Estimated Number of...

Effects of long-term exposure to ammonium sulfate particles on growth and gas exchange rates of Fagus crenata, Castanopsis sieboldii, Larix kaempferi and Cryptomeria japonica seedlings

NASA Astrophysics Data System (ADS)

Yamaguchi, Masahiro; Otani, Yoko; Li, Peiran; Nagao, Hiroshi; Lenggoro, I. Wuled; Ishida, Atsushi; Yazaki, Kenichi; Noguchi, Kyotaro; Nakaba, Satoshi; Yamane, Kenichi; Kuroda, Katsushi; Sano, Yuzou; Funada, Ryo; Izuta, Takeshi

2014-11-01

To clarify the effects of long-term exposure to ammonium sulfate (AS) particles on growth and physiological functions of forest tree species, seedlings of Fagus crenata, Castanopsis sieboldii, Larix kaempferi and Cryptomeria japonica were exposed to submicron-size AS particles during two growing seasons from 3 June 2011 to 8 October 2012. The mean sulfate concentration in PM2.5 increased during the exposure inside the chamber in 2011 and 2012 by 2.73 and 4.32 μg SO42- m-3, respectively. No significant effects of exposure to AS particles were detected on the whole-plant dry mass of the seedlings. These results indicate that the exposure to submicrometer AS particles at the ambient level for two growing seasons did not significantly affect the growth of the seedlings. No significant effects of exposure to AS particles were found on the net photosynthetic rate in the leaves or needles of F. crenata, C. sieboldii and L. kaempferi seedlings. Also, in the previous-year needles of C. japonica seedlings, exposure to AS particles significantly reduced the net photosynthetic rate, which may be caused by the reduction in the concentration of ribulose-1, 5-bisphosphate carboxylase/oxygenase (Rubisco). On the contrary, in current-year needles of C. japonica seedlings, net photosynthetic rate significantly increased with exposure to AS particles, which may be the result of increases in stomatal conductance and concentrations of Rubisco and chlorophyll. Furthermore, exposure to AS particles correlated with an increase in concentrations of NH4+, free amino acid and total soluble protein, suggesting that AS particles may be deliquesced, absorbed into the leaves and metabolized into amino acid and protein. These results suggest that net photosynthesis in the needles of C. japonica is relatively sensitive to submicron-size AS particles as compared with the other three tree species.

Trends in Injection Risk Behaviors among People Who Inject Drugs and the Impact of Harm Reduction Programs in Ukraine, 2007-2013.

PubMed

Makarenko, Iuliia; Ompad, D C; Sazonova, Y; Saliuk, T; DeHovitz, J; Gensburg, L

2017-02-01

The study examined trends in injection risk behaviors among people who inject drugs (PWIDs) and assessed the impact of harm reduction programs in Ukraine during 2007-2013. We performed a secondary analysis of the data collected in serial cross-sectional bio-behavioral surveillance surveys administered with PWIDs in Ukraine in 2007, 2008, 2011, and 2013. Using data from 14 Ukrainian cities, we assessed short-term trends in injection risk behaviors with the Cochran-Armitage test for trend and multivariable logistic regression models, adjusted for age, sex, region, marital status, education level, occupation, age at injection drug use initiation, experience of overdose, and self-reported HIV status. The overall test for trend indicated a statistically significant decrease over time for sharing needle/syringe during the last injection (p < 0.0001), sharing needle/syringe at least once in the last 30 days (p < 0.0001), and using a common container for drug preparation (p < 0.0001). The prevalence of injecting drugs from pre-loaded syringes was high (61.0%) and did not change over the study period. After adjusting for all significant confounders and comparing to 2007, the prevalence of sharing needle/syringe during the last injection was unchanged in 2008 (OR = 1.06, 95% CI = 0.92, 1.21), and declined in 2011 (OR = 0.18, 95% CI = 0.15, 0.22) and 2013 (OR = 0.17, 95% CI = 0.14, 0.21). Sharing needles/syringes in the last 30 days significantly decreased when compared to that in 2007 (2008: OR = 0.81, 95% CI = 0.74, 0.89; 2011: OR = 0.43, 95% CI = 0.38, 0.47; and 2013: OR = 0.31, 95% CI = 0.27, 0.35). The prevalence of using common instruments for drug preparation also decreased compared to that in 2007 (2008: OR = 0.88, 95% CI = 0.85, 0.91; 2011: OR = 0.85, 95% CI = 0.85, 0.90; and 2013: OR = 0.74, 95% CI = 0.71, 0.76). The observed reduction in the prevalence of injection risk behavior over time is encouraging. Our findings suggest that prevention programs in Ukraine have positive impact and provide support for governmental expansion of these programs.

Virtue ethics as an alternative to deontological and consequential reasoning in the harm reduction debate.

PubMed

Christie, Timothy; Groarke, Louis; Sweet, William

2008-02-01

There is strong evidence that harm reduction interventions such as Supervised Injection Sites and Needle Exchange Programs prevent many of the negative consequences of problematic substance use. Yet many governments, including the United States and Canada, still do not endorse these interventions, claiming that they do not get people off of drugs and send a mixed message. This paper will analyze objections to harm reduction in light of the ethical theories of John Stuart Mill, Immanuel Kant and Aristotle. The most important ethical issue in the abstinence vs. harm reduction debate is whether harm reduction - because it does not require individuals to either reduce their consumption of illicit substances or to abstain from illicit substance use - can be ethically justified. Harm reduction interventions are clearly justified on Utilitarian grounds because, based on the evidence, such policies would produce the greatest good for the greatest number. However, Kant would not think that the values guiding harm reduction are ethical because the justification of harm reduction interventions focuses exclusively on examining consequences. Virtue Ethics seeks to find the proper balance between harm reduction and abstinence. We claim that the virtue of compassion would provide a defense of harm reduction.

[Reflections on drug policies in Brazil].

PubMed

de Andrade, Tarcísio Matos

2011-12-01

This article contains some reflections on drug policies in Brazil. In the first two chapters, taking the needle exchange programs (SEPs) as the starting point, the author discusses the trajectory of the Harm Reduction Policy in Brazil and the role played in it by the Department of STD, AIDS and Viral Hepatitis. The third chapter examines the actions developed by the National Coordination of Mental Health, Alcohol and Other Drugs and the Office of Drug Policies - SENAD, after the retraction of the Department of STD and AIDS from drug policies, as well as the introduction of PEAD and the "Crack Plan" in the country. In the fourth and fifth chapters the provisions of the current Brazilian policy on drugs and its limitations related mainly to the fragility of the Family Health Strategy are discussed, and some of the actions foreseen in the PEAD and the "Crack Plan" are critically analyzed. In the sixth chapter the author examines the effects of repression in the name of combating trafficking in the Brazilian policy on drugs having as background of the marginalization and social exclusion of users. Finally, some proposals are presented for the Alcohol and Drugs Policy in Brazil.

A comparison of Espocan and Tuohy needles for the combined spinal-epidural technique for labor analgesia.

PubMed

Browne, Ingrid M; Birnbach, David J; Stein, Deborah J; O'Gorman, David A; Kuroda, Maxine

2005-08-01

When using the needle-through-needle combined spinal-epidural (CSE) technique for labor analgesia, failure to obtain cerebrospinal fluid (CSF), paresthesias, and intrathecal or intravascular migration of the catheter are of concern. Epidural needles with spinal needle apertures, such as the back-hole Espocan (ES) needles, are available and may reduce these risks. We describe the efficacy and adverse events associated with a modified epidural needle (ES) versus a conventional Tuohy needle for CSE. One-hundred parturients requesting labor analgesia (CSE) were randomized into 2 groups: 50-ES 18-gauge modified epidural needle with 27-gauge Pencan atraumatic spinal needle, 50-conventional 18-gauge Tuohy needle with 27-gauge Gertie Marx atraumatic spinal needle. Information on intrathecal or intravascular catheter placement, paresthesia on introduction of spinal needle, failure to obtain CSF through the spinal needle after placement of epidural needle, unintentional dural puncture, and epidural catheter function was obtained. No intrathecal catheter placement occurred in either group. Rates of intravascular catheter placement and unintentional dural puncture were similar between the groups. Significant differences were noted regarding spinal needle-induced paresthesia (14% ES versus 42% Tuohy needles, P = 0.009) and failure to obtain CSF on first attempt (8% ES versus 28% Tuohy needles, P < 0.02). Use of ES needles for CSE significantly reduces paresthesia associated with the insertion of the spinal needle and is associated with more frequent successful spinal needle placement on the first attempt. The use of modified epidural needles with a back hole for combined spinal-epidural technique significantly reduces paresthesia associated with the insertion of the spinal needle and is associated with more frequent successful spinal needle placement on the first attempt.

Legal space for syringe exchange programs in hot spots of injection drug use-related crime.

PubMed

Allen, Sean T; Ruiz, Monica S; Jones, Jeff; Turner, Monique M

2016-04-26

Copious evidence indicates that syringe exchange programs (SEPs) are effective structural interventions for HIV prevention among persons who inject drugs (PWID). The efficacy of SEPs in supporting the public health needs of PWID populations is partially dependent on their accessibility and consistent utilization among injectors. Research has shown that SEP access is an important predictor of PWID retention at SEPs, yet policies exist that may limit the geographic areas where SEP operations may legally occur. Since 2000 in the District of Columbia (DC), SEP operations have been subject to the 1000 Foot Rule (§48-1121), a policy that prohibits the distribution of "any needle or syringe for the hypodermic injection of any illegal drug in any area of the District of Columbia which is within 1000 feet of a public or private elementary or secondary school (including a public charter school)." The 1000 Foot Rule may impede SEP services in areas that are in urgent need for harm reduction services, such as locations where injections are happening in "real time" or where drugs are purchased or exchanged. We examined the effects of the 1000 Foot Rule on SEP operational space in injection drug use (IDU)-related crime (i.e., heroin possession or distribution) hot spots from 2000 to 2010. Data from the DC Metropolitan Police Department were used to identify IDU-related crime hot spots. School operation data were matched to a dataset that described the approximate physical property boundaries of land parcels. A 1000-ft buffer was applied to all school property boundaries. The overlap between the IDU-related crime hot spots and the school buffer zones was calculated by academic year. When overlaying the land space associated with IDU-related crime hot spots on the maps of school boundaries per the 1000-ft buffer zone stipulation, we found that the majority of land space in these locations was ineligible for legal SEP operations. More specifically, the ineligible space in the identified hot spots in each academic year ranged from 51.93 to 88.29 % of the total hot spot area. The removal of the 1000 Foot Rule could significantly improve the public health of PWID via increased access to harm reduction services. Buffer zone policies that restrict SEP operational space negatively affect the provision of harm reduction services to PWID.

Usability Testing of an Interactive Virtual Reality Distraction Intervention to Reduce Procedural Pain in Children and Adolescents With Cancer.

PubMed

Birnie, Kathryn A; Kulandaivelu, Yalinie; Jibb, Lindsay; Hroch, Petra; Positano, Karyn; Robertson, Simon; Campbell, Fiona; Abla, Oussama; Stinson, Jennifer

2018-06-01

Needle procedures are among the most distressing aspects of pediatric cancer-related treatment. Virtual reality (VR) distraction offers promise for needle-related pain and distress given its highly immersive and interactive virtual environment. This study assessed the usability (ease of use and understanding, acceptability) of a custom VR intervention for children with cancer undergoing implantable venous access device (IVAD) needle insertion. Three iterative cycles of mixed-method usability testing with semistructured interviews were undertaken to refine the VR. Participants included 17 children and adolescents (8-18 years old) with cancer who used the VR intervention prior to or during IVAD access. Most participants reported the VR as easy to use (82%) and understand (94%), and would like to use it during subsequent needle procedures (94%). Based on usability testing, refinements were made to VR hardware, software, and clinical implementation. Refinements focused on increasing responsiveness, interaction, and immersion of the VR program, reducing head movement for VR interaction, and enabling participant alerts to steps of the procedure by clinical staff. No adverse events of nausea or dizziness were reported. The VR intervention was deemed acceptable and safe. Next steps include assessing feasibility and effectiveness of the VR intervention for pain and distress.

Text Exchange System

NASA Technical Reports Server (NTRS)

Snyder, W. V.; Hanson, R. J.

1986-01-01

Text Exchange System (TES) exchanges and maintains organized textual information including source code, documentation, data, and listings. System consists of two computer programs and definition of format for information storage. Comprehensive program used to create, read, and maintain TES files. TES developed to meet three goals: First, easy and efficient exchange of programs and other textual data between similar and dissimilar computer systems via magnetic tape. Second, provide transportable management system for textual information. Third, provide common user interface, over wide variety of computing systems, for all activities associated with text exchange.

76 FR 2160 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-12

... Exchange's rules also expressly set forth reciprocity provisions.\\6\\ In other words, the Exchange is... exchanges that employ a similar program under their rules. Reciprocity provisions also exist for the $2.50... reciprocity provision, the Exchange's existing strike setting programs demonstrate the intent [[Page 2161

Optimizing EUS-guided liver biopsy sampling: comprehensive assessment of needle types and tissue acquisition techniques.

PubMed

Schulman, Allison R; Thompson, Christopher C; Odze, Robert; Chan, Walter W; Ryou, Marvin

2017-02-01

EUS-guided liver biopsy sampling using FNA and, more recently, fine-needle biopsy (FNB) needles has been reported with discrepant diagnostic accuracy, in part due to differences in methodology. We aimed to compare liver histologic yields of 4 EUS-based needles and 2 percutaneous needles to identify optimal number of needle passes and suction. Six needle types were tested on human cadaveric tissue: one 19G FNA needle, one existing 19G FNB needle, one novel 19G FNB needle, one 22G FNB needle, and two 18G percutaneous needles (18G1 and 18G2). Two needle excursion patterns (1 vs 3 fanning passes) were performed on all EUS needles. Primary outcome was number of portal tracts. Secondary outcomes were degree of fragmentation and specimen adequacy. Pairwise comparisons were performed using t tests, with a 2-sided P < .05 considered to be significant. Multivariable regression analysis was performed. In total, 288 liver biopsy samplings (48 per needle type) were performed. The novel 19G FNB needle had significantly increased mean portal tracts compared with all needle types. The 22G FNB needle had significantly increased portal tracts compared with the 18G1 needle (3.8 vs 2.5, P < .001) and was not statistically different from the 18G2 needle (3.8 vs 3.5, P = .68). FNB needles (P < .001) and 3 fanning passes (P ≤ .001) were independent predictors of the number of portal tracts. A novel 19G EUS-guided liver biopsy needle provides superior histologic yield compared with 18G percutaneous needles and existing 19G FNA and core needles. Moreover, the 22G FNB needle may be adequate for liver biopsy sampling. Investigations are underway to determine whether these results can be replicated in a clinical setting. Copyright © 2017 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

Prevalence and correlates of HIV infection among men who inject drugs in a remote area of Vietnam.

PubMed

Nghiem, Van T; Bui, Thanh C; Nadol, Patrick P; Phan, Son H; Kieu, Binh T; Kling, Ryan; Hammett, Theodore M

2018-02-14

Lack of information on the HIV epidemic among men who inject drugs (MWID) in northwestern Vietnam, a remote area, may hamper national efforts to control the disease. We examined HIV prevalence, needle-syringe sharing behaviors, and associated factors among MWID in three areas of northwestern Vietnam. We used descriptive analysis to report the characteristics, frequency of risk behaviors, and of access to healthcare services among the MWID. Univariable logistic regression was used to assess the associations between the HIV infection, needle-syringe sharing behaviors, and their independent variables. We further explored these associations in multivariable analyses where we included independent variables based on a priori knowledge and their associations with the dependent variables determined in univariable analyses (p <  0.25). The HIV prevalence was 37.9, 16.9, and 18.5% for Tuan Giao, Bat Xat, and Lao Cai City, respectively, and 25.4% overall. MWID of Thai minority ethnicity were more likely to be HIV-positive (adjusted odds ratio (AOR) 3.55; 95% confidence interval (CI) 1.84-6.87). The rate of needle-syringe sharing in the previous 6 months was approximately 9% among the MWID in Tuan Giao and Lao Cai City, and 27.8% in Bat Xat. Two thirds of the participants never underwent HIV testing before this study. Ever having been tested for HIV before this study was not associated with any needle-syringe sharing behaviors. Among the HIV-positive MWID, those who received free clean needles and syringes were less likely to give used needles and syringes to peers (AOR 0.21; 95% CI 0.06-0.79). Going to a "hotspot" in the previous week was associated with increased odds of needle-syringe sharing in multiple subgroups. Our findings on HIV prevalence and testing participation among a subset of MWID in the northwestern Vietnam were corroborated with trend analysis results from the most recent HIV/STI Integrated Biological and Behavioral Surveillance report (data last collected in 2013.) We provided important insights into these MWID's risky injection behaviors. We suggest heightened emphasis on HIV testing and needle and syringe provision for this population. Also, policymakers and program implementers should target hotspots as a main venue to tackle HIV epidemics.

76 FR 8796 - Self-Regulatory Organizations; International Securities Exchange, LLC; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-15

... Rule Change To Expand the Short Term Option Series Program February 9, 2011. Pursuant to Section 19(b... Series Program. The text of the proposed rule change is available on the Exchange's Web site http://www... Term Option Series Program (``STOS Program'') \\3\\ so that the Exchange may select fifteen option...

Transperineal prostate biopsy under magnetic resonance image guidance: a needle placement accuracy study.

PubMed

Blumenfeld, Philip; Hata, Nobuhiko; DiMaio, Simon; Zou, Kelly; Haker, Steven; Fichtinger, Gabor; Tempany, Clare M C

2007-09-01

To quantify needle placement accuracy of magnetic resonance image (MRI)-guided core needle biopsy of the prostate. A total of 10 biopsies were performed with 18-gauge (G) core biopsy needle via a percutaneous transperineal approach. Needle placement error was assessed by comparing the coordinates of preplanned targets with the needle tip measured from the intraprocedural coherent gradient echo images. The source of these errors was subsequently investigated by measuring displacement caused by needle deflection and needle susceptibility artifact shift in controlled phantom studies. Needle placement error due to misalignment of the needle template guide was also evaluated. The mean and standard deviation (SD) of errors in targeted biopsies was 6.5 +/- 3.5 mm. Phantom experiments showed significant placement error due to needle deflection with a needle with an asymmetrically beveled tip (3.2-8.7 mm depending on tissue type) but significantly smaller error with a symmetrical bevel (0.6-1.1 mm). Needle susceptibility artifacts observed a shift of 1.6 +/- 0.4 mm from the true needle axis. Misalignment of the needle template guide contributed an error of 1.5 +/- 0.3 mm. Needle placement error was clinically significant in MRI-guided biopsy for diagnosis of prostate cancer. Needle placement error due to needle deflection was the most significant cause of error, especially for needles with an asymmetrical bevel. (c) 2007 Wiley-Liss, Inc.

Needle tip visibility in 3D ultrasound images

NASA Astrophysics Data System (ADS)

Arif, Muhammad; Moelker, Adriaan; van Walsum, Theo

2017-03-01

Needle visibility is of crucial importance for ultrasound guided interventional procedures. However, several factors, such as shadowing by bone or gas and tissue echogenic properties similar to needles, may compromise needle visibility. Additionally, small angle between the ultrasound beam and the needle, as well as small gauged needles may reduce visibility. Variety in needle tips design may also affect needle visibility. Whereas several studies have investigated needle visibility in 2D ultrasound imaging, no data is available for 3D ultrasound imaging, a modality that has great potential for image guidance interventions1. In this study, we evaluated needle visibility using a 3D ultrasound transducer. We examined different needles in a tissue mimicking liver phantom at three angles (200, 550 and 900) and quantify their visibility. The liver phantom was made by 5% polyvinyl alcohol solution containing 1% Silica gel particles to act as ultrasound scattering particles. We used four needles; two biopsy needles (Quick core 14G and 18G), one Ablation needle (Radiofrequency Ablation 17G), and Initial puncture needle (IP needle 17G). The needle visibility was quantified by calculating contrast to noise ratio. The results showed that the visibility for all needles were almost similar at large angles. However the difference in visibility at lower angles is more prominent. Furthermore, the visibility increases with the increase in angle of ultrasound beam with needles.

22 CFR 62.60 - Termination of designation

Code of Federal Regulations, 2010 CFR

2010-04-01

... management audit. (e) Change in ownership or control. An exchange visitor program designation is not... Foreign Relations DEPARTMENT OF STATE PUBLIC DIPLOMACY AND EXCHANGES EXCHANGE VISITOR PROGRAM Termination... is eligible to apply for a new program designation. (d) Failure to file an annual management audit. A...

Accurate core position control in polymer optical waveguides using the Mosquito method for three-dimensional optical wiring

NASA Astrophysics Data System (ADS)

Date, Kumi; Ishigure, Takaaki

2017-02-01

Polymer optical waveguides with graded-index (GI) circular cores are fabricated using the Mosquito method, in which the positions of parallel cores are accurately controlled. Such an accurate arrangement is of great importance for a high optical coupling efficiency with other optical components such as fiber ribbons. In the Mosquito method that we developed, a core monomer with a viscous liquid state is dispensed into another liquid state monomer for cladding via a syringe needle. Hence, the core positions are likely to shift during or after the dispensing process due to several factors. We investigate the factors, specifically affecting the core height. When the core and cladding monomers are selected appropriately, the effect of the gravity could be negligible, so the core height is maintained uniform, resulting in accurate core heights. The height variance is controlled in +/-2 micrometers for the 12 cores. Meanwhile, larger shift in the core height is observed when the needle-tip position is apart from the substrate surface. One of the possible reasons of the needle-tip height dependence is the asymmetric volume contraction during the monomer curing. We find a linear relationship between the original needle-tip height and the core-height observed. This relationship is implemented in the needle-scan program to stabilize the core height in different layers. Finally, the core heights are accurately controlled even if the cores are aligned on various heights. These results indicate that the Mosquito method enables to fabricate waveguides in which the cores are 3-dimensionally aligned with a high position accuracy.

Exchange Studies as Actor-Networks: Following Korean Exchange Students in Swedish Higher Education

ERIC Educational Resources Information Center

Ahn, Song-ee

2011-01-01

This article explores how Korean exchange students organized their studies during exchange programs in Swedish higher education. For most students, the programs became a disordered period in relation to their education. The value of exchange studies seems mainly to be extra-curricular. Drawing upon actor network theory, the article argues that the…

78 FR 6275 - Medicaid, Children's Health Insurance Programs, and Exchanges: Essential Health Benefits in...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-30

... Medicaid, Children's Health Insurance Programs, and Exchanges: Essential Health Benefits in Alternative...'s Health Insurance Programs, and Exchanges: Essential Health Benefits in Alternative Benefit Plans... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Parts 430...

77 FR 31724 - Exchange Visitor Program-Summer Work Travel; Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-30

... DEPARTMENT OF STATE 22 CFR Part 62 RIN 1400-AD14 [Public Notice 7902] Exchange Visitor Program--Summer Work Travel; Correction AGENCY: Department of State. ACTION: Interim final rule; correction SUMMARY: This document contains minor corrections to the Exchange Visitor Program--Summer Work Travel...

Treatment readiness, attitudes toward, and experiences with methadone and buprenorphine maintenance therapy among people who inject drugs in Malaysia.

PubMed

Vijay, Aishwarya; Bazazi, Alexander R; Yee, Ilias; Kamarulzaman, Adeeba; Altice, Frederick L

2015-07-01

Little is known about attitudes toward and experiences with opioid maintenance therapy (OMT) among people who inject drugs in Malaysia, a country where people who inject drugs comprise 1.3% of the adult population. In 2010, 460 people who inject drugs in Greater Kuala Lumpur, Malaysia were surveyed to evaluate attitudes toward and experiences with OMT and treatment readiness. Attitudes towards OMT with both methadone and buprenorphine were assessed using an opinions scale. Multivariable linear regression was used to assess correlates of treatment readiness, measured with the 19-item Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES). All 460 participants used opioids and nearly all (99.1%) met criteria for opioid dependence. Few had had previous experience with methadone (9.3%) or buprenorphine (12.6%) maintenance therapy, yet many had used methadone (55.2%) or buprenorphine (51.7%) outside of treatment settings. Fifteen percent had injected buprenorphine in the past month, and of the few that were currently receiving buprenorphine maintenance therapy, almost all were injecting it. The majority of subjects exhibited a moderate level of treatment readiness and a preference for methadone over buprenorphine. Those with low treatment readiness scores were more likely to have previous experience with compulsory drug detention centers (p<0.01), needle/syringe exchange programs (p<0.005), or be of Indian ethnicity (p<0.001). Past use of methadone (p<0.01), older age (p<0.001), higher stress symptom severity (p<0.001), and sharing of needles or syringes (p<0.05) were associated with higher treatment readiness scores. There are suboptimal levels of OMT experience among people who inject drugs that may be improved by addressing factors that influence patient attitudes. Those individuals with moderate treatment readiness may be targeted by brief motivational and cognitive interventions in primary care, prisons or OMT clinics aimed at improving entry into and retention in treatment. Copyright © 2015 Elsevier Inc. All rights reserved.

Treatment readiness, attitudes toward, and experiences with methadone and buprenorphine maintenance therapy among people who inject drugs in Malaysia

PubMed Central

Vijay, Aishwarya; Bazazi, Alexander R.; Yee, Ilias; Kamarulzaman, Adeeba; Altice, Frederick L.

2016-01-01

Background Little is known about attitudes toward and experiences with opioid maintenance therapy (OMT) among people who inject drugs in Malaysia, a country where people who inject drugs comprise 1.3% of the adult population. Methods In 2010, 460 people who inject drugs in Greater Kuala Lumpur, Malaysia were surveyed to evaluate attitudes toward and experience with OMT and treatment readiness. Attitudes towards OMT with both methadone and buprenorphine were assessed using an opinions scale. Multivariable linear regression was used to assess correlates of treatment readiness, measured with the 19-item Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES). Results All 460 participants used opioids and nearly all (99.1%) met criteria for opioid dependence. Few had had previous experience with methadone (9.3%) or buprenorphine (12.6%) maintenance therapy, yet many had used methadone (55.2%) or buprenorphine (51.7%) outside of treatment settings. Fifteen percent had injected buprenorphine in the past month, and of the few that were currently receiving buprenorphine maintenance therapy, almost all were injecting it. The majority of subjects exhibited a moderate level of treatment readiness and a preference for methadone over buprenorphine. Those with low treatment readiness scores were more likely to have previous experience with compulsory drug detention centers (p<0.01), needle/syringe exchange programs (p<0.005), or be of Indian ethnicity (p<0.001). Past use of methadone (p<0.01), older age (p<0.001), stress symptom severity (p<0.001), and sharing of needles or syringes (p<0.05) were associated with higher treatment readiness scores. Conclusion There are suboptimal levels of OMT experience among people who inject drugs that may be improved by addressing factors that influence patient attitudes. Those individuals with moderate treatment readiness may be targeted by brief motivational and cognitive interventions in primary care, prisons or OMT clinics aimed at improving entry into and retention in treatment. PMID:25841703

Database & information tools for transportation research management : Connecticut transportation research peer exchange report of a thematic peer exchange.

DOT National Transportation Integrated Search

2006-05-01

Specific objectives of the Peer Exchange were: : Discuss and exchange information about databases and other software : used to support the program-cycles managed by state transportation : research offices. Elements of the program cycle include: :...

Recovering Infectious HIV from Novel Syringe-Needle Combinations with Low Dead Space Volumes.

PubMed

Abdala, Nadia; Patel, Amisha; Heimer, Robert

This study determines if detachable syringe-needle combinations redesigned to reduce their dead space volume may substantially reduce the burden of exposure to infectious HIV among people who inject drugs. Two novel, low dead space (LDS) syringe-needle designs-one added a piston to the plunger (LDS syringe) and the other added a filler to the needle (LDS needle) to reduce their dead space-were compared to standard detachable needle-syringe combinations and to syringes with fixed needles. LDS and standard syringes attached to LDS and standard needles of 23-, 25-, and 27-gauge size were contaminated with HIV-infected blood in the laboratory. The proportion of syringe-needle combinations containing infectious HIV was analyzed after syringes were (1) stored up to 7 days at 22°C or (2) rinsed with water. Detachable syringes attached to 25-gauge needles yielded comparable proportions of syringes with infectious HIV, whether the needle was standard or LDS. Among needles of greater diameter (23 gauge), LDS needles tended to reduce recoverable HIV to a greater extent than standard needles. Syringes with fixed needles showed superior results to LDS syringes attached to needles of equivalent diameter and were less likely to get clogged by blood. Detachable LDS syringe-needle designs must be recommended with caution since they still pose potential risk for HIV transmission. Distribution of LDS syringes and needles must be accompanied by recommendations and instructions for their proper rinsing and disinfection in order to reduce viral burden and chances of needle clogging.

Plasticity in seedling morphology, biomass allocation and physiology among ten temperate tree species in response to shade is related to shade tolerance and not leaf habit.

PubMed

Chmura, D J; Modrzyński, J; Chmielarz, P; Tjoelker, M G

2017-03-01

Mechanisms of shade tolerance in tree seedlings, and thus growth in shade, may differ by leaf habit and vary with ontogeny following seed germination. To examine early responses of seedlings to shade in relation to morphological, physiological and biomass allocation traits, we compared seedlings of 10 temperate species, varying in their leaf habit (broadleaved versus needle-leaved) and observed tolerance to shade, when growing in two contrasting light treatments - open (about 20% of full sunlight) and shade (about 5% of full sunlight). We analyzed biomass allocation and its response to shade using allometric relationships. We also measured leaf gas exchange rates and leaf N in the two light treatments. Compared to the open treatment, shading significantly increased traits typically associated with high relative growth rate (RGR) - leaf area ratio (LAR), specific leaf area (SLA), and allocation of biomass into leaves, and reduced seedling mass and allocation to roots, and net assimilation rate (NAR). Interestingly, RGR was not affected by light treatment, likely because of morphological and physiological adjustments in shaded plants that offset reductions of in situ net assimilation of carbon in shade. Leaf area-based rates of light-saturated leaf gas exchange differed among species groups, but not between light treatments, as leaf N concentration increased in concert with increased SLA in shade. We found little evidence to support the hypothesis of a increased plasticity of broadleaved species compared to needle-leaved conifers in response to shade. However, an expectation of higher plasticity in shade-intolerant species than in shade-tolerant ones, and in leaf and plant morphology than in biomass allocation was supported across species of contrasting leaf habit. © 2016 German Botanical Society and The Royal Botanical Society of the Netherlands.

Sex and drugs and rock'n'roll.

PubMed

Cassidy, J

The community center at the housing estate of St. Mellons in Cardiff, Wales, has two projects serving youth. A physician and nurse make up a team operating family planning clinic at the youth center on Friday afternoons. Local graffiti artists have created brightly colored posters to promote the drop-in center. Teenagers come to the youth center to play pool, drink coffee, and to listen to music. In a room next to this activity, the team distributes contraceptives (e.g., condoms). They also counsel teens about sexuality, relationships, self-respect, health, and disease. They work to dispel any incorrect information that they often hear. Counseling provides the teens correct information, which they can convey to their peers. The director of family planning and well-woman services for South Glamorgan finds peer education to be more effective than sex education in schools. A psychiatric nurse and her community drug colleagues set up a drop-in center for a needle exchange, but the team finds itself acting as a drugs information service. The advice it gives includes ho to use drugs more safely, possible adverse reactions, referrals (medical, detoxification, and counseling), and the nature of substances on the street. Clients trust the team so much that they share with the team members when there is a bad drug on the market. An outreach worker has headed up a residential week-end with some teens to further discuss drug use. Despite their success and popularity, lack of financial or human resources prevents expansion of both service. The drug needle exchange/information service tried to work out of another youth center, but fear by neighbors that it would give the area a bad name hampered its opening.

Accidental needle sticks, the Occupational Safety and Health Administration, and the fallacy of public policy.

PubMed

Wolf, Bruce L; Marks, Albert; Fahrenholz, John M

2006-07-01

Current Occupational Safety and Health Administration (OSHA) guidelines mandate the use of safety needles when allergy injections are given. Safety needles for intradermal testing remain optional. Whether safety needles reduce the number of accidental needle sticks (ANSs) in the outpatient setting has yet to be proven. To determine the rate of ANSs with new (safety) needles vs old needles used in allergy immunotherapy and intradermal testing. Allergy practices from 22 states were surveyed by e-mail. Seventy practices (28%) responded to the survey. Twice as many ANSs occurred in practices giving immunotherapy when using new needles vs old needles (P < .01). The rate of ANSs was roughly the same for intradermal testing with new needles vs old needles. These findings further question whether OSHA's guidelines for safety needle use in outpatient practice need revision and if allergy practices might be excluded from the requirement to use safety needles.

Emission of Volatile Sulfur Compounds from Spruce Trees 1

PubMed Central

Rennenberg, Heinz; Huber, Beate; Schröder, Peter; Stahl, Klaus; Haunold, Werner; Georgii, Hans-Walter; Slovik, Stefan; Pfanz, Hardy

1990-01-01

Spruce (Picea Abies L.) trees from the same clone were supplied with different, but low, amounts of plant available sulfate in the soil (9.7-18.1 milligrams per 100 grams of soil). Branches attached to the trees were enclosed in a dynamic gas exchange cuvette and analyzed for the emission of volatile sulfur compounds. Independent of the sulfate supply in the soil, H2S was the predominant reduced sulfur compound continuously emitted from the branches with high rates during the day and low rates in the night. In the light, as well as in the dark, the rates of H2S emission increased exponentially with increasing water vapor flux from the needles. Approximately 1 nanomole of H2S was found to be emitted per mole of water. When stomata were closed completely, only minute emission of H2S was observed. Apparently, H2S emission from the needles is highly dependent on stromatal aperture, and permeation through the cuticle is negligible. In several experiments, small amounts of dimethylsulfide and carbonylsulfide were also detected in a portion of the samples. However, SO2 was the only sulfur compound consistently emitted from branches of spruce trees in addition to H2S. Emission of SO2 mainly proceeded via an outburst starting before the beginning of the light period. The total amount of SO2 emitted from the needles during this outburst was correlated with the plant available sulfate in the soil. The diurnal changes in sulfur metabolism that may result in an outburst of SO2 are discussed. PMID:16667315

Professional Student Exchange Program (PSEP), 2008-2010

ERIC Educational Resources Information Center

Western Interstate Commission for Higher Education, 2008

2008-01-01

The Western Interstate Commission for Higher Education (WICHE) Professional Student Exchange Program enables students in 12 Western states to enroll in selected out-of-state professional programs, usually because those fields of study are not available at public institutions in their home states. Exchange students receive preference in admission.…

5 CFR 2641.207 - One-year restriction on any former private sector assignee under the Information Technology...

Code of Federal Regulations, 2014 CFR

2014-01-01

... private sector assignee under the Information Technology Exchange Program representing, aiding, counseling... assignee under the Information Technology Exchange Program representing, aiding, counseling or assisting in... the Information Technology Exchange Program, 5 U.S.C. chapter 37, no former assignee shall knowingly...

5 CFR 2641.207 - One-year restriction on any former private sector assignee under the Information Technology...

Code of Federal Regulations, 2013 CFR

2013-01-01

... private sector assignee under the Information Technology Exchange Program representing, aiding, counseling... assignee under the Information Technology Exchange Program representing, aiding, counseling or assisting in... the Information Technology Exchange Program, 5 U.S.C. chapter 37, no former assignee shall knowingly...

5 CFR 2641.207 - One-year restriction on any former private sector assignee under the Information Technology...

Code of Federal Regulations, 2010 CFR

2010-01-01

... private sector assignee under the Information Technology Exchange Program representing, aiding, counseling... assignee under the Information Technology Exchange Program representing, aiding, counseling or assisting in... the Information Technology Exchange Program, 5 U.S.C. chapter 37, no former assignee shall knowingly...

5 CFR 2641.207 - One-year restriction on any former private sector assignee under the Information Technology...

Code of Federal Regulations, 2011 CFR

2011-01-01

... private sector assignee under the Information Technology Exchange Program representing, aiding, counseling... assignee under the Information Technology Exchange Program representing, aiding, counseling or assisting in... the Information Technology Exchange Program, 5 U.S.C. chapter 37, no former assignee shall knowingly...

5 CFR 2641.207 - One-year restriction on any former private sector assignee under the Information Technology...

Code of Federal Regulations, 2012 CFR

2012-01-01

... private sector assignee under the Information Technology Exchange Program representing, aiding, counseling... assignee under the Information Technology Exchange Program representing, aiding, counseling or assisting in... the Information Technology Exchange Program, 5 U.S.C. chapter 37, no former assignee shall knowingly...

The Influence of Faculty Exchange Programs on Faculty Members' Professional Development

ERIC Educational Resources Information Center

Alkarzon, Awni

2016-01-01

This paper addresses the problems facing faculty members, who made short-term international exchange programs in foreign countries; in their attempts to internationalize the campus through teaching, research, and service. Some faculty members who participated in foreign exchange programs try to infuse their international experience through…

Statistical Report: Academic Year 2014-15. Student Exchange Program

ERIC Educational Resources Information Center

Western Interstate Commission for Higher Education, 2015

2015-01-01

This report covers fall 2014 enrollments for WUE [Western Undergraduate Exchange], WRGP [Western Regional Graduate Program], and PSEP [Professional Student Exchange Program]. It details the funds that flow between students' home states and the enrolling PSEP institutions that receive them. This newly expanded format gives detailed enrollment for…

Educators Exchange Program, 1996. Evaluation Report.

ERIC Educational Resources Information Center

Armstrong, William B.; Turingan, Maria R.; Bersentes, Gina H.

Following an initial effort in 1994, the Educators Exchange Program 1996 (EEP-96) was the second project completed under a training and educational exchange agreement reached between California's San Diego Community College District (SDCCD) and the republic of Mexico. In EEP-96, the district provided a five-week technological training program to…

Beyond NIMBYism: understanding community antipathy toward needle distribution services.

PubMed

Davidson, Peter J; Howe, Mary

2014-05-01

In late 2007 the Homeless Youth Alliance (HYA), a small non-profit serving homeless youth in the Haight-Ashbury neighbourhood of San Francisco, USA, attempted to move its needle exchange service from a site on the Haight street commercial strip to a community centre approximately 150m away. The reaction of the housed community in the area was vocal and organized, and attracted considerable regional media attention. Ultimately, the plan to move the service had to be cancelled. The authors were, respectively, board chair and executive director of HYA at the time, and collected extensive field notes and media records as events unfolded. In this paper, we re-examine these events through literatures on contested spaces and on 'Not In My Backyard' (NIMBY) resistance to social services. We found that opposition to the service relocation had little to do with opposition to needle exchange itself, but rather was symptomatic of broader contestation over the identity and character of the neighbourhood. On the one hand, the neighbourhood had experienced skyrocketing housing prices over the past 40 years, making home ownership almost exclusively the province of the wealthy. On the other, the neighbourhood retains historic connections to the 1968 'Summer of Love', and the main commercial strip forms the centre of an active injecting drug use scene. As a consequence, many home owners who felt they had made considerable sacrifices to afford to live in the area expressed a sense of being "under siege" from drug users, and also believed that the City government pursues a deliberate policy of "keeping the Haight weird" by supporting ongoing service provision to drug users in the area. Housed residents responded to this situation in a variety of ways. One response was to engage in what we term 'defensive place making', in which a small part of a broader neighbourhood is reimagined as "a different neighbourhood". HYA's attempt to move from its current location to this 'different neighbourhood' was thus perceived as an "invasion" which threatened to break down a tentatively established separate identity. We conclude with a discussion of the relevance of these events for understanding and mitigating community opposition to services for drug users elsewhere. Copyright © 2013 Elsevier B.V. All rights reserved.

Beyond NIMBYism: Understanding community antipathy toward needle distribution services

PubMed Central

Davidson, Peter J.; Howe, Mary

2014-01-01

In late 2007 the Homeless Youth Alliance (HYA), a small non-profit serving homeless youth in the Haight-Ashbury neighbourhood of San Francisco, USA, attempted to move its needle exchange service from a site on the Haight street commercial strip to a community centre approximately 150 m away. The reaction of the housed community in the area was vocal and organized, and attracted considerable regional media attention. Ultimately, the plan to move the service had to be cancelled. The authors were, respectively, board chair and executive director of HYA at the time, and collected extensive field notes and media records as events unfolded. In this paper, we re-examine these events through literatures on contested spaces and on ‘Not In My Backyard’ (NIMBY) resistance to social services. We found that opposition to the service relocation had little to do with opposition to needle exchange itself, but rather was symptomatic of broader contestation over the identity and character of the neighbourhood. On the one hand, the neighbourhood had experienced skyrocketing housing prices over the past 40 years, making home ownership almost exclusively the province of the wealthy. On the other, the neighbourhood retains historic connections to the 1968 ‘Summer of Love’, and the main commercial strip forms the centre of an active injecting drug use scene. As a consequence, many home owners who felt they had made considerable sacrifices to afford to live in the area expressed a sense of being “under siege” from drug users, and also believed that the City government pursues a deliberate policy of “keeping the Haight weird” by supporting ongoing service provision to drug users in the area. Housed residents responded to this situation in a variety of ways. One response was to engage in what we term ‘defensive place making’, in which a small part of a broader neighbourhood is reimagined as “a different neighbourhood”. HYA’s attempt to move from its current location to this ‘different neighbourhood’ was thus perceived as an “invasion” which threatened to break down a tentatively established separate identity. We conclude with a discussion of the relevance of these events for understanding and mitigating community opposition to services for drug users elsewhere. PMID:24309432

Comparison of Spinal Needle Deflection in a Ballistic Gel Model.

PubMed

Rand, Ethan; Christolias, George; Visco, Christopher; R Singh, Jaspal

2016-10-01

Percutaneous diagnostic and therapeutic procedures are commonly used in the treatment of spinal pain. The success of these procedures depends on the accuracy of needle placement, which is influenced by needle size and shape. The purpose of this study is to examine and quantify the deviation of commonly used spinal needles based on needle tip design and gauge, using a ballistic gel tissue simulant. Six needles commonly used in spinal procedures (Quincke, Short Bevel, Chiba, Tuohy, Hustead, Whitacre) were selected for use in this study. Ballistic gel samples were made in molds of two depths, 40mm and 80 mm. Each needle was mounted in a drill press to ensure an accurate needle trajectory. Distance of deflection was recorded for each needle. In comparing the mean deflection of 22 gauge needles of all types at 80 mm of depth, deflection was greatest among beveled needles [Short Bevel (9.96 ± 0.77 mm), Quincke (8.89 ± 0.17 mm), Chiba (7.71 ± 1.16 mm)], moderate among epidural needles [Tuohy (7.64 ± 0.16 mm) and least among the pencil-point needles [Whitacre (0.73 ± 0.34 mm)]. Increased gauge (25 g) led to a significant increase in deflection among beveled needles. The direction of deflection was away from the bevel with Quincke, Chiba and Short Beveled needles and toward the bevel of the Tuohy and Hustead needles. Deflection of the Whitacre pencil-point needle was minimal. There is clinical utility in knowing the relative deflection of various needle tips. When a procedure requires a needle to be steered around obstacles, or along non-collinear targets, the predictable and large amount of deflection obtained through use of a beveled spinal needle may prove beneficial.

Comparison of Spinal Needle Deflection in a Ballistic Gel Model

PubMed Central

Rand, Ethan; Christolias, George; Visco, Christopher; R. Singh, Jaspal

2016-01-01

Background Percutaneous diagnostic and therapeutic procedures are commonly used in the treatment of spinal pain. The success of these procedures depends on the accuracy of needle placement, which is influenced by needle size and shape. Objectives The purpose of this study is to examine and quantify the deviation of commonly used spinal needles based on needle tip design and gauge, using a ballistic gel tissue simulant. Materials and Methods Six needles commonly used in spinal procedures (Quincke, Short Bevel, Chiba, Tuohy, Hustead, Whitacre) were selected for use in this study. Ballistic gel samples were made in molds of two depths, 40mm and 80 mm. Each needle was mounted in a drill press to ensure an accurate needle trajectory. Distance of deflection was recorded for each needle. Results In comparing the mean deflection of 22 gauge needles of all types at 80 mm of depth, deflection was greatest among beveled needles [Short Bevel (9.96 ± 0.77 mm), Quincke (8.89 ± 0.17 mm), Chiba (7.71 ± 1.16 mm)], moderate among epidural needles [Tuohy (7.64 ± 0.16 mm) and least among the pencil-point needles [Whitacre (0.73 ± 0.34 mm)]. Increased gauge (25 g) led to a significant increase in deflection among beveled needles. The direction of deflection was away from the bevel with Quincke, Chiba and Short Beveled needles and toward the bevel of the Tuohy and Hustead needles. Deflection of the Whitacre pencil-point needle was minimal. Conclusions There is clinical utility in knowing the relative deflection of various needle tips. When a procedure requires a needle to be steered around obstacles, or along non-collinear targets, the predictable and large amount of deflection obtained through use of a beveled spinal needle may prove beneficial. PMID:27847693

Bronchoscopy with endobronchial ultrasound guided transbronchial needle aspiration vs. transthoracic needle aspiration in lung cancer diagnosis and staging.

PubMed

Munoz, Mark L; Lechtzin, Noah; Li, Qing Kay; Wang, KoPen; Yarmus, Lonny B; Lee, Hans J; Feller-Kopman, David J

2017-07-01

In evaluating patients with suspected lung cancer, it is important to not only obtain a tissue diagnosis, but also to obtain enough tissue for both histologic and molecular analysis in order to appropriately stage the patient with a safe and efficient strategy. The diagnostic approach may often be dependent on local resources and practice patterns rather than current guidelines. We Describe lung cancer staging at two large academic medical centers to identify the impact different procedural approaches have on patient outcomes. We conducted a retrospective cohort study of all patients undergoing a lung cancer diagnostic evaluation at two multidisciplinary centers during a 1-year period. Identifying complication rates and the need for multiple biopsies as our primary outcomes, we developed a multivariate regression model to determine features associated with complications and need for multiple biopsies. Of 830 patients, 285 patients were diagnosed with lung cancers during the study period. Those staged at the institution without an endobronchial ultrasound (EBUS) program were more likely to require multiple biopsies (OR 3.62, 95% CI: 1.71-7.67, P=0.001) and suffer complications associated with the diagnostic procedure (OR 10.2, 95% CI: 3.08-33.58, P<0.001). Initial staging with transthoracic needle aspiration (TTNA) and conventional bronchoscopy were associated with greater need for subsequent biopsies (OR 8.05 and 14.00, 95% CI: 3.43-18.87 and 5.17-37.86, respectively) and higher complication rates (OR 37.75 and 7.20, 95% CI: 10.33-137.96 and 1.36-37.98, respectively). Lung cancer evaluation at centers with a dedicated EBUS program results in fewer biopsies and complications than at multidisciplinary counterparts without an EBUS program.

Decomposition of Economic Inequality in Needle and Syringe Programs Utilization to its Determinants among Men Who Inject Drugs in Tehran using Blinder-Oaxaca Decomposition Method.

PubMed

Noroozi, Mehdi; Rahimi, Ebrahim; Ghisvand, Hessam; Qorbani, Mostafa; Sharifi, Hamid; Noroozi, Alireza; Farhoudian, Ali; Marshall, Brandon D L; Jorjoran Shoshtari, Zahra; Karimi, Salah Eddin; Rezaei, Omid; Armoon, Bahram

2018-06-07

According to latest available data there are more of 300,000 people injects drug users (PWID) in Iran. In this study, we used a Blinder-Oaxaca (BO) decomposition to explore the relative contributions of inequality in utilization of NSPs and to decompose it to its determinants in Teheran. We used data from a cross-sectional survey using snowball sampling to recruit 500 PWID from June to July 2016 in Tehran. Participants were reported injecting drug use in the past month, were able to speak and comprehend Farsi enough to respond to survey questions, and were able to provide informed consent to complete the interview. We used a BO method to decompose the role of economic inequality on utilization of needle and syringe programs. A total 520 of clients participated in the study of which data was fully complete for 500. The selected predictor variables (age, education level, marital status, homelessness, HIV risk perception, and HIV knowledge) together explain 54% (8.5% out of 16%) of total inequality in utilization of needle and syringe programs and the remaining 46% constitute the unexplained residual. HIV risk perception status contributed about 38% (3.3% out of 8.5%) to the total health inequality, followed by HIV knowledge (26%) and education level were contributed 20% each, respectively. The results showed that contribution of economic inequalities in utilization of NSPs was primarily explained by the differential effects of HIV risk perception and HIV knowledge among PWID. Reducing HIV risk perception and increasing HIV knowledge might be essential to efforts to eliminate inequalities in access to NSPs among PWID.

Patterns of HIV Risks and Related Factors among People Who Inject Drugs in Kermanshah, Iran: A Latent Class Analysis.

PubMed

Sharifi, Hamid; Mirzazadeh, Ali; Noroozi, Alireza; Marshall, Brandon D L; Farhoudian, Ali; Higgs, Peter; Vameghi, Meroe; Mohhamadi Shahboulaghi, Farahnaz; Qorbani, Mostafa; Massah, Omid; Armoon, Bahram; Noroozi, Mehdi

2017-01-01

The objective of this study was to explore patterns of drug use and sexual risk behaviors among people who inject drugs (PWID) in Iran. We surveyed 500 PWID in Kermanshah concerning demographic characteristics, sexual risk behaviors, and drug-related risk behaviors in the month prior to study. We used latent class analysis (LCA) to establish a baseline model of risk profiles and to identify the optimal number of latent classes, and we used ordinal regression to identify factors associated with class membership. Three classes of multiple HIV risk were identified. The probability of membership in the high-risk class was 0.33, compared to 0.26 and 0.40 for the low- and moderate-risk classes, respectively. Compared to members in the lowest-risk class (reference group), the highest-risk class members had higher odds of being homeless (OR = 4.5, CI: 1.44-8.22; p = 0.001) in the past 12 months. Members of the high-risk class had lower odds of regularly visiting a needle and syringe exchange program as compared to the lowest-risk class members (AOR = 0.42, CI: 0.2-0.81; p = 0.01). Findings show the sexual and drug-related HIV risk clusters among PWID in Iran, and emphasize the importance of developing targeted prevention and harm reduction programs for all domains of risk behaviors, both sexual and drug use related.

Automatic Robotic Steering of Flexible Needles from 3D Ultrasound Images in Phantoms and Ex Vivo Biological Tissue.

PubMed

Mignon, Paul; Poignet, Philippe; Troccaz, Jocelyne

2018-05-29

Robotic control of needle bending aims at increasing the precision of percutaneous procedures. Ultrasound feedback is preferable for its clinical ease of use, cost and compactness but raises needle detection issues. In this paper, we propose a complete system dedicated to robotized guidance of a flexible needle under 3D ultrasound imaging. This system includes a medical robot dedicated to transperineal needle positioning and insertion, a rapid path planning for needle steering using bevel-tip needle natural curvature in tissue, and an ultrasound-based automatic needle detection algorithm. Since ultrasound-based automatic needle steering is often made difficult by the needle localization in biological tissue, we quantify the benefit of using flexible echogenic needles for robotized guidance under 3D ultrasound. The "echogenic" term refers to the etching of microstructures on the needle shaft. We prove that these structures improve needle visibility and detection robustness in ultrasound images. We finally present promising results when reaching targets using needle steering. The experiments were conducted with various needles in different media (synthetic phantoms and ex vivo biological tissue). For instance, with nitinol needles the mean accuracy is 1.2 mm (respectively 3.8 mm) in phantoms (resp. biological tissue).

Ant Lion Optimization algorithm for kidney exchanges.

PubMed

Hamouda, Eslam; El-Metwally, Sara; Tarek, Mayada

2018-01-01

The kidney exchange programs bring new insights in the field of organ transplantation. They make the previously not allowed surgery of incompatible patient-donor pairs easier to be performed on a large scale. Mathematically, the kidney exchange is an optimization problem for the number of possible exchanges among the incompatible pairs in a given pool. Also, the optimization modeling should consider the expected quality-adjusted life of transplant candidates and the shortage of computational and operational hospital resources. In this article, we introduce a bio-inspired stochastic-based Ant Lion Optimization, ALO, algorithm to the kidney exchange space to maximize the number of feasible cycles and chains among the pool pairs. Ant Lion Optimizer-based program achieves comparable kidney exchange results to the deterministic-based approaches like integer programming. Also, ALO outperforms other stochastic-based methods such as Genetic Algorithm in terms of the efficient usage of computational resources and the quantity of resulting exchanges. Ant Lion Optimization algorithm can be adopted easily for on-line exchanges and the integration of weights for hard-to-match patients, which will improve the future decisions of kidney exchange programs. A reference implementation for ALO algorithm for kidney exchanges is written in MATLAB and is GPL licensed. It is available as free open-source software from: https://github.com/SaraEl-Metwally/ALO_algorithm_for_Kidney_Exchanges.

Program objectives for the National Water Data Exchange (NAWDEX) for fiscal year 1979

USGS Publications Warehouse

Edwards, Melvin D.

1978-01-01

This report describes the program objectives of the National Water Data Exchange (NAWDEX) for Fiscal Year 1979. These objectives include NAWDEX membership, program administration, management, and coordination, NAWDEX services, identification of sources of water data, indexing of water data, programs and systems documentation, recommended methods for the handling and exchange of water data, training, and technical assistance to NAWDEX members. (Woodard-USGS)

Geographical and climatic limits of needle types of one- and two-needled pinyon pines

USGS Publications Warehouse

Cole, K.L.; Fisher, J.; Arundel, S.T.; Cannella, J.; Swift, S.

2008-01-01

Aim: The geographical extent and climatic tolerances of one- and two-needled pinyon pines (Pinus subsect. Cembroides) are the focus of questions in taxonomy, palaeoclimatology and modelling of future distributions. The identification of these pines, traditionally classified by one- versus two-needled fascicles, is complicated by populations with both one- and two-needled fascicles on the same tree, and the description of two more recently described one-needled varieties: the fallax-type and californiarum-type. Because previous studies have suggested correlations between needle anatomy and climate, including anatomical plasticity reflecting annual precipitation, we approached this study at the level of the anatomy of individual pine needles rather than species. Location: Western North America. Methods: We synthesized available and new data from field and herbarium collections of needles to compile maps of their current distributions across western North America. Annual frequencies of needle types were compared with local precipitation histories for some stands. Historical North American climates were modelled on a c. 1-km grid using monthly temperature and precipitation values. A geospatial model (ClimLim), which analyses the effect of climate-modulated physiological and ecosystem processes, was used to rank the importance of seasonal climate variables in limiting the distributions of anatomical needle types. Results: The pinyon needles were classified into four distinct types based upon the number of needles per fascicle, needle thickness and the number of stomatal rows and resin canals. The individual needles fit well into four categories of needle types, whereas some trees exhibit a mixture of two needle types. Trees from central Arizona containing a mixture of Pinus edulis and fallax-type needles increased their percentage of fallax-type needles following dry years. All four needle types occupy broader geographical regions with distinctive precipitation regimes. Pinus monophylla and californiarum-type needles occur in regions with high winter precipitation. Pinus edulis and fallax-type needles are found in regions with high monsoon precipitation. Areas supporting californiarum-type and fallax-type needle distributions are additionally characterized by a more extreme May-June drought. Main conclusions: These pinyon needle types seem to reflect the amount and seasonality of precipitation. The single needle fascicle characterizing the fallax type may be an adaptation to early summer or periodic drought, while the single needle of Pinus monophylla may be an adaptation to summer-autumn drought. Although the needles fit into four distinct categories, the parent trees are sometimes less easily classified, especially near their ancestral Pleistocene ranges in the Mojave and northern Sonoran deserts. The abundance of trees with both one- and two-needled fascicles in the zones between P. monophylla, P. edulis and fallax-type populations suggest that needle fascicle number is an unreliable characteristic for species classification. Disregarding needle fascicle number, the fallax-type needles are nearly identical to P. edulis, supporting Little's (1968) initial classification of these trees as P. edulis var. fallax, while the californiarum-type needles have a distinctive morphology supporting Bailey's (1987) classification of this tree as Pinus californiarum.

Strategies to expand the living donor pool for kidney transplantation.

PubMed

de Klerk, Marry; Zuidema, Willij C; Ijzermans, Jan N M; Weimar, Willem

2008-05-01

Structural shortage of deceased donor kidneys for transplantation has resulted in the expansion of living donation programs. A number of possibilities are now being explored, since it became clear that donors do not need to be genetically related to their recipients. Apart from classical direct donation we now conduct paired exchange, list exchange, altruistic donation and domino paired exchange programs. Other alternative programs are desensitization and transplantation across the blood type barrier. The purpose of this article is to give a general view of all optimizing living donation programs by reviewing the literature. First we describe logistic solutions, thereafter the more intensive medical treatments. We observed a wide variation in clinical experiences with living donation dependent on local jurisdiction, culture and customs. Professionals disagree on various ethical issues inherent to alternative programs. In our opinion logistic solutions like paired exchange, list exchange and altruistic donation programs are to be preferred over the more medical demanding programs e.g. desensitization and transplantation across the blood type barrier.

A novel adaptive needle insertion sequencing for robotic, single needle MR-guided high-dose-rate prostate brachytherapy

NASA Astrophysics Data System (ADS)

Borot de Battisti, M.; de Senneville, B. Denis; Hautvast, G.; Binnekamp, D.; Lagendijk, J. J. W.; Maenhout, M.; Moerland, M. A.

2017-05-01

MR-guided high-dose-rate (HDR) brachytherapy has gained increasing interest as a treatment for patients with localized prostate cancer because of the superior value of MRI for tumor and surrounding tissues localization. To enable needle insertion into the prostate with the patient in the MR bore, a single needle MR-compatible robotic system involving needle-by-needle dose delivery has been developed at our institution. Throughout the intervention, dose delivery may be impaired by: (1) sub-optimal needle positioning caused by e.g. needle bending, (2) intra-operative internal organ motion such as prostate rotations or swelling, or intra-procedural rectum or bladder filling. This may result in failure to reach clinical constraints. To assess the first aforementioned challenge, a recent study from our research group demonstrated that the deposited dose may be greatly improved by real-time adaptive planning with feedback on the actual needle positioning. However, the needle insertion sequence is left to the doctor and therefore, this may result in sub-optimal dose delivery. In this manuscript, a new method is proposed to determine and update automatically the needle insertion sequence. This strategy is based on the determination of the most sensitive needle track. The sensitivity of a needle track is defined as its impact on the dose distribution in case of sub-optimal positioning. A stochastic criterion is thus presented to determine each needle track sensitivity based on needle insertion simulations. To assess the proposed sequencing strategy, HDR prostate brachytherapy was simulated on 11 patients with varying number of needle insertions. Sub-optimal needle positioning was simulated at each insertion (modeled by typical random angulation errors). In 91% of the scenarios, the dose distribution improved when the needle was inserted into the most compared to the least sensitive needle track. The computation time for sequencing was less than 6 s per needle track. The proposed needle insertion sequencing can therefore assist in delivering an optimal dose in HDR prostate brachytherapy.

Modelling and characterisation of a ultrasound-actuated needle for improved visibility in ultrasound-guided regional anaesthesia and tissue biopsy.

PubMed

Kuang, Y; Hilgers, A; Sadiq, M; Cochran, S; Corner, G; Huang, Z

2016-07-01

Clear needle visualisation is recognised as an unmet need for ultrasound guided percutaneous needle procedures including regional anaesthesia and tissue biopsy. With inadequate needle visibility, these procedures may result in serious complications or a failed operation. This paper reports analysis of the modal behaviour of a previously proposed ultrasound-actuated needle configuration, which may overcome this problem by improving needle visibility in colour Doppler imaging. It uses a piezoelectric transducer to actuate longitudinal resonant modes in needles (outer diameter 0.8-1.2mm, length>65mm). The factors that affect the needle's vibration mode are identified, including the needle length, the transducer's resonance frequency and the gripping position. Their effects are investigated using finite element modelling, with the conclusions validated experimentally. The actuated needle was inserted into porcine tissue up to 30mm depth and its visibility was observed under colour Doppler imaging. The piezoelectric transducer is able to generate longitudinal vibration with peak-to-peak amplitude up to 4μm at the needle tip with an actuating voltage of 20Vpp. Actuated in longitudinal vibration modes (distal mode at 27.6kHz and transducer mode at 42.2kHz) with a drive amplitude of 12-14Vpp, a 120mm needle is delineated as a coloured line in colour Doppler images, with both needle tip and shaft visualised. The improved needle visibility is maintained while the needle is advanced into the tissue, thus allowing tracking of the needle position in real time. Moreover, the needle tip is highlighted by strong coloured artefacts around the actuated needle generated by its flexural vibration. A limitation of the technique is that the transducer mode requires needles of specific lengths so that the needle's resonance frequency matches the transducer. This may restrict the choice of needle lengths in clinical applications. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

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TU-H-CAMPUS-JeP3-05: Adaptive Determination of Needle Sequence HDR Prostate Brachytherapy with Divergent Needle-By-Needle Delivery

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

Borot de Battisti, M; Maenhout, M; Lagendijk, J J W

Purpose: To develop a new method which adaptively determines the optimal needle insertion sequence for HDR prostate brachytherapy involving divergent needle-by-needle dose delivery by e.g. a robotic device. A needle insertion sequence is calculated at the beginning of the intervention and updated after each needle insertion with feedback on needle positioning errors. Methods: Needle positioning errors and anatomy changes may occur during HDR brachytherapy which can lead to errors in the delivered dose. A novel strategy was developed to calculate and update the needle sequence and the dose plan after each needle insertion with feedback on needle positioning errors. Themore » dose plan optimization was performed by numerical simulations. The proposed needle sequence determination optimizes the final dose distribution based on the dose coverage impact of each needle. This impact is predicted stochastically by needle insertion simulations. HDR procedures were simulated with varying number of needle insertions (4 to 12) using 11 patient MR data-sets with PTV, prostate, urethra, bladder and rectum delineated. Needle positioning errors were modeled by random normally distributed angulation errors (standard deviation of 3 mm at the needle’s tip). The final dose parameters were compared in the situations where the needle with the largest vs. the smallest dose coverage impact was selected at each insertion. Results: Over all scenarios, the percentage of clinically acceptable final dose distribution improved when the needle selected had the largest dose coverage impact (91%) compared to the smallest (88%). The differences were larger for few (4 to 6) needle insertions (maximum difference scenario: 79% vs. 60%). The computation time of the needle sequence optimization was below 60s. Conclusion: A new adaptive needle sequence determination for HDR prostate brachytherapy was developed. Coupled to adaptive planning, the selection of the needle with the largest dose coverage impact increases chances of reaching the clinical constraints. M. Borot de Battisti is funded by Philips Medical Systems Nederland B.V.; M. Moerland is principal investigator on a contract funded by Philips Medical Systems Nederland B.V.; G. Hautvast and D. Binnekamp are fulltime employees of Philips Medical Systems Nederland B.V.« less

[Effects of slow twisting needle insertion and tubing needle insertion at Neiguan (PC 6) on cardiovascular function: a comparative study].

PubMed

Ning, Shaoli; Zhao, Lihua; Xu, Lingjun; Huang, Yu; Pang, Yong; Huang, Dingjian

2016-01-01

To compare the effects between slow twisting needle insertion and tubing needle insertion. With cross-over design, 100 healthy young subjects (half male and half female) aged from 19 to 23 years were randomly divided into two groups by random digital table, 50 cases in each one. At the first stage, subjects in the group A were treated with slow twisting needle insertion while, subjects in,the group B were treated with tubing needle insertion. One week later, the procedure of second stage was performed alternately. The needle was inserted into Neiguan (PC 6) with two methods by one acupuncturist. The needle was retained for 5 min before removal. Five min before needle insertion as well as needle withdrawal and 30 min after needle withdrawal, ZXG-E automatic cardiovascular diagnostic apparatus was used to test cardiovascular function. At the tim of needle withdrawal, slow twisting needle insertion could improve effect work of kinetics (EWK), effective blood volume (BV) and reduce elastic expansion coefficient of blood vessel (FEK) and left ventricular spray blood impedance (VER), which was significantly different from tubing needle insertion (all P < 0.05). Thirty min after needle withdrawal, the differences of the indices of cardiovascular function between the two groups were not significant (all P > 0.05). The slow twisting needle insertion is significantly superior to tubing needle insertion on lowering vascular tension and VER, improving EWK and BV.

[Needle breakage during mandibular block anaesthesia: prevention and retrieval].

PubMed

Baart, J A; van Amerongen, W E; de Jong, K J M; Allard, R H B

2006-12-01

Disposable needles for dental local anaesthesia do not break easily. Still, needle breakage does occur, and is mainly caused by unexpected movements of the patient or pre-use bending of the needle by the dentist. If a dental needle breaks while administering local anaesthesia, the dentist should prevent panic. If the patient opens his mouth wide the needle might still be visible. If so, the needle is removed. If the needle is no longer visible, the site where the needle has penetrated the mucosa should be marked with a permanent marker. The dentist will contact a maxillofacial surgeon for immediate consultation. The maxillofacial surgeon will try to retrieve the broken dental needle under general anaesthesia.

Behavior of Tip-Steerable Needles in ex vivo and in vivo Tissue

PubMed Central

Majewicz, Ann; Marra, Steven P.; van Vledder, Mark G.; Lin, MingDe; Choti, Michael A.; Song, Danny Y.; Okamura, Allison M.

2012-01-01

Robotic needle steering is a promising technique to improve the effectiveness of needle-based clinical procedures, such as biopsies and ablation, by computer-controlled, curved insertions of needles within solid organs. In this paper, we explore the capabilities, challenges, and clinical relevance of asymmetric-tip needle steering though experiments in ex vivo and in vivo tissue. We evaluate the repeatability of needle insertion in inhomogeneous biological tissue and compare ex vivo and in vivo needle curvature and insertion forces. Steerable needles curved more in kidney than in liver and prostate, likely due to differences in tissue properties. Pre-bent needles produced higher insertion forces in liver and more curvature in vivo than ex vivo. When compared to straight stainless steel needles, steerable needles did not cause a measurable increase in tissue damage and did not exert more force during insertion. The minimum radius of curvature achieved by pre-bent needles was 5.23 cm in ex vivo tissue, and 10.4 cm in in vivo tissue. The curvatures achieved by bevel tip needles were negligible for in vivo tissue. The minimum radius of curvature for bevel tip needles in ex vivo tissue was 16.4 cm; however, about half of the bevel tip needles had negligible curvatures. We also demonstrate a potential clinical application of needle steering by targeting and ablating overlapping regions of cadaveric canine liver. PMID:22711767

Fusion of electromagnetic trackers to improve needle deflection estimation: simulation study.

PubMed

Sadjadi, Hossein; Hashtrudi-Zaad, Keyvan; Fichtinger, Gabor

2013-10-01

We present a needle deflection estimation method to anticipate needle bending during insertion into deformable tissue. Using limited additional sensory information, our approach reduces the estimation error caused by uncertainties inherent in the conventional needle deflection estimation methods. We use Kalman filters to combine a kinematic needle deflection model with the position measurements of the base and the tip of the needle taken by electromagnetic (EM) trackers. One EM tracker is installed on the needle base and estimates the needle tip position indirectly using the kinematic needle deflection model. Another EM tracker is installed on the needle tip and estimates the needle tip position through direct, but noisy measurements. Kalman filters are then employed to fuse these two estimates in real time and provide a reliable estimate of the needle tip position, with reduced variance in the estimation error. We implemented this method to compensate for needle deflection during simulated needle insertions and performed sensitivity analysis for various conditions. At an insertion depth of 150 mm, we observed needle tip estimation error reductions in the range of 28% (from 1.8 to 1.3 mm) to 74% (from 4.8 to 1.2 mm), which demonstrates the effectiveness of our method, offering a clinically practical solution.

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Model Adoption Exchange Payment System: Technical Specifications and User Instructions.

ERIC Educational Resources Information Center

Ambrosino, Robert J.

This user's manual, designed to meet the needs of adoption exchange administrators and program managers for a formal tool to assist them in the overall management and operation of their program, presents the Model Adoption Exchange Payment System (MAEPS), which was developed to improve the delivery of adoption exchange services throughout the…

Can a virtual reality assessment of fine motor skill predict successful central line insertion?

PubMed

Mohamadipanah, Hossein; Parthiban, Chembian; Nathwani, Jay; Rutherford, Drew; DiMarco, Shannon; Pugh, Carla

2016-10-01

Due to the increased use of peripherally inserted central catheter lines, central lines are not performed as frequently. The aim of this study is to evaluate whether a virtual reality (VR)-based assessment of fine motor skills can be used as a valid and objective assessment of central line skills. Surgical residents (N = 43) from 7 general surgery programs performed a subclavian central line in a simulated setting. Then, they participated in a force discrimination task in a VR environment. Hand movements from the subclavian central line simulation were tracked by electromagnetic sensors. Gross movements as monitored by the electromagnetic sensors were compared with the fine motor metrics calculated from the force discrimination tasks in the VR environment. Long periods of inactivity (idle time) during needle insertion and lack of smooth movements, as detected by the electromagnetic sensors, showed a significant correlation with poor force discrimination in the VR environment. Also, long periods of needle insertion time correlated to the poor performance in force discrimination in the VR environment. This study shows that force discrimination in a defined VR environment correlates to needle insertion time, idle time, and hand smoothness when performing subclavian central line placement. Fine motor force discrimination may serve as a valid and objective assessment of the skills required for successful needle insertion when placing central lines. Copyright © 2016 Elsevier Inc. All rights reserved.

[Treatment of Paget's disease with diphosphonate (disodium ethydronate)].

PubMed

Caniggia, A; Gennari, C; Guideri, R; Vattimo, A; Nardi, P

1976-01-07

16 patients suffering from Paget's disease were studied before, during and after 3 or 6 month treatment with disodium ethydronate (EHDP) per os. An appreciable improvement in pain symptomatology was noted and at times an evident improvement in audiometry; from the metabolic viewpoint there was a fall in serum alkaline phosphatase and urinary excretion of calcium and hydroxyproline. A study of radiocalcium kinetics demonstrated a reduction in the exchangeable calcium pool and the fractional turnover rate. Histological examination following needle biopsy of the iliac crest showed evident diminution in the active bone cell population (osteoclasts, osteoblasts) and, in certain cases, appearance of osteoid borders.

Stereo Navi 2.0: software for stereotaxic surgery of the common marmoset (Callithrix jacchus).

PubMed

Tokuno, Hironobu; Tanaka, Ikuko; Umitsu, Yoshitomo; Nakamura, Yasuhisa

2009-11-01

Recently, we reported our web-accessible digital brain atlas of the common marmoset (Callithrix jacchus) at http://marmoset-brain.org:2008. Using digital images obtained during construction of this website, we developed stand-alone software for navigation of electrodes or injection needles for stereotaxic electrophysiological or anatomical experiments in vivo. This software enables us to draw lines on exchangeable section images, measure the length and angle of lines, superimpose a stereotaxic reference grid on the image, and send the image to the system clipboard. The software, Stereo Navi 2.0, is freely available at our brain atlas website.

Does Needle Rotation Improve Lesion Targeting?

PubMed Central

Badaan, Shadi; Petrisor, Doru; Kim, Chunwoo; Mozer, Pierre; Mazilu, Dumitru; Gruionu, Lucian; Patriciu, Alex; Cleary, Kevin; Stoianovici, Dan

2011-01-01

Background Image-guided robots are manipulators that operate based on medical images. Perhaps the most common class of image-guided robots are robots for needle interventions. Typically, these robots actively position and/or orient a needle guide, but needle insertion is still done by the physician. While this arrangement may have safety advantages and keep the physician in control of needle insertion, actuated needle drivers can incorporate other useful features. Methods We first present a new needle driver that can actively insert and rotate a needle. With this device we investigate the use of needle rotation in controlled in-vitro experiments performed with a specially developed revolving needle driver. Results These experiments show that needle rotation can improve targeting and may reduce errors by as much as 70%. Conclusion The new needle driver provides a unique kinematic architecture that enables insertion with a compact mechanism. Perhaps the most interesting conclusion of the study is that lesions of soft tissue organs may not be perfectly targeted with a needle without using special techniques, either manually or with a robotic device. The results of this study show that needle rotation may be an effective method of reducing targeting errors. PMID:21360796

Thyroid fine-needle aspiration cytology: performance data of neoplastic and malignant cases as identified from 1558 responses in the ASCP Non-GYN Assessment program thyroid fine-needle performance data.

PubMed

Eilers, Stan G; LaPolice, Paula; Mukunyadzi, Perkins; Kapur, Umesh; Wendel Spiczka, Amy; Shah, Ajay; Saleh, Husain; Adeniran, Adebowale; Nunez, Amberly; Balachandran, Indra; Clark, Jennifer J; Lemon, Larry

2014-10-01

Fine-needle aspiration of the thyroid is a common procedure, with an established role in reducing unnecessary thyroid surgery and identifying neoplasms and malignancies. The study evaluated 1558 responses in the American Society for Clinical Pathology (ASCP) Non-GYN Assessment program of aspirates of thyroid neoplasms and malignancies and placed them into the following groups: group A (target or correct interpretation), group B (incorrect interpretation as a benign thyroid nodule), group C (incorrect interpretation malignant aspirate as thyroid neoplasm), and group D (malignant diagnosis with incorrect interpretation). In clinical practice, responses in groups A, C, and D would lead to surgical excision, whereas responses in group B would not. Of a total of 1558 responses, 78.5% of the responses were in group A, 8.5% in group B, 3.75% in group C, and 9.25% in group D. By individual diagnosis, the group rates were 86.5%, 0%, 11%, and 2.5% for anaplastic thyroid carcinoma; 83%, 5.5%, 4.25%, and 7.25% for papillary thyroid carcinoma; 79%, 7%, 6%, and 8% for medullary thyroid carcinoma; 83.5% 6.75%, 0%, and 9.75% for Hürthle cell neoplasm; and 61%, 22%, 0%, and 17% for follicular neoplasm in groups A, B, C, and D respectively. Fine-needle aspiration was effective in diagnosing thyroid neoplasms and malignancies and in separating thyroid nodules into surgical and nonsurgical categories. Data from a large group of cytology professionals showed good performance; however, there is room for improvement, especially in making specific diagnoses. In particular, follicular neoplasm and follicular variant of papillary thyroid carcinoma were challenging diagnoses for participants. © 2014 The Authors. Cancer Cytopathology published by Wiley Periodicals, Inc. on behalf of American Cancer Society.

Paraesthesia during the needle-through-needle and the double segment technique for combined spinal epidural anaesthesia.

PubMed

Ahn, H J; Choi, D H; Kim, C S

2006-07-01

Paraesthesia during regional anaesthesia is an unpleasant sensation for patients and, more importantly, in some cases it is related to neurological injury. Relatively few studies have been conducted on the frequency of paraesthesia during combined spinal epidural anaesthesia. We compared two combined spinal epidural anaesthesia techniques: the needle-through-needle technique and the double segment technique in this respect. We randomly allocated 116 parturients undergoing elective Caesarean section to receive anaesthesia using one of these techniques. Both techniques were performed using a 27G pencil point needle, an 18G Tuohy needle, and a 20G multiport epidural catheter from the same manufacturer. The overall frequency of paraesthesia was higher in the needle-through-needle technique group (56.9% vs. 31.6%, p = 0.011). The frequency of paraesthesia at spinal needle insertion was 20.7% in the needle-through-needle technique group and 8.8% in the double segment technique group; whereas the frequency of paraesthesia at epidural catheter insertion was 46.6% in the needle-through-needle technique group and 24.6% in the double segment technique group.

Effect of needle size and type, reuse of needles, insertion speed, and removal of hair on contamination of joints with tissue debris and hair after arthrocentesis.

PubMed

Adams, Stephen B; Moore, George E; Elrashidy, Mohammed; Mohamed, Ahmed; Snyder, Paul W

2010-08-01

To assess joint contamination with tissue and hair after arthrocentesis of equine fetlock joints. Experimental. Limb specimens from 8 equine cadavers. Soft tissues including the joint capsule were harvested from the dorsal aspect of the fetlock joints and mounted on a wooden frame. Needles inserted through the joint tissue preparation were flushed into tissue culture plates that were examined for tissue and hair debris. Variables evaluated were gauge and type of needle (16, 18, 20, and 22 G sharp disposable needles and 20 G disposable spinal needles with stylet), number of times each needle was used (1, 2, 3, 4), length of hair (unclipped, clipped, shaved with razor), and needle insertion speed (fast, slow). Descriptive and statistical evaluations were performed. Tissue contamination was identified in 1145 of 1260 wells and hair contamination was identified in 384 of 1260 wells. Twenty gauge needles inserted through unclipped hair resulted in the least amount of hair contamination. Compared with 20 G needles with fast insertion 1 time through unclipped hair the odds ratios for contamination with hair were significantly greater for 16 G sharp disposable needles, 20 G spinal needles, clipped hair, shaved hair, and reuse of the needles. Spinal needles inserted through unclipped hair transferred many long hairs into the joint space. Reuse of needles for arthrocentesis should be avoided. Removal of hair is not indicated for arthrocentesis with sharp injection needles but is recommended when using spinal needles with stylets. Joint contamination with hair and tissue debris will be decreased by specific needle insertion techniques. Decreased contamination of joints may reduce the frequency of joint infections after arthrocentesis.

EUS Needle Identification Comparison and Evaluation study (with videos).

PubMed

Tang, Shou-Jiang; Vilmann, Andreas S; Saftoiu, Adrian; Wang, Wanmei; Streba, Costin Teodor; Fink, Peter P; Griswold, Michael; Wu, Ruonan; Dietrich, Christoph F; Jenssen, Christian; Hocke, Michael; Kantowski, Marcus; Pohl, Jürgen; Fockens, Paul; Annema, Jouke T; van der Heijden, Erik H F M; Havre, Roald Flesland; Pham, Khanh Do-Cong; Kunda, Rastislav; Deprez, Pierre H; Mariana, Jinga; Vazquez-Sequeiros, Enrique; Larghi, Alberto; Buscarini, Elisabetta; Fusaroli, Pietro; Lahav, Maor; Puri, Rajesh; Garg, Pramod Kumar; Sharma, Malay; Maluf-Filho, Fauze; Sahai, Anand; Brugge, William R; Lee, Linda S; Aslanian, Harry R; Wang, Andrew Y; Shami, Vanessa M; Markowitz, Arnold; Siddiqui, Ali A; Mishra, Girish; Scheiman, James M; Isenberg, Gerard; Siddiqui, Uzma D; Shah, Raj J; Buxbaum, James; Watson, Rabindra R; Willingham, Field F; Bhutani, Manoop S; Levy, Michael J; Harris, Cynthia; Wallace, Michael B; Nolsøe, Christian Pállson; Lorentzen, Torben; Bang, Niels; Sørensen, Sten Mellerup; Gilja, Odd Helge; D'Onofrio, Mirko; Piscaglia, Fabio; Gritzmann, Norbert; Radzina, Maija; Sparchez, Zeno Adrian; Sidhu, Paul S; Freeman, Simon; McCowan, Timothy C; de Araujo, Cyrillo Rodrigues; Patel, Akash; Ali, Mohammad Adel; Campbell, Garth; Chen, Edward; Vilmann, Peter

2016-09-01

EUS-guided FNA or biopsy sampling is widely practiced. Optimal sonographic visualization of the needle is critical for image-guided interventions. Of the several commercially available needles, bench-top testing and direct comparison of these needles have not been done to reveal their inherent echogenicity. The aims are to provide bench-top data that can be used to guide clinical applications and to promote future device research and development. Descriptive bench-top testing and comparison of 8 commonly used EUS-FNA needles (all size 22 gauge): SonoTip Pro Control (Medi-Globe); Expect Slimline (Boston Scientific); EchoTip, EchoTip Ultra, EchoTip ProCore High Definition (Cook Medical); ClearView (Conmed); EZ Shot 2 (Olympus); and BNX (Beacon Endoscopic), and 2 new prototype needles, SonoCoat (Medi-Globe), coated by echogenic polymers made by Encapson. Blinded evaluation of standardized and unedited videos by 43 EUS endoscopists and 17 radiologists specialized in GI US examination who were unfamiliar with EUS needle devices. There was no significant difference in the ratings and rankings of these needles between endosonographers and radiologists. Overall, 1 prototype needle was rated as the best, ranking 10% to 40% higher than all other needles (P < .01). Among the commercially available needles, the EchoTip Ultra needle and the ClearView needle were top choices. The EZ Shot 2 needle was ranked statistically lower than other needles (30%-75% worse, P < .001). All FNA needles have their inherent and different echogenicities, and these differences are similarly recognized by EUS endoscopists and radiologists. Needles with polymeric coating from the entire shaft to the needle tip may offer better echogenicity. Copyright © 2016 American Society for Gastrointestinal Endoscopy. All rights reserved.

A comparison of 25 gauge Quincke spinal needle with 26 gauge Eldor spinal needle for the elective Caesarian sections: insertion characteristics and complications.

PubMed

Tabedar, S; Maharjan, S K; Shrestha, B R; Shrestha, B M

2003-01-01

The study was designed to compare the insertion characteristics and incidence of PDPH between 25 gauge Quincke needle and 26 gauge Eldor needle for spinal anaesthesia in elective c/s. 60 pregnant women (aged 19-35 yrs and weighing 58 -67 kg) undergoing elective caesarean section were randomized into group A (Quincke spinal needle group) or group B (Eldor spinal needle group). Spinal anaesthesia was performed with 2.9 ml 0.5% heavy bupivacaine using 25 gauge Quincke spinal needle in group A and 26 Gauge Eldor spinal needle in group B. Onset, time of first identification of backflow of CSF, number of attempts, level of sensory and motor blockade, failure of anaesthesia, inadequate anaesthesia and incidence of PDPH were recorded. Quincke spinal needle was found easy at insertion, first attempt was successful in 90% of cases, whereas Eldor spinal needle was successful at first attempt in only 60% of cases. Early identification of CSF was seen in Eldor spinal needle group in 3.5 seconds vs. 5.2 seconds in Quincke spinal needle group. Blood mixed CSF was seen in 8 Quincke spinal needle group vs. none in Eldor spinal needle group. Onset was similar between both groups i.e. in 6 minutes. Failure of anaesthesia was none in Eldor spinal needle group vs. 2 in quincke spinal needle group. Height of sensory block achieved was T4 level in 26 parturients,T6 in 1 ,T8 in 1 and no anaesthesia at all in another 2 parturient as compared to T4 level in 29 and T3 in 1 parturient in Eldor spinal needle group. The degree of motor block with the use of Bromage criteria showed a motor score of 1 or 2 in 26 parturients in Quincke spinal needle group vs. same in all cases in Eldor spinal needle group. The total incidence of PDPH was 8.3 % (5 out of 60 parturient) which occurred all in Quincke spinal needle group. 2 parturient who developed severe PDPH required epidural blood patch. 26 gauge Eldor spinal needle was found to be better than 25 gauge Quincke spinal needle for caesarian sections to decrease the incidence of PDPH, though not all insertion characteristics were in favour of the Eldor needle.

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Modeling, Production, and Testing of an Echogenic Needle for Ultrasound-Guided Nerve Blocks.

PubMed

Bigeleisen, Paul E; Hess, Aaron; Zhu, Richard; Krediet, Annelot

2016-06-01

We have designed, produced, and tested an echogenic needle based on a sawtooth pattern where the height of the tooth was 1.25 times the wavelength of the ultrasound transducer. A numeric solution to the time-independent wave equation (Helmholtz equation) was used to create a model of backscattering from a needle. A 21-gauge stainless steel prototype was manufactured and tested in a water bath. Backscattering from the needle was compared to theoretical predications from our model. Based on these results, an 18-gauge prototype needle was fabricated from stainless steel and tested in a pig cadaver. This needle was compared to a commercial 18-gauge echogenic needle (Pajunk Medical Systems, Tucker, GA) by measuring the brightness of the needle relative to the background of sonograms of a needle in a pig cadaver. The backscattering from the 21-gauge prototype needle reproduced the qualitative predictions of our model. At 30° and 45° of insonation, our prototype performed equivalently to the Pajunk needle. At 60°, our prototype was significantly brighter than the Pajunk needle (P = .017). In conclusion, we chose a model for the design of an echogenic needle and modeled it on the basis of a solution to the Helmholtz equation. A prototype needle was tested in a water bath and compared to the model prediction. After verification of our model, we designed an 18-gauge needle, which performed better than an existing echogenic needle (Pajunk) at 60° of insonation. Our needle will require further testing in human trials. © 2016 by the American Institute of Ultrasound in Medicine.

Comparison of sprotte and Quincke needles with respect to spinal fluid leakage using artificial spinal cord.

PubMed

Amaki, Yoshikiyo; Moriyama, Michihiko; Kuzuta, Toshimichi; Yabe, Keiko; Kaneko, Misato

1997-12-01

This research investigated whether the Sprotte needle causes less leakage of CSF than the Quincke needle in the artificial spinal cord. The changes in intradural pressure, extradural pressure, and leaked volume of CSF were evaluated following puncture with Sprotte and Quincke needles in the artificial spinal cord. The decrease in intradural pressure was 9.7±1.8 mm H 2 O with the Sprotte needle and 20.5±2.7 mm H 2 O with the Quincke needle (P<0.05). The volume of leakage of artificial CSF was 2.0±0.3 ml with the Sprotte needle and 3.3 ±0.3 ml with the Quincke needle (P<0.01). The extradural pressure increase was 166.1±8.2 mm H 2 O with the Sprotte needle and 186.8±13.2 mm H 2 O with the Quincke needle (P<0.05). The Sprotte needle produces less CSF leakage than the Quincke needle.

[Observation on therapeutic effect of three needling method on piriformis injury syndrome].

PubMed

Yang, Jun-xiong; Zhu, Xiao-yi

2008-03-01

To search for an effective needling method for treatment of piriformis injury syndrome. Eighty-two cases were randomly divided into a three needling group and a routine needling group, 41 cases in each group. The three needling group were treated by acupuncture at Huantiao (GB 30), Yanglingquan (GB 34) and Shenmai (BL 62), with needling shallow, middle and deep layers for Huantiao, Yanglingquan, and after acupuncture massage was given at the Foot-Taiyang Channel and the Foot-Shaoyang Channel on lumbosacral region and the affected foot. The routine needling group were treated by routine needling at Huantiao (GB 30), Juliao (GB 29), Chengfu (BL 36), Yanglingquan (GB 34), massage was given also. Their therapeutic effects were compared. The cured rate was 87.8% in the three needling group and 63.4% in the routine needling group, with a significant difference between the two groups (P < 0.05). The therapeutic effect of three needling method on piriformis injury syndrome is better than that of routine needling.

A major trade-off between structural and photosynthetic investments operative across plant and needle ages in three Mediterranean pines.

PubMed

Kuusk, Vivian; Niinemets, Ülo; Valladares, Fernando

2018-04-01

Pine (Pinus) species exhibit extensive variation in needle shape and size between juvenile (primary) and adult (secondary) needles (heteroblasty), but few studies have quantified the changes in needle morphological, anatomical and chemical traits upon juvenile-to-adult transition. Mediterranean pines keep juvenile needles longer than most other pines, implying that juvenile needles play a particularly significant role in seedling and sapling establishment in this environment. We studied needle anatomical, morphological and chemical characteristics in juvenile and different-aged adult needles in Mediterranean pines Pinus halepensis Mill., Pinus pinea L. and Pinus nigra J. F. Arnold subsp. salzmannii (Dunal) Franco hypothesizing that needle anatomical modifications upon juvenile-to-adult transition lead to a trade-off between investments in support and photosynthetic tissues, and that analogous changes occur with needle aging albeit to a lower degree. Compared with adult needles, juvenile needles of all species were narrower with 1.6- to 2.4-fold lower leaf dry mass per unit area, and had ~1.4-fold thinner cell walls, but needle nitrogen content per dry mass was similar among plant ages. Juvenile needles also had ~1.5-fold greater mesophyll volume fraction, ~3-fold greater chloroplast volume fraction and ~1.7-fold greater chloroplast exposed to mesophyll exposed surface area ratio, suggesting overall greater photosynthetic activity. Changes in needle traits were similar in aging adult needles, but the magnitude was generally less than the changes upon juvenile to adult transition. In adult needles, the fraction in support tissues scaled positively with known ranking of species tolerance of drought (P. halepensis > P. pinea > P. nigra). Across all species, and needle and plant ages, a negative correlation between volume fractions of mesophyll and structural tissues was observed, manifesting a trade-off between biomass investments in different needle functions. These results demonstrate that within the broad trade-off, juvenile and adult needle morphophysiotypes are separated by varying investments in support and photosynthetic functions. We suggest that the ecological advantage of the juvenile morphophysiotype is maximization of carbon gain of establishing saplings, while adult needle physiognomy enhances environmental stress tolerance of established plants.

Examination of surface conditions and other physical properties of commonly used stainless steel acupuncture needles.

PubMed

Xie, Yi Min; Xu, Shanqing; Zhang, Claire Shuiqing; Xue, Charlie Changli

2014-04-01

The present work examined the surface conditions and various other physical properties of sterilised single-use stainless steel acupuncture needles from two of the most popular brands widely used in many countries. Scanning electron microscope (SEM) images were taken for 10 randomly chosen needles from each brand. Further SEM images were taken after each of these needles underwent a standard manipulation with an acupuncture needling practice gel. A comparison of forces and torques during the needling process was also carried out. The SEM images revealed significant surface irregularities and inconsistencies at the needle tips, especially for needles from one of the two brands. Metallic lumps and small, loosely attached pieces of material were observed on the surfaces of some needles. Some of the lumps and pieces of material seen on the needle surfaces disappeared after the acupuncture manipulation. If these needles had been used on patients, the metallic lumps and small pieces of material could have been deposited in human tissues, which could have caused adverse events such as dermatitis. Malformed needle tips might also cause other adverse effects including bleeding, haematoma/bruising, or strong pain during needling. An off-centre needle tip could result in the needle altering its direction during insertion and consequently failing to reach the intended acupuncture point or damaging adjacent tissues. These findings highlight the need for improved quality control of acupuncture needles, with a view to further enhancing the safety and comfort of acupuncture users.

IAC Standardized Reporting of Breast Fine-Needle Aspiration Biopsy Cytology.

PubMed

Field, Andrew S; Schmitt, Fernando; Vielh, Philippe

2017-01-01

There have been many changes in the roles of fine-needle aspiration biopsy (FNAB) and core needle biopsy (CNB) in the diagnostic workup of breast lesions in routine breast clinics and in mammographic breast screening programs, as well as changes in the management algorithms utilized and the treatments available, since the NCI consensus on breast FNAB cytology in 1996. A standardized approach will improve training and performance of FNAB and smear-making techniques, and structured reporting will improve the quality and reproducibility of reports across departments, cities and countries providing a basis for quality assurance measures and improving patient care and facilitating research. Linking cytology reports to management algorithms will increase the clinicians' use of FNAB cytology and where appropriate CNB, and enhance the use of ancillary tests for prognostic testing. The IAC recognizes that the local medical infrastructure and resources for breast imaging, biopsy and treatment will influence the diagnostic workup and management of breast disease, but best practice guidelines should be established and modified as required. © 2016 S. Karger AG, Basel.

[Our experience using "Huber Plus" needles in our infusion center].

PubMed

Tazumi, Keiko; Kouji, Keiko; Matsumura, Natsuko; Nabetani, Yoshiko; Kondo, Motoi; Tomono, Kazunori; Mizuki, Masao

2008-01-01

We conducted a pilot trial to compare the operability and safety of two huber needles in the infusion center. In the present study, we used huber needles without the safety cover and one huber needle with the safety cover (Huber Plus(R)). Both huber needles were used nine times. The successful puncture rate of the first time puncture and the incidence of needle accidents with both huber needles were 100% and 0%, respectively. The evaluation of pain and uneasiness by VAS (Visual Analogue scale)revealed the superiority of the safety needle over the than non-safety needle(pain: 3.8 vs 2.6, uneasiness: 3.7 vs 0.5). To our knowledge, this is the first report of the safety of the huber needle in Japan. This system may be recommended in Japan to avoid needle stick injuries, patient pain and uneasiness.

Using insulin pen needles up to five times does not affect needle tip shape nor increase pain intensity.

PubMed

Puder, Jardena J; Atar, Michael; Muller, Beat; Pavan, Marco; Keller, Ulrich

2005-02-01

Reusing insulin pen needles could help to reduce the increasing economic burden of diabetes. We tested the hypothesis that reusing insulin pen needles leads to needle tip deformity and increased pain. Three blinded reviewers assessed 123 electron microscope pictures analyzing needle tip deformity of insulin pen needles used up to four times by diabetic subjects and up to five times by blinded non-diabetic volunteers. The estimated frequency of needle use was correlated to the actual number of needle use. Pain intensity and unpleasantness of each injection were measured by a visual analogue scale and their differences analyzed by Kruskal-Wallis analysis of variance. Unused needles could be differentiated visually from used needles. However, there was no correlation between the actual and guessed number of times a needle was used (r = 0.07, P = 0.2). Evaluating all 270 injections, neither pain intensity nor unpleasantness increased with repeated injections of the same needles in people with diabetes (P = 0.1 and 0.96) and in the volunteers (P = 0.63 and 0.92). Using pen needles four to five times does not lead to progressive needle tip deformity and does not increase pain intensity or unpleasantness, but could increase convenience and lead to substantial financial savings in Europe of around EUR 100 million/year.

Comparison of 25 G and 29 G Quincke spinal needles in paediatric day case surgery. A prospective randomized study of the puncture characteristics, success rate and postoperative complaints.

PubMed

Kokki, H; Hendolin, H

1996-01-01

A comparison of a 25 G with a 29 G Quincke needle was performed in paediatric day case surgery. Sixty healthy children aged 1 year to 13 years were randomly allocated to have spinal anaesthesia with either 25 G or 29 G Quincke needle without an introducer needle. There was a failure rate of 10% with the 29 G spinal needle compared with 0% with the 25 G needle. The time needed to perform dural puncture was shorter using 25 G than 29 G needle, 22 (+/- 31)(SD) vs 59 (+/- 63) s. The time taken for cerebrospinal fluid to appear at the needle hub was also longer, 4 (+/- 3) vs 8 (+/- 5) s. The number of puncture attempts was similar, 1.2 (+/- 0.6) vs 1.4 (+/- 0.8), with 25 G and 29 G needle. Low back pain, 5 vs1, and nonpositional headache, 2 vs 4, after 25 G and 29 G needles, respectively, were the most frequent postoperative complaints. Mild postdural puncture headache occurred in one eight year old male patient in the 25 G group. In conclusion, lumbar puncture without introducer needle was possible with both needles. The puncture characteristics favoured the 25 G needle. A shorter needle could partly alleviate the difficulties with the 29 G needle.

Crash Data Improvement Program : An RSPCB Peer Exchange

DOT National Transportation Integrated Search

2011-08-04

This report provides a summary of the Crash Data Improvement Program (CDIP) peer exchange sponsored by the Federal Highway Administrations (FHWA) Office of Safety on August 4, 2011. The peer exchange was hosted in conjunction with the annual Traff...

Comparison of fine-needle aspiration and core needle biopsy under ultrasonographic guidance for detecting malignancy and for the tissue-specific diagnosis of salivary gland tumors.

PubMed

Eom, H-J; Lee, J H; Ko, M-S; Choi, Y J; Yoon, R G; Cho, K J; Nam, S Y; Baek, J H

2015-06-01

Diagnostic test accuracy studies for ultrasonography-guided fine-needle aspiration and ultrasonography-guided core needle biopsy have shown inconclusive results due to their heterogenous study designs. Our aim was to compare the diagnostic accuracy of ultrasonography-guided fine-needle aspiration versus ultrasonography-guided core needle biopsy for detecting malignant tumors of the salivary gland and for the tissue-specific diagnosis of salivary gland tumors in a single tertiary hospital. This retrospective study was approved by our institutional review board and informed consent was waived. Four hundred twelve patients who underwent ultrasonography-guided fine-needle aspiration (n = 155) or ultrasonography-guided core needle biopsy (n = 257) with subsequent surgical confirmation or clinical follow-up were enrolled. We compared the diagnostic accuracy of ultrasonography-guided fine-needle aspiration and ultrasonography-guided core needle biopsy regarding malignant salivary gland tumors and the correct tissue-specific diagnosis of benign and malignant tumors. We also tested the difference between these procedures according to the operator's experience and lesion characteristics. The inconclusive rates of ultrasonography-guided fine-needle aspiration and ultrasonography-guided core needle biopsy were 19% and 4%, respectively (P < .001). The overall accuracy of ultrasonography-guided core needle biopsy for diagnosing malignant tumors was significantly higher than that of ultrasonography-guided fine-needle aspiration (P = .024). The correct tissue-specific diagnosis rates of ultrasonography-guided fine-needle aspiration and ultrasonography-guided core needle biopsy were 95% versus 97% for benign tumors (P = .648) and 67% versus 80% for malignant tumors (P = .310). Trainees showed significantly lower accuracy with ultrasonography-guided fine-needle aspiration than with ultrasonography-guided core needle biopsy for diagnosing malignant tumors (P = .021). There was no difference between the diagnostic accuracy of ultrasonography-guided fine-needle aspiration and ultrasonography-guided core needle biopsy according to the internal composition of the lesions. There were no complications requiring intervention or hospitalization in our patients. Ultrasonography-guided core needle biopsy is superior to ultrasonography-guided fine-needle aspiration in detecting and characterizing malignant tumors of the salivary gland and could emerge as the diagnostic method of choice for patients presenting with a salivary gland mass. © 2015 by American Journal of Neuroradiology.

Environmental control of CO2-assimilation and leaf conductance in Larix decidua Mill. : I. A comparison of contrasting natural environments.

PubMed

Benecke, U; Schulze, E -D; Matyssek, R; Havranek, W M

1981-08-01

CO 2 -assimilation and leaf conductance of Larix decidua Mill. were measured in the field at high (Patscherkofel, Austria) and low (Bayreuth, Germany) elevation in Europe, and outside its natural range along an altitudinal gradient in New Zealand.Phenology of leaf and stem growth showed New Zealand sites to have much longer growing seasons than in Europe, so that the timberline (1,330 m) season was almost twice as long as at the Austrian timberline (1,950 m).The maximum rates of photosynthesis, A max , were similar at all sites after completion of leaf growth, namely 3 to 3.5 μmol m -2 s -1 . Only the sun needles of the Bayreuth tree reached 3.5 to 5 μmol m -2 s -1 . Light response curves for CO 2 -assimilation changed during leaf ontogeny, the slope being less in young than in adult leaves. The temperature optimum for 90% of maximum photosynthesis was at all sites similar between ca. 12-28°C for much of the summer. Only at the cooler high altitude timberline sites were optima lower at ca. 10-16°C in developing needles during early summer.A linear correlation existed between A max and leaf conductance at A max , and this showed no difference between the sites except for sun needles at Bayreuth.Leaf conductance responded strongly to light intensity and this was concurrent with the light response of CO 2 -uptake. A short-term and a long-term effect were differentiated. With increasing age maximum rates of CO 2 -uptake and leaf conductance at A max increased, whereas short-term response during changes in light declined. The stomata became less responsive with increasing age and tended to remain open. The stomatal responses to light have a significant effect on the water use efficiency during diurnal courses. A higher water use efficiency was found for similar atmospheric conditions in spring than in autumn.Stomata responded with progressive closure to declining air humidity in a similar manner under dissimilar climates. Humidity response thus showed insensitivity to habitat differences.From the diurnal course of gas-exchange stomata were more closed at timberline (1,330 m) than at lower elevations but this did not lead to corresponding site differences in CO 2 -exchange suggesting Larix may not be operating at high water use efficiency when air is humid.The main difference between habitats studied was in the time necessary for completion of needle development. Similarity in photosynthesis and leaf conductance existed between sites when tree foliage was compared at the same stage of development. Length of growing season and time requirement for foliar development appear to be a principle factor in the carbon balance of deciduous species. The evergreen habit may be more effective in counterbalancing the effects of cool short summers.

[Training program design of acupuncture and moxibustion manipulation techniques].

PubMed

Dong, Qin

2009-12-01

As an important component of acupuncture-moxibustion science, needling and moxibustion is one methodology and technology and its technical characteristics determine its special status and role in training programs. It is closely ralated to meridians-collaterals-acupoints and acupuncture treatment. Therefore, it demands an overall planning for acupuncture professional skills that consists of meridians-collaterals-acupoints knowledge and acupuncture treatment techniques. The practical training courses are the step by step progress involving repeated practices.

Needle Steering in Biological Tissue using Ultrasound-based Online Curvature Estimation

PubMed Central

Moreira, Pedro; Patil, Sachin; Alterovitz, Ron; Misra, Sarthak

2014-01-01

Percutaneous needle insertions are commonly performed for diagnostic and therapeutic purposes. Accurate placement of the needle tip is important to the success of many needle procedures. The current needle steering systems depend on needle-tissue-specific data, such as maximum curvature, that is unavailable prior to an interventional procedure. In this paper, we present a novel three-dimensional adaptive steering method for flexible bevel-tipped needles that is capable of performing accurate tip placement without previous knowledge about needle curvature. The method steers the needle by integrating duty-cycled needle steering, online curvature estimation, ultrasound-based needle tracking, and sampling-based motion planning. The needle curvature estimation is performed online and used to adapt the path and duty cycling. We evaluated the method using experiments in a homogenous gelatin phantom, a two-layer gelatin phantom, and a biological tissue phantom composed of a gelatin layer and in vitro chicken tissue. In all experiments, virtual obstacles and targets move in order to represent the disturbances that might occur due to tissue deformation and physiological processes. The average targeting error using our new adaptive method is 40% lower than using the conventional non-adaptive duty-cycled needle steering method. PMID:26229729

A systematic approach to fabricate high aspect ratio silicon micro-needles for transdermal drug delivery

NASA Astrophysics Data System (ADS)

Ng, H. B.; Shearwood, C.

2007-12-01

The successful development of micro-needles can help transport drugs and vaccines both effectively and painlessly across the skin. However, not all micro-needles are strong enough to withstand the insertion forces and viscoelasticity of the skin. The work here focuses on the micro-fabrication of high aspect ratio needles with careful control of needle-profile using dry etching technologies. Silicon micro-needles, 150μm in length with base-diameters ranging from 90 to 240μm have been investigated in this study. A novel, multiple-sacrificial approach has been demonstrated as suited to the fabrication of long micro-needle bodies with positive profiles. The parameters that control the isotropic etching are adjusted to control the ratio of the needle-base diameter to needle length. By careful control of geometry, the needle profile can be engineered to give a suitable tip size for penetration, as well as a broad needle base to facilitate the creation of either single or multiple-through holes. This approach allows the mechanical properties of the otherwise brittle needles to be optimized. Finite element analysis indicates that the micro-needles will fracture prematurely due to buckling, with forces ranging from 10 to 30mN.

Differences as Catalysts for Professional Learning--Participating in a Student Exchange Program between Sweden and Uganda

ERIC Educational Resources Information Center

Vikström, Sofia; Kamwesiga, Julius; Mubangizi, Andrew; Guidetti, Susanne

2017-01-01

The aim was to describe the experiences of some university students and the effect on their own learning and professional development by participating in an exchange program. Data were derived from two focus group interviews with students (n = 12) who enrolled in a 12-week international exchange program between: (a) the occupational therapy…

75 FR 77019 - Self-Regulatory Organizations; C2 Options Exchange, Incorporated; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-10

... Rule Change Related to the Penny Pilot Program December 3, 2010. Pursuant to Section 19(b)(1) of the... relating to the Penny Pilot Program. The text of the proposed rule change is available on the Exchange's... language regarding the Penny Pilot Program tracks that of the language of Chicago Board Options Exchange...

75 FR 43596 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-26

... Improvement Mechanism Until July 18, 2011 July 16, 2010. Pursuant to Section 19(b)(1) of the Securities... extended the pilot program until July 18, 2007.\\7\\ In July 2007, the Exchange extended the pilot program until July 18, 2008.\\8\\ In July 2008, the Exchange extended the pilot program until July 18, 2009.\\9\\ In...

Effect of beam steering on the visibility of echogenic and non-echogenic needles: a laboratory study.

PubMed

Uppal, Vishal; Sondekoppam, Rakesh V; Ganapathy, Sugantha

2014-10-01

During peripheral nerve block procedures, needle visibility decreases as the angle of needle insertion relative to skin increases due to loss of reflective signals. The primary aim of our study was to compare the effect of beam steering on the visibility of echogenic and non-echogenic block needles. PAJUNK non-echogenic and echogenic needles were inserted into pork meat at 20°, 40°, 60°, and 70° angles, and electronic beam steering was applied at three different angles (shallow, medium, and steep) to obtain the best possible needle images. Eleven anesthesiologists blinded to the type of needle or use of beam steering scored the images obtained (0 = needle not visible; 10 = excellent needle shaft and tip visibility). Mean scores were used to classify the needles as poor visibility (mean score 0-3.3), intermediate visibility (mean score 3.4-6.6), or good visibility (mean score 6.7-10). At 20°, the visibility scores were intermediate to good in all groups. At 40°, the mean (SD) visibility score for the non-echogenic needle improved significantly from 3.1 (1.4) to 7.9 (1.8) with application of beam steering (difference = 4.8; 95% confidence interval [CI]: 3.1 to 6.6; P < 0.001). At 60°, the mean (SD) visibility score for the non-echogenic needle was poor 0.6 (0.7) and remained poor 2.4 (1.1) with beam steering. One the other hand, the echogenic needle without beam steering 6.5 (1.8) scored significantly better than the non-echogenic needle with beam steering 2.4 (1.1) (difference = 4.2; 95% CI: 2.7 to 5.6; P < 0.001). At 70°, the mean needle visibility score was poor for the non-echogenic needle with or without beam steering. In contrast, the echogenic needle attained an intermediate visibility score with or without beam steering. Beam steering did not significantly change the visibility scores of either the echogenic or the non-echogenic needle (P = 0.088 and 0.056, respectively) at a 70° angle. The PAJUNK echogenic needle, with or without beam steering, was more visible when compared with the non-echogenic needle at 60° and 70° angles of insertion. In contrast, at a 40° angle of needle insertion, the non-echogenic needle with beam steering was more visible compared with the echogenic needle.

22 CFR 62.26 - Specialists.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., international educational exchange, museum exhibitions, labor law, public administration, and library science... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Specialists. 62.26 Section 62.26 Foreign Relations DEPARTMENT OF STATE PUBLIC DIPLOMACY AND EXCHANGES EXCHANGE VISITOR PROGRAM Specific Program...

The Children's Art Exchange.

ERIC Educational Resources Information Center

Stone, Nancy

1989-01-01

Describes Vermont's Art Exchange Program and its goal of sensitizing Soviet and U.S. children to the common humanity they share. Discusses this program's attempts to break down barriers of fear and stereotyping by promoting the exchange of art and writing between children. (KO)

Needle bar for warp knitting machines

DOEpatents

Hagel, Adolf; Thumling, Manfred

1979-01-01

Needle bar for warp knitting machines with a number of needles individually set into slits of the bar and having shafts cranked to such an extent that the head section of each needle is in alignment with the shaft section accommodated by the slit. Slackening of the needles will thus not influence the needle spacing.

Robot-Assisted Needle Steering

PubMed Central

Reed, Kyle B.; Majewicz, Ann; Kallem, Vinutha; Alterovitz, Ron; Goldberg, Ken; Cowan, Noah J.; Okamura, Allison M.

2012-01-01

Needle insertion is a critical aspect of many medical treatments, diagnostic methods, and scientific studies, and is considered to be one of the simplest and most minimally invasive medical procedures. Robot-assisted needle steering has the potential to improve the effectiveness of existing medical procedures and enable new ones by allowing increased accuracy through more dexterous control of the needle tip path and acquisition of targets not accessible by straight-line trajectories. In this article, we describe a robot-assisted needle steering system that uses three integrated controllers: a motion planner concerned with guiding the needle around obstacles to a target in a desired plane, a planar controller that maintains the needle in the desired plane, and a torsion compensator that controls the needle tip orientation about the axis of the needle shaft. Experimental results from steering an asymmetric-tip needle in artificial tissue demonstrate the effectiveness of the system and its sensitivity to various environmental and control parameters. In addition, we show an example of needle steering in ex vivo biological tissue to accomplish a clinically relevant task, and highlight challenges of practical needle steering implementation. PMID:23028210

Hyper- and viscoelastic modeling of needle and brain tissue interaction.

PubMed

Lehocky, Craig A; Yixing Shi; Riviere, Cameron N

2014-01-01

Deep needle insertion into brain is important for both diagnostic and therapeutic clinical interventions. We have developed an automated system for robotically steering flexible needles within the brain to improve targeting accuracy. In this work, we have developed a finite element needle-tissue interaction model that allows for the investigation of safe parameters for needle steering. The tissue model implemented contains both hyperelastic and viscoelastic properties to simulate the instantaneous and time-dependent responses of brain tissue. Several needle models were developed with varying parameters to study the effects of the parameters on tissue stress, strain and strain rate during needle insertion and rotation. The parameters varied include needle radius, bevel angle, bevel tip fillet radius, insertion speed, and rotation speed. The results will guide the design of safe needle tips and control systems for intracerebral needle steering.

Complementary knowledge sharing: Experiences of nursing students participating in an educational exchange program between Madagascar and Norway.

PubMed

Tjoflåt, Ingrid; Razaonandrianina, Julie; Karlsen, Bjørg; Hansen, Britt Sætre

2017-02-01

To describe how Malagasy and Norwegian nursing students experience an educational exchange program in Madagascar. Previous studies show that nursing students participating in an educational exchange program enhanced their cultural knowledge and experienced personal growth. However, few studies have described two-way exchange programs, including experiences from both the hosts' and the guest students' perspectives. This study applies a descriptive qualitative design. Data were collected in 2015 by means of five semi-structured interviews with Malagasy students and two focus group interview sessions with Norwegian students. They were analysed using qualitative content analysis. The study was conducted in Madagascar. The data analyses revealed one main theme and two sub-themes related to the Malagasy and Norwegian nursing students' experiences. Main theme: complementary knowledge sharing; sub-themes: (1) learning from each other and (2) challenges of working together. The findings indicate that both the Malagasy and Norwegian nursing students experienced the exchange program as valuable and essential in exchanging knowledge. They also highlighted challenges, linked mainly to language barriers and the lack of available resources. Copyright © 2016 Elsevier Ltd. All rights reserved.

SU-D-213AB-06: Surface Texture and Insertion Speed Effect on Needle Friction.

PubMed

Abdullah, A; Golecki, C; Barnett, A; Moore, J

2012-06-01

High frictional forces between the needle surface and tissue cause tissue deflection which hinders accurate needle placement for procedures such as brachytherapy and needle biopsy. Accurate needle placement isimportant to maximize procedure efficacy. This work investigates how needle surface roughness and insertion speed affect the frictional forcebetween a needle and tissue. A friction experiment was conducted to measure the force of friction between bovine liver and three 11 gauge needles having Ra surface roughness of 3.43, 1.33, and 0.2 μm. Each of the three needles were mounted on a linear slide and were advanced and retracted through bovine liver at speeds of 50, 100, 150, and 200 mm/s for a total of 12 trials. In each trial the needle was advanced and retracted in 10 cycles producing a steady state insertion force and a steady state retraction force for each cycle. A force sensor connecting the needle to the linear slide recorded the resistance force of the needle sliding through the liver. The liver was mounted in a box with a pneumatic cylinder which compressed the liver sample by 11.65 kPa. The roughest needle (Ra = 3.43 μm) on average produced 68, 73, 74, and 73% lower friction force than the smoothest needle (Ra = 0.2 μm) for the speeds of 50, 100, 150, and 200mm/s, respectively. The second roughest needle (Ra = 1.33 μm) on average produced 25, 45, 60 and 64% lower friction force than the smoothest needle (Ra = 0.2 μm) for the speeds of 50, 100, 150, and 200 mm/s, respectively. Rougher needle surface texture and higher insertion speed reduced frictional forces between the tissue and the needle. Future studies will examine how frictional forces can be modeled and predicted given surface texture and insertion speed. © 2012 American Association of Physicists in Medicine.

Standardized Curriculum for Commercial Garment and Apparel Construction.

ERIC Educational Resources Information Center

Mississippi State Dept. of Education, Jackson. Office of Vocational, Technical and Adult Education.

Standardized curricula are provided for two courses for the secondary vocational education program in Mississippi: commercial garment and apparel construction I and II. The seven units in commercial garment and apparel construction I are as follows: orientation; securing a job; human relations; safety; maintenance; needle trade techniques; and…

Is the pencil point spinal needle a better choice in younger patients? A comparison of 24G Sprotte with 27G Quincke needles in an unselected group of general surgical patients below 46 years of age.

PubMed

Brattebø, G; Wisborg, T; Rodt, S A; Røste, I

1995-05-01

Reports have indicated that there are less postoperative complaints after the use of pencil pointed spinal needles. We compared a 24G Sprotte needle with a 27G Quincke needle in a randomised study of 200 healthy patients (49% females), aged 15-46 years. Four patients (2%) reported postdural puncture headache, three with the 24G Sprotte needle and one with the 27G Quincke needle. Thirteen patients (7%) suffered with nonspecific headache, with no significant difference between the two groups. Of the 57 (29%) who reported backpain, a significantly higher proportion had received spinal anaesthesia with the Sprotte needle (OR = 2.06). There was a significantly higher incidence of insufficient blocks after dural puncture with the Sprotte needle. Ease of needle insertion and number of puncture attempts was the same for both needle types.

[Design and application of silver needle-knife].

PubMed

Sun, Guodong; Shi, Bin; Zhang, Benwu; Xu, Haidong

2015-04-01

A silver needle-knife which has the dual function of silver needle and needle-knife is designed. The main components of this silver needle-knife are approximately 50% silver and approximately 50% nichrome. The silver needle-knife is composed of five parts, including needle-knife tail, spiral handle; steering handle, needle-knife body and needle-knife edge. It converges the advantages of needle-knife and silver needle, which can cut loose of diseased tissue and peel adhesion of lesions, but also be heated with moxa cone and thermal therapeutic instrument, and connect with electroacupuncture apparatus. It has the function of warming channel and removing coldness, dispelling wind and eliminating dampness, resolving spasm and relieving pain, dredging the channel and so on. Due to the spiral handle and the steering handle, the operation is easier, which reduces the blindness of cutting and increase the safety. It is mainly used for soft tissue injury, rheumatism and rheumatoid arthritis, as well as degenerative diseases of spine and joint, and it has obvious efficacy on some internal medical diseases.

Teleoperated master-slave needle insertion.

PubMed

Abolhassani, Niki; Patel, Rajni V

2009-12-01

Accuracy of needle tip placement and needle tracking in soft tissue are of particular importance in many medical procedures. In recent years, developing autonomous and teleoperated systems for needle insertion has become an active area of research. In this study, needle insertion was performed using a master-slave set-up with multi-degrees of freedom. The effect of force feedback on the accuracy of needle insertion was investigated. In addition, this study compared autonomous, teleoperated and semi-autonomous needle insertion. The results of this study show that incorporation of force feedback can improve teleoperated needle insertion. However, autonomous and semi-autonomous needle insertions, which use feedback from a deflection model, provide significantly better performance. Development of a haptic master-slave needle insertion system, which is capable of performing some autonomous tasks based on feedback from tissue deformation and needle deflection models, can improve the performance of autonomous robotics-based insertions as well as non-autonomous teleoperated manual insertions. Copyright (c) 2009 John Wiley & Sons, Ltd.

75 FR 76758 - Program for Allocation of Regulatory Responsibilities Pursuant to Rule 17d-2; Order Approving and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-09

... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-63430; File No. 4-618] Program for Allocation of Regulatory Responsibilities Pursuant to Rule 17d-2; Order Approving and Declaring Effective a Plan for the Allocation of Regulatory Responsibilities Between BATS Exchange, Inc., BATS Y-Exchange, Inc., Chicago Board Options Exchange, Inc., Chicago...

U.S. Foundation Funding for Change in South Africa: An Update. South African Information Exchange Working Paper Number 10.

ERIC Educational Resources Information Center

Micou, Ann M.

The South African Information Exchange (SAIE) has published an update of 35 existing organizations who are engaged in funding initiatives for specific areas of South African and United States educational exchange programs. One list is alphabetical by such program categories as: academic exchange, academic support, adult education, advocacy,…

[Academic origin of round magnetic needle and standardization operation].

PubMed

Cheng, Yan-Ting; Zhang, Tian-Sheng; Meng, Li-Qiang; Shi, Rui-Qi; Ji, Lai-Xi

2014-07-01

The origin and development of round magnetic needle was explored, and the structure of round magnetic needle was introduced in detail, including the handle, the body and the tip of the needle. The clinical opera tion of round magnetic needle were standardized from the aspects of the methods of holding needle, manipulation skill, tapping position, strength of manipulation, application scope and matters needing attention, which laid foundation for the popularization and application of round magnetic needle.

Needle tip visualization by bevel-point ultrasound generator and prototype photoacoustic imaging system

NASA Astrophysics Data System (ADS)

Irisawa, Kaku; Murakoshi, Dai; Hashimoto, Atsushi; Yamamoto, Katsuya; Hayakawa, Toshiro

2017-03-01

Visualization of the tip of medical devices like needles or catheters under ultrasound imaging has been a continuous topic since the early 1980's. In this study, a needle tip visualization system utilizing photoacoustic effects is proposed. In order to visualize the needle tip, an optical fiber was inserted into a needle. The optical fiber tip is placed on the needle bevel and affixed with black glue. The pulsed laser light from laser diode was transferred to the optical fiber and converted to ultrasound due to laser light absorption of the black glue and the subsequent photoacoustic effect. The ultrasound is detected by transducer array and reconstructed into photoacoustic images in the ultrasound unit. The photoacoustic image is displayed with a superposed ultrasound B-mode image. As a system evaluation, the needle is punctured into bovine meat and the needle tip is observed with commercialized conventional linear transducers or convex transducers. The needle tip is visualized clearly at 7 and 12 cm depths with linear and convex probes, respectively, even with a steep needle puncture angle of around 90 degrees. Laser and acoustic outputs, and thermal rise at the needle tip, were measured and were well below the limits of the safety standards. Compared with existing needle tip visualization technologies, the photoacoustic needle tip visualization system has potential distinguishable features for clinical procedures related with needle puncture and injection.

Histological observation for needle-tissue interactions.

PubMed

Nakagawa, Yoshiyuki; Koseki, Yoshihiko

2013-01-01

We histologically investigated tissue fractures and deformations caused by ex vivo needle insertions. The tissue was formalin-fixed while the needle remained in the tissue. Following removal of the needle, the tissue was microtomed, stained, and observed microscopically. This method enabled observations of cellular and tissular conditions where deformations caused by needle insertions were approximately preserved. For this study, our novel method presents preliminary findings related with tissue fractures and the orientation of needle blade relative to muscle fibers. When the needle blade was perpendicular to the muscle fiber, transfiber fractures and relatively large longitudinal deformations occurred. When the needle blade was parallel to the muscle fiber, interfiber fractures and relatively small longitudinal deformations occurred. This made a significant difference in the resistance force of the needle insertions.

Promoting medical competencies through international exchange programs: benefits on communication and effective doctor-patient relationships.

PubMed

Jacobs, Fabian; Stegmann, Karsten; Siebeck, Matthias

2014-03-04

Universities are increasingly organizing international exchange programs to meet the requirements of growing globalisation in the field of health care. Analyses based on the programs' fundamental theoretical background are needed to confirm the learning value for participants. This study investigated the extent of sociocultural learning in an exchange program and how sociocultural learning affects the acquisition of domain-specific competencies. Sociocultural learning theories were applied to study the learning effect for German medical students from the LMU Munich, Munich, Germany, of participation in the medical exchange program with Jimma University, Jimma, Ethiopia. First, we performed a qualitative study consisting of interviews with five of the first program participants. The results were used to develop a questionnaire for the subsequent, quantitative study, in which 29 program participants and 23 matched controls performed self-assessments of competencies as defined in the Tuning Project for Health Professionals. The two interrelated studies were combined to answer three different research questions. The participants rated their competence significantly higher than the control group in the fields of doctor-patient relationships and communication in a medical context. Participant responses in the two interrelated studies supported the link between the findings and the suggested theoretical background. Overall, we found that the exchange program affected the areas of doctor-patient relationships and effective communication in a medical context. Vygotsky's sociocultural learning theory contributed to explaining the learning mechanisms of the exchange program.

A Multicenter comparative trial of a novel EUS-guided core biopsy needle (SharkCore™) with the 22-gauge needle in patients with solid pancreatic mass lesions

PubMed Central

Naveed, Mariam; Siddiqui, Ali A.; Kowalski, Thomas E.; Loren, David E.; Khalid, Ammara; Soomro, Ayesha; Mazhar, Syed M.; Yoo, Joseph; Hasan, Raza; Yalamanchili, Silpa; Tarangelo, Nicholas; Taylor, Linda J.; Adler, Douglas G.

2018-01-01

Background and Objectives: The ability to obtain adequate tissue of solid pancreatic lesions by EUS-guided remains a challenge. The aim of this study was to compare the performance characteristics and safety of EUS-FNA for evaluating solid pancreatic lesions using the standard 22-gauge needle versus a novel EUS biopsy needle. Methods: This was a multicenter retrospective study of EUS-guided sampling of solid pancreatic lesions between 2009 and 2015. Patients underwent EUS-guided sampling with a 22-gauge SharkCore (SC) needle or a standard 22-gauge FNA needle. Technical success, performance characteristics of EUS-FNA, the number of needle passes required to obtain a diagnosis, diagnostic accuracy, and complications were compared. Results: A total of 1088 patients (mean age = 66 years; 49% female) with pancreatic masses underwent EUS-guided sampling with a 22-gauge SC needle (n = 115) or a standard 22-gauge FNA needle (n = 973). Technical success was 100%. The frequency of obtaining an adequate cytology by EUS-FNA was similar when using the SC and the standard needle (94.1% vs. 92.7%, respectively). The sensitivity, specificity, and diagnostic accuracy of EUS-FNA for tissue diagnosis were not significantly different between two needles. Adequate sample collection leading to a definite diagnosis was achieved by the 1st, 2nd, and 3rd pass in 73%, 92%, and 98% of procedures using the SC needle and 20%, 37%, and 94% procedures using the standard needle (P < 0.001), respectively. The median number of passes to obtain a tissue diagnosis using the SC needle was significantly less as compared to the standard needle (1 and 3, respectively; P < 0.001). Conclusions: The EUS SC biopsy needle is safe and technically feasible for EUS-FNA of solid pancreatic mass lesions. Preliminary results suggest that the SC needle has a diagnostic yield similar to the standard EUS needle and significantly reduces the number of needle passes required to obtain a tissue diagnosis. PMID:29451167

Development of 3D ultrasound needle guidance for high-dose-rate interstitial brachytherapy of gynaecological cancers

NASA Astrophysics Data System (ADS)

Rodgers, J.; Tessier, D.; D'Souza, D.; Leung, E.; Hajdok, G.; Fenster, A.

2016-04-01

High-dose-rate (HDR) interstitial brachytherapy is often included in standard-of-care for gynaecological cancers. Needles are currently inserted through a perineal template without any standard real-time imaging modality to assist needle guidance, causing physicians to rely on pre-operative imaging, clinical examination, and experience. While two-dimensional (2D) ultrasound (US) is sometimes used for real-time guidance, visualization of needle placement and depth is difficult and subject to variability and inaccuracy in 2D images. The close proximity to critical organs, in particular the rectum and bladder, can lead to serious complications. We have developed a three-dimensional (3D) transrectal US system and are investigating its use for intra-operative visualization of needle positions used in HDR gynaecological brachytherapy. As a proof-of-concept, four patients were imaged with post-insertion 3D US and x-ray CT. Using software developed in our laboratory, manual rigid registration of the two modalities was performed based on the perineal template's vaginal cylinder. The needle tip and a second point along the needle path were identified for each needle visible in US. The difference between modalities in the needle trajectory and needle tip position was calculated for each identified needle. For the 60 needles placed, the mean trajectory difference was 3.23 +/- 1.65° across the 53 visible needle paths and the mean difference in needle tip position was 3.89 +/- 1.92 mm across the 48 visible needles tips. Based on the preliminary results, 3D transrectal US shows potential for the development of a 3D US-based needle guidance system for interstitial gynaecological brachytherapy.

Detecting stages of needle penetration into tissues through force estimation at needle tip using fiber Bragg grating sensors

NASA Astrophysics Data System (ADS)

Kumar, Saurabh; Shrikanth, Venkoba; Amrutur, Bharadwaj; Asokan, Sundarrajan; Bobji, Musuvathi S.

2016-12-01

Several medical procedures involve the use of needles. The advent of robotic and robot assisted procedures requires dynamic estimation of the needle tip location during insertion for use in both assistive systems as well as for automatic control. Most prior studies have focused on the maneuvering of solid flexible needles using external force measurements at the base of the needle holder. However, hollow needles are used in several procedures and measurements of forces in proximity of such needles can eliminate the need for estimating frictional forces that have high variations. These measurements are also significant for endoscopic procedures in which measurement of forces at the needle holder base is difficult. Fiber Bragg grating sensors, due to their small size, inert nature, and multiplexing capability, provide a good option for this purpose. Force measurements have been undertaken during needle insertion into tissue mimicking phantoms made of polydimethylsiloxane as well as chicken tissue using an 18-G needle instrumented with FBG sensors. The results obtained show that it is possible to estimate the different stages of needle penetration including partial rupture, which is significant for procedures in which precise estimation of needle tip position inside the organ or tissue is required.

Modeling and Control of Needles with Torsional Friction

PubMed Central

Reed, Kyle B.; Okamura, Allison M.; Cowan, Noah J.

2010-01-01

A flexible needle can be accurately steered by robotically controlling the bevel tip orientation as the needle is inserted into tissue. Friction between the long, flexible needle shaft and the tissue can cause a significant discrepancy between the orientation of the needle tip and the orientation of the base where the needle angle is controlled. Our experiments show that several common phantom tissues used in needle steering experiments impart substantial friction forces to the needle shaft, resulting in a lag of over 45° for a 10 cm insertion depth in some phantoms; clinical studies report torques large enough to cause similar errors during needle insertions. Such angle discrepancies will result in poor performance or failure of path planners and image-guided controllers, since the needles used in percutaneous procedures are too small for state-of-the-art imaging to accurately measure the tip angle. To compensate for the angle discrepancy, we develop an estimator using a mechanics-based model of the rotational dynamics of a needle being inserted into tissue. Compared to controllers that assume a rigid needle in a frictionless environment, our estimator-based controller improves the tip angle convergence time by nearly 50% and reduces the path deviation of the needle by 70%. PMID:19695979

Syringe Exchange, Injecting and Intranasal Drug Use

PubMed Central

Arasteh, Kamyar; McKnight, Courtney; Ringer, Martin; Friedman, Samuel R.

2016-01-01

Objective To assess trends in injecting and non-injecting drug use after implementation of large-scale syringe exchange in New York City. The belief that implementation of syringe exchange will lead to increased drug injecting has been a persistent argument against syringe exchange. Methods Administrative data on route of administration for primary drug of abuse among patients entering the Beth Israel methadone maintenance program from 1995 – 2007. Approximately 2000 patients enter the program each year. Results During and after the period of large scale implementation of syringe exchange, the numbers of methadone program entrants reporting injecting drug use decreased while the numbers of entrants reporting intranasal drug use increased (p < .001). Conclusion While assessing possible effects of syringe exchange on trends in injecting drug use is inherently difficult, this may be the strongest data collected to date showing a lack of increase in drug injecting following implementation of syringe exchange. PMID:19891668

17 CFR 38.605 - Requirements for financial surveillance program.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 17 Commodity and Securities Exchanges 1 2014-04-01 2014-04-01 false Requirements for financial surveillance program. 38.605 Section 38.605 Commodity and Securities Exchanges COMMODITY FUTURES TRADING... financial surveillance program. A designated contract market's financial surveillance program for futures...

17 CFR 38.605 - Requirements for financial surveillance program.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 17 Commodity and Securities Exchanges 1 2013-04-01 2013-04-01 false Requirements for financial surveillance program. 38.605 Section 38.605 Commodity and Securities Exchanges COMMODITY FUTURES TRADING... financial surveillance program. A designated contract market's financial surveillance program for futures...

Assessing the role of syringe dispensing machines and mobile van outlets in reaching hard-to-reach and high-risk groups of injecting drug users (IDUs): a review

PubMed Central

Islam, Md Mofizul; Conigrave, Katherine M

2007-01-01

Reaching hard-to-reach and high-risk injecting drug users (IDUs) is one of the most important challenges for contemporary needle syringe programs (NSPs). The aim of this review is to examine, based upon the available international experience, the effectiveness of syringe vending machines and mobile van/bus based NSPs in making services more accessible to these hard-to-reach and high-risk groups of IDUs. A literature search revealed 40 papers/reports, of which 18 were on dispensing machines (including vending and exchange machines) and 22 on mobile vans. The findings demonstrate that syringe dispensing machines and mobile vans are promising modalities of NSPs, which can make services more accessible to the target group and in particular to the harder-to-reach and higher-risk groups of IDUs. Their anonymous and confidential approaches make services attractive, accessible and acceptable to these groups. These two outlets were found to be complementary to each other and to other modes of NSPs. Services through dispensing machines and mobile vans in strategically important sites are crucial elements in continuing efforts in reducing the spread of HIV and other blood borne viruses among IDUs. PMID:17958894

20 CFR 652.205 - May funds authorized under the Act be used to supplement funding for labor exchange programs...

Code of Federal Regulations, 2010 CFR

2010-04-01

... supplement funding for labor exchange programs authorized under separate legislation? 652.205 Section 652.205... § 652.205 May funds authorized under the Act be used to supplement funding for labor exchange programs... under sections 7(a) or 7(b) of the Act to supplement funding of any workforce activity carried out under...

Assessment of suturing in the vertical plane shows the efficacy of the multi-degree-of-freedom needle driver for neonatal laparoscopy.

PubMed

Takazawa, Shinya; Ishimaru, Tetsuya; Fujii, Masahiro; Harada, Kanako; Sugita, Naohiko; Mitsuishi, Mamoru; Iwanaka, Tadashi

2013-11-01

We have developed a thin needle driver with multiple degrees-of-freedom (DOFs) for neonatal laparoscopic surgery. The tip of this needle driver has three DOFs for grasp, deflection and rotation. Our aim was to evaluate the performance of the multi-DOF needle driver in vertical plane suturing. Six pediatric surgeons performed four directional suturing tasks in the vertical plane using the multi-DOF needle driver and a conventional one. Assessed parameters were the accuracy of insertion and exit, the depth of suture, the inclination angle of the needle and the force applied on the model. In left and right direction sutures, the inclination angle of the needle with the multi-DOF needle driver was significantly smaller than that with the conventional one (p = 0.014, 0.042, respectively). In left and right direction sutures, the force for pulling the model with the multi-DOF needle driver was smaller than that with the conventional one (p = 0.036, 0.010, respectively). This study showed that multi-directional suturing on a vertical plane using the multi-DOF needle driver had better needle trajectories and was less invasive as compared to a conventional needle driver.

Faculty Exchange Programs.

ERIC Educational Resources Information Center

Terrell, Roland

After examining the foundation of Florida Junior College's (FJC's) Faculty Exchange Program, which involved gaining administrative support and making necessary contacts with other colleges, this descriptive report goes on to recount the experiences of the first three sets of instructors to be exchanged. First, the report describes the selection of…

22 CFR 62.11 - Duties of responsible officers.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Duties of responsible officers. 62.11 Section 62.11 Foreign Relations DEPARTMENT OF STATE PUBLIC DIPLOMACY AND EXCHANGES EXCHANGE VISITOR PROGRAM... facilitate the successful completion of the exchange visitor's program. (c) Communications. Conduct the...

Idaho Transportation Department : 2010 research program peer exchange.

DOT National Transportation Integrated Search

2010-05-01

The objectives of the peer exchange were to: : 1. Identify strengths, challenges, and opportunities for program and project management; : 2. Understand management expectations of the ITD Research Program; : 3. Review processes for project selection a...

Research peer exchange, 2014.

DOT National Transportation Integrated Search

2017-08-01

The WSDOT Research Peer Exchange was held in Olympia, Washington on May 13 and 14, 2014 and addressed Research Program and Project Management as described in the following paragraphs: Program Management There are numerous funding programs, standing c...

Does a paresthesia during spinal needle insertion indicate intrathecal needle placement?

PubMed

Pong, Ryan P; Gmelch, Benjamin S; Bernards, Christopher M

2009-01-01

Paresthesias are relatively common during spinal needle insertion, however, the clinical significance of the paresthesia is unknown. A paresthesia may result from needle-to-nerve contact with a spinal nerve in the epidural space, or, with far lateral needle placement, may result from contact with a spinal nerve within the intervertebral foramen. However, it is also possible and perhaps more likely, that paresthesias occur when the spinal needle contacts a spinal nerve root within the subarachnoid space. This study was designed to test this latter hypothesis. Patients (n = 104) scheduled for surgery under spinal anesthesia were observed during spinal needle insertion. If a paresthesia occurred, the needle was fixed in place and the stylet removed to observe whether cerebrospinal fluid (CSF) flowed from the hub. The presence of CSF was considered proof that the needle had entered the subarachnoid space. Paresthesias occurred in 14/103 (13.6%) of patients; 1 patient experienced a paresthesia twice. All paresthesias were transient. Following a paresthesia, CSF was observed in the needle hub 86.7% (13/15) of the time. Our data suggest that the majority of transient paresthesias occur when the spinal needle enters the subarachnoid space and contacts a spinal nerve root. Therefore, when transient paresthesias occur during spinal needle placement it is appropriate to stop and assess for the presence of CSF in the needle hub, rather than withdraw and redirect the spinal needle away from the side of the paresthesia as some authors have suggested.

Intra-operative navigation of a 3-dimensional needle localization system for precision of irreversible electroporation needles in locally advanced pancreatic cancer.

PubMed

Bond, L; Schulz, B; VanMeter, T; Martin, R C G

2017-02-01

Irreversible electroporation (IRE) uses multiple needles and a series of electrical pulses to create pores in cell membranes and cause cell apoptosis. One of the demands of IRE is the precise needle spacing required. Two-dimensional intraoperative ultrasound (2-D iUS) is currently used to measure inter-needle distances but requires significant expertise. This study evaluates the potential of three-dimensional (3-D) image guidance for placing IRE needles and calculating needle spacing. A prospective clinical evaluation of a 3-D needle localization system (Explorer™) was evaluated in consecutive patients from April 2012 through June 2013 for unresectable pancreatic adenocarcinoma. 3-D reconstructions of patients' anatomy were generated from preoperative CT images, which were aligned to the intraoperative space. Thirty consecutive patients with locally advanced pancreatic cancer were treated with IRE. The needle localization system setup added an average of 6.5 min to each procedure. The 3-D needle localization system increased surgeon confidence and ultimately reduced needle placement time. IRE treatment efficacy is highly dependent on accurate needle spacing. The needle localization system evaluated in this study aims to mitigate these issues by providing the surgeon with additional visualization and data in 3-D. The Explorer™ system provides valuable guidance information and inter-needle distance calculations. Copyright © 2016 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

Method to Reduce Target Motion Through Needle-Tissue Interactions.

PubMed

Oldfield, Matthew J; Leibinger, Alexander; Seah, Tian En Timothy; Rodriguez Y Baena, Ferdinando

2015-11-01

During minimally invasive surgical procedures, it is often important to deliver needles to particular tissue volumes. Needles, when interacting with a substrate, cause deformation and target motion. To reduce reliance on compensatory intra-operative imaging, a needle design and novel delivery mechanism is proposed. Three-dimensional finite element simulations of a multi-segment needle inserted into a pre-existing crack are presented. The motion profiles of the needle segments are varied to identify methods that reduce target motion. Experiments are then performed by inserting a needle into a gelatine tissue phantom and measuring the internal target motion using digital image correlation. Simulations indicate that target motion is reduced when needle segments are stroked cyclically and utilise a small amount of retraction instead of being held stationary. Results are confirmed experimentally by statistically significant target motion reductions of more than 8% during cyclic strokes and 29% when also incorporating retraction, with the same net insertion speed. By using a multi-segment needle and taking advantage of frictional interactions on the needle surface, it is demonstrated that target motion ahead of an advancing needle can be substantially reduced.

Design and Production of an Articulating Needle Guide for Ultrasound-Guided Needle Block Manufactured With a Three-Dimensional Printer: Technical Communication.

PubMed

Bigeleisen, Paul E

2017-05-15

Needle guides may allow the practitioner to align the needle with the probe when ultrasound-guided nerve block is performed. The author's goal was to design and fabricate an inexpensive ($1.90), disposable, needle guide that could articulate over a range from 85 degrees to 0 degrees with a three-dimension printer. Three-dimensional representations of an L50, L25, and C 60 ultrasound probe (Sono Site, Bothell, WA) were created using a laser scanner. Computer-aided design software (Solid Works, Waltham, MA) was used to design a needle bracket and needle guide to attach to these probes. A three-dimensional printer was used to fabricate the needle bracket and guide with acrylonitrile polybutadiene polystyrene. An echogenic needle was held in plane with the needle guide. The author performed a supraclavicular block in a morbidly obese patient. The needle was easily visualized. Similar guides that are commercially available cost as much as $400. A knowledge of computer-aided design is necessary for this work.

Laser Generated Leaky Acoustic Waves for Needle Visualization.

PubMed

Wu, Kai-Wen; Wang, Yi-An; Li, Pai-Chi

2018-04-01

Ultrasound (US)-guided needle operation is usually used to visualize both tissue and needle position such as tissue biopsy and localized drug delivery. However, the transducer-needle orientation is limited due to reflection of the acoustic waves. We proposed a leaky acoustic wave method to visualize the needle position and orientation. Laser pulses are emitted on top of the needle to generate acoustic waves; then, these acoustic waves propagate along the needle surface. Leaky wave signals are detected by the US array transducer. The needle position can be calculated by phase velocities of two different wave modes and their corresponding emission angles. In our experiments, a series of needles was inserted into a tissue mimicking phantom and porcine tissue to evaluate the accuracy of the proposed method. The results show that the detection depth is up to 51 mm and the insertion angle is up to 40° with needles of different diameters. It is demonstrated that the proposed approach outperforms the conventional B-mode US-guided needle operation in terms of the detection range while achieving similar accuracy. The proposed method reveals the potentials for further clinical applications.

77 FR 68193 - Self-Regulatory Organizations; NYSE Arca, Inc.; Order Granting Approval of Proposed Rule Change...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-15

... Available Under the Short Term Option Series Program (``STOS Program''), To Allow for the Exchange To Delist... Program Under Limited Circumstances November 8, 2012. I. Introduction On September 6, 2012, NYSE Arca, Inc...'') to make certain modifications to the Exchange's Short Term Option Series Program (``STOS Program...

78 FR 60966 - Self-Regulatory Organizations: Miami International Securities Exchange LLC; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-02

.... As such, marketing fee programs,\\7\\ and customer posting incentive programs,\\8\\ are based on... its current Priority Customer Rebate Program (the ``Program'') until October 31, 2013.\\3\\ The Program... Priority Customer \\6\\ order transmitted by that Member which is executed on the Exchange in all multiply...

78 FR 48535 - Self-Regulatory Organizations; NYSE MKT LLC; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-08

... Extending the Pilot Period for the Exchange's Retail Liquidity Program for an Additional 12 Months, To... period for the Exchange's Retail Liquidity Program (the ``Retail Liquidity Program'' or the ``Program... Retail Liquidity Program,\\3\\ currently scheduled to expire on July 31, 2013, for an additional 12 months...

[Deep needling and shallow needling at three acupoints around ear for subjective tinnitus: a randomized controlled trial].

PubMed

Yin, Tao; Ni, Jinxia; Zhu, Wenzeng

2015-10-01

To compare the effective differences between deep needling and shallow needling at three acupoints around ear for subjective tinnitus. Fifty patients with subjective tinnitus were randomized divided into a deep needling group and a shallow needling group, 25 cases in each group. Twenty-two patients in the deep needling group and 20 patients in the shallow needling group were brought into statistic in the end. In the two groups, the three acupoints around ear and distal acupoints were both selected. The acupoints of the affected side such as Yifeng (TE 17), Tinghui (GB 2), Ermen (TE 21), Zhigou (TE 6), Zhongzhu (TE 3) and Hegu (LI 4) were adopted. Yifeng (TE 17), Tinghui (GB 2) and Ermen (TE 21) were acupunctured 30-38 mm in the deep needling group and 15-20 mm in the shallow needling group. The other acupoints were conventionally acupunctured in the two groups. The needles were retained for 30 min,once a day and five times a week for all patients. The treatment was continuously for 4 weeks in the two groups. Tinnitus handicap inventory (THI) scores, tinnitus grades and visual analogue scale (VAS) for tinnitus sound levels were observed before and after treatment, and the effects of the two groups were compared. The total effective rate in the deep needling group was 59.1% (13/22), and it was better than 20.0% (4/20) in the shallow needling group (P < 0.05). In the deep needling, group, the THI score, tinnitus grade and the VAS score were improved than those before treatment (all P < 0.05). In the shallow needling group, the three above indices before and after treatment were not different in statistical significance (all P > 0.05). After treatment, all the three indices in the deep needling group were superior to those in the shallow needling group (all P < 0.05). Acupuncture at the three acupoints around ear deeply could apparently improve tinnitus, and reduce tinnitus sound levels for subjective tinnitus. The effect is better than that by shallow needling at the three acupoints.

75 FR 64755 - Program for Allocation of Regulatory Responsibilities Pursuant to Rule 17d-2; Notice of Filing...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-20

... American Stock Exchange LLC, BATS Exchange, Inc., BATS Y-Exchange, Inc., Chicago Board Options Exchange, Incorporated, Chicago Stock Exchange, Inc., EDGA Exchange, Inc., EDGX Exchange, Inc., Financial Industry Regulatory Authority, Inc., International Securities Exchange, LLC, The NASDAQ Stock Market LLC, National...

75 FR 21051 - Program for Allocation of Regulatory Responsibilities Pursuant to Rule 17d-2; Notice of Filing...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-22

... American Stock Exchange LLC, BATS Exchange, Inc., Chicago Board Options Exchange, Incorporated, Chicago Stock Exchange, Inc., EDGA Exchange, Inc., EDGX Exchange, Inc., Financial Industry Regulatory Authority, Inc., International Securities Exchange, LLC, The NASDAQ Stock Market LLC, National Stock Exchange...

Measles vaccination using a microneedle patch☆

PubMed Central

Edens, Chris; Collins, Marcus L.; Ayers, Jessica; Rota, Paul A.; Prausnitz, Mark R.

2013-01-01

Measles vaccination programs would benefit from delivery methods that decrease cost, simplify logistics, and increase safety. Conventional subcutaneous injection is limited by the need for skilled healthcare professionals to reconstitute and administer injections, and by the need for safe needle handling and disposal to reduce the risk of disease transmission through needle re-use and needlestick injury. Microneedles are micron-scale, solid needles coated with a dry formulation of vaccine that dissolves in the skin within minutes after patch application. By avoiding the use of hypodermic needles, vaccination using a microneedle patch could be carried out by minimally trained personnel with reduced risk of blood-borne disease transmission. The goal of this study was to evaluate measles vaccination using a microneedle patch to address some of the limitations of subcutaneous injection. Viability of vaccine virus dried onto a microneedle patch was stabilized by incorporation of the sugar, trehalose, and loss of viral titer was less than 1 log10(TCID50) after storage for at least 30 days at room temperature. Microneedle patches were then used to immunize cotton rats with the Edmonston-Zagreb measles vaccine strain. Vaccination using microneedles at doses equaling the standard human dose or one-fifth the human dose generated neutralizing antibody levels equivalent to those of a subcutaneous immunization at the same dose. These results show that measles vaccine can be stabilized on microneedles and that vaccine efficiently reconstitutes in vivo to generate a neutralizing antibody response equivalent to that generated by subcutaneous injection. PMID:23044406

Optimal training for emergency needle thoracostomy placement by prehospital personnel: didactic teaching versus a cadaver-based training program.

PubMed

Grabo, Daniel; Inaba, Kenji; Hammer, Peter; Karamanos, Efstathios; Skiada, Dimitra; Martin, Matthew; Sullivan, Maura; Demetriades, Demetrios

2014-09-01

Tension pneumothorax can rapidly progress to cardiac arrest and death if not promptly recognized and appropriately treated. We sought to evaluate the effectiveness of traditional didactic slide-based lectures (SBLs) as compared with fresh tissue cadaver-based training (CBT) for placement of needle thoracostomy (NT). Forty randomly selected US Navy corpsmen were recruited to participate from incoming classes of the Navy Trauma Training Center at the LAC + USC Medical Center and were then randomized to one of two NT teaching methods. The following outcomes were compared between the two study arms: (1) time required to perform the procedure, (2) correct placement of the needle, and (3) magnitude of deviation from the correct position. During the study period, a total of 40 corpsmen were enrolled, 20 randomized to SBL and 20 to CBT arms. When outcomes were analyzed, time required to NT placement was not different between the two arms. Examination of the location of needle placement revealed marked differences between the two study groups. Only a minority of the SBL group (35%) placed the NT correctly in the second intercostal space. In comparison, the majority of corpsmen assigned to the CBT group demonstrated accurate placement in the second intercostal space (75%). In a CBT module, US Navy corpsmen were better trained to place NT accurately than their traditional didactic SBL counterparts. Further studies are indicated to identify the optimal components of effective simulation training for NT and other emergent interventions.

N-heptane decomposition in multi-needle to plate electrical discharge

NASA Astrophysics Data System (ADS)

Pekarek, Stanislav; Pospisil, Milan

2003-10-01

Plasma based technologies are becoming more and more important for destruction of volatile organic compounds in air streams. The most frequent electrical discharges tested for VOC decomposition are corona and dielectric barrier discharge. We proposed [1] multi-hollow needles to plate atmospheric pressure discharge enhanced by the flow of the mixture of air with VOC through the needles. In this case all reactive mixture will pass through the active zone of the discharge. The high-speed gas flow near the exit of the needle will also efficiently cool the electrodes. Hence the higher values of the discharge current can be obtained without the danger of the discharge transition to the spark. The chemical reactions leading to the VOC decomposition can therefore be enhanced [2]. We performed an experimental study of the n-heptane decomposition efficiency on its concentration in air in the input of the discharge. We choose n-heptane, an important part of organic solvents and part of automotive fuels, as a representative of saturated alkanes. We found that with decreasing n-heptane concentration the decomposition efficiency increases. Acknowledgement: This work was supported by the research program No: J04/98:212300016 "Pollution control and monitoring of the Environment" of the Czech Technical University in Prague. References [1] S. Pekárek, V. Køíha, M. Pospíil - J. Physics D, Appl. Physics, 34, 117 (2001). [2] O. Goosens, T. Callebaut, Y. Akishev, C. Leys - IEEE Trans. Plasma Sc. 30, 176 (2002).

Correlates of risky injection practices among past-year injection drug users among the US general population.

PubMed

Ropelewski, Lauren R; Mancha, Brent E; Hulbert, Alicia; Rudolph, Abby E; Martins, Silvia S

2011-07-01

With an estimated 1 million active injection drug users (IDUs), injection drug use continues to be a public health concern in the United States. Risky injection practices have been associated with the transmission of HIV, Hepatitis B and C, as well as other skin and soft tissue infections. We used data from 463 respondents, aged 18 and older, who were past-year IDUs in the 2005-2008 National Survey of Drug Use and Health (NSDUH). We investigated correlates of risky injection behavior among these recent IDUs. Older age (≥ 35 versus 18-25) was associated with reusing one's own needle at last injection (aOR=1.80 [1.02-3.17], as were past year heroin (aOR=2.59 [1.18-5.66]) and cocaine injection (aOR=2.17 [1.13-4.15]). Past year crack cocaine use was positively associated with not cleaning needles with bleach (aOR=2.18 [1.10-4.33]). Past year cocaine injection was associated with obtaining needles in a risky manner (aOR=2.29 [1.23-4.25]). Methamphetamine injection was associated with obtaining needles in less risky ways (aOR=0.41 [0.20-0.84]). Our findings indicate that some IDUs are continuing to engage in high risk injection behaviors. The identification of potential at-risk populations of IDUs may have implications for harm reduction interventions and HIV prevention programs. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

42 CFR 435.1205 - Alignment with exchange initial open enrollment period.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Alignment with exchange initial open enrollment... Between Medicaid, CHIP, Exchanges and Other Insurance Affordability Programs § 435.1205 Alignment with... electronic interface, an electronic account transferred from another insurance affordability program. (2) For...

Motivation for International Exchange.

ERIC Educational Resources Information Center

Brewer, Elizabeth

An objective analysis of students' initial motivation for studying overseas was attempted by surveying students before they embarked on their exchange programs. Eighty-eight students who were planning to study in France, Great Britain, Germany, and the People's Republic of China were surveyed. The exchange program was sponsored by the University…

Administration of International Cooperative Education Exchanges. A Wingspread Consultation.

ERIC Educational Resources Information Center

Sprinkle, Robert M., Ed.

Papers are presented from a consultation program on administration of international cooperative education exchanges. The papers provide the broad context in which the International Association for the Exchange of Students for Technical Experience/United States will develop programs and administrative services to facilitate international placements…

West Virginia Peer Exchange : Streamlining Highway Safety Improvement Program Project Delivery - An RSPCB Peer Exchange

DOT National Transportation Integrated Search

2014-09-01

The West Virginia Division of Highways (WV DOH) hosted a Peer Exchange to share information and experiences for streamlining Highway Safety Improvement Program (HSIP) project delivery. The event was held September 23 to 24, 2014 in Charleston, West V...

Effects of insertion speed and trocar stiffness on the accuracy of needle position for brachytherapy

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

McGill, Carl S.; Schwartz, Jonathon A.; Moore, Jason Z.

2012-04-15

Purpose: In prostate brachytherapy, accurate positioning of the needle tip to place radioactive seeds at its target site is critical for successful radiation treatment. During the procedure, needle deflection leads to seed misplacement and suboptimal radiation dose to cancerous cells. In practice, radiation oncologists commonly use high-speed hand needle insertion to minimize displacement of the prostate as well as the needle deflection. Effects of speed during needle insertion and stiffness of trocar (a solid rod inside the hollow cannula) on needle deflection are studied. Methods: Needle insertion experiments into phantom were performed using a 2{sup 2} factorial design (2 parametersmore » at 2 levels), with each condition having replicates. Analysis of the deflection data included calculating the average, standard deviation, and analysis of variance (ANOVA) to find significant single and two-way interaction factors. Results: The stiffer tungsten carbide trocar is effective in reducing the average and standard deviation of needle deflection. The fast insertion speed together with the stiffer trocar generated the smallest average and standard deviation for needle deflection for almost all cases. Conclusions: The combination of stiff tungsten carbide trocar and fast needle insertion speed are important to decreasing needle deflection. The knowledge gained from this study can be used to improve the accuracy of needle insertion during brachytherapy procedures.« less

Incidence of tissue coring with the 25-gauge Quincke and Whitacre spinal needles.

PubMed

Campbell, D C; Douglas, M J; Taylor, G

1996-01-01

Tissue cores, implanted into the subarachnoid space during subarachnoid injections, can develop into intraspinal lumbar epidermoid tumors. The availability of smaller needles has made spinal anesthesia more popular. Therefore, this prospective, randomized, blinded study was undertaken to determine whether tissue coring occurs with two of the currently used 25-gauge spinal needles. Fifteen 25-gauge Quincke and seventeen 25-gauge Whitacre spinal needles, in which cerebrospinal fluid (CSF) was not identified and the local anesthetic solution not injected, were obtained from adult male patients undergoing spinal anesthesia. The needles were then evaluated by a pathologist following randomization with similar sterile, unused spinal needles. Twenty additional needles, ten of each type, in which CSF was identified and through which local anesthetic was injected, were also randomized with similar sterile, unused spinal needles and examined. Tissue cores were identified in 12 of the 15 Quincke and 7 of the 17 Whitacre spinal needles in which CSF was not identified (P < .05). Of the 20 needles in which CSF was identified and local anesthetic injected, no tissue cores were identified in the 10 Whitacre needles and only one small tissue core was identified in the 10 Quincke needles. All the tissue cores were identified as fat tissue. The 25-gauge Quincke and 25-gauge Whitacre spinal needles currently used in anesthesia can produce tissue coring.

Ultrasound-guided fine needle aspiration versus core needle biopsy: comparison of post-biopsy hematoma rates and risk factors.

PubMed

Chae, In Hye; Kim, Eun-Kyung; Moon, Hee Jung; Yoon, Jung Hyun; Park, Vivian Y; Kwak, Jin Young

2017-07-01

To compare post-biopsy hematoma rates between ultrasound guided-fine needle aspiration and ultrasound guided-core needle biopsy, and to investigate risk factors for post-biopsy hematoma. A total of 5304 thyroid nodules which underwent ultrasound guided biopsy were included in this retrospective study. We compared clinical and US features between patients with and without post-biopsy hematoma. Associations between these features and post-biopsy hematoma were analyzed. Post-biopsy hematoma rate was 0.8% (43/5121) for ultrasound guided-fine needle aspiration and 4.9% (9/183) for ultrasound guided-core needle biopsy (P < 0.001). For ultrasound guided-fine needle aspiration, gender, age, size, presence of vascularity, and suspicious US features were not associated with post-biopsy hematoma according to experience level. Post-biopsy hematoma occurred significantly more with ultrasound guided-core needle biopsy (9/179, 5.0%) than with ultrasound guided-fine needle aspiration (9/1138, 0.8%) (P < 0.001) in experienced performers and ultrasound guided-core needle biopsy was the only significant risk factor for post-biopsy hematoma (adjusted Odds Ratio, 6.458, P < 0.001). Post-biopsy hematoma occurred significantly more in ultrasound guided-core needle biopsy than in ultrasound guided-fine needle aspiration and ultrasound guided-core needle biopsy was the only independent factor of post-biopsy hematoma in thyroid nodules.

Government-Industry Data Exchange Program (GIDEP) and NASA Advisories

NASA Technical Reports Server (NTRS)

Sampson, Michael J.

2010-01-01

This viewgraph presentation reviews the Government-Industry Data Exchange Program (GIDEP) and NASA Advisories policy to practice. The contents include: 1) Purpose of the Government-Industry Data Exchange Program (GIDEP); 2) NASA and GSFC Documentation; 3) NASA Advisories, differences from GIDEP; 4) GIDEP Distribution by Originator; 5) New Interim GIDEP Policy for Suspect Counterfeits; 6) NASA and Suspect Counterfeits; 7) Threats to GIDEP; and 8) Conclusions and Contact Information.

Comparison of 21-Gauge and 22-Gauge Aspiration Needle in Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration

PubMed Central

Akulian, Jason; Lechtzin, Noah; Yasin, Faiza; Kamdar, Biren; Ernst, Armin; Ost, David E.; Ray, Cynthia; Greenhill, Sarah R.; Jimenez, Carlos A.; Filner, Joshua; Feller-Kopman, David

2013-01-01

Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive procedure originally performed using a 22-gauge (22G) needle. A recently introduced 21-gauge (21G) needle may improve the diagnostic yield and sample adequacy of EBUS-TBNA, but prior smaller studies have shown conflicting results. To our knowledge, this is the largest study undertaken to date to determine whether the 21G needle adds diagnostic benefit. Methods: We retrospectively evaluated the results of 1,299 patients from the American College of Chest Physicians Quality Improvement Registry, Education, and Evaluation (AQuIRE) Diagnostic Registry who underwent EBUS-TBNA between February 2009 and September 2010 at six centers throughout the United States. Data collection included patient demographics, sample adequacy, and diagnostic yield. Analysis consisted of univariate and multivariate hierarchical logistic regression comparing diagnostic yield and sample adequacy of EBUS-TBNA specimens by needle gauge. Results: A total of 1,235 patients met inclusion criteria. Sample adequacy was obtained in 94.9% of the 22G needle group and in 94.6% of the 21G needle group (P = .81). A diagnosis was made in 51.4% of the 22G and 51.3% of the 21G groups (P = .98). Multivariate hierarchical logistic regression showed no statistical difference in sample adequacy or diagnostic yield between the two groups. The presence of rapid onsite cytologic evaluation was associated with significantly fewer needle passes per procedure when using the 21G needle (P < .001). Conclusions: There is no difference in specimen adequacy or diagnostic yield between the 21G and 22G needle groups. EBUS-TBNA in conjunction with rapid onsite cytologic evaluation and a 21G needle is associated with fewer needle passes compared with a 22G needle. PMID:23632441

NMR Model of PrgI-SipD Interaction and its Implications in the Needle-Tip Assembly of the Salmonella Type III Secretion System

PubMed Central

Rathinavelan, Thenmalarchelvi; Lara-Tejero, Maria; Lefebre, Matthew; Chatterjee, Srirupa; McShan, Andrew C.; Guo, Da-Chuan; Tang, Chun; Galan, Jorge E.; De Guzman, Roberto N.

2014-01-01

Salmonella and other pathogenic bacteria use the type III secretion system (T3SS) to inject virulence proteins into human cells to initiate infections. The structural component of the T3SS contains a needle and a needle tip. The needle is assembled from PrgI needle protomers and the needle tip is capped with several copies of the SipD tip protein. How a tip protein docks on the needle is unclear. A crystal structure of a PrgI-SipD fusion protein docked on the PrgI needle results in steric clash of SipD at the needle tip when modeled on the recent atomic structure of the needle. Thus, there is currently no good model of how SipD is docked on the PrgI needle tip. Previously, we showed by NMR paramagnetic relaxation enhancement (PRE) methods that a specific region in the SipD coiled-coil is the binding site for PrgI. Others have hypothesized that a domain of the tip protein – the N-terminal α-helical hairpin, has to swing away during the assembly of the needle apparatus. Here, we show by PRE methods that a truncated form of SipD lacking the α-helical hairpin domain binds more tightly to PrgI. Further, PRE-based structure calculations revealed multiple PrgI binding sites on the SipD coiled-coil. Our PRE results together with the recent NMR-derived atomic structure of the Salmonella needle suggest a possible model of how SipD might dock at the PrgI needle tip. SipD and PrgI are conserved in other bacterial T3SSs, thus our results have wider implication in understanding other needle-tip complexes. PMID:24951833

Methods for prostate stabilization during transperineal LDR brachytherapy.

PubMed

Podder, Tarun; Sherman, Jason; Rubens, Deborah; Messing, Edward; Strang, John; Ng, Wan-Sing; Yu, Yan

2008-03-21

In traditional prostate brachytherapy procedures for a low-dose-rate (LDR) radiation seed implant, stabilizing needles are first inserted to provide some rigidity and support to the prostate. Ideally this will provide better seed placement and an overall improved treatment. However, there is much speculation regarding the effectiveness of using regular brachytherapy needles as stabilizers. In this study, we explored the efficacy of two types of needle geometries (regular brachytherapy needle and hooked needle) and several clinically feasible configurations of the stabilization needles. To understand and assess the prostate movement during seed implantation, we collected in vivo data from patients during actual brachytherapy procedures. In vitro experimentation with tissue-equivalent phantoms allowed us to further understand the mechanics behind prostate stabilization. We observed superior stabilization with the hooked needles compared to the regular brachytherapy needles (more than 40% in bilateral parallel needle configuration). Prostate movement was also reduced significantly when regular brachytherapy needles were in an angulated configuration as compared to the parallel configuration (more than 60%). When the hooked needles were angulated for stabilization, further reduction in prostate displacement was observed. In general, for convenience of dosimetric planning and to avoid needle collision, all needles are desired to be in a parallel configuration. In this configuration, hooked needles provide improved stabilization of the prostate. On the other hand, both regular and hooked needles appear to be equally effective in reducing prostate movement when they are in angulated configurations, which will be useful in seed implantation using a robotic system. We have developed nonlinear spring-damper model for the prostate movement which can be used for adapting dosimetric planning during brachytherapy as well as for developing more realistic haptic devices and training simulators.

Promoting medical competencies through international exchange programs: benefits on communication and effective doctor-patient relationships

PubMed Central

2014-01-01

Background Universities are increasingly organizing international exchange programs to meet the requirements of growing globalisation in the field of health care. Analyses based on the programs’ fundamental theoretical background are needed to confirm the learning value for participants. This study investigated the extent of sociocultural learning in an exchange program and how sociocultural learning affects the acquisition of domain-specific competencies. Methods Sociocultural learning theories were applied to study the learning effect for German medical students from the LMU Munich, Munich, Germany, of participation in the medical exchange program with Jimma University, Jimma, Ethiopia. First, we performed a qualitative study consisting of interviews with five of the first program participants. The results were used to develop a questionnaire for the subsequent, quantitative study, in which 29 program participants and 23 matched controls performed self-assessments of competencies as defined in the Tuning Project for Health Professionals. The two interrelated studies were combined to answer three different research questions. Results The participants rated their competence significantly higher than the control group in the fields of doctor-patient relationships and communication in a medical context. Participant responses in the two interrelated studies supported the link between the findings and the suggested theoretical background. Conclusion Overall, we found that the exchange program affected the areas of doctor-patient relationships and effective communication in a medical context. Vygotsky’s sociocultural learning theory contributed to explaining the learning mechanisms of the exchange program. PMID:24589133

[Try to discuss manipulation of the "Feijing Zouqi" needling technique].

PubMed

Zhou, Dan; Gao, Ying; Wang, Fu-chun

2008-03-01

Based on description of "Feijing Zouqi" needling methods in Jin Zhen Fu (Rhyme Prose of Golden Needle) written by Xu Feng, and explain and analyze the descriptions of "Feijing Zouqi" needling method in Zhenjiu Juying (A Collection of Gems in Acu-Moxibustion) written by Gao Wu, Zhenjiu Wendui written by Wang Ji, Zhenjiu Dacheng (Great Compendium on Acu-Moxibustion) written by Yang Ji-zhou, Yixue Rumen (Elementary Medicine) written by LI Chan and many other works, summarize the technique characteristics of all the "Feijing Zouqi" needling methods. The characteristic of "Qinglong Baiwei" needling method is " first toward the left, then toward the right, slowly move or adjust with the hand"; and "Baihu Yaotou" needling method emphasizes "Tuifang Jinyuan" and "Yaozhen "; key point of "Canggui Tanxue" needling method is "Zuanti Sifang"; Chifeng Yingyuan" needling method emphasizes "Siwei Feixuan".

Cutting performance orthogonal test of single plane puncture biopsy needle based on puncture force

NASA Astrophysics Data System (ADS)

Xu, Yingqiang; Zhang, Qinhe; Liu, Guowei

2017-04-01

Needle biopsy is a method to extract the cells from the patient's body with a needle for tissue pathological examination. Many factors affect the cutting process of soft tissue, including the geometry of the biopsy needle, the mechanical properties of the soft tissue, the parameters of the puncture process and the interaction between them. This paper conducted orthogonal experiment of main cutting parameters based on single plane puncture biopsy needle, and obtained the cutting force curve of single plane puncture biopsy needle by studying the influence of the inclination angle, diameter and velocity of the single plane puncture biopsy needle on the puncture force of the biopsy needle. Stage analysis of the cutting process of biopsy needle puncture was made to determine the main influencing factors of puncture force during the cutting process, which provides a certain theoretical support for the design of new type of puncture biopsy needle and the operation of puncture biopsy.

Effect of fuel and nozzle geometry on the off-axis oscillation of needle in diesel injectors using high-speed X-ray phase contrast imaging

NASA Astrophysics Data System (ADS)

Zhang, X.; Liu, J.; Wang, J.

2016-05-01

The diesel spray characteristics are strongly influenced by the flow dynamics inside the injector nozzle. Moreover, the off-axis oscillation of needle could lead to variation of orifice flow in the nozzle. In this paper, the needle oscillation was investigated using high-speed X-ray phase contrast imaging and quantitative image processing. The effects of fuel, injection pressure and nozzle geometry on the needle oscillation were analyzed. The results showed that the vertical and horizontal oscillation of needle was independent on the injection pressure. The maximum oscillation range of 14μ m was found. Biodiesel application slightly decreased the needle oscillation due to high viscosity. The needle oscillation range increased generally with increasing hole number. The larger needle oscillation in multi-hole injectors was dominated by the geometry problem or production issue at lower needle lift. In addition, the influence of needle oscillation on the spray morphology was also discussed.

Is Skin-Touch Sham Needle Not Placebo? A Double-Blind Crossover Study on Pain Alleviation

PubMed Central

Homma, Ikuo; Izumizaki, Masahiko

2015-01-01

It remains an open question whether placebo/sham acupuncture, in which the needle tip presses the skin, can be used as a placebo device for research on pain. We compare the analgesic effect of the skin-touch placebo needle with that of the no-touch placebo needle, in which the needle tip does not touch the skin, in a double-blind crossover manner including no-treatment control in 23 healthy volunteers. The subjects received painful electrical stimulation in the forearm before and during needle retention to the LI 4 acupoint and after the removal of the needle and rated pain intensity using a visual analogue scale. We found no significant difference in analgesic effects among the skin-touch placebo needle, no-touch placebo needle, and no-treatment control at every point before, during, and after the treatments (p > 0.05). The results indicate that the skin-touch placebo needle can be used as a placebo device in clinical studies on pain. PMID:26064153

Difficulties in spinal needle use. Insertion characteristics and failure rates associated with 25-, 27- and 29-gauge Quincke-type spinal needles.

PubMed

Tarkkila, P; Huhtala, J; Salminen, U

1994-08-01

The effect of different size (25-, 27- and 29-gauge) Quincke-type spinal needles on the incidence of insertion difficulties and failure rates was investigated in a randomised, prospective study with 300 patients. The needle size was randomised but the insertion procedure was standardised. The time to achieve dural puncture was significantly longer with the 29-gauge spinal needle compared with the larger bore needles and was due to the greater flexibility of the thin needle. However, the difference was less than 1 min and cannot be considered clinically significant. There were no significant differences between groups in the number of insertion attempts or failures and the same sensory level of analgesia was reached with all the needle sizes studied. Postoperatively, no postdural puncture headaches occurred in the 29-gauge spinal needle group, whilst in the 25- and 27-gauge needle groups, the postdural puncture headache rates were 7.4% and 2.1% respectively. The incidence of backache was similar in all study groups. We conclude that dural puncture with a 29-gauge spinal needle is clinically as easy as with larger bore needles and its use is indicated in patients who have a high risk of postdural puncture headache.

Development of Repulsive Barrier Discharge from Twin Needles

NASA Astrophysics Data System (ADS)

Ueno, Hideki; Hata, Koji; Nakayama, Hiroshi

2007-03-01

Barrier discharge characteristics have been investigated for a twin needles-to-plane electrode configuration in dry air. The characteristics of barrier discharge under ac voltage application have been investigated for various distances between two needle tips (d=1.0--4.0 mm). We have found that corona discharge behavior strongly depends on needle-tip distance. In the case of a twin-needles configuration with a long needle-tip distance (d=4.0 mm), discharges from the two needle tips develop into a dielectric barrier with almost a straight path. On the contrary, the development of repulsive discharges from two needle tips in the gap between needles and a barrier was obtained for the shortest needle-tip distance investigated here (d=1.0 mm) and it was enhanced by increasing the peak voltage. From detailed time-resolved observations, development of repulsive discharge was observed only during positive polarity upon ac voltage application. Moreover, the degree of repulsion increased with increasing applied voltage of positive polarity. The observed unique discharge behavior can be interpreted as the effect of field relaxation induced not only by charge accumulation on the barrier surface, which is markedly enhanced at a short needle-tip distance, but also by space charge by coronas between two needles.

The effects of needle deformation during lumbar puncture.

PubMed

Özdemir, Hasan Hüseyin; Demir, Caner F; Varol, Sefer; Arslan, Demet; Yıldız, Mustafa; Akil, Eşref

2015-01-01

The aim of this study is to assess deformation of the tip and deflection from the axis of 22-gauge Quincke needles when they are used for diagnostic lumbar puncture (LP). Thus, it can be determined whether constructional alterations of needles are important for predicting clinical problems after diagnostic LP. The 22-gauge Quincke needles used for diagnostic LP were evaluated. A specially designed protractor was used for measurement and evaluation. Waist circumference was measured in each patient. Patients were questioned about headaches occurring after LP. A total of 115 Quincke-type spinal needles used in 113 patients were evaluated. No deflection was detected in 38 (33.1%) of the needles. Deflection between 0.1° and 5° occurred in 43 (37.3%) of the needles and deflection ≥ 5.1° occurred in 34 patients (29.6%). Forty-seven (41.5%) patients experienced post lumbar puncture headache (PLPH) and 13 (11.5%) patients experienced intracranial hypotension (IH). No statistically significant correlation between the degree of deflection and headache was found (P > 0.05). Epidural blood patch was performed for three patients. Deformity in the form of bending like a hook occurred in seven needles and IH occurred in six patients using these needles. Two of the needles used in three patients requiring blood patch were found to be bent. Deformation of needles may increase complications after LP. Needle deformation may lead to IH. In case of deterioration in the structure of the needle, termination of the puncture procedure and the use of a new needle could reduce undesirable clinical consequences, especially IH.

Comparison of Sample Adequacy and Diagnostic Yield of 19- and 22-G EBUS-TBNA Needles.

PubMed

Chaddha, Udit; Ronaghi, Reza; Elatre, Waafa; Chang, Ching-Fei; Mahdavi, Ramyar

2018-05-16

The 2016 CHEST consensus guidelines recommend use of either 21- or 22-G needles for endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). We decided to prospectively compare sample adequacy and diagnostic yield of the 19-G with the 22-G EBUS needle, hypothesizing that a larger gauge difference might magnify the differences between 2 needle sizes. Twenty-seven patients undergoing EBUS-TBNA at our institution were evaluated. All cases were performed by a single operator formally trained in interventional pulmonology. Both Olympus 19- and 22-G needles were used at each lymph node station in an alternating manner. Rapid on-site cytology evaluation was used and a separate cell block was prepared for each needle at each station. Fifty-six lymph nodes were analyzed. Diagnoses included cancer (36%, including 1 lymphoma), reactive lymphoid tissue (53%), and sarcoidosis (11%). One hundred sixty-two and 163 passes were made with the 22- and 19-G needle, respectively. Sample adequacy was 73% and 46% with the 22 and 19-G needle, respectively (P<0.001). Significantly fewer passes were bloody with the 22-G compared with the 19-G needle (19% vs. 59%; P<0.001). Diagnostic yield was not different between the 22- and 19-G needles (95% vs. 93%; P=0.62). In addition to no difference in diagnostic yield, the 19-G needle yielded samples that were frequently less adequate and more often bloody compared with the 22-G needle. Despite the larger caliber lumen, we conclude that the 19-G needle does not confer a diagnostic advantage.

America-Israel Young Ambassadors Student Exchange Program. Orientation Manual.

ERIC Educational Resources Information Center

Neeson, Eileen; And Others

This orientation manual for the America-Israel Young Ambassadors Student Exchange Program is written for the exchange of high school students between these two countries. The goal is to familiarize American students with the history, politics, economy, religions and society of Israel. Thirteen training sessions are suggested on the following…

North Central Texas Council of Governments peer exchange on bicycle and pedestrian count programs : a TPCB peer exchange

DOT National Transportation Integrated Search

2013-05-29

This report highlights key recommendations and best practices identified at the peer exchange on bicycle and pedestrian count programs, held on May 29 and May 30, 2013 in Arlington, Texas. The North Central Texas Council of Governments (NCTCOG) reque...

StarBright Learning Exchange

ERIC Educational Resources Information Center

Kalinowski, Michael

2007-01-01

This article features StarBright Learning Exchange, a program that provides a cross-cultural exchange between Australian and South African early childhood educators. The program was originated when its president, Carol Allen, and her colleague, Karen Williams, decided that they could no longer sit by and watch the unfolding social catastrophe that…

Does a child's fear of needles decrease through a learning event with needles?

PubMed

Kajikawa, Natsuki; Maeno, Takami; Maeno, Tetsuhiro

2014-09-01

Most children have a fear of needles. Suitable preparation can decrease the pain and fear of needles in hospitals; however, few have examined how such preparation affects healthy children. This study examined whether learning with needles decreases fear of needles and changes motivation to get vaccinations in school-age children and the possible association between fear of needles and motivation toward vaccinations. This study included children participating in the "Let's Be Doctors" event, which was held in 4 child centers in Tsukuba city, Ibaraki, Japan. In this event, children learned about injections and how a vaccine works, and injected a vaccine (water) into skin (sponge) using a real syringe and imitation needle. Data were collected just before and after the event by anonymous self-assessment questionnaires that used a 4-point Likert scale to assess fear of needles, motivation to get vaccinations, recommendation of vaccinations, and fear toward doctors among the children. Answers were divided into two categories for statistical analysis. In total, 194 children participated in the event and 191 children answered the questionnaire (response rate 98.5%). We analyzed 180 subjects, comprising 79 boys (43.9%) and 94 girls (52.2%), mean age of 8.1 ± 1.0 years. The number of children reporting a fear of needles decreased from 69 (38.3%) before the event to 51 (28.3%) after the event, and those unwilling to get vaccinations decreased from 48 (26.7%) to 27 (15.0%). Children who reported fear of needles before the event were more unwilling to get vaccinations than those with no fear of needles (36 [52.2%] vs. 12 [10.8%]), while after the event the number of needle-fearing children unwilling to get vaccinations decreased to 19 (27.5%). Children's fear of needles and unwillingness to get vaccinations were decreased after experiencing a learning event with needles. The fear of needles is associated with a negative motivation to get vaccinations in children.

Deployment of deer-resistant western redcedar (Thuja plicata)

Treesearch

John Russell

2008-01-01

Protecting planted western redcedar (Thuja plicata) seedlings from deer browse in the Pacific Northwest and British Columbia is estimated to cost up to CAN$ 25 million annually. Recent studies linking deer browse and needle monoterpenes has resulted in the initiation of a breeding program for deer-resistant western redcedar at Cowichan Lake Research...

Histology of white pine blister rust in needles of resistant and susceptible eastern white pine

Treesearch

Joel A. Jurgens; Robert A. Blanchette; Paul J. Zambino; Andrew David

2003-01-01

White pine blister rust, Cronartium ribicola, has plagued the forests of North America for almost a century. Over past decades, eastern white pine (Pinus strobus) that appear to tolerate the disease have been selected and incorporated into breeding programs. Seeds from P. strobus with putative resistance were...

Developing a Competence-Based Addiction Medicine Curriculum in Indonesia: The Training Needs Assessment

ERIC Educational Resources Information Center

Pinxten, W. J. L.; De Jong, C.; Hidayat, T.; Istiqomah, A. N.; Achmad, Y. M.; Raya, R. P.; Norviatin, D.; Siregar, I. M. P.

2011-01-01

Indonesia has one of the fastest growing, injecting drugs user-driven, human immunodeficiency virus (HIV) epidemics in Asia. Coverage of needle and syringe programs (NSPs), opioid substitution therapy (OST), and antiretroviral treatment (ART) is increasing, but is still low, whereas professional training in addiction medicine is not yet…

78 FR 52224 - Self-Regulatory Organizations; BOX Options Exchange LLC; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-22

... Trader Continuing Education Program (S501) is a computer-based education program developed by many of the... Continuing Education Program, which is developed and maintained by the Securities Industry Regulatory Council... change will authorize the Exchange to administer different CE programs to differently registered...

Residual Injection Risk Behavior, HIV Infection, and the Evaluation of Syringe Exchange Programs

ERIC Educational Resources Information Center

Des Jarlais, Don C.; Braine, Naomi; Yi, Huso; Turner, Charles

2007-01-01

This study assessed relationships between residual risk behavior (risk behavior among persons participating in effective HIV prevention programs) and HIV infection. Structured interviews and HIV tests were obtained from participants in six large U.S. syringe exchange programs. Program characteristics were obtained through interviews with the…

Implementing rapid HIV testing in outreach and community settings: results from an advancing HIV prevention demonstration project conducted in seven U.S. cities.

PubMed

Bowles, Kristina E; Clark, Hollie A; Tai, Eric; Sullivan, Patrick S; Song, Binwei; Tsang, Jenny; Dietz, Craig A; Mir, Julita; Mares-DelGrasso, Azul; Calhoun, Cindy; Aguirre, Daisy; Emerson, Cicily; Heffelfinger, James D

2008-01-01

The goals of this project were to assess the feasibility of conducting rapid human immunodeficiency virus (HIV) testing in outreach and community settings to increase knowledge of HIV serostatus among groups disproportionately affected by HIV and to identify effective nonclinical venues for recruiting people in the targeted populations. Community-based organizations (CBOs) in seven U.S. cities conducted rapid HIV testing in outreach and community settings, including public parks, homeless shelters, and bars. People with reactive preliminary positive test results received confirmatory testing, and people confirmed to be HIV-positive were referred to health-care and prevention services. A total of 23,900 people received rapid HIV testing. Of the 267 people (1.1%) with newly diagnosed HIV infection, 75% received their confirmatory test results and 64% were referred to care. Seventy-six percent were from racial/ethnic minority groups, and 58% identified themselves as men who have sex with men, 72% of whom reported having multiple sex partners in the past year. Venues with the highest proportion of new HIV diagnoses were bathhouses, social service organizations, and needle-exchange programs. The acceptance rate for testing was 60% among sites collecting this information. Findings from this demonstration project indicate that offering rapid HIV testing in outreach and community settings is a feasible approach for reaching members of minority groups and people at high risk for HIV infection. The project identified venues that would be important to target and offered lessons that could be used by other CBOs to design and implement similar programs in the future.

77 FR 68194 - Self-Regulatory Organizations; NYSE MKT LLC; Order Granting Approval of Proposed Rule Change, as...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-15

... Available Under the Short Term Option Series Program (``STOS Program''), To Allow for the Exchange To Delist... Program Under Limited Circumstances November 8, 2012. I. Introduction On September 6, 2012, NYSE MKT LLC... make certain modifications to the Exchange's Short Term Option Series Program (``STOS Program''). The...

[Quality assurance of fine-needle aspiration cytology of the organized mammography screening].

PubMed

Bak, Mihály; Konyár, Eva; Schneider, Ferenc; Bidlek, Mária; Szabó, Eva; Nyári, Tibor; Godény, Mária; Kásler, Miklós

2010-08-08

The National Public Health Program has established the organized mammography screening in Hungary. The aim of our study was to determine the quality assurance of breast aspiration cytology. Cytology results were rated to 5 categories (C1, C2, C3, C4 and C5). All cytology reports were compared with the final histology diagnosis. 1361 women had aspiration cytology diagnosis performed from a total of 47718 mammography non-negative lesions. There were 805 (59.1%) benign and 187 (13.7%) malignant alterations. Sensitivity was 91%, specificity 88%, positive predictive value 96.6% and negative predictive value turned to be 71% (p<0.001). The auditing values of fine needle aspiration cytology in our laboratory meet, or in certain aspects exceed the proposed minimum threshold values.

Male-to-Female Transgender and Transsexual Clients of HIV Service Programs in Los Angeles County, California

PubMed Central

Edwards, Jordan W.; Fisher, Dennis G.; Reynolds, Grace L.

2007-01-01

Data on HIV risk were collected with the Countywide Risk Assessment Survey from 2126 participants; 92 were male-to-female transgender persons (i.e., cross-dressers, and those who identify with the opposite sex), and 9 were male-to-female transsexual individuals (i.e., those who have undergone gender-reassignment surgery or other procedures). Transgender-identified individuals were more likely than the rest of the sample to have received hormone injections, offensive comments, and HIV testing; injected hormones with a used needle; been Asian or American Indian; been paid for sexual intercourse; and lived in unstable housing but less likely to have used heroin. Transgender-identified individuals are at high risk for HIV infection because of reuse of needles and being paid for sexual intercourse. PMID:17463365

Male-to-female transgender and transsexual clients of HIV service programs in Los Angeles County, California.

PubMed

Edwards, Jordan W; Fisher, Dennis G; Reynolds, Grace L

2007-06-01

Data on HIV risk were collected with the Countywide Risk Assessment Survey from 2126 participants; 92 were male-to-female transgender persons (i.e., cross-dressers, and those who identify with the opposite sex), and 9 were male-to-female transsexual individuals (i.e., those who have undergone gender-reassignment surgery or other procedures). Transgender-identified individuals were more likely than the rest of the sample to have received hormone injections, offensive comments, and HIV testing; injected hormones with a used needle; been Asian or American Indian; been paid for sexual intercourse; and lived in unstable housing but less likely to have used heroin. Transgender-identified individuals are at high risk for HIV infection because of reuse of needles and being paid for sexual intercourse.

Pine needle abortion biomarker detected in bovine fetal fluids

USDA-ARS?s Scientific Manuscript database

Pine needle abortion is a naturally occurring condition in free-range cattle caused by the consumption of pine needles from select species of cypress, juniper, pine, and spruce trees. Confirmatory diagnosis of pine needle abortion has previously relied on a combined case history of pine needle cons...

21 CFR 880.5580 - Acupuncture needle.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Acupuncture needle. 880.5580 Section 880.5580 Food... § 880.5580 Acupuncture needle. (a) Identification. An acupuncture needle is a device intended to pierce the skin in the practice of acupuncture. The device consists of a solid, stainless steel needle. The...

Complications after LP related to needle type: pencil-point versus Quincke.

PubMed

Aamodt, A; Vedeler, C

2001-06-01

We studied the incidence of complications after diagnostic lumbar puncture (LP) related to needle type. A 5 months' observational study of routine diagnostic LP in 83 patients was conducted. Significantly more headache was observed after LP using thicker cutting needles (20G Quincke) compared with thinner cutting or non-cutting needles (22G Quincke or pencil-point). No significant difference in complications after LP was found between the 22G Quincke and pencil-point needles. The size of the needle and not the needle shape seems to be the main determinant for post-dural puncture headache (PDPH).

Mixed mode fuel injector with individually moveable needle valve members

DOEpatents

Stewart, Chris; Chockley, Scott A.; Ibrahim, Daniel R.; Lawrence, Keith; Tomaseki, Jay; Azam, Junru H.; Tian, Steven Ye; Shafer, Scott F.

2004-08-03

A fuel injector includes a homogenous charge nozzle outlet set and a conventional nozzle outlet set controlled respectively, by first and second needle valve members. One of the needle valve members moves to an open position while the other needle valve member remains stationary for a homogeneous charge injection event. The former needle valve member stays stationary while the other needle valve member moves to an open position for a conventional injection event. One of the needle valve members is at least partially positioned in the other needle valve member. Thus, the injector can perform homogeneous charge injection events, conventional injection events, or even a mixed mode having both types of injection events in a single engine cycle.

The incidence of coring with blunt versus sharp needles.

PubMed

Wani, Tariq; Wadhwa, Anupama; Tobias, Joseph D

2014-03-01

With the advent of safety needles to prevent inadvertent needle sticks in the operating room (OR), a potentially new issue has arisen. These needles may result in coring, or the shaving off of fragments of the rubber stopper, when the needle is pierced through the rubber stopper of the medication vial. These fragments may be left in the vial and then drawn up with the medication and possibly injected into patients. The current study prospectively evaluated the incidence of coring when blunt and sharp needles were used to pierce rubber topped vials. We also evaluated the incidence of coring in empty medication vials with rubber tops. The rubber caps were then pierced with either an18-gauge sharp hypodermic needle or a blunt plastic (safety) needle. Coring occurred in 102 of 250 (40.8%) vials when a blunt needle was used versus 9 of 215 (4.2%) vials with a sharp needle (P < 0.0001). A significant incidence of coring was demonstrated when a blunt plastic safety needle was used. This situation is potentially a patient safety hazard and methods to eliminate this problem are needed. Copyright © 2014 Elsevier Inc. All rights reserved.

Effect of spinal needle characteristics on measurement of spinal canal opening pressure.

PubMed

Bellamkonda, Venkatesh R; Wright, Thomas C; Lohse, Christine M; Keaveny, Virginia R; Funk, Eric C; Olson, Michael D; Laack, Torrey A

2017-05-01

A wide variety of spinal needles are used in clinical practice. Little is currently known regarding the impact of needle length, gauge, and tip type on the needle's ability to measure spinal canal opening pressure. This study aimed to investigate the relationship between these factors and the opening-pressure measurement or time to obtain an opening pressure. Thirteen distinct spinal needles, chosen to isolate the effects of length, gauge, and needle-point type, were prospectively tested on a lumbar puncture simulator. The key outcomes were the opening-pressure measurement and the time required to obtain that measure. Pressures were recorded at 10-s intervals until 3 consecutive, identical readings were observed. Time to measure opening pressure increased with increasing spinal needle length, increasing gauge, and the Quincke-type (cutting) point (P<0.001 for all). The time to measurement ranged from 30s to 530s, yet all needle types were able to obtain a consistent opening pressure measure. Although opening pressure estimates are unlikely to vary markedly by needle type, the time required to obtain the measurement increased with increasing needle length and gauge and with Quincke-type needles. Copyright © 2017 Elsevier Inc. All rights reserved.

Robust path planning for flexible needle insertion using Markov decision processes.

PubMed

Tan, Xiaoyu; Yu, Pengqian; Lim, Kah-Bin; Chui, Chee-Kong

2018-05-11

Flexible needle has the potential to accurately navigate to a treatment region in the least invasive manner. We propose a new planning method using Markov decision processes (MDPs) for flexible needle navigation that can perform robust path planning and steering under the circumstance of complex tissue-needle interactions. This method enhances the robustness of flexible needle steering from three different perspectives. First, the method considers the problem caused by soft tissue deformation. The method then resolves the common needle penetration failure caused by patterns of targets, while the last solution addresses the uncertainty issues in flexible needle motion due to complex and unpredictable tissue-needle interaction. Computer simulation and phantom experimental results show that the proposed method can perform robust planning and generate a secure control policy for flexible needle steering. Compared with a traditional method using MDPs, the proposed method achieves higher accuracy and probability of success in avoiding obstacles under complicated and uncertain tissue-needle interactions. Future work will involve experiment with biological tissue in vivo. The proposed robust path planning method can securely steer flexible needle within soft phantom tissues and achieve high adaptability in computer simulation.

A data-driven soft sensor for needle deflection in heterogeneous tissue using just-in-time modelling.

PubMed

Rossa, Carlos; Lehmann, Thomas; Sloboda, Ronald; Usmani, Nawaid; Tavakoli, Mahdi

2017-08-01

Global modelling has traditionally been the approach taken to estimate needle deflection in soft tissue. In this paper, we propose a new method based on local data-driven modelling of needle deflection. External measurement of needle-tissue interactions is collected from several insertions in ex vivo tissue to form a cloud of data. Inputs to the system are the needle insertion depth, axial rotations, and the forces and torques measured at the needle base by a force sensor. When a new insertion is performed, the just-in-time learning method estimates the model outputs given the current inputs to the needle-tissue system and the historical database. The query is compared to every observation in the database and is given weights according to some similarity criteria. Only a subset of historical data that is most relevant to the query is selected and a local linear model is fit to the selected points to estimate the query output. The model outputs the 3D deflection of the needle tip and the needle insertion force. The proposed approach is validated in ex vivo multilayered biological tissue in different needle insertion scenarios. Experimental results in five different case studies indicate an accuracy in predicting needle deflection of 0.81 and 1.24 mm in the horizontal and vertical lanes, respectively, and an accuracy of 0.5 N in predicting the needle insertion force over 216 needle insertions.

Electromyographic Comparison of Forearm Muscle Movements for Fine Skin Suturing Between an Enlarged Pen Needle Holder and a Webster Needle Holder

PubMed Central

Ohata, Erika; Matsuo, Kiyoshi; Ban, Ryokuya; Shiba, Masato; Yasunaga, Yoshichika

2013-01-01

Background: For surgical suturing, a Webster needle holder uses wrist supinating with supinator and extrinsic muscles, whereas a pen needle holder uses finger twisting with intrinsic and extrinsic muscles. Because the latter is better suited to microsurgery, which requires fine suturing with less forearm muscle movement, we have recently adopted an enlarged pen needle holder scaled from a micro needle holder for fine skin suturing. In this study, we assessed whether the enlarged pen needle holder reduced forearm muscle movement during fine skin suturing as compared with the Webster needle holder. Methods: A fine skin-suturing task was performed using pen holding with the enlarged micro needle holder or scissor holding with the Webster needle holder by 9 experienced and 6 inexperienced microsurgeons. The task lasted for 60 seconds and was randomly performed 3 times for each method. Forearm flexor and extensor muscular activities were evaluated by surface electromyography. Results: The enlarged pen needle holder method required significantly less forearm muscle movement for experienced microsurgeons despite it being their first time using the instrument. There was no significant difference between 2 methods for inexperienced microsurgeons. Conclusions: Experienced microsurgeons conserved forearm muscle movement by finger twisting in fine skin suturing with the enlarged pen needle holder. Inexperienced microsurgeons may benefit from the enlarged pen needle holder, even for fine skin suturing, to develop their internal acquisition model of the dynamics of finger twisting. PMID:23691259

Electromyographic comparison of forearm muscle movements for fine skin suturing between an enlarged pen needle holder and a webster needle holder.

PubMed

Ohata, Erika; Matsuo, Kiyoshi; Ban, Ryokuya; Shiba, Masato; Yasunaga, Yoshichika

2013-01-01

For surgical suturing, a Webster needle holder uses wrist supinating with supinator and extrinsic muscles, whereas a pen needle holder uses finger twisting with intrinsic and extrinsic muscles. Because the latter is better suited to microsurgery, which requires fine suturing with less forearm muscle movement, we have recently adopted an enlarged pen needle holder scaled from a micro needle holder for fine skin suturing. In this study, we assessed whether the enlarged pen needle holder reduced forearm muscle movement during fine skin suturing as compared with the Webster needle holder. A fine skin-suturing task was performed using pen holding with the enlarged micro needle holder or scissor holding with the Webster needle holder by 9 experienced and 6 inexperienced microsurgeons. The task lasted for 60 seconds and was randomly performed 3 times for each method. Forearm flexor and extensor muscular activities were evaluated by surface electromyography. The enlarged pen needle holder method required significantly less forearm muscle movement for experienced microsurgeons despite it being their first time using the instrument. There was no significant difference between 2 methods for inexperienced microsurgeons. Experienced microsurgeons conserved forearm muscle movement by finger twisting in fine skin suturing with the enlarged pen needle holder. Inexperienced microsurgeons may benefit from the enlarged pen needle holder, even for fine skin suturing, to develop their internal acquisition model of the dynamics of finger twisting.

Influence of needle bevel design on injection pain and needle deformation in dental local infiltration anaesthesia - randomized clinical trial.

PubMed

Dau, M; Buttchereit, I; Ganz, C; Frerich, B; Anisimova, E N; Daubländer, M; Kämmerer, P W

2017-11-01

The aims of this in vivo study were to evaluate the impact of needle bevel design on patients' pain perception and the mechanical deformation of the needle tip after the injection. In a prospective single-blinded trial, 150 patients received conventional infiltration anaesthesia for dental treatment by one examiner. Patients were randomized for one out of three different needle bevel types (scalpel-designed bevel needle (SB), n=50; triple bevel needle (TB), n=50; regular bevel needle (RB), n=50). Subjects' self-reported injection pain perception was evaluated using a numeric rating scale (NRS). For each needle tip, deformations after single use were measured using SEM. A significant lower injection pain level was found in SB (mean 2.1±1.2) than in TB (mean 3.5±1.6;) and RB (mean 3.4±1.0; all P<0.001). A needle deformation was detected in about 97.3% of all needles (SB 50/50, TB 50/50, and RB: 46/50). A higher number of barbs were found in SB (29/50) versus TB (17/50) and RB (19/50). For dental local infiltration anaesthesia, injection needles with a scalpel-designed bevel demonstrated significantly less injection pain. Needle tip deflections after anaesthetic agent infiltration, especially barbed hooks on the non-cutting edge may result in greater soft tissue trauma. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Expert System For Heat Exchanger

NASA Technical Reports Server (NTRS)

Bagby, D. Gordon; Cormier, Reginald A.

1991-01-01

Diagnosis simplified for non-engineers. Developmental expert-system computer program assists operator in controlling, monitoring operation, diagnosing malfunctions, and ordering repairs of heat-exchanger system dissipating heat generated by 20-kW radio transmitter. System includes not only heat exchanger but also pumps, fans, sensors, valves, reservoir, and associated plumbing. Program conceived to assist operator while avoiding cost of keeping engineer in full-time attendance. Similar programs developed for heating, ventilating, and air-conditioning systems.

Program objectives for the National Water Data Exchange (NAWDEX) for fiscal year 1978

USGS Publications Warehouse

Edwards, Melvin D.

1977-01-01

This report presents the program objectives for the National Water Data Exchange (Nawdex) for Fiscal Year 1978, October 1, 1977 to September 30, 1978. Objectives covered include Nawdex mambership, membership participation, Nawdex services, identification of sources of water data, the indexing of water data, systems development and implementation, training, recommended standards for the handling and exchange of water data, and program management. The report provides advance information on Nawdex activities, thereby, allowing the activities to be better integrated into the planning and operation of programs of member organizations. (Woodard-USGS)

Implementation of a written protocol for management of central venous access devices: a theoretical and practical education, including bedside examinations.

PubMed

Ahlin, Catharina; Klang-Söderkvist, Birgitta; Brundin, Seija; Hellström, Birgitta; Pettersson, Karin; Johansson, Eva

2006-01-01

The objectives of this study were to evaluate registered nurses' (RN) compliance with a local clinical central venous access device (CVAD) protocol after completing an educational program and to determine RNs' perception of the program. Seventy-five RNs working in hematology participated in the educational part of the program. Sixty-eight RNs were examined while changing CVAD dressings or placing a Huber needle into a port on actual patients. Sixty percent of the RNs passed the examination and reported that the program increased their knowledge. The results indicated that the educational program could be recommended for use when implementing a new clinical protocol.

Issues and challenges associated with classifying neoplasms in percutaneous needle biopsies of incidentally found small renal masses.

PubMed

Evans, Andrew J; Delahunt, Brett; Srigley, John R

2015-03-01

Percutaneous needle core biopsy has become acceptable for classifying renal tumours and guiding patient management in the setting of an incidentally-detected small renal mass (SRM), defined as an asymptomatic, non-palpable mass <4cm in maximum dimension. Long-held concerns preventing the incorporation of biopsies into routine patient care, including the perception of poor diagnostic yield and risks of complications such as bleeding or biopsy tract seeding, have largely been disproven. While needle biopsies for SRMs have traditionally been performed in academic centres, pathologists based in non-academic centres can expect to encounter these specimens as urologists and/or interventional radiologist trainees complete their training programs and begin work in non-academic centres. This review covers the rationale for performing these biopsies, the expected diagnostic yield, relevant differential diagnoses and an approach to classifying SRMs based on limited samples as well as the use of immunohistochemical (IHC) staining panels to aid in this process. There is also an undeniable learning curve for pathologists faced with reporting these biopsies and a number of issues and potential pitfalls attributable to sampling must be kept in mind by pathologists and clinicians alike. Copyright © 2015 Elsevier Inc. All rights reserved.

Thinning effect on photosynthesis depends on needle ages in a Chinese fir (Cunninghamia lanceolata) plantation.

PubMed

Li, Ren-Shan; Yang, Qing-Peng; Zhang, Wei-Dong; Zheng, Wen-Hui; Chi, Yong-Gang; Xu, Ming; Fang, Yun-Ting; Gessler, Arthur; Li, Mai-He; Wang, Si-Long

2017-02-15

Canopies in evergreen coniferous plantations often consist of various-aged needles. However, the effect of needle age on the photosynthetic responses to thinning remains ambiguous. Photosynthetic responses of different-aged needles to thinning were investigated in a Chinese fir (Cunninghamia lanceolata) plantation. A dual isotope approach [simultaneous measurements of stable carbon (δ 13 C) and oxygen (δ 18 O) isotopes] was employed to distinguish between biochemical and stomatal limitations to photosynthesis. Our results showed that increases in net photosynthesis rates upon thinning only occurred in the current-year and one-year-old needles, and not in the two- to four-year-old needles. The increased δ 13 C and declined δ 18 O in current year needles of trees from thinned stands indicated that both the photosynthetic capacity and stomatal conductance resulted in increasing photosynthesis. In one-year-old needles of trees from thinned stands, an increased needle δ 13 C and a constant needle δ 18 O were observed, indicating the photosynthetic capacity rather than stomatal conductance contributed to the increasing photosynthesis. The higher water-soluble nitrogen content in current-year and one-year-old needles in thinned trees also supported that the photosynthetic capacity plays an important role in the enhancement of photosynthesis. In contrast, the δ 13 C, δ 18 O and water-soluble nitrogen in the two- to four-year-old needles were not significantly different between the control and thinned trees. Thus, the thinning effect on photosynthesis depends on needle age in a Chinese fir plantation. Our results highlight that the different responses of different-aged needles to thinning have to be taken into account for understanding and modelling ecosystem responses to management, especially under the expected environmental changes in future. Copyright © 2016 Elsevier B.V. All rights reserved.

[Possibility of cauda equina nerve root damage from lumbar punctures performed with 25-gauge Quincke and Whitacre needles].

PubMed

Reina, M A; López, A; Villanueva, M C; De Andrés, J A; Martín, S

2005-05-01

To assess the possibility of puncturing nerve roots in the cauda equina with spinal needles with different point designs and to quantify the number of axons affected. We performed in vitro punctures of human nerve roots taken from 3 fresh cadavers. Twenty punctures were performed with 25-gauge Whitacre needles and 40 with 25-gauge Quincke needles; half the Quincke needle punctures were carried out with the point perpendicular to the root and the other half with the point parallel to it. The samples were studied by optical and scanning electron microscopy. The possibility of finding the needle orifece inserted inside the nerve was assessed. On a photographic montage, we counted the number of axons during a hypothetical nerve puncture. Nerve roots used in this study were between 1 and 2.3 mm thick, allowing the needle to penetrate the root in the 52 samples studied. The needle orifice was never fully located inside the nerve in any of the samples. The numbers of myelinized axons affected during nerve punctures 0.2 mm deep were 95, 154, and 81 for Whitacre needles, Quincke needles with the point held perpendicular, or the same needle type held parallel, respectively. During punctures 0.5 mm deep, 472, 602, and 279 were affected for each puncture group, respectively. The differences in all cases were statistically significant. It is possible to achieve intraneural puncture with 25-gauge needles. However, full intraneural placement of the orifice of the needle is unlikely. In case of nerve trauma, the damage could be greater if puncture is carried out with a Quincke needle with the point inserted perpendicular to the nerve root.

The effects of needle deformation during lumbar puncture

PubMed Central

Özdemir, Hasan Hüseyin; Demir, Caner F.; Varol, Sefer; Arslan, Demet; Yıldız, Mustafa; Akil, Eşref

2015-01-01

Objective: The aim of this study is to assess deformation of the tip and deflection from the axis of 22-gauge Quincke needles when they are used for diagnostic lumbar puncture (LP). Thus, it can be determined whether constructional alterations of needles are important for predicting clinical problems after diagnostic LP. Materials and Methods: The 22-gauge Quincke needles used for diagnostic LP were evaluated. A specially designed protractor was used for measurement and evaluation. Waist circumference was measured in each patient. Patients were questioned about headaches occurring after LP. Results: A total of 115 Quincke-type spinal needles used in 113 patients were evaluated. No deflection was detected in 38 (33.1%) of the needles. Deflection between 0.1° and 5° occurred in 43 (37.3%) of the needles and deflection ≥ 5.1° occurred in 34 patients (29.6%). Forty-seven (41.5%) patients experienced post lumbar puncture headache (PLPH) and 13 (11.5%) patients experienced intracranial hypotension (IH). No statistically significant correlation between the degree of deflection and headache was found (P > 0.05). Epidural blood patch was performed for three patients. Deformity in the form of bending like a hook occurred in seven needles and IH occurred in six patients using these needles. Two of the needles used in three patients requiring blood patch were found to be bent. Conclusion: Deformation of needles may increase complications after LP. Needle deformation may lead to IH. In case of deterioration in the structure of the needle, termination of the puncture procedure and the use of a new needle could reduce undesirable clinical consequences, especially IH. PMID:25883480

Clogging in staked-in needle pre-filled syringes (SIN-PFS): Influence of water vapor transmission through the needle shield.

PubMed

De Bardi, M; Müller, R; Grünzweig, C; Mannes, D; Rigollet, M; Bamberg, F; Jung, T A; Yang, K

2018-06-01

Staked-in needle pre-fillable syringes (SIN-PFS) are a convenient delivery system widely established in the growing pharmaceutical market. Under specific storage conditions, the needle of PFS containing high concentration drug product (DP) solution is prone to clogging, which prevents administration of the liquid. The purpose of this study is to clarify the clogging phenomenon of SIN-PFS and to elucidate the role of water vapor transmission via the needle shield. The presence of liquid within needles is a prerequisite condition for clogging and was investigated non-invasively by neutron imaging (NI) to confirm that liquid can migrate into the needle under certain processing conditions. The water vapor transmission rate (WVTR) of different needle shields was measured and the impact of temperature and relative humidity (rH) on the WVTR was investigated on sheets with the same composition as used in commercial needle shields. Our study clearly showed that the partial vapor pressure difference (ΔPP) across the needle shield is the dominant driving factor for water vapor transmission. A linear correlation between ΔPP and WVTR was found and a model to predict the water vapor transmission for PFS under specific storage conditions was developed. The impact of the WVTR on needle clogging was confirmed by clogging tests performed on SIN-PFS stored under different conditions. Thereby, we clearly show that high water loss induced by higher WVTR can be correlated to an increased occurrence of needle clogging. In conclusion, the WVTR of the needle shield plays a key role in needle clogging and the established WVTR model can be employed to assess the clogging risk for product development. Copyright © 2018 Elsevier B.V. All rights reserved.

Physical Properties Of Acupuncture Needles: Do Disposable Acupuncture Needles Break With Normal Use

DTIC Science & Technology

2016-06-01

Lamb shank, which has complexity of tendon, fascia, and bone, was used to mimic human tissue. The needles (n=10) were stressed in the tissue substitute...needles were re-imaged after stressing and visually assessed. RESULTS: Only one manufacturing scuff mark was noted out of 90 needles before stress ...testing. Needles buckled but did not break when they were stressed beyond normal clinical use. No cracks or fractures were noted after stress

The research of knitting needle status monitoring setup

NASA Astrophysics Data System (ADS)

Liu, Lu; Liao, Xiao-qing; Zhu, Yong-kang; Yang, Wei; Zhang, Pei; Zhao, Yong-kai; Huang, Hui-jie

2013-09-01

In textile production, quality control and testing is the key to ensure the process and improve the efficiency. Defect of the knitting needles is the main factor affecting the quality of the appearance of textiles. Defect detection method based on machine vision and image processing technology is universal. This approach does not effectively identify the defect generated by damaged knitting needles and raise the alarm. We developed a knitting needle status monitoring setup using optical imaging, photoelectric detection and weak signal processing technology to achieve real-time monitoring of weaving needles' position. Depending on the shape of the knitting needle, we designed a kind of Glass Optical Fiber (GOF) light guides with a rectangular port used for transmission of the signal light. To be able to capture the signal of knitting needles accurately, we adopt a optical 4F system which has better imaging quality and simple structure and there is a rectangle image on the focal plane after the system. When a knitting needle passes through position of the rectangle image, the reflected light from needle surface will back to the GOF light guides along the same optical system. According to the intensity of signals, the computer control unit distinguish that the knitting needle is broken or curving. The experimental results show that this system can accurately detect the broken needles and the curving needles on the knitting machine in operating condition.

Needle path planning and steering in a three-dimensional non-static environment using two-dimensional ultrasound images

PubMed Central

Vrooijink, Gustaaf J.; Abayazid, Momen; Patil, Sachin; Alterovitz, Ron; Misra, Sarthak

2015-01-01

Needle insertion is commonly performed in minimally invasive medical procedures such as biopsy and radiation cancer treatment. During such procedures, accurate needle tip placement is critical for correct diagnosis or successful treatment. Accurate placement of the needle tip inside tissue is challenging, especially when the target moves and anatomical obstacles must be avoided. We develop a needle steering system capable of autonomously and accurately guiding a steerable needle using two-dimensional (2D) ultrasound images. The needle is steered to a moving target while avoiding moving obstacles in a three-dimensional (3D) non-static environment. Using a 2D ultrasound imaging device, our system accurately tracks the needle tip motion in 3D space in order to estimate the tip pose. The needle tip pose is used by a rapidly exploring random tree-based motion planner to compute a feasible needle path to the target. The motion planner is sufficiently fast such that replanning can be performed repeatedly in a closed-loop manner. This enables the system to correct for perturbations in needle motion, and movement in obstacle and target locations. Our needle steering experiments in a soft-tissue phantom achieves maximum targeting errors of 0.86 ± 0.35 mm (without obstacles) and 2.16 ± 0.88 mm (with a moving obstacle). PMID:26279600

COMPARISON OF DRY NEEDLING VS. SHAM ON THE PERFORMANCE OF VERTICAL JUMP.

PubMed

Bandy, William D; Nelson, Russell; Beamer, Lisa

2017-10-01

Dry needling has been reported to decrease pain in subjects having myofascial trigger points, as well as pain in muscle and connective tissue. The purpose of the study was to compare the effects on the ability to perform a two-legged vertical jump between a group who received one bout of dry needling and a group who received one bout of a sham treatment. Thirty-five healthy students (19 males, 16 females) were recruited to participate in this study (mean age 22.7+/- 2.4 years). The subjects were randomly divided into two groups- dry needling (n=18) vs sham (n=17). The dry needling group received needling to four sites on bilateral gastrocnemius muscles; two at the medial head and two at the lateral head. The sham group had the four areas of the gastrocnemius muscle pressed with the tube housing the needle, but the needle was never inserted into the skin. Two-legged vertical jump was measured with chalk marks on the wall before and after the dry needling and sham treatments. Analysis with a t-test indicated that the dry needling group significantly increased vertical jump height 1.2 inches over the sham group. One bout of dry needling showed an immediate effect at significantly increasing vertical jump height in healthy, young adults. Future research is needed to determine if dry needling has any long-term effects. 2b.

Injection Drug Users' Perceived Barriers to Using Self-Initiated Harm Reduction Strategies.

PubMed

Bonar, Erin E; Rosenberg, Harold

2014-08-01

Increasing the frequency with which injecting drug users (IDUs) engage in self-initiated harm reduction strategies could improve their health, but few investigations have examined IDUs' perceived barriers to engaging in these behaviors. We interviewed 90 IDUs recruited from needle exchanges to assess: a) perceived obstacles to their use of two specific harm reduction strategies (i.e., test shots and pre-injection skin cleaning) designed to reduce two unhealthy outcomes (i.e., overdose and bacterial infections, respectively) and b) their use of other risk-reduction practices. The most frequently cited barrier for both test shots and skin cleaning was being in a rush to inject one's drugs. Other, less commonly cited barriers were strategy-specific (e.g., buying drugs from a known dealer as a reason not to do a test shot; not having access to cleaning supplies as a reason not to clean skin). Regarding other risk reduction practices, participants' most frequently reported using new or clean injecting supplies and avoiding sharing needles and injecting supplies. Some, but not all, of the barriers generated by participants in our study were similar to those frequently reported in other investigations, perhaps due to differences in the type of sample recruited or in the harm reduction behaviors investigated.

Injection Drug Users’ Perceived Barriers to Using Self-Initiated Harm Reduction Strategies

PubMed Central

Rosenberg, Harold

2014-01-01

Introduction and Aims Increasing the frequency with which injecting drug users (IDUs) engage in self-initiated harm reduction strategies could improve their health, but few investigations have examined IDUs’ perceived barriers to engaging in these behaviors. Method We interviewed 90 IDUs recruited from needle exchanges to assess: a) perceived obstacles to their use of two specific harm reduction strategies (i.e., test shots and pre-injection skin cleaning) designed to reduce two unhealthy outcomes (i.e., overdose and bacterial infections, respectively) and b) their use of other risk-reduction practices. Results The most frequently cited barrier for both test shots and skin cleaning was being in a rush to inject one’s drugs. Other, less commonly cited barriers were strategy-specific (e.g., buying drugs from a known dealer as a reason not to do a test shot; not having access to cleaning supplies as a reason not to clean skin). Regarding other risk reduction practices, participants’ most frequently reported using new or clean injecting supplies and avoiding sharing needles and injecting supplies. Discussion and Conclusions Some, but not all, of the barriers generated by participants in our study were similar to those frequently reported in other investigations, perhaps due to differences in the type of sample recruited or in the harm reduction behaviors investigated. PMID:25419201

Influence of Light and Temperature on Monoterpene Emission Rates from Slash Pine

PubMed Central

Tingey, David T.; Manning, Marybeth; Grothaus, Louis C.; Burns, Walter F.

1980-01-01

There is a growing awareness of vegetation's role as a source of potentially reactive hydrocarbons that may serve as photochemical oxidant precursors. This study assessed the influence of light and temperature, independently, on monoterpene emissions from slash pine (Pinus elliottii Engelm.). Plants were preconditioned in a growth chamber, then transferred to an environmentally controlled gas exchange chamber. Samples of the chamber atmosphere were collected; the monoterpenes were concentrated cryogenically and measured by gas chromatography. Five monoterpenes (α-pinene, β-pinene, myrcene, limonene, and β-phellandrene) were present in the vapor phase surrounding the plants in sufficient quantity for reliable measurement. Light did not directly influence monoterpene emission rates since the emissions were similar in both the dark and at various light intensities. Monoterpene emission rates increased exponentially with temperature (i. e. emissions depend on temperature in a log-linear manner). The summed emissions of the five monoterpenes ranged from 3 to 21 micrograms C per gram dry weight per hour as temperature was increased from 20 to 46 C. Initially, emission rates from heat-stressed needles were similar to healthy needles, but rates decreased 11% per day. Daily carbon loss through monoterpene emissions accounted for approximately 0.4% of the carbon fixed during photosynthesis. PMID:16661285

Influence of light and temperature on monoterpene emission rates from slash pine.

PubMed

Tingey, D T; Manning, M; Grothaus, L C; Burns, W F

1980-05-01

There is a growing awareness of vegetation's role as a source of potentially reactive hydrocarbons that may serve as photochemical oxidant precursors. This study assessed the influence of light and temperature, independently, on monoterpene emissions from slash pine (Pinus elliottii Engelm.). Plants were preconditioned in a growth chamber, then transferred to an environmentally controlled gas exchange chamber. Samples of the chamber atmosphere were collected; the monoterpenes were concentrated cryogenically and measured by gas chromatography. Five monoterpenes (alpha-pinene, beta-pinene, myrcene, limonene, and beta-phellandrene) were present in the vapor phase surrounding the plants in sufficient quantity for reliable measurement. Light did not directly influence monoterpene emission rates since the emissions were similar in both the dark and at various light intensities. Monoterpene emission rates increased exponentially with temperature (i. e. emissions depend on temperature in a log-linear manner). The summed emissions of the five monoterpenes ranged from 3 to 21 micrograms C per gram dry weight per hour as temperature was increased from 20 to 46 C. Initially, emission rates from heat-stressed needles were similar to healthy needles, but rates decreased 11% per day. Daily carbon loss through monoterpene emissions accounted for approximately 0.4% of the carbon fixed during photosynthesis.

Modeling whole-tree carbon assimilation rate using observed transpiration rates and needle sugar carbon isotope ratios.

PubMed

Hu, Jia; Moore, David J P; Riveros-Iregui, Diego A; Burns, Sean P; Monson, Russell K

2010-03-01

*Understanding controls over plant-atmosphere CO(2) exchange is important for quantifying carbon budgets across a range of spatial and temporal scales. In this study, we used a simple approach to estimate whole-tree CO(2) assimilation rate (A(Tree)) in a subalpine forest ecosystem. *We analysed the carbon isotope ratio (delta(13)C) of extracted needle sugars and combined it with the daytime leaf-to-air vapor pressure deficit to estimate tree water-use efficiency (WUE). The estimated WUE was then combined with observations of tree transpiration rate (E) using sap flow techniques to estimate A(Tree). Estimates of A(Tree) for the three dominant tree species in the forest were combined with species distribution and tree size to estimate and gross primary productivity (GPP) using an ecosystem process model. *A sensitivity analysis showed that estimates of A(Tree) were more sensitive to dynamics in E than delta(13)C. At the ecosystem scale, the abundance of lodgepole pine trees influenced seasonal dynamics in GPP considerably more than Engelmann spruce and subalpine fir because of its greater sensitivity of E to seasonal climate variation. *The results provide the framework for a nondestructive method for estimating whole-tree carbon assimilation rate and ecosystem GPP over daily-to weekly time scales.

SU-E-T-758: To Determine the Source Dwell Positions of HDR Brachytherapy Using 2D 729 Ion Chamber Array

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

Kumar, Syam; Sitha

2015-06-15

Purpose: Determination of source dwell positions of HDR brachytherapy using 2D 729 ion chamber array Methods: Nucletron microselectron HDR and PTW 2D array were used for the study. Different dwell positions were assigned in the HDR machine. Rigid interstitial needles and vaginal applicator were positioned on the 2D array. The 2D array was exposed for this programmed dwell positions. The positional accuracy of the source was analyzed after the irradiation of the 2D array. This was repeated for different dwell positions. Different test plans were transferred from the Oncentra planning system and irradiated with the same applicator position on themore » 2D array. The results were analyzed using the in house developed excel program. Results: Assigned dwell positions versus corresponding detector response were analyzed. The results show very good agreement with the film measurements. No significant variation found between the planned and measured dwell positions. Average dose response with 2D array between the planned and nearby dwell positions was found to be 0.0804 Gy for vaginal cylinder applicator and 0.1234 Gy for interstitial rigid needles. Standard deviation between the doses for all the measured dwell positions for interstitial rigid needle for 1 cm spaced positions were found to be 0.33 and 0.37 for 2cm spaced dwell positions. For intracavitory vaginal applicator this was found to be 0.21 for 1 cm spaced dwell positions and 0.06 for 2cm spaced dwell positions. Intracavitory test plans reproduced on the 2D array with the same applicator positions shows the ideal dose distribution with the TPS planned. Conclusion: 2D array is a good tool for determining the dwell position of HDR brachytherapy. With the in-house developed program in excel it is easy and accurate. The traditional way with film analysis can be replaced by this method, as the films will be more costly.« less

Smart surgical needle actuated by shape memory alloys for percutaneous procedures

NASA Astrophysics Data System (ADS)

Konh, Bardia

Background: Majority of cancer interventions today are performed percutaneously using needle-based procedures, i.e. through the skin and soft tissue. Insufficient accuracy using conventional surgical needles motivated researchers to provide actuation forces to the needle's body for compensating the possible errors of surgeons/physicians. Therefore, active needles were proposed recently where actuation forces provided by shape memory alloys (SMAs) are utilized to assist the maneuverability and accuracy of surgical needles. This work also aims to introduce a novel needle insertion simulation to predict the deflection of a bevel tip needle inside the tissue. Methods: In this work first, the actuation capability of a single SMA wire was studied. The complex response of SMAs was investigated via a MATLAB implementation of the Brinson model and verified via experimental tests. The material characteristics of SMAs were simulated by defining multilinear elastic isothermal stress-strain curves. Rigorous experiments with SMA wires were performed to determine the material properties as well as to show the capability of the code to predict a stabilized SMA transformation behavior with sufficient accuracy. The isothermal stress-strain curves of SMAs were simulated and defined as a material model for the Finite Element Analysis of the active needle. In the second part of this work, a three-dimensional finite element (FE) model of the active steerable needle was developed to demonstrate the feasibility of using SMA wires as actuators to bend the surgical needle. In the FE model, birth and death method of defining boundary conditions, available in ANSYS, was used to achieve the pre-strain condition on SMA wire prior to actuation. This numerical model was validated with needle deflection experiments with developed prototypes of the active needle. The third part of this work describes the design optimization of the active using genetic algorithm aiming for its maximum flexibility. Design parameters influencing the steerability include the needle's diameter, wire diameter, pre-strain, and its offset from the needle. A simplified model was developed to decrease the computation time in iterative analyses of the optimization algorithm. In the fourth part of this work a design of an active needling system was proposed where actuation forces of SMAs as well as shape memory polymers (SMPs) were incorporated. SMP elements provide two major additional advantages to the design: (i) recovery of the SMP's plastic deformation by heating the element above its glass transition temperature, and (ii) achieving a higher needle deflection by having a softer stage of SMP at higher temperatures with less amount of actuation force. Finally, in the fifth and last part of this study, an Arbitrary-Lagrangian-Eulerian formulation in LS-DYNA software was used to model the solid-fluid interactions between the needle and tissue. A 150mm long needle was considered to bend within the tissue due to the interacting forces on its asymmetric bevel tip. Some additional assumptions were made to maintain a reasonable computational time, with no need of parallel processing, while having practical accuracies. Three experimental tests of needle steering in a soft phantom were performed to validate the simulation. Results: The finite element model of the active needle was first validated experimentally with developed prototypes. Several design parameters affecting the needle's deflection such as the needle's Young's modulus, the SMA's pre-strain and its offset from the neutral axis of the cannula were studied using the FE model. Then by the integration of the SMA characteristics with the automated optimization schemes an improved design of the active needle was obtained. Real-time experiments with different prototypes showed that the quickest response and the maximum deflection were achieved by the needle with two sections of actuation compared to a single section of actuation. Also the feasibility of providing actuation forces using both SMAs and SMPs for the surgical needle was demonstrated in this study. The needle insertion simulation was validated while observing less than 10% deviation between the estimated amount of needle deflection by the simulation and by the experiments. Using this model the effect of needle diameter and its bevel tip angle on the final shape of the needle was investigated. Conclusion: The numerical and experimental studies of this work showed that a highly maneuverable active needle can be made using the actuation of multiple SMA wires in series. To maneuver around the anatomical obstacles of the human body and reach the target location, thin sharp needles are recommended as they would create a smaller radius of curvature. The insertion model presented in this work is intended to be used as a base structure for path planning and training purposes for future studies. (Abstract shortened by UMI.).

The effect of SO2 pollution on pine needle structure

Treesearch

E. A. Zhitkova; L. L. Novitskaya

2000-01-01

Fall and winter needles from pines growing near the Kostomuksha oredressing mill (KODM) were collected and studied by light microscopy. Fall needles showed symptoms of SO2 influence and no specific seasonal changes in mesophyll. The injury rates of needle surface and mesophyll showed that pollutants penetrate into the needles through stomata and...

Multi-resolution Gabor wavelet feature extraction for needle detection in 3D ultrasound

NASA Astrophysics Data System (ADS)

Pourtaherian, Arash; Zinger, Svitlana; Mihajlovic, Nenad; de With, Peter H. N.; Huang, Jinfeng; Ng, Gary C.; Korsten, Hendrikus H. M.

2015-12-01

Ultrasound imaging is employed for needle guidance in various minimally invasive procedures such as biopsy guidance, regional anesthesia and brachytherapy. Unfortunately, a needle guidance using 2D ultrasound is very challenging, due to a poor needle visibility and a limited field of view. Nowadays, 3D ultrasound systems are available and more widely used. Consequently, with an appropriate 3D image-based needle detection technique, needle guidance and interventions may significantly be improved and simplified. In this paper, we present a multi-resolution Gabor transformation for an automated and reliable extraction of the needle-like structures in a 3D ultrasound volume. We study and identify the best combination of the Gabor wavelet frequencies. High precision in detecting the needle voxels leads to a robust and accurate localization of the needle for the intervention support. Evaluation in several ex-vivo cases shows that the multi-resolution analysis significantly improves the precision of the needle voxel detection from 0.23 to 0.32 at a high recall rate of 0.75 (gain 40%), where a better robustness and confidence were confirmed in the practical experiments.

Randomized in vitro and in vivo evaluation of different biopsy needles and devices for breast biopsy.

PubMed

Helbich, T H; Rudas, M; Böhm, G; Huber, S; Wagner, T; Taucher, S; Wolf, G; Mostbeck, G H

1999-01-01

In an experimental study (in vitro and in vivo) we evaluated the efficacy of various biopsy needles/devices for breast biopsy. In vitro, biopsies of five human cadaveric breast specimens were performed using 33 different needles/devices ranging from 14 to 20-gauge. Of these 33 needles/devices, 22 optimally performing needles were selected for the in vivo study. In the clinical part of the study, 44 breast lesions were randomly biopsied with each of the 22 needles/devices under stereotactic guidance. Tissue specimens were analysed quantitatively and qualitatively. Several automatic long-throw guns (Acecut, Asap, Biopty, Magnum) obtained greater tissue areas and had a better histopathologic score than the conventional type of a side-notch needle like Trucut, an aspiration needle like Surecut, or an end-cut needle like Autovac. The automatic long-throw guns performed better than the short-throw Monopty gun. Regardless of needle size (14-20-gauge), breast biopsies should be routinely performed with automated long-throw side-notch guns (Acecut, Asap, Biopty, Magnum).

Casimir interaction of rodlike particles in a two-dimensional critical system.

PubMed

Eisenriegler, E; Burkhardt, T W

2016-09-01

We consider the fluctuation-induced interaction of two thin, rodlike particles, or "needles," immersed in a two-dimensional critical fluid of Ising symmetry right at the critical point. Conformally mapping the plane containing the needles onto a simpler geometry in which the stress tensor is known, we analyze the force and torque between needles of arbitrary length, separation, and orientation. For infinite and semi-infinite needles we utilize the mapping of the plane bounded by the needles onto the half plane, and for two needles of finite length we use the mapping onto an annulus. For semi-infinite and infinite needles the force is expressed in terms of elementary functions, and we also obtain analytical results for the force and torque between needles of finite length with separation much greater than their length. Evaluating formulas in our approach numerically for several needle geometries and surface universality classes, we study the full crossover from small to large values of the separation to length ratio. In these two limits the numerical results agree with results for infinitely long needles and with predictions of the small-particle operator expansion, respectively.

A new posterior iliac puncture/aspiration needle.

PubMed

Islam, Anwarul

2016-03-25

The needles that are currently used for obtaining bone marrow aspirate samples from the posterior ilium are typically those of 1930s vintage (eg, Klima, Salah or similar needles), which were specifically designed for sternal aspiration. These needles are not designed to obtain bone marrow aspirate samples from the posterior ilium and as a result they are unsatisfactory particularly if the patient is large or obese. A new posterior iliac puncture/aspiration needle has therefore been designed, which is particularly suited for bone marrow aspiration from the posterior ilium. The needle was tested on five cadavers and on five patients. The design and construction of the needle was found to be satisfactory and a marked improvement over the conventional sternal puncture needles particularly when large or obese patients were concerned. The new posterior iliac bone marrow aspiration needle has advantages that overcome the limitations of using a conventional sternal puncture needle to obtain marrow aspirates from the posterior ilium. 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/

77 FR 67424 - Self-Regulatory Organizations; C2 Options Exchange, Incorporated; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-09

... available to Participants various application programming interfaces (``APIs''),\\4\\ such as CBOE Market... certain order and trade data to the Exchange, which data the Exchange uses to conduct surveillances of its markets and Participants. \\4\\ APIs are computer programs that allow Participants to interface with the...

77 FR 54629 - Self-Regulatory Organizations; International Securities Exchange, LLC; Order Granting Approval of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-05

.... Introduction On May 21, 2012, the International Securities Exchange, LLC (``ISE'' or ``Exchange'') filed with... its Short Term Option Series Program (``STOS Program'') to permit, during the expiration week of an... open for trading Short Term Option Series at $0.50 strike price intervals for option classes that trade...

German-Algerian University Exchange from the Perspective of Students and Teachers: Results of an Intercultural Survey

ERIC Educational Resources Information Center

Doring, Nicola; Lahmar, Kamel; Bouabdallah, Mohamed; Bouafia, Mohamed; Bouzid, Djamel; Gobsch, Gerhard; Runge, Erich

2010-01-01

Academic exchange programs provide students and teachers with the opportunity to study or work temporarily at educational institutions abroad. For exchange programs to be successful in promoting intercultural education, they must be designed with their participants in mind. The present study constitutes an investigation of attitudes and…

75 FR 6006 - Office of Safe and Drug-Free Schools; Cooperative Civic Education and Economic Education Exchange...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-05

... DEPARTMENT OF EDUCATION Office of Safe and Drug-Free Schools; Cooperative Civic Education and Economic Education Exchange Program Catalog of Federal Domestic Assistance (CFDA) Number: 84.304A. ACTION... the Cooperative Civic Education and Economic Education Exchange Program. The notice stated that a list...

75 FR 21095 - 60-Day Notice of Proposed Information Collection: Recording, Reporting, and Data Collection...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-22

... Requirements Under 22 CFR Part 62, the Exchange Visitor Program--Student and Exchange Visitor Information... Office of Management and Budget (OMB) approval for the information collection described below. The... 62 (DS-7000), the Exchange Visitor Program Application (Form DS-3036); and Update of Information on...

Developing Sustainable International Library Exchange Programs: The CUNY-Shanghai Library Faculty Exchange Model

ERIC Educational Resources Information Center

Chao, Sheau-yueh J.; Evans, Beth; Phillips, Ryan; Polger, Mark Aaron; Posner, Beth; Sexton, Ellen

2013-01-01

This paper describes the City University of New York (CUNY)-Shanghai Librarian Faculty Exchange Program. By observing and working in academic library services at CUNY, Shanghai University (SU), and Shanghai Normal University (SNU), participants were able to teach and learn from their colleagues, bringing their experiences back to further share…

Patient Protection and Affordable Care Act; Exchange functions: standards for Navigators and non-Navigator assistance personnel; consumer assistance tools and programs of an Exchange and certified application counselors. Final rule.

PubMed

2013-07-17

This final rule addresses various requirements applicable to Navigators and non-Navigator assistance personnel in Federally-facilitated Exchanges, including State Partnership Exchanges, and to non-Navigator assistance personnel in State Exchanges that are funded through federal Exchange Establishment grants. It finalizes the requirement that Exchanges must have a certified application counselor program. It creates conflict-of-interest, training and certification, and meaningful access standards; clarifies that any licensing, certification, or other standards prescribed by a state or Exchange must not prevent application of the provisions of title I of the Affordable Care Act; adds entities with relationships to issuers of stop loss insurance to the list of entities that are ineligible to become Navigators; and clarifies that the same ineligibility criteria that apply to Navigators apply to certain non-Navigator assistance personnel. The final rule also directs that each Exchange designate organizations which will then certify their staff members and volunteers to be application counselors that assist consumers and facilitate enrollment in qualified health plans and insurance affordability programs, and provides standards for that designation.

[Needling technique of Professor Li Yan-Fang].

PubMed

Li, Li-Jun

2014-01-01

Experiences of needling techniques of Professor LI Ya- fang is introduced in this article. Gentle and superficial insertion is adopted by Professor LI in clinic. Emphases are put on the qi regulation function, needling sensation to the affected region and insertion with both hands, especially the function of the left hand as pressing hand. The gentle and superficial insertion should be done as the follows: hold the needle with the right hand, press gently along the running course of meridians with the left hand to promote qi circulation, hard pressing should be applied at acupoints to disperse the local qi and blood, insert the needle gently and quickly into the subcutaneous region with the right hand, and stop the insertion when patient has the needling sensation. While the fast needling is characterized with shallow insertion and swift manipulation: the left hand of the manipulator should press first along the running course of the meridian, and fix the local skin, hold the needle with the right hand and insert the needle quickly into the acupoint. Withdrawal of the needle should be done immediately after the reinforcing and reducing manipulations. Professor LI is accomplished in qi regulation. It is held by him that regulating qi circulation is essence of acupuncture, letting the patient get the needling sensation is the most important task of needling. Lifting, thrusting and rotation manipulations should be applied to do reinforcing or reducing. The tissue around the tip of the needle should not be too contracted or too relaxed, and the resistance should not be too strong or too weak. The feeling of the insertion hand of the practitioner should not be too smooth or too hesitant. Needle should be inserted into the skin quickly at the moment of hard pressing by the left hand. And then, slow rotation and gentle lifting and thrusting can be applied to promote the needling sensation like electric current pass through and to reach the affected region along the running course of meridians.

Comparison of 21-gauge and 22-gauge aspiration needle in endobronchial ultrasound-guided transbronchial needle aspiration: results of the American College of Chest Physicians Quality Improvement Registry, Education, and Evaluation Registry.

PubMed

Yarmus, Lonny B; Akulian, Jason; Lechtzin, Noah; Yasin, Faiza; Kamdar, Biren; Ernst, Armin; Ost, David E; Ray, Cynthia; Greenhill, Sarah R; Jimenez, Carlos A; Filner, Joshua; Feller-Kopman, David

2013-04-01

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive procedure originally performed using a 22-gauge (22G) needle. A recently introduced 21-gauge (21G) needle may improve the diagnostic yield and sample adequacy of EBUS-TBNA, but prior smaller studies have shown conflicting results. To our knowledge, this is the largest study undertaken to date to determine whether the 21G needle adds diagnostic benefit. We retrospectively evaluated the results of 1,299 patients from the American College of Chest Physicians Quality Improvement Registry, Education, and Evaluation (AQuIRE) Diagnostic Registry who underwent EBUS-TBNA between February 2009 and September 2010 at six centers throughout the United States. Data collection included patient demographics, sample adequacy, and diagnostic yield. Analysis consisted of univariate and multivariate hierarchical logistic regression comparing diagnostic yield and sample adequacy of EBUS-TBNA specimens by needle gauge. A total of 1,235 patients met inclusion criteria. Sample adequacy was obtained in 94.9% of the 22G needle group and in 94.6% of the 21G needle group (P = .81). A diagnosis was made in 51.4% of the 22G and 51.3% of the 21G groups (P = .98). Multivariate hierarchical logistic regression showed no statistical difference in sample adequacy or diagnostic yield between the two groups. The presence of rapid onsite cytologic evaluation was associated with significantly fewer needle passes per procedure when using the 21G needle (P < .001). There is no difference in specimen adequacy or diagnostic yield between the 21G and 22G needle groups. EBUS-TBNA in conjunction with rapid onsite cytologic evaluation and a 21G needle is associated with fewer needle passes compared with a 22G needle.

Electromagnetic-Tracked Biopsy under Ultrasound Guidance: Preliminary Results

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

Hakime, Antoine, E-mail: thakime@yahoo.com; Deschamps, Frederic; Marques De Carvalho, Enio Garcia

2012-08-15

Purpose: This study was designed to evaluate the accuracy and safety of electromagnetic needle tracking for sonographically guided percutaneous liver biopsies. Methods: We performed 23 consecutive ultrasound-guided liver biopsies for liver nodules with an electromagnetic tracking of the needle. A sensor placed at the tip of a sterile stylet (18G) inserted in a coaxial guiding trocar (16G) used for biopsy was localized in real time relative to the ultrasound imaging plane, thanks to an electromagnetic transmitter and two sensors on the ultrasound probe. This allows for electronic display of the needle tip location and the future needle path overlaid onmore » the real-time ultrasound image. Distance between needle tip position and its electronic display, number of needle punctures, number of needle pull backs for redirection, technical success (needle positioned in the target), diagnostic success (correct histopathology result), procedure time, and complication were evaluated according to lesion sizes, depth and location, operator experience, and 'in-plane' or 'out-of-plane' needle approach. Results: Electronic display was always within 2 mm from the real position of the needle tip. The technical success rate was 100%. A single needle puncture without repuncture was used in all patients. Pull backs were necessary in six patients (26%) to obtain correct needle placement. The overall diagnostic success rate was 91%. The overall true-positive, true-negative, false-negative, and failure rates of the biopsy were 100% (19/19) 100% (2/2), 0% (0/23), and 9% (2/23). The median total procedure time from the skin puncture to the needle in the target was 30 sec (from 5-60 s). Lesion depth and localizations, operator experience, in-plane or out-of-plane approach did not affect significantly the technical, diagnostic success, or procedure time. Even when the tumor size decreased, the procedure time did not increase. Conclusions: Electromagnetic-tracked biopsy is accurate to determine needle tip position and allows fast and accurate needle placement in targeted liver nodules.« less

Automatic Multiple-Needle Surgical Planning of Robotic-Assisted Microwave Coagulation in Large Liver Tumor Therapy

PubMed Central

Liu, Shaoli; Xia, Zeyang; Liu, Jianhua; Xu, Jing; Ren, He; Lu, Tong; Yang, Xiangdong

2016-01-01

The “robotic-assisted liver tumor coagulation therapy” (RALTCT) system is a promising candidate for large liver tumor treatment in terms of accuracy and speed. A prerequisite for effective therapy is accurate surgical planning. However, it is difficult for the surgeon to perform surgical planning manually due to the difficulties associated with robot-assisted large liver tumor therapy. These main difficulties include the following aspects: (1) multiple needles are needed to destroy the entire tumor, (2) the insertion trajectories of the needles should avoid the ribs, blood vessels, and other tissues and organs in the abdominal cavity, (3) the placement of multiple needles should avoid interference with each other, (4) an inserted needle will cause some deformation of liver, which will result in changes in subsequently inserted needles’ operating environment, and (5) the multiple needle-insertion trajectories should be consistent with the needle-driven robot’s movement characteristics. Thus, an effective multiple-needle surgical planning procedure is needed. To overcome these problems, we present an automatic multiple-needle surgical planning of optimal insertion trajectories to the targets, based on a mathematical description of all relevant structure surfaces. The method determines the analytical expression of boundaries of every needle “collision-free reachable workspace” (CFRW), which are the feasible insertion zones based on several constraints. Then, the optimal needle insertion trajectory within the optimization criteria will be chosen in the needle CFRW automatically. Also, the results can be visualized with our navigation system. In the simulation experiment, three needle-insertion trajectories were obtained successfully. In the in vitro experiment, the robot successfully achieved insertion of multiple needles. The proposed automatic multiple-needle surgical planning can improve the efficiency and safety of robot-assisted large liver tumor therapy, significantly reduce the surgeon’s workload, and is especially helpful for an inexperienced surgeon. The methodology should be easy to adapt in other body parts. PMID:26982341

Composition, formation, and regulation of the cytosolic c-ring, a dynamic component of the type III secretion injectisome.

PubMed

Diepold, Andreas; Kudryashev, Mikhail; Delalez, Nicolas J; Berry, Richard M; Armitage, Judith P

2015-01-01

Many gram-negative pathogens employ a type III secretion injectisome to translocate effector proteins into eukaryotic host cells. While the structure of the distal "needle complex" is well documented, the composition and role of the functionally important cytosolic complex remain less well understood. Using functional fluorescent fusions, we found that the C-ring, an essential and conserved cytosolic component of the system, is composed of ~22 copies of SctQ (YscQ in Yersinia enterocolitica), which require the presence of YscQC, the product of an internal translation initiation site in yscQ, for their cooperative assembly. Photoactivated localization microscopy (PALM) reveals that in vivo, YscQ is present in both a free-moving cytosolic and a stable injectisome-bound state. Notably, fluorescence recovery after photobleaching (FRAP) shows that YscQ exchanges between the injectisome and the cytosol, with a t½ of 68 ± 8 seconds when injectisomes are secreting. In contrast, the secretin SctC (YscC) and the major export apparatus component SctV (YscV) display minimal exchange. Under non-secreting conditions, the exchange rate of YscQ is reduced to t½ = 134 ± 16 seconds, revealing a correlation between C-ring exchange and injectisome activity, which indicates a possible role for C-ring stability in regulation of type III secretion. The stabilization of the C-ring depends on the presence of the functional ATPase SctN (YscN). These data provide new insights into the formation and composition of the injectisome and present a novel aspect of type III secretion, the exchange of C-ring subunits, which is regulated with respect to secretion.

A clinical guide to needle desensitization for the paediatric patient.

PubMed

Taylor, Greig D; Campbell, Caroline

2015-05-01

Needle phobia is a common problem encountered by dental practitioners and it can pose a challenge, especially in the paediatric patient. Needle desensitization can be used for patients who have needle fear or phobia and help them overcome this by repeated, non-threatening and controlled contacts. This paper will describe an accepted technique of needle desensitization and work through the steps required to achieve a successful outcome of local anaesthesia being delivered in a calm, safe and controlled manner. Clinical Relevance: Needle desensitization is an effective technique which can be used to enable a needle phobic patient to receive a dental injection.

Image-based tracking of the suturing needle during laparoscopic interventions

NASA Astrophysics Data System (ADS)

Speidel, S.; Kroehnert, A.; Bodenstedt, S.; Kenngott, H.; Müller-Stich, B.; Dillmann, R.

2015-03-01

One of the most complex and difficult tasks for surgeons during minimally invasive interventions is suturing. A prerequisite to assist the suturing process is the tracking of the needle. The endoscopic images provide a rich source of information which can be used for needle tracking. In this paper, we present an image-based method for markerless needle tracking. The method uses a color-based and geometry-based segmentation to detect the needle. Once an initial needle detection is obtained, a region of interest enclosing the extracted needle contour is passed on to a reduced segmentation. It is evaluated with in vivo images from da Vinci interventions.

An ultra-high field strength MR image-guided robotic needle delivery system for in-bore small animal interventions.

PubMed

Gravett, Matthew; Cepek, Jeremy; Fenster, Aaron

2017-11-01

The purpose of this study was to develop and validate an image-guided robotic needle delivery system for accurate and repeatable needle targeting procedures in mouse brains inside the 12 cm inner diameter gradient coil insert of a 9.4 T MR scanner. Many preclinical research techniques require the use of accurate needle deliveries to soft tissues, including brain tissue. Soft tissues are optimally visualized in MR images, which offer high-soft tissue contrast, as well as a range of unique imaging techniques, including functional, spectroscopy and thermal imaging, however, there are currently no solutions for delivering needles to small animal brains inside the bore of an ultra-high field MR scanner. This paper describes the mechatronic design, evaluation of MR compatibility, registration technique, mechanical calibration, the quantitative validation of the in-bore image-guided needle targeting accuracy and repeatability, and demonstrated the system's ability to deliver needles in situ. Our six degree-of-freedom, MR compatible, mechatronic system was designed to fit inside the bore of a 9.4 T MR scanner and is actuated using a combination of piezoelectric and hydraulic mechanisms. The MR compatibility and targeting accuracy of the needle delivery system are evaluated to ensure that the system is precisely calibrated to perform the needle targeting procedures. A semi-automated image registration is performed to link the robot coordinates to the MR coordinate system. Soft tissue targets can be accurately localized in MR images, followed by automatic alignment of the needle trajectory to the target. Intra-procedure visualization of the needle target location and the needle were confirmed through MR images after needle insertion. The effects of geometric distortions and signal noise were found to be below threshold that would have an impact on the accuracy of the system. The system was found to have negligible effect on the MR image signal noise and geometric distortion. The system was mechanically calibrated and the mean image-guided needle targeting and needle trajectory accuracies were quantified in an image-guided tissue mimicking phantom experiment to be 178 ± 54 μm and 0.27 ± 0.65°, respectively. An MR image-guided system for in-bore needle deliveries to soft tissue targets in small animal models has been developed. The results of the needle targeting accuracy experiments in phantoms indicate that this system has the potential to deliver needles to the smallest soft tissue structures relevant in preclinical studies, at a wide variety of needle trajectories. Future work in the form of a fully-automated needle driver with precise depth control would benefit this system in terms of its applicability to a wider range of animal models and organ targets. © 2017 American Association of Physicists in Medicine.

Displacement of Canada's largest public illicit drug market in response to a police crackdown

PubMed Central

Wood, Evan; Spittal, Patricia M.; Small, Will; Kerr, Thomas; Li, Kathy; Hogg, Robert S.; Tyndall, Mark W.; Montaner, Julio S.G.; Schechter, Martin T.

2004-01-01

Background Law enforcement is often used in an effort to reduce the social, community and health-related harms of illicit drug use by injection drug users (IDUs). There are, however, few data on the benefits of such enforcement or on the potential harms. A large-scale police “crackdown” to control illicit drug use in Vancouver's Downtown Eastside provided us with an opportunity to evaluate the effect. Methods As part of our ongoing prospective cohort study of IDUs in Vancouver, we examined data collected from 244 IDUs in the 3 months before the police crackdown and from 142 IDUs in the 3 months after the start of the crackdown, on Apr. 7, 2003. All study subjects were active drug users. We also examined external data on needle exchanges and syringe disposal. Results The 2 groups of IDUs were statistically similar: they were mainly young (mean age 39 years) and male (63%), and they had injected illicit drugs for 13 years on average. Ethnic background and the proportion homeless were also similar. There were no statistically significant reported differences (all p > 0.1) in the street price of heroin, cocaine or “crack” in the 2 periods. In the 3-month periods before and after the crackdown, respectively, the rates of daily heroin injection were 27.9% and 26.8%, daily cocaine injection 28.7% and 27.5%, and daily crack use 59.4% and 60.6% (all p > 0.1). The proportions of study subjects receiving methadone treatment, 41.0% and 44.4% (p = 0.516), did not differ. However, the proportions reporting a change in where drugs were used, 22.5% and 33.8% (p < 0.05), and the proportions reporting a change in the neighbourhood of use because of police presence, 18.1% and 26.8% (p < 0.05), increased significantly. Needle-exchange data confirmed that the community levels of drug use were unchanged. Disposal statistics demonstrated that the monthly average number of used syringes found on the streets outside the traditional area of drug use increased from 784 in the 3 months before Apr. 1 to 1253 in the subsequent 3 months (p = 0.002) and the monthly average number of used syringes found in public boxes for the safe disposal of syringes decreased from 865 to 502 (p = 0.018). Interpretation The effort to control illicit drug use did not alter the price of drugs or the frequency of use, nor did it encourage enrolment in methadone treatment programs. Several measures indicated displacement of injection drug use from the area of the crackdown into adjacent areas of the city, which has implications for both recruitment of new initiates into injection drug use and HIV prevention efforts. PMID:15136548

Displacement of Canada's largest public illicit drug market in response to a police crackdown.

PubMed

Wood, Evan; Spittal, Patricia M; Small, Will; Kerr, Thomas; Li, Kathy; Hogg, Robert S; Tyndall, Mark W; Montaner, Julio S G; Schechter, Martin T

2004-05-11

Law enforcement is often used in an effort to reduce the social, community and health-related harms of illicit drug use by injection drug users (IDUs). There are, however, few data on the benefits of such enforcement or on the potential harms. A large-scale police "crackdown" to control illicit drug use in Vancouver's Downtown Eastside provided us with an opportunity to evaluate the effect. As part of our ongoing prospective cohort study of IDUs in Vancouver, we examined data collected from 244 IDUs in the 3 months before the police crackdown and from 142 IDUs in the 3 months after the start of the crackdown, on Apr. 7, 2003. All study subjects were active drug users. We also examined external data on needle exchanges and syringe disposal. The 2 groups of IDUs were statistically similar: they were mainly young (mean age 39 years) and male (63%), and they had injected illicit drugs for 13 years on average. Ethnic background and the proportion homeless were also similar. There were no statistically significant reported differences (all p > 0.1) in the street price of heroin, cocaine or "crack" in the 2 periods. In the 3-month periods before and after the crackdown, respectively, the rates of daily heroin injection were 27.9% and 26.8%, daily cocaine injection 28.7% and 27.5%, and daily crack use 59.4% and 60.6% (all p > 0.1). The proportions of study subjects receiving methadone treatment, 41.0% and 44.4% (p = 0.516), did not differ. However, the proportions reporting a change in where drugs were used, 22.5% and 33.8% (p < 0.05), and the proportions reporting a change in the neighbourhood of use because of police presence, 18.1% and 26.8% (p < 0.05), increased significantly. Needle-exchange data confirmed that the community levels of drug use were unchanged. Disposal statistics demonstrated that the monthly average number of used syringes found on the streets outside the traditional area of drug use increased from 784 in the 3 months before Apr. 1 to 1253 in the subsequent 3 months (p = 0.002) and the monthly average number of used syringes found in public boxes for the safe disposal of syringes decreased from 865 to 502 (p = 0.018). The effort to control illicit drug use did not alter the price of drugs or the frequency of use, nor did it encourage enrollment in methadone treatment programs. Several measures indicated displacement of injection drug use from the area of the crackdown into adjacent areas of the city, which has implications for both recruitment of new initiates into injection drug use and HIV prevention efforts.

78 FR 78426 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing of Proposed Rule Change To Adopt...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-26

... Participant (``CP'') program (the ``CP Program'') to incent competitive quoting and trading volume in exchange... Rule Change 1. Purpose The Exchange proposes to adopt new Rule 7.25 in order to create the CP Program... CP Program will offer an alternative to the existing Lead Market Maker (``LMM'') program on the...

Percutaneous Biopsy of Osteoid Osteomas Prior to Percutaneous Treatment Using Two Different Biopsy Needles

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

Laredo, Jean-Denis, E-mail: jean-denis.laredo@lrb.aphp.fr; Hamze, Bassam; Jeribi, Riadh

2009-09-15

Biopsy is usually performed as the first step in percutaneous treatment of osteoid osteomas prior to laser photocoagulation. At our institution, 117 patients with a presumed diagnosis of osteoid osteoma had a trephine biopsy before a percutaneous laser photocoagulation. Biopsies were made using two different types of needles. A Bonopty biopsy needle (14-gauge cannula, 16-gauge trephine needle; Radi Medical Systems, Uppsala, Sweden) was used in 65 patients, and a Laurane biopsy needle (11-gauge cannula, 12.5-gauge trephine needle; Laurane Medical, Saint-Arnoult, France) in 43 patients. Overall biopsy results were positive for osteoid osteoma in 83 (70.9%) of the 117 cases. Themore » Laurane needle provided a significantly higher positive rate (81.4%) than the Bonopty needle (66.1%; p < 0.05). This difference was not due to the size of the nidus, which was similar in the two groups (p < 0.05) and may be an effect of differences in needle caliber (12.5 vs. 14 gauge) as well as differences in needle design. The rate of positive biopsy results obtained in the present series with the Laurane biopsy needle is, to our knowledge, the highest rate reported in series dealing with percutaneous radiofrequency ablation and laser photocoagulation of osteoid osteomas.« less

Optimal Decisions for Organ Exchanges in a Kidney Paired Donation Program.

PubMed

Li, Yijiang; Song, Peter X-K; Zhou, Yan; Leichtman, Alan B; Rees, Michael A; Kalbfleisch, John D

2014-05-01

The traditional concept of barter exchange in economics has been extended in the modern era to the area of living-donor kidney transplantation, where one incompatible donor-candidate pair is matched to another pair with a complementary incompatibility, such that the donor from one pair gives an organ to a compatible candidate in the other pair and vice versa. Kidney paired donation (KPD) programs provide a unique and important platform for living incompatible donor-candidate pairs to exchange organs in order to achieve mutual benefit. In this paper, we propose novel organ allocation strategies to arrange kidney exchanges under uncertainties with advantages, including (i) allowance for a general utility-based evaluation of potential kidney transplants and an explicit consideration of stochastic features inherent in a KPD program; and (ii) exploitation of possible alternative exchanges when the originally planned allocation cannot be fully executed. This allocation strategy is implemented using an integer programming (IP) formulation, and its implication is assessed via a data-based simulation system by tracking an evolving KPD program over a series of match runs. Extensive simulation studies are provided to illustrate our proposed approach.

Injection safety among primary health care workers in Jazan Region, Saudi Arabia.

PubMed

Ismail, A A; Mahfouz, M S; Makeen, A

2014-07-01

Occupational exposure to percutaneous injuries is a substantial source of infections with blood-borne pathogens among health-care workers. Few studies evaluated injection safety practices in Saudi Arabia. To examine the structure and process of injection safety at primary health care level in Jazan health district, to evaluate knowledge, attitudes, and practices of primary health care physicians and nurses towards injection safety, and to determine the incidence of needle stick injuries among health care workers in Jazan region, Saudi Arabia. A cross-sectional study was conducted in Jazan primary health care centers (PHCCs), Saudi Arabia from September 2011 to March 2012. Data were collected using an observational checklist and data collection sheet. Jazan city health district was chosen at random from the 14 health sectors in Jazan region. All the 33 (10 urban, and 23 rural) PHCCs of Jazan city were included in this study to get the predetermined sample size of health care workers. 200 health care workers (HCWs) were recruited (29% physicians, and 71% nurses). Syringes in the PHCCs were disposable (100%), individually packed (92%), and available at all volumes (98%). Methods of safe disposal of needles and sharps were also operated through contracting with professional companies in 84.8% of instances. Urban PHCCs had more posts for injection safety promotion than rural centers (p=0.02). Continuous Medical Education (CME) programs on infection control were present in only 60% of PHCCs. At least 95% of HCWs in Jazan believed that sharp objects should be kept in a puncture-proof container, kept in a closed container, or disposed by a professional company. More than 80% of HCWs washed their hands by soap and water and cleaned them by alcohol before giving injection, and also got the three doses of hepatitis B vaccine.The rate of needle stick injury in the past year was 14%, without a significant difference between nurses and physicians (p=0.8). Jazan PHCCs have reasonable facilities that prevent needle-stick injuries. We need to design and implement more educational programs on safety injection, and increase promotion of safety injection posters, especially in rural PHCCs.

Needle Stick Injuries, Sharp Injuries and other Occupational Exposures to Blood and Body Fluids among Health Care Workers in a general hospital in Sarajevo, Bosnia and Herzegovina.

PubMed

Musa, Sanjin; Peek-Asa, Corinne; Young, Tracy; Jovanovic, Nina

2014-01-01

Health Professional exposures of health care workers (HCW) to potentially infective blood and body fluids presents a serious health threat, including hepatitis B, hepatitis C and HIV transmission. This study was conducted to assess the risk for and reporting of needle stick injuries, sharp injuries and other occupational exposures of health care workers in a large healthcare center in Sarajevo. This cross-sectional survey was conducted in May 2013. The study target population included all hospital health care workers who had a high potential for exposure. The estimated sample size was 48 physicians, 132 nurses/technicians and 30 auxiliary personnel. During their career, 124 (63.3%) HCW reported exposures to blood and body fluids. In total, needle stick injuries (66.1%) were the most common source of exposure, followed by contact with intact skin (12.1%) and cut with sharp object (11.3%). Only 43 (35.5%) reported any of these exposures to health authorities during their career. The odds of exposure to needle stick injuries and other occupational exposures to blood and bodily fluids were significantly higher among medical nurses/technicians (AOR=4.98, 95%CI=1.52-16,1) and auxiliary (AOR=4.30, 95% CI=1.07-17.34) personnel when compared to physicians. HCW in the operation room, intervention ambulance and laboratory (AOR=3.73, 95%CI=1.43-9.72) had higher odds of exposure than workers in the ambulatory departments. Needle stick Injuries, Sharp Injuries and other Occupational Exposures to Blood and Body Fluids among health care workers are underestimated hazard. Especially, for HCW who work in operation room/interventional ambulance. There is a need for preventive programs for HCW and further work on the establishment of an effective surveillance system.

[Research progress of needles with knife-edge for carotid cardiac syndrome].

PubMed

Tan, Lingqiong; Zhao, Yanling

2015-04-01

According to topographic anatomy, pathogenesis and by retrieving, summarizing and analyzing literature regarding needle-knife and needles with knife-edge for carotid cardiac syndrome, it is found out that clinical misdiagnosis rate of carotid cardiac syndrome is considerably high. Needle-knife and needles with knife-edge could significantly improve the clinical symptoms of carotid cardiac syndrome, showing characteristic and advantage in treatment, but it is deficient in technique standard and efficacy criteria that should be united and authoritative. Researches regarding pathogenesis of carotid cardiac syndrome are not systematic. Clinical observation regarding long-term efficacy and relapse of needle-knife and needles with knife-edge treatment is rare. It is believed that the awareness on carotid cardiac syndrome should be increased to reduce misdiagnosis; scientific and standardized technique standard and efficacy criteria should be established; systematic and comprehensive researches regarding mechanism of needle-knife and needles with knife-edge for carotid cardiac syndrome should be launched; besides, clinical discussion regarding its long-term efficacy should start to provide a better clinical guideline.

Detection of Membrane Puncture with Haptic Feedback using a Tip-Force Sensing Needle.

PubMed

Elayaperumal, Santhi; Bae, Jung Hwa; Daniel, Bruce L; Cutkosky, Mark R

2014-09-01

This paper presents calibration and user test results of a 3-D tip-force sensing needle with haptic feedback. The needle is a modified MRI-compatible biopsy needle with embedded fiber Bragg grating (FBG) sensors for strain detection. After calibration, the needle is interrogated at 2 kHz, and dynamic forces are displayed remotely with a voice coil actuator. The needle is tested in a single-axis master/slave system, with the voice coil haptic display at the master, and the needle at the slave end. Tissue phantoms with embedded membranes were used to determine the ability of the tip-force sensors to provide real-time haptic feedback as compared to external sensors at the needle base during needle insertion via the master/slave system. Subjects were able to determine the position of the embedded membranes with significantly better accuracy using FBG tip feedback than with base feedback using a commercial force/torque sensor (p = 0.045) or with no added haptic feedback (p = 0.0024).

Detection of Membrane Puncture with Haptic Feedback using a Tip-Force Sensing Needle

PubMed Central

Elayaperumal, Santhi; Bae, Jung Hwa; Daniel, Bruce L.; Cutkosky, Mark R.

2015-01-01

This paper presents calibration and user test results of a 3-D tip-force sensing needle with haptic feedback. The needle is a modified MRI-compatible biopsy needle with embedded fiber Bragg grating (FBG) sensors for strain detection. After calibration, the needle is interrogated at 2 kHz, and dynamic forces are displayed remotely with a voice coil actuator. The needle is tested in a single-axis master/slave system, with the voice coil haptic display at the master, and the needle at the slave end. Tissue phantoms with embedded membranes were used to determine the ability of the tip-force sensors to provide real-time haptic feedback as compared to external sensors at the needle base during needle insertion via the master/slave system. Subjects were able to determine the position of the embedded membranes with significantly better accuracy using FBG tip feedback than with base feedback using a commercial force/torque sensor (p = 0.045) or with no added haptic feedback (p = 0.0024). PMID:26509101

Effect of vibration frequency on biopsy needle insertion force.

PubMed

Tan, Lei; Qin, Xuemei; Zhang, Qinhe; Zhang, Hongcai; Dong, Hongjian; Guo, Tuodang; Liu, Guowei

2017-05-01

Needle insertion is critical in many clinical medicine procedures, such as biopsy, brachytherapy, and injection therapy. A platform with two degrees of freedom was set up to study the effect of vibration frequency on needle insertion force. The gel phantom deformation at the needle cutting edge and the Voigt model are utilized to develop a dynamic model to explain the relationship between the insertion force and needle-tip velocity. The accuracy of this model was verified by performing needle insertions into phantom gel. The effect of vibration on insertion force can be explained as the vibration increasing the needle-tip velocity and subsequently increasing the insertion force. In a series of needle insertion experiments with different vibration frequencies, the peak forces were selected for comparison to explore the effect of vibration frequency on needle insertion force. The experimental results indicate that the insertion force at 500Hz increases up to 17.9% compared with the force at 50Hz. Copyright © 2017 IPEM. Published by Elsevier Ltd. All rights reserved.

Precision grid and hand motion for accurate needle insertion in brachytherapy

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

McGill, Carl S.; Schwartz, Jonathon A.; Moore, Jason Z.

2011-08-15

Purpose: In prostate brachytherapy, a grid is used to guide a needle tip toward a preplanned location within the tissue. During insertion, the needle deflects en route resulting in target misplacement. In this paper, 18-gauge needle insertion experiments into phantom were performed to test effects of three parameters, which include the clearance between the grid hole and needle, the thickness of the grid, and the needle insertion speed. Measurement apparatus that consisted of two datum surfaces and digital depth gauge was developed to quantify needle deflections. Methods: The gauge repeatability and reproducibility (GR and R) test was performed on themore » measurement apparatus, and it proved to be capable of measuring a 2 mm tolerance from the target. Replicated experiments were performed on a 2{sup 3} factorial design (three parameters at two levels) and analysis included averages and standard deviation along with an analysis of variance (ANOVA) to find significant single and two-way interaction factors. Results: Results showed that grid with tight clearance hole and slow needle speed increased precision and accuracy of needle insertion. The tight grid was vital to enhance precision and accuracy of needle insertion for both slow and fast insertion speed; additionally, at slow speed the tight, thick grid improved needle precision and accuracy. Conclusions: In summary, the tight grid is important, regardless of speed. The grid design, which shows the capability to reduce the needle deflection in brachytherapy procedures, can potentially be implemented in the brachytherapy procedure.« less

Spinal needle force monitoring during lumbar puncture using fiber Bragg grating force device.

PubMed

Ambastha, Shikha; Umesh, Sharath; Dabir, Sundaresh; Asokan, Sundarrajan

2016-11-01

A technique for real-time dynamic monitoring of force experienced by a spinal needle during lumbar puncture using a fiber Bragg grating (FBG) sensor is presented. The proposed FBG force device (FBGFD) evaluates the compressive force on the spinal needle during lumbar puncture, particularly avoiding the bending effect on the needle. The working principle of the FBGFD is based on transduction of force experienced by the spinal needle into strain variations monitored by the FBG sensor. FBGFD facilitates external mounting of a spinal needle for its smooth insertion during lumbar puncture without any intervention. The developed FBGFD assists study and analysis of the force required for the spinal needle to penetrate various tissue layers from skin to the epidural space; this force is indicative of the varied resistance offered by different tissue layers for the spinal needle traversal. Calibration of FBGFD is performed on a micro-universal testing machine for 0 to 20 N range with an obtained resolution of 0.021 N. The experimental trials using spinal needles mounted on FBGFD are carried out on a human cadaver specimen with punctures made in the lumbar region from different directions. Distinct forces are recorded when the needle encounters skin, muscle tissue, and a bone in its traversing path. Real-time spinal needle force monitoring using FBGFD may reduce potentially serious complications during the lumbar puncture, such as overpuncturing of tissue regions, by impeding the spinal needle insertion at epidural space.

Augmented reality guidance system for peripheral nerve blocks

NASA Astrophysics Data System (ADS)

Wedlake, Chris; Moore, John; Rachinsky, Maxim; Bainbridge, Daniel; Wiles, Andrew D.; Peters, Terry M.

2010-02-01

Peripheral nerve block treatments are ubiquitous in hospitals and pain clinics worldwide. State of the art techniques use ultrasound (US) guidance and/or electrical stimulation to verify needle tip location. However, problems such as needle-US beam alignment, poor echogenicity of block needles and US beam thickness can make it difficult for the anesthetist to know the exact needle tip location. Inaccurate therapy delivery raises obvious safety and efficacy issues. We have developed and evaluated a needle guidance system that makes use of a magnetic tracking system (MTS) to provide an augmented reality (AR) guidance platform to accurately localize the needle tip as well as its projected trajectory. Five anesthetists and five novices performed simulated nerve block deliveries in a polyvinyl alcohol phantom to compare needle guidance under US alone to US placed in our AR environment. Our phantom study demonstrated a decrease in targeting attempts, decrease in contacting of critical structures, and an increase in accuracy of 0.68 mm compared to 1.34mm RMS in US guidance alone. Currently, the MTS uses 18 and 21 gauge hypodermic needles with a 5 degree of freedom sensor located at the needle tip. These needles can only be sterilized using an ethylene oxide process. In the interest of providing clinicians with a simple and efficient guidance system, we also evaluated attaching the sensor at the needle hub as a simple clip-on device. To do this, we simultaneously performed a needle bending study to assess the reliability of a hub-based sensor.

A review of the benefits and pitfalls of phantoms in ultrasound-guided regional anesthesia.

PubMed

Hocking, Graham; Hebard, Simon; Mitchell, Christopher H

2011-01-01

With the growth of ultrasound-guided regional anesthesia, so has the requirement for training tools to practice needle guidance skills and evaluate echogenic needles. Ethically, skills in ultrasound-guided needle placement should be gained in a phantom before performance of nerve blocks on patients in clinical practice. However, phantom technology is varied, and critical evaluation of the images is needed to understand their application to clinical use. Needle visibility depends on the echogenicity of the needle relative to the echogenicity of the tissue adjacent the needle. We demonstrate this point using images of echogenic and nonechogenic needles in 5 different phantoms at both shallow angles (20 degrees) and steep angles (45 degrees). The echogenicity of phantoms varies enormously, and this impacts on how needles are visualized. Water is anechoic, making all needles highly visible, but does not fix the needle to allow practice placement. Gelatin phantoms and Blue Phantoms provide tactile feedback but have very low background echogenicity, which greatly exaggerates needle visibility. This makes skill acquisition easier but can lead to false confidence in regard to clinical ability. Fresh-frozen cadavers retain much of the textural feel of live human tissue and are nearly as echogenic. Similar to clinical practice, this makes needles inserted at steep angles practically invisible, unless they are highly echogenic. This review describes the uses and pitfalls of phantoms that have been described or commercially produced. Copyright © 2011 by American Society of Regional Anesthesia and Pain Medicine

Prospective clinical evaluation of the Polyperf® Safe, a safety Huber needle, in cancer patients.

PubMed

Goossens, Godelieve A; Moons, Philip; Jérôme, Martine; Stas, Marguerite

2011-01-01

Evaluation of the Polyperf® Safe (PPS) needle on safety and user-friendliness, as experienced by first-time and non-first-time users of the device. A prospective, descriptive study was carried out at the University Hospitals Leuven, Belgium. Five hundred PPS needles were individually evaluated in cancer patients. Different aspects of the PPS were assessed: packaging, needle insertion, and needle removal. Nurses were asked whether they had previously inserted or removed this type of needle. We compared the PPS needle with the standard Gripper® needle in terms of safety, ease of use, and ease of training. Three hundred sixty-six evaluation forms were available for analysis (73.2%). Packaging and access evaluations were scored positively, except for two aspects: (1) needle stability, and (2) ease of dressing. Ease of removal was scored unsatisfactory in up to 22.4% of the registrations. Pain at insertion was reported in about 20% registrations, and blood contact was reported by 2.5% of non-first-time users. Safety was scored as good, although ease of use and ease in training scored 25.4% and 43.8%, respectively, lower than the Gripper®. In general, nurses evaluated the PPS positively, with the exception of needle stability, ease of dressing, and ease of removal. No needlestick accidents were recorded. Aspects of ease of use and ease of training for PPS needles scored less than those for the Gripper® needles in up to one-third of the registrations.

COMPARISON OF DRY NEEDLING VS. SHAM ON THE PERFORMANCE OF VERTICAL JUMP

PubMed Central

Nelson, Russell; Beamer, Lisa

2017-01-01

Introduction Dry needling has been reported to decrease pain in subjects having myofascial trigger points, as well as pain in muscle and connective tissue. Objective The purpose of the study was to compare the effects on the ability to perform a two-legged vertical jump between a group who received one bout of dry needling and a group who received one bout of a sham treatment. Methods Thirty-five healthy students (19 males, 16 females) were recruited to participate in this study (mean age 22.7+/- 2.4 years). The subjects were randomly divided into two groups- dry needling (n=18) vs sham (n=17). The dry needling group received needling to four sites on bilateral gastrocnemius muscles; two at the medial head and two at the lateral head. The sham group had the four areas of the gastrocnemius muscle pressed with the tube housing the needle, but the needle was never inserted into the skin. Two-legged vertical jump was measured with chalk marks on the wall before and after the dry needling and sham treatments. Results Analysis with a t-test indicated that the dry needling group significantly increased vertical jump height 1.2 inches over the sham group. Conclusion One bout of dry needling showed an immediate effect at significantly increasing vertical jump height in healthy, young adults. Future research is needed to determine if dry needling has any long-term effects. Level of Evidence 2b PMID:29181252

Cadaveric validation of dry needle placement in the lateral pterygoid muscle.

PubMed

Mesa-Jiménez, Juan A; Sánchez-Gutiérrez, Jesús; de-la-Hoz-Aizpurua, José L; Fernández-de-las-Peñas, César

2015-02-01

The aim of this anatomical study was to determine if a needle is able to reach the lateral pterygoid muscle during the application of dry needling technique. A dry needling approach using 2 needles of 50 to 60 mm in length, one inserted over the zygomatic process posterior at the obituary arch (for the superior head) and other inserted below the zygomatic process between the mandibular condyle and the coronoid process (for the inferior head), was proposed. A progressive dissection into 3 stages was conducted into 2 heads of fresh male cadavers. First, dry needling of the lateral pterygoid muscle was applied on the cadaver. Second, a block dissection containing the lateral pterygoid was harvested. Finally, the ramus of the mandible was sectioned by osteotomy to visualize the lateral pterygoid muscle with the needle placements. With the needles inserted into the cadaver, the block dissection revealed that the superior needle reached the superior (sphenoid) head of the lateral pterygoid muscle and the inferior needle reached the inferior (pterygoid) head of the muscle. At the final stage of the dissection, when the ramus of the mandible was sectioned by osteotomy, it was revealed that the superior needle entered into the belly of the superior head of the lateral pterygoid muscle. This anatomical study supports that dry needling technique for the lateral pterygoid muscle can be properly conducted with the proposed approach. Copyright © 2015 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

Spinal needle force monitoring during lumbar puncture using fiber Bragg grating force device

NASA Astrophysics Data System (ADS)

Ambastha, Shikha; Umesh, Sharath; Dabir, Sundaresh; Asokan, Sundarrajan

2016-11-01

A technique for real-time dynamic monitoring of force experienced by a spinal needle during lumbar puncture using a fiber Bragg grating (FBG) sensor is presented. The proposed FBG force device (FBGFD) evaluates the compressive force on the spinal needle during lumbar puncture, particularly avoiding the bending effect on the needle. The working principle of the FBGFD is based on transduction of force experienced by the spinal needle into strain variations monitored by the FBG sensor. FBGFD facilitates external mounting of a spinal needle for its smooth insertion during lumbar puncture without any intervention. The developed FBGFD assists study and analysis of the force required for the spinal needle to penetrate various tissue layers from skin to the epidural space; this force is indicative of the varied resistance offered by different tissue layers for the spinal needle traversal. Calibration of FBGFD is performed on a micro-universal testing machine for 0 to 20 N range with an obtained resolution of 0.021 N. The experimental trials using spinal needles mounted on FBGFD are carried out on a human cadaver specimen with punctures made in the lumbar region from different directions. Distinct forces are recorded when the needle encounters skin, muscle tissue, and a bone in its traversing path. Real-time spinal needle force monitoring using FBGFD may reduce potentially serious complications during the lumbar puncture, such as overpuncturing of tissue regions, by impeding the spinal needle insertion at epidural space.

Distinguishing between microscale gaseous bubbles and liquid drops

NASA Astrophysics Data System (ADS)

Tan, Beng Hau; An, Hongjie; Chan, Chon U.; Ohl, Claus-Dieter

2015-11-01

In recent years, there has been strong research interest in decorating surfaces with tiny bubbles and drops due to their potential applications in reducing slippage in micro and nanofluidic devices. Both nanobubbles and nanodrops are typically nucleated by exchanging fluids over a suitable substrate. However, the nucleation experiments present many challenges, such as reproducibility and the possibility of contamination. The use of one-use plastic syringes and needle cannulas in nucleation experiments can introduce polymeric contamination. A contaminated experiment may nucleate bubbles, drops or both. Moreover, it is surprisingly difficult to distinguish between bubbles and drops under the usual atomic force microscopy or optical techniques. Here we present an experimental study comparing bubbles and oil (PDMS) drops on an atomically smooth surface (HOPG). Instead of nucleating the objects via solvent exchange, we directly introduced bubbles via electrolysis, and oil drops by injecting a dilute solution. Contrary to previous reports, we find that under careful AFM characterisation, liquid drops and gaseous bubbles respond differently to a change in imaging force, and moreover present different characteristic force curves.

Endovascular retrieval of dental needle retained in the internal carotid artery.

PubMed

Moore, Kenneth; Khan, Nickalus R; Michael, L Madison; Arthur, Adam S; Hoit, Daniel

2017-03-08

Intravascular foreign bodies are a known complication of medical and dental procedures. Dental anesthetic needles may be broken off and retained in the oropharynx. These needles have occasionally been reported to migrate through the oral mucosa in to deeper structures. Here we present the case of a 57-year-old man who had a retained dental needle that had migrated into his internal carotid artery. The needle was removed using endovascular techniques. To our knowledge, this is the first report of a retained dental needle being retrieved using this method. We review the literature on intravascular foreign bodies, retained dental needles, and endovascular techniques for retrieval of such foreign bodies. 2017 BMJ Publishing Group Ltd.

75 FR 34499 - Self-Regulatory Organizations; International Securities Exchange, LLC; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-17

... maker/taker pricing program. The text of the proposed rule change is available on the Exchange's Web... qualification standards for market makers to receive a rebate under the Exchange's maker/taker pricing program... trading month for series trading between $0.03 and $5.00 in premium. \\8\\ The concept of incenting market...

Developing additional capacity for wilderness management: An international exchange program between South Africa and United States wilderness rangers

Treesearch

Pierre van den Berg; Ralph Swain

2007-01-01

Wilderness managers have limited time to initiate international exchanges. Additionally, the benefits to developing capacity for wilderness management around the globe are not significant enough to make the effort cost-effective. International assistance, including wilderness management exchange programs, is critical to protecting wild areas around the globe. Former...

77 FR 31411 - Self-Regulatory Organizations; International Securities Exchange, LLC; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-25

... program related to an incentive plan for certain Foreign Currency (``FX'') options traded on the Exchange... Rule Change to Terminate a Pilot Program Related to an Incentive Plan for Certain Foreign Currency Options Traded on the Exchange and To Make a Technical Change to the Schedule of Fees May 21, 2012...

77 FR 75234 - Self-Regulatory Organizations; BOX Options Exchange LLC; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-19

... Proposed Rule Change To Extend the Penny Pilot Program December 13, 2012. Pursuant to Section 19(b)(1) of... Proposed Rule Change BOX Options Exchange LLC (the ``Exchange'') proposes to amend Rule 7260 (Penny Pilot... penny increments (``Penny Pilot Program''). The text of the proposed rule change is available from the...

Biology of a Pine Needle Sheath Midge, Contarinia Acuta Gagne (Diptera: Cecidomyiidae), on Loblolly Pine

Treesearch

Julie C. Weatherby; John C. Moser; Raymond J. Gagné; Huey N. Wallace

1989-01-01

The biology of a pine needle sheath midge, Contarinia acuta Gagné is described for a new host in Louisiana. This midge was found feeding within the needle sheath on elongating needles of loblolly pine, P. taeda L. Needle droop and partial defoliation were evident on heavily infested trees. Overwintering C. acuta...

Evaluation of heat transfer in acupuncture needles: convection and conduction approaches.

PubMed

Tzou, Chieh-Han John; Yang, Tzyy-Yih; Chung, Ya-Chien

2015-04-01

Originating in ancient China, acupuncture using needles has been developed for thousands of years and has received attention for its reported medical remedies, such as pain relief and chronic disease treatment. Heat transfer through the needles, which might have effects on the biomechanism of acupuncture, providing a stimulus and regulating homeostasis, has never been studied. This article analyzes the significance of heat transfer through needles via convection and conduction, approached by means of computational analysis. The needle is a cylindrical body, and an axis symmetrical steady-state heat-transfer model that viscosity and static pressure was not applied. This article evaluates heat transfer via acupuncture needles by using five metal materials: silver, copper, brass, iron, and stainless steel. A silver needle of the type extensively applied in acupuncture can dissipate more than seven times as much heat as a stainless steel needle of the same type. Heat transfer through such a needle is significant, compared to natural body-energy consumption over a range of ambient temperatures. The mechanism by which heat flows in or out of the body through the needles may be crucial in the remedial efficacy of acupuncture. Copyright © 2015. Published by Elsevier B.V.

Comparative cyto-histological study of needle tip aspirates and entry sites after intravitreal injection using different needle types

PubMed Central

Lytvynchuk, Lyubomyr; Sergienko, Andrij; Savytska, Iryna; Albert, Réka; Glittenberg, Carl; Binder, Susanne; Petrovski, Goran

2017-01-01

A comparison of the cellular content of needle tip aspirates and entry sites after transconjunctival intravitreal injection (IVI) using different needle types was performed. White outbred rats and human cadaver eyes were used for IVI by hypodermic 27 gauge (G) and 30G needles, and spinal anesthesia Pencan 27G needles. Aspiration of vitreous for quantitative morphological and cell cultivation analysis, as well as cyto-histological analysis of aspirates and entry sites were carried out. The most common cells in the aspirates from all needle types were conjunctival epithelial-, ciliary body non-pigmented epithelial- and sclerocyte-like cells and granular proteins. Crystallized vitreous specimens were present in each aspirate. The entry sites of hypodermic needles showed marked trauma in all wall layers of rat and human eyes accompanied by cellular destruction and hemorrhages. Pencan 27G needle caused less tissue trauma with partial reposition of sclerocytes. Transconjunctival IVIs with hypodermic 27G and 30G, and Pencan 27G needles result in trauma of all layers of the eyeball. The possible consequences of cellular content being cut and injected into the eye, as well as the entry site wound shape deserve future consideration and improvements. PMID:28692684

Simulation and experimental studies in needle-tissue interactions.

PubMed

Konh, Bardia; Honarvar, Mohammad; Darvish, Kurosh; Hutapea, Parsaoran

2017-08-01

This work aims to introduce a new needle insertion simulation to predict the deflection of a bevel-tip needle inside soft tissue. The development of such a model, which predicts the steering behavior of the needle during needle-tissue interactions, could improve the performance of many percutaneous needle-based procedures such as brachytherapy and thermal ablation, by means of the virtual path planning and training systems of the needle toward the target and thus reducing possible incidents of complications in clinical practices. The Arbitrary-Lagrangian-Eulerian (ALE) formulation in LS-DYNA software was used to model the solid-fluid interactions between the needle and tissue. Since both large deformation and fracture of the continuum need to be considered in this model, applying ALE method for fluid analysis was considered a suitable approach. A 150 mm long needle was used to bend within the tissue due to the interacting forces on its asymmetric bevel tip. Three experimental cases of needle steering in a soft phantom were performed to validate the simulation. An error measurement of less than 10 % was found between the predicted deflection by the simulations and the one observed in experiments, validating our approach with reasonable accuracy. The effect of the needle diameter and its bevel tip angle on the final shape of the needle was investigated using this model. To maneuver around the anatomical obstacles of the human body and reach the target location, thin sharp needles are recommended, as they would create a smaller radius of curvature. The insertion model presented in this work is intended to be used as a base structure for path planning and training purposes for future studies.

Impact of Type of Needle on Incidence of Intravascular Injection During Diagnostic Lumbar Medial Branch Block.

PubMed

Joo, Young; Kim, Yong Chul; Lee, Sang Chul; Kim, Hye Young; Park, Keun Suk; Choi, Eun Joo; Moon, Jee Youn

2016-01-01

Intravascular (IV) injection of local anesthetics is a potential cause of false-negative results after lumbar medial branch nerve blockade (L-MBB) performed to diagnose facetogenic back pain. The aim of the present study was to identify the relationship between the needle type and the incidence of IV injection in patients undergoing L-MBB using fluoroscopy with digital subtraction imaging (DSI). In this prospective randomized study, we compared the incidence of IV uptake of contrast medium using the Quincke needle and Whitacre needle under real-time DSI during L-MBB. Clinical and demographic factors associated with the occurrence of IV uptake were also investigated. In total, 126 patients were randomized into the Quincke needle group (n = 62) and Whitacre needle group (n = 64). Intravascular uptake of contrast medium was observed in 66 (9.8%) of 671 L-MBB procedures under DSI. The incidence of IV uptake was 13.9% (47/338) using the Quincke needle and 5.7% (19/333) using the Whitacre needle. In the multivariate generalized estimating equations analysis, use of a Quincke needle was related to positive IV injection at a 1.898-fold higher rate than was use of a Whitacre needle (95% confidence interval, 1.025-3.516) and a positive aspiration test predicted IV injection at a 21.735-fold higher rate (95% confidence interval, 11.996-52.258). Lumbar medial branch nerve blockade using the Quincke needle was associated with a 1.9-fold higher rate of IV injection than was L-MBB using the Whitacre needle under DSI. Although further study is needed to confirm the clinical efficacy, Whitacre needles can be considered to reduce the risk of IV injection during L-MBB.

Diagnostic accuracy of 22/25-gauge core needle in endoscopic ultrasound-guided sampling: systematic review and meta-analysis.

PubMed

Oh, Hyoung-Chul; Kang, Hyun; Lee, Jae Young; Choi, Geun Joo; Choi, Jung Sik

2016-11-01

To compare the diagnostic accuracy of endoscopic ultrasound-guided core needle aspiration with that of standard fine-needle aspiration by systematic review and meta-analysis. Studies using 22/25-gauge core needles, irrespective of comparison with standard fine needles, were comprehensively reviewed. Pooled sensitivity, specificity, diagnostic odds ratio (DOR), and summary receiver operating characteristic curves for the diagnosis of malignancy were used to estimate the overall diagnostic efficiency. The pooled sensitivity, specificity, and DOR of the core needle for the diagnosis of malignancy were 0.88 (95% confidence interval [CI], 0.84 to 0.90), 0.99 (95% CI, 0.96 to 1), and 167.37 (95% CI, 65.77 to 425.91), respectively. The pooled sensitivity, specificity, and DOR of the standard needle were 0.84 (95% CI, 0.79 to 0.88), 1 (95% CI, 0.97 to 1), and 130.14 (95% CI, 34.00 to 495.35), respectively. The area under the curve of core and standard needle in the diagnosis of malignancy was 0.974 and 0.955, respectively. The core and standard needle were comparable in terms of pancreatic malignancy diagnosis. There was no significant difference in procurement of optimal histologic cores between core and standard needles (risk ratio [RR], 0.545; 95% CI, 0.187 to 1.589). The number of needle passes for diagnosis was significantly lower with the core needle (standardized mean difference, -0.72; 95% CI, -1.02 to -0.41). There were no significant differences in overall complications (RR, 1.26; 95% CI, 0.34 to 4.62) and technical failure (RR, 5.07; 95% CI, 0.68 to 37.64). Core and standard needles were comparable in terms of diagnostic accuracy, technical performance, and safety profile.

Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid

MedlinePlus

... News Physician Resources Professions Site Index A-Z Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid ... Needle Aspiration Biopsy of the Thyroid? What is Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid? ...

From "connecting the dots" to "threading the needle:" The challenges ahead in managing agricultural landscapes for environmental quality

USDA-ARS?s Scientific Manuscript database

Non point source pollution from agriculture is one of the most challenging problems facing society. In this book chapter, we briefly review the development of “landscape thinking” in agriculture and how this has been incorporated into the USDA Conservation Effects Assessment Program (CEAP). We pre...

Dual mode fuel injector with one piece needle valve member

DOEpatents

Lawrence, Keith E.; Hinrichsen, Michael H.; Buckman, Colby

2005-01-18

A fuel injector includes a homogenous charge nozzle outlet set and a conventional nozzle outlet set controlled respectively by inner and outer needle value members. The homogenous charged nozzle outlet set is defined by an outer needle value member that is moveably positioned in an injector body, which defines the conventional nozzle outlet set. The inner needle valve member is positioned in the outer needle valve member. The outer needle valve member is a piece component that includes at least one external guide surface, an external value surface and an internal valve seat.

Dual mode fuel injection system and fuel injector for same

DOEpatents

Lawrence, Keith E.; Tian, Ye

2005-09-20

A fuel injection system has the ability to produce two different spray patterns depending on the positioning of a needle control valve member. Positioning of the needle control valve member determines which of the two needle control chambers are placed in a low pressure condition. First and second needle valve members have closing hydraulic surfaces exposed to fluid pressure in the two needle control chambers. The injector preferably includes a homogenous charge nozzle outlet set and a conventional nozzle outlet set controlled respectively, by the first and second needle valve members.

Veres needle in the pleural space.

PubMed

Jenkins, D W; McKinney, M K; Szpak, M W; Booker, J L

1983-11-01

The Veres needle is designed to allow entry into body cavities without trauma to underlying organs. Its major use has been in the induction of a pneumoperitoneum for peritoneoscopy. An initial successful evaluation of its use was in the pleural space of dogs. A subsequent analysis of complications in 69 thoracenteses using the Veres needle and 152 thoracenteses using a conventional needle favored the Veres needle (P = .05). We believe that the Veres needle is a safe and technically superior instrument for thoracentesis and that it deserves further application and study.

Proteomic analysis of Pinus radiata needles: 2-DE map and protein identification by LC/MS/MS and substitution-tolerant database searching.

PubMed

Valledor, Luis; Castillejo, Maria A; Lenz, Christof; Rodríguez, Roberto; Cañal, Maria J; Jorrín, Jesús

2008-07-01

Pinus radiata is one of the most economically important forest tree species, with a worldwide production of around 370 million m (3) of wood per year. Current selection of elite trees to be used in conservation and breeding programes requires the physiological and molecular characterization of available populations. To identify key proteins related to tree growth, productivity and responses to environmental factors, a proteomic approach is being utilized. In this paper, we present the first report of the 2-DE protein reference map of physiologically mature P. radiata needles, as a basis for subsequent differential expression proteomic studies related to growth, development, biomass production and responses to stresses. After TCA/acetone protein extraction of needle tissue, 549 +/- 21 well-resolved spots were detected in Coommassie-stained gels within the 5-8 pH and 10-100 kDa M(r) ranges. The analytical and biological variance determined for 450 spots were of 31 and 42%, respectively. After LC/MS/MS analysis of in-gel tryptic digested spots, proteins were identified by using the novel Paragon algorithm that tolerates amino acid substitution in the first-pass search. It allowed the confident identification of 115 out of the 150 protein spots subjected to MS, quite unusual high percentage for a poor sequence database, as is the case of P. radiata. Proteins were classified into 12 or 18 groups based on their corresponding cell component or biological process/pathway categories, respectively. Carbohydrate metabolism and photosynthetic enzymes predominate in the 2-DE protein profile of P. radiata needles.

22 CFR 62.20 - Professors and research scholars.

Code of Federal Regulations, 2011 CFR

2011-04-01

...) Purpose. The purpose of the Exchange Visitor Program, in part, is to foster the exchange of ideas between... research efforts. The exchange of professors and research scholars promotes the exchange of ideas, research...

Convolution neural networks for real-time needle detection and localization in 2D ultrasound.

PubMed

Mwikirize, Cosmas; Nosher, John L; Hacihaliloglu, Ilker

2018-05-01

We propose a framework for automatic and accurate detection of steeply inserted needles in 2D ultrasound data using convolution neural networks. We demonstrate its application in needle trajectory estimation and tip localization. Our approach consists of a unified network, comprising a fully convolutional network (FCN) and a fast region-based convolutional neural network (R-CNN). The FCN proposes candidate regions, which are then fed to a fast R-CNN for finer needle detection. We leverage a transfer learning paradigm, where the network weights are initialized by training with non-medical images, and fine-tuned with ex vivo ultrasound scans collected during insertion of a 17G epidural needle into freshly excised porcine and bovine tissue at depth settings up to 9 cm and [Formula: see text]-[Formula: see text] insertion angles. Needle detection results are used to accurately estimate needle trajectory from intensity invariant needle features and perform needle tip localization from an intensity search along the needle trajectory. Our needle detection model was trained and validated on 2500 ex vivo ultrasound scans. The detection system has a frame rate of 25 fps on a GPU and achieves 99.6% precision, 99.78% recall rate and an [Formula: see text] score of 0.99. Validation for needle localization was performed on 400 scans collected using a different imaging platform, over a bovine/porcine lumbosacral spine phantom. Shaft localization error of [Formula: see text], tip localization error of [Formula: see text] mm, and a total processing time of 0.58 s were achieved. The proposed method is fully automatic and provides robust needle localization results in challenging scanning conditions. The accurate and robust results coupled with real-time detection and sub-second total processing make the proposed method promising in applications for needle detection and localization during challenging minimally invasive ultrasound-guided procedures.

Two-dimensional mapping of needle visibility with linear and curved array for ultrasound-guided interventional procedure

NASA Astrophysics Data System (ADS)

Susanti, Hesty; Suprijanto, Kurniadi, Deddy

2018-02-01

Needle visibility in ultrasound-guided technique has been a crucial factor for successful interventional procedure. It has been affected by several factors, i.e. puncture depth, insertion angle, needle size and material, and imaging technology. The influences of those factors made the needle not always well visible. 20 G needles of 15 cm length (Nano Line, facet) were inserted into water bath with variation of insertion angles and depths. Ultrasound measurements are performed with BK-Medical Flex Focus 800 using 12 MHz linear array and 5 MHz curved array in Ultrasound Guided Regional Anesthesia mode. We propose 3 criteria to evaluate needle visibility, i.e. maximum intensity, mean intensity, and the ratio between minimum and maximum intensity. Those criteria were then depicted into representative maps for practical purpose. The best criterion candidate for representing the needle visibility was criterion 1. Generally, the appearance pattern of the needle from this criterion was relatively consistent, i.e. for linear array, it was relatively poor visibility in the middle part of the shaft, while for curved array, it is relatively better visible toward the end of the shaft. With further investigations, for example with the use of tissue-mimicking phantom, the representative maps can be built for future practical purpose, i.e. as a tool for clinicians to ensure better needle placement in clinical application. It will help them to avoid the "dead" area where the needle is not well visible, so it can reduce the risks of vital structures traversing and the number of required insertion, resulting in less patient morbidity. Those simple criteria and representative maps can be utilized to evaluate general visibility patterns of the needle in vast range of needle types and sizes in different insertion media. This information is also important as an early investigation for future research of needle visibility improvement, i.e. the development of beamforming strategies and ultrasound enhanced (echogenic) needle.

77 FR 27593 - Exchange Visitor Program-Summer Work Travel

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-11

... aware, however, that the salutary foreign affairs goals of the Exchange Visitor Program, including the...-line universities are not eligible for the program; 3. Sponsors and foreign entities cannot provide host employers cash or gift incentives (though they may host job fairs); 4. Sponsors must provide...

Washington State Department of Transportation Research Office peer exchange : summary report, May 9-12, 2005.

DOT National Transportation Integrated Search

2005-05-01

The intent of the Peer Exchange was to provide an opportunity for state research programs to : learn from each other about research program management practices in order to improve their : programs. : As a condition for approval of FHWA planning and ...

[Comparison of chemical components of essential oils in needles of Pinus massoniana Lamb and Pinus elliottottii Engelm from Guangxi].

PubMed

Shen, Changmao; Duan, Wengui; Cen, Bo; Tan, Jianhui

2006-11-01

Essential oils were extracted by steam distillation from the needles of Pinus massoniana Lamb and Pinus elliottottii Engelm grown in Guangxi. Various factors such as pine needle dosage and extraction time which may influence the oil yield were investigated. The optimum conditions were found to be as follows: pine needle dosage 700 g, extraction time 5 h. The essential oil yields from the needles of Pinus massoniana Lamb and Pinus elliottottii Engelm were 0.45% and 0.19%, respectively. Moreover, the chemical compositions of the essential oils were analyzed by gas chromatography (GC) and gas chromatography-mass spectrometry (GC-MS). Sixty four components in the essential oil from needle of Pinus massoniana Lamb were separated and twenty of them (98.59%) were identified while seventy three components in the essential oil from needle of Pinus elliottottii Engelm were separated and twenty nine of them (94.23%) were identified. Generally, the compositions of the essential oils from needles of the two varieties were similar but the contents of some compounds differed greatly. Especially, the content of alpha-pinene in the essential oils from Pinus massoniana Lamb needles was 2.6 times as that from Pinus elliottottii Engelm needles, but the content of beta-pinene was less than the latter. Mono- and sesquiterpenes were the main composition of the essential oils from Pinus massoniana Lamb and Pinus elliottottii Engelm needles.

Estimating needle tip deflection in biological tissue from a single transverse ultrasound image: application to brachytherapy.

PubMed

Rossa, Carlos; Sloboda, Ron; Usmani, Nawaid; Tavakoli, Mahdi

2016-07-01

This paper proposes a method to predict the deflection of a flexible needle inserted into soft tissue based on the observation of deflection at a single point along the needle shaft. We model the needle-tissue as a discretized structure composed of several virtual, weightless, rigid links connected by virtual helical springs whose stiffness coefficient is found using a pattern search algorithm that only requires the force applied at the needle tip during insertion and the needle deflection measured at an arbitrary insertion depth. Needle tip deflections can then be predicted for different insertion depths. Verification of the proposed method in synthetic and biological tissue shows a deflection estimation error of [Formula: see text]2 mm for images acquired at 35 % or more of the maximum insertion depth, and decreases to 1 mm for images acquired closer to the final insertion depth. We also demonstrate the utility of the model for prostate brachytherapy, where in vivo needle deflection measurements obtained during early stages of insertion are used to predict the needle deflection further along the insertion process. The method can predict needle deflection based on the observation of deflection at a single point. The ultrasound probe can be maintained at the same position during insertion of the needle, which avoids complications of tissue deformation caused by the motion of the ultrasound probe.

Cadaveric and Ultrasonographic Validation of Needling Placement in the Cervical Multifidus Muscle.

PubMed

Fernández-de-Las-Peñas, César; Mesa-Jiménez, Juan A; Paredes-Mancilla, Jose A; Koppenhaver, Shane L; Fernández-Carnero, Samuel

2017-06-01

The aim of this study was to determine if a needle is able to reach the cervical multifidus during the application of dry needling or acupuncture. Dry needling and ultrasound imaging of cervical multifidi was conducted on 5 patients (age: 32 ± 5 years) with mechanical neck pain and on 2 fresh cadavers (age: 64 ± 1 years). Dry needling was done using a needle of 40 mm in length inserted perpendicular to the skin about 1 cm lateral to the spinous process at C3-C4. The needle was advanced from a posterior to anterior direction into the cervical multifidus with a slight inferior-medial angle (approximately 10°) to reach the vertebra lamina. For the cadaveric study, the multifidus was isolated by carefully resecting the superficial posterior cervical muscles: trapezius, splenius, and semispinalis. For the ultrasonographic study, a convex transducer was placed transversely over C3-C4 after the insertion of the needle into the muscle. The results of both the cadaveric and ultrasonic studies found that the needle does pierce the cervical multifidus muscle during insertion and that the tip of the needle rests properly against the vertebral laminae, thereby guarding the sensitive underlying spinal structures from damage. This anatomical and ultrasound imaging study supports that dry needling of the cervical multifidus could be conducted clinically. Copyright © 2017. Published by Elsevier Inc.

Secure Container For Discarded Hypodermic Needles

NASA Technical Reports Server (NTRS)

Lee, Angelene M.

1992-01-01

Container designed for safe retention of discarded blood-collecting hypodermic needles and similar sharp objects used in life-science experiments aboard spacecraft. Needles inserted through self-closing lid and retained magnetically. They are inserted, sharp end first, through spring-loaded flap. Long needles and needles on syringes cannot turn around in container. Can be emptied, cleaned, and reused. Used on Earth to provide unusually secure containment of sharp objects.

[Effect of twirling-reinforcing-reducing needling manipulations on contents of serum acetylcholine and arterial NOS and cGMP in stress-induced hypertension rats].

PubMed

Liu, Wei; Zhu, Ling-Qun; Chen, Si-Si; Lu, Shu-Chao; Tang, Jie; Liu, Qing-Guo

2015-04-01

To observe the effect of twirling-reinforcing or reducing needling manipulations on plasma acetylcholine (Ach) content and expression of nitric oxide synthetase (NOS) and cyclic guanosine monophosphate (cGMP) in thoracic artery tissue in stress-induced hypertension rats. A total of 60 male rats were randomly divided into blank control, model, acupuncture (no-needle-manipulation) , twirling-reinforcing needling and twirling-reducing needling groups (n = 12 in each group). The stress hypertension model was established by giving the animals with noise and electric shock stimulation (paw), twice a day for 15 days. Acupuncture stimulation was applied to bilateral "Taichong" (LR 3) for 1 min, followed by retaining the needles for 20 min. The treatment was conducted once daily for 7 days. Systolic blood pressure of the rat's tail was detected with non-invasive method and plasma Ach, and NOS and cGMP contents in the thoracic artery tissue were measured using ELISA method. Compared with the control group, the systolic blood pressure was significantly higher in the model group after 15 days' stress stimulation (P < 0.01), while the contents of plasma Ach, arterial NOS and cGMP were markedly down-regulated (P < 0.01). Following 7 days' acupuncture interventions, the increased blood pressure was down-regulated in the no-needle-manipulation, twirling-reinforcing needling and twirling-reducing needling groups (P < 0.05, P < 0.01); and the decreased Ach and NOS in the 3 treatment groups, and cGMP levels in the twirling-reinforcing and twirling-reducing needling groups were remarkably up-regulated (P < 0.01, P < 0.05). No significant change of arterial cGMP content was found in the no-needle-manipulation group (P > 0.05). The effect of the twirling-reducing needling was superior to that of no-needle-manipulation and twirling-reinforcing needling in lowering blood pressure and raising plasma Ach content (P < 0.05, P < 0.01). The twirling-reducing needling of acupuncture has a significant anti-hypertensive effect in stress hypertension rats, which may be associated with its effects in raising blood Ach, and arterial NOS and cGMP levels.

A comparison of the Cook single lumen immature ovum IVM needle to the Steiner-Tan pseudo double lumen flushing needle for oocyte retrieval for IVM.

PubMed

Rose, B I; Laky, D

2013-06-01

This study compared the impact of using the Steiner-Tan pseudo double lumen needle for antral follicle oocyte retrieval to using a conventional non-flushing needle. The Steiner-Tan needle has a much smaller dead space than the needles commonly used for IVM oocyte retrievals. This was a retrospective cohort study. The patient population was determined by the time period in which a patient underwent IVM in a single physician's IVF practice. The following data was abstracted from clinical and embryology records: oocytes retrieved, oocytes matured, early maturing oocytes, oocytes fertilized, embryo quality measures, retrieval time, needle punctures, clot formation, and clinical pregnancy rate. The Steiner-Tan needle did not increase the number of oocytes retrieved. It also did not increase the time required for retrieval. However, flushing of antral follicles significantly decreased clot formation in fluid aspirates. Use of the Steiner-Tan needle also significantly decreased the number of vaginal needle punctures during each case. There was a trend toward improved embryo quality, but statistical power was inadequate to show a difference. The primary benefit of the Steiner-Tan needle was on the embryological aspects of IVM. Decreased blood and blood clots in the aspirates made an IVM retrieval more like conventional IVF for the embryologist. The patient also experienced less tissue trauma without increasing anesthesia or surgical time. There was no improvement in the number of oocytes retrieved, but based on the results, we hypothesized that oocytes were more commonly retrieved from slightly large follicles than when using a routine needle.

The use of the 25 Sprotte needle markedly reduces post-dural puncture headache in routine neurological practice.

PubMed

Bertolotto, Antonio; Malentacchi, Maria; Capobianco, Marco; di Sapio, Alessia; Malucchi, Simona; Motuzova, Yana; Pulizzi, Annalisa; Berchialla, Paola; Sperli, Francesca

2016-02-01

The objectives of this article are to test the feasibility of lumbar puncture (LP) using 25-gauge (G) needles in daily neurological practice and to compare the risk of post-dural puncture headache (PDPH) with four types of needles. In a prospective rater-blind study, pros and cons of four different LP needles, the 20G Quincke (20Q), 22G Sprotte (22S), 25G Whitacre (25W) and 25G Sprotte (25S), were evaluated in 394 LPs performed by seven neurologists. The neurologist performing the LP recorded the type and size of needle, intensity of pain, safety, time of the procedure and failure or success. Between five and 15 days later another neurologist, blind to the type of needle used, completed an ad-hoc questionnaire for PDPH. PDPH developed in 35.9% patients when using a 20Q needle, and in 12.9%, 6.8% and 1.6%, respectively, when using a 22S, 25W or 25S needle. The difference in incidence of PDPH following LP performed with the 20Q needle and the 25S or 22S was statistically significant (p < 0.001 and p = 0.008, respectively) and it approached significance when comparing the 25S and 25W (p = 0.06). As 25W and 25S needles need CSF aspiration, LP requires more time and skill. Pain caused by LP was similar with the four needles. The use of the 25S needle in diagnostic LP reduces the frequency and severity of PDPH. © International Headache Society 2015.

Evaluation of Magnetic Resonance Imaging-Compatible Needles and Interactive Sequences for Musculoskeletal Interventions Using an Open High-Field Magnetic Resonance Imaging Scanner

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

Wonneberger, Uta, E-mail: uta.wonneberger@charite.d; Schnackenburg, Bernhard, E-mail: bernhard.schnackenburg@philips.co; Streitparth, Florian, E-mail: florian.streitparth@charite.de

2010-04-15

In this article, we study in vitro evaluation of needle artefacts and image quality for musculoskeletal laser-interventions in an open high-field magnetic resonance imaging (MRI) scanner at 1.0T with vertical field orientation. Five commercially available MRI-compatible puncture needles were assessed based on artefact characteristics in a CuSO4 phantom (0.1%) and in human cadaveric lumbar spines. First, six different interventional sequences were evaluated with varying needle orientation to the main magnetic field B0 (0{sup o} to 90{sup o}) in a sequence test. Artefact width, needle-tip error, and contrast-to-noise ratio (CNR) were calculated. Second, a gradient-echo sequence used for thermometric monitoring wasmore » assessed and in varying echo times, artefact width, tip error, and signal-to-noise ratio (SNR) were measured. Artefact width and needle-tip error correlated with needle material, instrument orientation to B0, and sequence type. Fast spin-echo sequences produced the smallest needle artefacts for all needles, except for the carbon fibre needle (width <3.5 mm, tip error <2 mm) at 45{sup o} to B0. Overall, the proton density-weighted spin-echo sequences had the best CNR (CNR{sub Muscle/Needle} >16.8). Concerning the thermometric gradient echo sequence, artefacts remained <5 mm, and the SNR reached its maximum at an echo time of 15 ms. If needle materials and sequences are accordingly combined, guidance and monitoring of musculoskeletal laser interventions may be feasible in a vertical magnetic field at 1.0T.« less

Needle localization using a moving stylet/catheter in ultrasound-guided regional anesthesia: a feasibility study

NASA Astrophysics Data System (ADS)

Beigi, Parmida; Rohling, Robert

2014-03-01

Despite the wide range and long history of ultrasound guided needle insertions, an unresolved issue in many cases is clear needle visibility. A well-known ad hoc technique to detect the needle is to move the stylet and look for changes in the needle appearance. We present a new method to automatically locate a moving stylet/catheter within a stationary cannula using motion detection. We then use this information to detect the needle trajectory and the tip. The differences between the current frame and the previous frame are detected and localized, to minimize the influence of tissue global motions. A polynomial fit based on the detected needle axis determines the estimated stylet shaft trajectory, and the extent of the differences along the needle axis represents the tip. Over a few periodic movements of the stylet including its full insertion into the cannula to the tip, a combination of polynomial fits determines the needle trajectory and the last detected point represents the needle tip. Experiments are conducted in water bath and bovine muscle tissue for several stylet/catheter materials. Results show that a plastic stylet has the best needle shaft and tip localization accuracy in the water bath with RMSE = 0:16 mm and RMSE = 0:51 mm, respectively. In the bovine tissue, the needle tip was best localized with the plastic catheter with RMSE = 0:33 mm. The stylet tip localization was most accurate with the steel stylet, with RMSE = 2:81 mm and the shaft was best localized with the plastic catheter, with RMSE = 0:32 mm.

Academic Performance and Personal Experience of Local, International, and Collaborative Exchange Students Enrolled in an Australian Pharmacy Program

PubMed Central

Grant, Gary D.; Anoopkumar-Dukie, Shailendra

2013-01-01

Objective. To assess the academic performance and experiences of local, international, and collaborative exchange students enrolled in a 4-year Australian bachelor of pharmacy degree program. Methods. Survey instruments exploring the demographics, background, and academic and cultural experiences of students during the program were administered in 2005 to students in all 4 years. Additionally, grades from each semester of the program for students (406 local, 70 international, 155 exchange) who graduated between 2002 and 2006 were analyzed retrospectively. Results. The main differences found in the survey responses among the 3 groups were in students’ motivations for choosing the degree program and school, with international and collaborative exchange students having put more thought into these decisions than local students. The average grades over the duration of the program were similar in all 3 demographic groups. However, local students slightly outperformed international students, particularly at the start of the year, whereas collaborative exchange students’ grades mirrored those of local students during the 2 years prior to leaving their home country of Malaysia but more closely mirrored those of international students in the final 2 years after arriving on campus in Australia. Conclusion. Despite differences in academic backgrounds and culture, international and exchange students can perform well compared to local students in a bachelor of pharmacy program and were actually more satisfied than local students with the overall experience. Studying in a foreign country can negatively influence academic grades to a small extent and this is probably related to adjusting to the new environment. PMID:24052651

Academic performance and personal experience of local, international, and collaborative exchange students enrolled in an Australian pharmacy program.

PubMed

Davey, Andrew K; Grant, Gary D; Anoopkumar-Dukie, Shailendra

2013-09-12

To assess the academic performance and experiences of local, international, and collaborative exchange students enrolled in a 4-year Australian bachelor of pharmacy degree program. Survey instruments exploring the demographics, background, and academic and cultural experiences of students during the program were administered in 2005 to students in all 4 years. Additionally, grades from each semester of the program for students (406 local, 70 international, 155 exchange) who graduated between 2002 and 2006 were analyzed retrospectively. The main differences found in the survey responses among the 3 groups were in students' motivations for choosing the degree program and school, with international and collaborative exchange students having put more thought into these decisions than local students. The average grades over the duration of the program were similar in all 3 demographic groups. However, local students slightly outperformed international students, particularly at the start of the year, whereas collaborative exchange students' grades mirrored those of local students during the 2 years prior to leaving their home country of Malaysia but more closely mirrored those of international students in the final 2 years after arriving on campus in Australia. Despite differences in academic backgrounds and culture, international and exchange students can perform well compared to local students in a bachelor of pharmacy program and were actually more satisfied than local students with the overall experience. Studying in a foreign country can negatively influence academic grades to a small extent and this is probably related to adjusting to the new environment.

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

Borot de Battisti, Maxence, E-mail: M.E.P.Borot@um

Purpose: The development of MR-guided high dose rate (HDR) brachytherapy is under investigation due to the excellent tumor and organs at risk visualization of MRI. However, MR-based localization of needles (including catheters or tubes) has inherently a low update rate and the required image interpretation can be hampered by signal voids arising from blood vessels or calcifications limiting the precision of the needle guidance and reconstruction. In this paper, a new needle tracking prototype is investigated using fiber Bragg gratings (FBG)-based sensing: this prototype involves a MR-compatible stylet composed of three optic fibers with nine sets of embedded FBG sensorsmore » each. This stylet can be inserted into brachytherapy needles and allows a fast measurement of the needle deflection. This study aims to assess the potential of FBG-based sensing for real-time needle (including catheter or tube) tracking during MR-guided intervention. Methods: First, the MR compatibility of FBG-based sensing and its accuracy was evaluated. Different known needle deflections were measured using FBG-based sensing during simultaneous MR-imaging. Then, a needle tracking procedure using FBG-based sensing was proposed. This procedure involved a MR-based calibration of the FBG-based system performed prior to the interventional procedure. The needle tracking system was assessed in an experiment with a moving phantom during MR imaging. The FBG-based system was quantified by comparing the gold-standard shapes, the shape manually segmented on MRI and the FBG-based measurements. Results: The evaluation of the MR compatibility of FBG-based sensing and its accuracy shows that the needle deflection could be measured with an accuracy of 0.27 mm on average. Besides, the FBG-based measurements were comparable to the uncertainty of MR-based measurements estimated at half the voxel size in the MR image. Finally, the mean(standard deviation) Euclidean distance between MR- and FBG-based needle position measurements was equal to 0.79 mm(0.37 mm). The update rate and latency of the FBG-based needle position measurement were 100 and 300 ms, respectively. Conclusions: The FBG-based needle tracking procedure proposed in this paper is able to determine the position of the complete needle, under MR-imaging, with better accuracy and precision, higher update rate, and lower latency compared to current MR-based needle localization methods. This system would be eligible for MR-guided brachytherapy, in particular, for an improved needle guidance and reconstruction.« less

[Flying needling therapy combined with clomiphene for ovulation failure in polycystic ovary syndrome:a randomized controlled trial].

PubMed

Ma, Hong; Quan, Xiaohong; Chen, Xiuhua; Dong, Ying

2016-11-12

To compare the efficacy among the combined treatment of flying needling therapy and clomiphene, the simple application of flying needling therapy and simple clomiphene in the treatment of ovulation failure in polycystic ovary syndrome (PCOS). Ninety patients of PCOS were randomized into a flying needling therapy group, a medication group and a combined treatment group, 30 cases in each one. In the flying needling therapy group, the flying needling therapy was simply applied to Ganshu (BL 18), Shenshu (BL 23), Zhongwan (CV 12), Shuifen (CV 9), Guanyuan (CV 4) and Zhongji (CV 3). The unilateral back- shu points were used alternatively in each treatment. The needles were inserted rapidly with rotation technique and even-needling manipulation. The needles were retained for 30 min. The treatment was given once every two days, 3 times a week. In the medication group, clomiphene was taken orally on the 5th day of menstruation, continuously for 5 days. In the combined treatment group, the flying needling therapy and clomiphene were used in combination. All of the patients were treated for 3 months and followed up for 1 month. The ovulation rates were compared among the three groups. The levels of androgen testosterone were compared before and after treatment. In the combined treatment group, the ovulation rate was 86.2% (100/116), better than 66.7% (80/120) in the flying needling therapy group and 69.6% (78/112) in the medication group (both P <0.05). The efficacy was similar between the fly needling therapy group and the medication group ( P >0.05). After treatment, the level of testosterone was reduced in the three groups (all P <0.05). In the combined treatment group, the improvement in androgen level was better than those in the flying needling therapy group and the medication group (both P <0.05). The efficacy was similar between the flying needling therapy group and the medication group ( P >0.05). The adverse reactions in the combined treatment group and the flying needling therapy group were lower than those in the medication group (both P <0.05). The flying needling therapy effectively improves in the ovulation failure of PCOS and its effect is similar to clomiphene. The allied treatment of them apparently improves the clinical efficacy and alleviates the adverse reactions.

[The Huber needle as a special cannula for the puncture of implanted ports and pumps--a mistake in multiple variations].

PubMed

Müller, H; Zierski, J

1988-10-03

Huber-point needles, which are thought to be noncoring, are usually recommended for puncture of implanted drug-delivery devices, such as ports and pumps. Nevertheless, we found occlusion by silicone chips deriving from the silicone inlet septum to be a major technical complication. Electron microscopic investigations demonstrated substantial loss of material from the port membrane after repeated puncture with this type of needle. During an in vitro test, multiple puncture with Huber-type cannulas led to a pressure-dependent leakage of a port after only 150 to 750 insertions of a needle. In addition, the forces necessary for puncture or for withdrawal of the needle were increased with Huber-point needles, possibly due to a coring effect. Another disadvantage of the available port needles is the formation of a hook at the tip, which may lead to additional lesion of the port or pump membrane. In our opinion, resterilization of Huber needles, recommended by the manufactures, is not advisable, because it is well known that safe sterilization of small lumina, e.g., the lumen of the needle, is impossible.

A variable stiffness mechanism for steerable percutaneous instruments: integration in a needle.

PubMed

De Falco, Iris; Culmone, Costanza; Menciassi, Arianna; Dankelman, Jenny; van den Dobbelsteen, John J

2018-06-04

Needles are advanced tools commonly used in minimally invasive medical procedures. The accurate manoeuvrability of flexible needles through soft tissues is strongly determined by variations in tissue stiffness, which affects the needle-tissue interaction and thus causes needle deflection. This work presents a variable stiffness mechanism for percutaneous needles capable of compensating for variations in tissue stiffness and undesirable trajectory changes. It is composed of compliant segments and rigid plates alternately connected in series and longitudinally crossed by four cables. The tensioning of the cables allows the omnidirectional steering of the tip and the stiffness tuning of the needle. The mechanism was tested separately under different working conditions, demonstrating a capability to exert up to 3.6 N. Afterwards, the mechanism was integrated into a needle, and the overall device was tested in gelatine phantoms simulating the stiffness of biological tissues. The needle demonstrated the capability to vary deflection (from 11.6 to 4.4 mm) and adapt to the inhomogeneity of the phantoms (from 21 to 80 kPa) depending on the activation of the variable stiffness mechanism. Graphical abstract ᅟ.

7 CFR 772.8 - Sale or exchange of security property.

Code of Federal Regulations, 2014 CFR

2014-01-01

..., DEPARTMENT OF AGRICULTURE SPECIAL PROGRAMS SERVICING MINOR PROGRAM LOANS § 772.8 Sale or exchange of security..., or sex in programs or activities receiving Federal financial assistance. Such provisions apply for as... security for the loan is adequate or will not change after the transaction. (iv) Sale proceeds remaining...

7 CFR 772.8 - Sale or exchange of security property.

Code of Federal Regulations, 2011 CFR

2011-01-01

..., DEPARTMENT OF AGRICULTURE SPECIAL PROGRAMS SERVICING MINOR PROGRAM LOANS § 772.8 Sale or exchange of security..., or sex in programs or activities receiving Federal financial assistance. Such provisions apply for as... security for the loan is adequate or will not change after the transaction. (iv) Sale proceeds remaining...

7 CFR 772.8 - Sale or exchange of security property.

Code of Federal Regulations, 2012 CFR

2012-01-01

..., DEPARTMENT OF AGRICULTURE SPECIAL PROGRAMS SERVICING MINOR PROGRAM LOANS § 772.8 Sale or exchange of security..., or sex in programs or activities receiving Federal financial assistance. Such provisions apply for as... security for the loan is adequate or will not change after the transaction. (iv) Sale proceeds remaining...

7 CFR 772.8 - Sale or exchange of security property.

Code of Federal Regulations, 2013 CFR

2013-01-01

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76 FR 33993 - Exchange Visitor Program

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-10

... political turmoil in Libya has affected Exchange Visitor Program college and university students studying in... employment for J-1 Libyan students does not apply to Federal Work-Study jobs. College and university students... program status and on-campus and off- campus employment for J-1 Libyan students. This action is necessary...

78 FR 6263 - Exchange Visitor Program-Fees and Charges

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-30

... following methods: Persons with access to the Internet will be able to view and comment on the rule and... update the Student and Exchange Visitor Information System (SEVIS) status, and similar requests). The... Designation on behalf of program sponsors and other program stakeholders. ABC is a method of identifying the...

75 FR 42802 - Self-Regulatory Organizations; International Securities Exchange, LLC; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-22

... under the Exchange's maker/taker pricing program. The text of the proposed rule change is available on... maker/taker pricing program. The Exchange recently adopted transaction fees and rebates for adding and... National Best Offer 80% of the time for series trading between $0.03 and $5.00 in premium in each of the...

Young Diplomats Program: Israeli School-to-School Exchange End-of-Year Report, 1986-87. OEA Evaluation Report.

ERIC Educational Resources Information Center

Mei, Dolores M.; And Others

The Young Diplomats Program: Israeli School-to-School Exchange, sponsored by the New York City Board of Education and the United States Information Agency, was an international exchange involving 15 American and 15 Israeli high school students. Students from five specialized New York and five specialized Israeli high schools participated.…

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Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-05

... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-69892] Order Exempting Market Makers Participating in NASDAQ Stock Market LLC's Market Quality Program From Section 11(d)(1) of the Securities Exchange Act of 1934 and Rule 11d1-2 Thereunder June 28, 2013. On March 13, 2013, the Securities and Exchange Commission (``Commission'') approved a...

77 FR 77141 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Filing of a Proposed Rule...

Federal Register 2010, 2011, 2012, 2013, 2014

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... housing the Exchange Traded Fund or, if the Exchange Traded Fund is not a series of a trust or company... investor confidence and market integrity, the Exchange designed the MQP Program to be highly transparent... voluntary program designed to promote market quality in MQP Securities.\\9\\ An MQP Company may list an...

77 FR 72581 - Patient Protection and Affordable Care Act; Establishment of the Multi-State Plan Program for the...

Federal Register 2010, 2011, 2012, 2013, 2014

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K-12th grade students as active contributors to research investigations

NASA Astrophysics Data System (ADS)

Rock, Barrett N.; Lauten, Gary N.

1996-12-01

The Earth Day: Forest Watch Program at the University of New Hampshire utilizes morphological and anatomical measurements made on branch and needle samples from eastern white pine ( Pinus strobus), collected by K-12 students throughout New Hampshire and Maine. White pine is considered to be a bio-indicator species for ozone exposure. A University research project which monitors the response of white pine to elevated levels of tropospheric ozone has been developed by the authors, who incorporate student-made measurements such as needle length, occurrence of diagnostic foliar symptoms, needle retention, and cellular levels of damage, into an on-going project which characterizes conifer response to a variety of air pollutants. The research team compares classroom measurements with laboratory spectral reflectance measurements made on student-collected branch samples, and infers state-of-health conditions in white pine from the two-state area. These state-of-health data are, in turn, compared with State-monitored tropospheric ozone measurements on a yearly basis, resulting in change-over-time analysis of both regional ozone levels and relative levels of tree health. Based on the work to data (1991-1996), student-derived data have been found to correlate well with spectral parameters and with spatial patterns of summer ozone levels, suggesting that student measurements represent an accurate and reliable source of data for research scientists. Specific examples of student datasets and comparisons with reflectance data and how these can be used for Landsat data verification are presented, along with a discussion of the importance of being able to assess the accuracy of student data. Research scientists need to recognize the tremendous potential for access to reliable data represented by student data-collection programs such as Earth Day:Forest Watch.

Development of a Hybrid Optical Biopsy Probe to Improve Prostate Cancer Diagnosis

DTIC Science & Technology

2011-06-01

integrated needle probe can be developed for guiding needle biopsy for prostate cancer diagnosis. Multi-modal optical measurements to be utilized for... needle probe can be developed for guiding needle biopsy for prostate cancer diagnosis. Multi-modal optical measurements to be utilized for the study...tissue, into a transrectal- ultrasound , needle - biopsy probe. In the development phase, documentation to obtain IRB approval for ex vivo human prostate

Brief reports: regional anesthesia needles can introduce ultrasound gel into tissues.

PubMed

Belavy, David

2010-09-01

Anesthesiologists may insert needles through ultrasound gel when performing ultrasound-guided regional anesthesia. In this study, it was determined whether needles carry gel into tissues. Ultrasound gel dyed blue was applied to pork rashers. Tuohy and short-bevel needles were passed through the gel and pork. The needles were then assessed for the presence of ultrasound gel. All needles, including those with stylets, carried gel and tissue within the lumen. Ultrasound gel may be injected around (and perhaps in) nerves during regional anesthesia procedures. Studies are needed to determine the implications of this practice.

Early Postoperative Results of Percutaneous Needle Fasciotomy in 451 Patients with Dupuytren Disease.

PubMed

Molenkamp, Sanne; Schouten, Tanneke A M; Broekstra, Dieuwke C; Werker, Paul M N; Moolenburgh, J Daniel

2017-06-01

Percutaneous needle fasciotomy is a minimally invasive treatment modality for Dupuytren disease. In this study, the authors analyzed the efficacy and complication rate of percutaneous needle fasciotomy using a statistical method that takes the multilevel structure of data, regarding multiple measurements from the same patient, into account. The data of 470 treated rays from 451 patients with Dupuytren disease that underwent percutaneous needle fasciotomy were analyzed retrospectively. The authors described the early postoperative results of percutaneous needle fasciotomy and applied linear mixed models to compare mean correction of passive extension deficit between joints and efficacy of primary versus secondary percutaneous needle fasciotomy. Mean preoperative passive extension deficits at the metacarpophalangeal, proximal interphalangeal, and distal interphalangeal joints were 37, 40, and 31 degrees, respectively. Mean preoperative total passive extension deficit was 54 degrees. Results were excellent, with a mean total passive extension deficit correction of 85 percent. Percutaneous needle fasciotomy was most effective for metacarpophalangeal joints and less effective for proximal interphalangeal and distal interphalangeal joints. Secondary percutaneous needle fasciotomy was as effective as primary percutaneous needle fasciotomy. Complications were rare and mostly minor. The results of this study confirm that percutaneous needle fasciotomy is an effective and safe treatment modality for patients with mild to moderate disease who prefer a minimally invasive procedure. Therapeutic, IV.

A Double-Blind Study on Acupuncture Sensations with Japanese Style of Acupuncture: Comparison between Penetrating and Placebo Needles.

PubMed

Nishiwaki, Masako; Takayama, Miho; Yajima, Hiroyoshi; Nasu, Morihiro; Park, Joel; Kong, Jian; Takakura, Nobuari

2018-01-01

To investigate the acupuncture sensations elicited by the Japanese style of acupuncture, penetrating acupuncture and skin-touch placebo needles were randomly administered at various insertion depths (5 and 10 mm for the penetrating needles and 1 and 2 mm for the placebo needles) at LI4 to 50 healthy subjects. Among the 12 acupuncture sensations in the Massachusetts General Hospital Acupuncture Sensation Scale (MASS), "heaviness" was the strongest and most frequently reported sensation with the 10 mm needles, but not with the 5 mm needles. There were no significant differences in number of sensations elicited, MASS index, range of spreading, and intensity of needle pain for 5 mm penetration versus 1 mm skin press and 10 mm penetration versus 2 mm skin press. The MASS index with 2 mm skin-touch needles was significantly larger than that with 1 mm skin-touch and 5 mm penetrating needles. The factor structures in the 12 acupuncture sensations between penetrating and skin-touch needles were different. The acupuncture sensations obtained in this study under satisfactorily performed double-blind (practitioner-patient) conditions suggest that a slight difference in insertion depth and skin press causes significant differences in quantity and quality of acupuncture sensations.

System for Manipulating Drops and Bubbles Using Acoustic Radiation Pressure

NASA Technical Reports Server (NTRS)

Oeftering, Richard C. (Inventor)

1999-01-01

The manipulation and control of drops of liquid and gas bubbles is achieved using high intensity acoustics in the form of and/or acoustic radiation pressure and acoustic streaming. generated by a controlled wave emission from a transducer. Acoustic radiation pressure is used to deploy or dispense drops into a liquid or a gas or bubbles into a liquid at zero or near zero velocity from the discharge end of a needle such as a syringe needle. Acoustic streaming is useful in manipulating the drop or bubble during or after deployment. Deployment and discharge is achieved by focusing the acoustic radiation pressure on the discharge end of the needle, and passing the acoustic waves through the fluid in the needle. through the needle will itself, or coaxially through the fluid medium surrounding the needle. Alternatively, the acoustic waves can be counter-deployed by focusing on the discharge end of the needle from a transducer axially aligned with the needle, but at a position opposite the needle, to prevent premature deployment of the drop or bubble. The acoustic radiation pressure can also be used for detecting the presence or absence of a drop or a bubble at the tip of a needle or for sensing various physical characteristics of the drop or bubble such as size or density.

A biplanar fluoroscopic approach for the measurement, modeling, and simulation of needle and soft-tissue interaction.

PubMed

Hing, James T; Brooks, Ari D; Desai, Jaydev P

2007-02-01

A methodology for modeling the needle and soft-tissue interaction during needle insertion is presented. The approach consists of the measurement of needle and tissue motion using a dual C-arm fluoroscopy system. Our dual C-arm fluoroscopy setup allows real time 3-D extraction of the displacement of implanted fiducials in the soft tissue during needle insertion to obtain the necessary parameters for accurate modeling of needle and soft-tissue interactions. The needle and implanted markers in the tissue are tracked during the insertion and withdrawal of the needle at speeds of 1.016 mm/s, 12.7 mm/s and 25.4 mm/s. Both image and force data are utilized to determine important parameters such as the approximate cutting force, puncture force, the local effective modulus (LEM) during puncture, and the relaxation of tissue. We have also validated the LEM computed from our finite element model with arbitrary needle puncture tasks. Based on these measurements, we developed a model for needle insertion and withdrawal that can be used to generate a 1-DOF force versus position profile that can be experienced by a user operating a haptic device. This profile was implemented on a 7-DOf haptic device designed in our laboratory.

Improving needle tip identification during ultrasound-guided procedures in anaesthetic practice.

PubMed

Scholten, H J; Pourtaherian, A; Mihajlovic, N; Korsten, H H M; A Bouwman, R

2017-07-01

Ultrasound guidance is becoming standard practice for needle-based interventions in anaesthetic practice, such as vascular access and peripheral nerve blocks. However, difficulties in aligning the needle and the transducer can lead to incorrect identification of the needle tip, possibly damaging structures not visible on the ultrasound screen. Additional techniques specifically developed to aid alignment of needle and probe or identification of the needle tip are now available. In this scoping review, advantages and limitations of the following categories of those solutions are presented: needle guides; alterations to needle or needle tip; three- and four-dimensional ultrasound; magnetism, electromagnetic or GPS systems; optical tracking; augmented (virtual) reality; robotic assistance; and automated (computerised) needle detection. Most evidence originates from phantom studies, case reports and series, with few randomised clinical trials. Improved first-pass success and reduced performance time are the most frequently cited benefits, whereas the need for additional and often expensive hardware is the greatest limitation to widespread adoption. Novice ultrasound users seem to benefit most and great potential lies in education. Future research should focus on reporting relevant clinical parameters to learn which technique will benefit patients most in terms of success and safety. © 2017 The Association of Anaesthetists of Great Britain and Ireland.

Evaluating Academic Programs Abroad: The CIEE Project. CIEE Occasional Papers on International Educational Exchange No. 21.

ERIC Educational Resources Information Center

Abrams, Irwin; Heller, Francis H.

The evaluation of overseas educational programs for U.S. students by the Council on International Educational Exchange (CIEE) is discussed. The history of the CIEE is reviewed from its beginnings in 1947 when its members were national programming agencies concerned with making travel arrangements for summer programs. As the CIEE grew in…

Pine Needles as Potential Energy Feedstock: Availability in the Central Himalayan State of Uttarakhand, India

NASA Astrophysics Data System (ADS)

Kala, L. D.; Subbarao, P. M. V.

2017-11-01

The amount of pine needles (pinus roxburgii) potentially available for use as energy feedstock in the Central Himalayan state of Uttarakhand in India has been estimated. It involves estimating the gross annual amount of pine needle yield followed by a comprehensive identification and quantification of the factors that affect the net annual pine needle yield available as energy feedstock. These factors include considerations such as accessibility, alternative uses, forest fires, other losses, etc., that are influenced by aspects ranging from physical constraints to traditional societal traits. Tree canopy cover method has been used for estimating the gross annual pine needle yield. The information on canopy density is obtained from remote sensing data, that forms the basis for forest classification. The annual gross pine needle yield has been estimated at 1.9 million tonnes while the annual net pine needle yield at 1.33 million tonnes. The annual primary energy potential of pine needles available as energy feedstock has also been estimated. For annual net energy potential estimation, thermal and electrical routes are considered. Electrical energy generation from pine needles using thermochemical conversion has been examined and the corresponding potential for electricity generation been estimated. An installed capacity of 789 MW can be supported with pine needles feedstock for supplying electricity in rural areas for five hours a day. For round the clock generation, an installed capacity of 165 MW can be supported by the pine needle energy feedstock.

Structures and electrochemical performances of pyrolized carbons from graphite oxides for electric double-layer capacitor

NASA Astrophysics Data System (ADS)

Kim, Ick-Jun; Yang, Sunhye; Jeon, Min-Je; Moon, Seong-In; Kim, Hyun-Soo; Lee, Yoon-Pyo; An, Kye-Hyeok; Lee, Young-Hee

The structural features and the electrochemical performances of pyrolized needle cokes from oxidized cokes are examined and compared with those of KOH-activated needle coke. The structure of needle coke is changed to a single phase of graphite oxide after oxidation treatment with an acidic solution having an NaClO 3/needle coke composition ratio of above 7.5, and the inter-layer distance of the oxidized needle coke is expanded to 6.9 Å with increasing oxygen content. After heating at 200 °C, the oxidized needle coke is reduced to a graphite structure with an inter-layer distance of 3.6 Å. By contrast, a change in the inter-layer distance in KOH-activated needle coke is not observed. An intercalation of pyrolized needle coke, observed on first charge, occurs at 1.0 V. This value is lower than that of KOH-activation needle coke. A capacitor using pyrolized needle coke exhibits a lower internal resistance of 0.57 Ω in 1 kHz, and a larger capacitance per weight and volume of 30.3 F g -1 and 26.9 F ml -1, in the two-electrode system over the potential range 0-2.5 V compared with those of a capacitor using KOH-activation of needle coke. This better electrochemical performance is attributed to a distorted graphene layer structure derived from the process of the inter-layer expansion and shrinkage.

Horizontal Curve Virtual Peer Exchange : an RSPCB Peer Exchange

DOT National Transportation Integrated Search

2014-06-01

This report summarizes the Horizontal Curve Virtual Peer Exchange sponsored by the Federal Highway Administration (FHWA) Office of Safetys Roadway Safety Professional Capacity Building Program on June 17, 2014. This virtual peer exchange was the f...

Influence of Needle Tip Distance on Barrier Discharge and Ozone Generation for Multiple Needles-Plane Electrode Configuration

NASA Astrophysics Data System (ADS)

Ueno, Hideki; Kawahara, Shintaro; Nakayama, Hiroshi

Relationship between barrier discharge characteristics and ozone generation under ac voltage application on triple needles-plane configuration has been investigated for various distances among triple needle-tips (d=0 ∼ 7.0mm) at constant distance between needle tip and plane (g=3.0mm) in dry air. Characteristics of barrier discharge and ozone generation depend on the needle-tips distance. It is considered that the influence is caused by space charge and accumulated charge suggested from discharge image by still camera and CCD camera. And ozone generation efficiency is also estimated by power consumption and ozone concentration. As a result, when the distance among triple needle-tips is narrow, the above-mentioned influence is strengthened. And in this case, ozone generation efficiency is improved.

Ozone production of hollow-needle-to-mesh negative corona discharge enhanced by dielectric tube on the needle electrode

NASA Astrophysics Data System (ADS)

Pekárek, Stanislav

2014-12-01

For the hollow-needle-to-mesh negative corona discharge in air, we studied the effect of placing the dielectric tube on the needle electrode and the effect of various positions of the end of this tube with respect to the tip of the needle electrode on the concentration of ozone produced by the discharge, the ozone production yield and the discharge V-A characteristics. We found that the placement of the dielectric tube on the needle electrode with a suitable position of this tube end with respect to the tip of the needle electrode for a particular discharge power led to a more than fourfold increase in the concentration of ozone produced by the discharge and also, for a constant airflow, the ozone production yield.

Imaging of implant needles for real-time HDR-brachytherapy prostate treatment using biplane ultrasound transducers.

PubMed

Siebert, Frank-André; Hirt, Markus; Niehoff, Peter; Kovács, György

2009-08-01

Ultrasound imaging is becoming increasingly important in prostate brachytherapy. In high-dose-rate (HDR) real-time planning procedures the definition of the implant needles is often performed by transrectal ultrasound. This article describes absolute measurements of the visibility and accuracy of manual detection of implant needle tips and compares measurement results of different biplane ultrasound systems in transversal and longitudinal (i.e., sagittal) ultrasound modes. To obtain a fixed coordinate system and stable conditions the measurements were carried out in a water tank using a dedicated marker system. Needles were manually placed in the phantom until the observer decided by the real-time ultrasound image that the zero position was reached. A comparison of three different ultrasound systems yielded an offset between 0.8 and 3.1 mm for manual detection of the needle tip in ultrasound images by one observer. The direction of the offset was discovered to be in the proximal direction, i.e., the actual needle position was located more distally compared to the ultrasound-based definition. In the second part of the study, the ultrasound anisotropy of trocar implant needles is reported. It was shown that the integrated optical density in a region of interest around the needle tip changes with needle rotation. Three peaks were observed with a phase angle of 120 degrees. Peaks appear not only in transversal but also in longitudinal ultrasound images, with a phase shift of 60 degrees. The third section of this study shows results of observer dependent influences on needle tip detection in sagittal ultrasound images considering needle rotation. These experiments were carried out using the marker system in a water tank. The needle tip was placed exactly at the position z=0 mm. It was found that different users tend to differently interpret the same ultrasound images. The needle tip was manually detected five times in the ultrasound images by three experienced observers at positions (+/- standard deviation) -0.53 +/- 0.16, -0.16 +/- 0.14, and -0.30 +/- 0.16 mm using a gain of 15 dB. The minus sign indicates that the needle tips were detected more proximally than the actual position of the needle tip. When using a gain of -15 dB the mean values of two observers resulted in -0.62 +/- 0.08 and -0.51 +/- 0.12 mm. Additionally an alternative approach to the direct needle tip definition was investigated. Two observers detected the solid part of the needle tip in sagittal images. This solid part, often named as "dead space end," is the distance between the needle tip and the beginning of the hollow part of the implant needle. The dead space end is 6.2 mm for the investigated needle type. Two users found mean values of -6.70 +/- 0.16 and -7.00 +/- 0.06 mm, respectively, for 15 dB gain and -6.90 +/- 0.09 and -7.02 +/- 0.06 mm using the -15 dB gain setting. The results show that ultrasound-based needle tip definition in sagittal viewing mode is accurate. The inter- and intraobserver errors should, however, be taken into account. A lower gain setting of the ultrasound system reduces the intraobserver error.

22 CFR 62.75 - Extension of program participation.

Code of Federal Regulations, 2010 CFR

2010-04-01

... participant (and the accompanying spouse and any dependents as a “continuing exchange visitor”. In creating...) When creating a SEVIS record for a “continuing exchange visitor,” the initial program start date and...

Drought-induced defoliation and long periods of near-zero gas exchange play a key role in accentuating metabolic decline of Scots pine.

PubMed

Poyatos, Rafael; Aguadé, David; Galiano, Lucía; Mencuccini, Maurizio; Martínez-Vilalta, Jordi

2013-10-01

Drought-induced defoliation has recently been associated with the depletion of carbon reserves and increased mortality risk in Scots pine (Pinus sylvestris). We hypothesize that defoliated individuals are more sensitive to drought, implying that potentially higher gas exchange (per unit of leaf area) during wet periods may not compensate for their reduced photosynthetic area. We measured sap flow, needle water potentials and whole-tree hydraulic conductance to analyse the drought responses of co-occurring defoliated and nondefoliated Scots pines in northeast Spain during typical (2010) and extreme (2011) drought conditions. Defoliated Scots pines showed higher sap flow per unit leaf area during spring, but were more sensitive to summer drought, relative to nondefoliated pines. This pattern was associated with a steeper decline in soil-to-leaf hydraulic conductance with drought and an enhanced sensitivity of canopy conductance to soil water availability. Near-homeostasis in midday water potentials was observed across years and defoliation classes, with minimum values of -2.5 MPa. Enhanced sensitivity to drought and prolonged periods of near-zero gas exchange were consistent with low levels of carbohydrate reserves in defoliated trees. Our results support the critical links between defoliation, water and carbon availability, and their key roles in determining tree survival and recovery under drought. © 2013 The Authors. New Phytologist © 2013 New Phytologist Trust.

Comparison of Sprotte and Quincke needles with respect to post dural puncture headache and backache.

PubMed

Tarkkila, P J; Heine, H; Tervo, R R

1992-01-01

The objective of this study was to compare 24-gauge Sprotte and 25-gauge Quincke needles with respect to post dural puncture headache and backache. Three hundred ASA Physical Status I or II patients scheduled for minor orthopedic or urologic operations under spinal anesthesia were chosen for this randomized, prospective study at a university hospital and a city hospital. Anesthetic technique, intravenous fluids, and postoperative pain therapy were standardized. Patients were randomly divided into three equal groups. Spinal anesthesia was performed with either a 24-gauge Sprotte needle or a 25-gauge Quincke needle with the cutting bevel parallel or perpendicular to the dural fibers. Anesthesia could not be performed in three cases with the Sprotte needle and in one case with the Quincke needle. The most common complications were post dural puncture backache (18.0%), post dural puncture headache (8.2%), and non-postural headache (6.7%). No major complications occurred. The Quincke needle with bevel perpendicular to the dural fibers caused a 17.9% incidence of post dural puncture headache. The Quincke with bevel parallel to the dural fibers and the Sprotte needles caused similar post dural puncture headache rates (4.5% and 2.4%, respectively). Other factors associated with post dural puncture headache were young age, early ambulation, and sedation during spinal anesthesia. There were no significant differences between needles in the incidence of post dural puncture backache. Our data indicate that Quincke needles should not be used with the needle bevel inserted perpendicular to the dural fibers. The Sprotte needle does not solve the problem of post dural puncture headache and backache.

Augmented Reality-Guided Lumbar Facet Joint Injections.

PubMed

Agten, Christoph A; Dennler, Cyrill; Rosskopf, Andrea B; Jaberg, Laurenz; Pfirrmann, Christian W A; Farshad, Mazda

2018-05-08

The aim of this study was to assess feasibility and accuracy of augmented reality-guided lumbar facet joint injections. A spine phantom completely embedded in hardened opaque agar with 3 ring markers was built. A 3-dimensional model of the phantom was uploaded to an augmented reality headset (Microsoft HoloLens). Two radiologists independently performed 20 augmented reality-guided and 20 computed tomography (CT)-guided facet joint injections each: for each augmented reality-guided injection, the hologram was manually aligned with the phantom container using the ring markers. The radiologists targeted the virtual facet joint and tried to place the needle tip in the holographic joint space. Computed tomography was performed after each needle placement to document final needle tip position. Time needed from grabbing the needle to final needle placement was measured for each simulated injection. An independent radiologist rated images of all needle placements in a randomized order blinded to modality (augmented reality vs CT) and performer as perfect, acceptable, incorrect, or unsafe. Accuracy and time to place needles were compared between augmented reality-guided and CT-guided facet joint injections. In total, 39/40 (97.5%) of augmented reality-guided needle placements were either perfect or acceptable compared with 40/40 (100%) CT-guided needle placements (P = 0.5). One augmented reality-guided injection missed the facet joint space by 2 mm. No unsafe needle placements occurred. Time to final needle placement was substantially faster with augmented reality guidance (mean 14 ± 6 seconds vs 39 ± 15 seconds, P < 0.001 for both readers). Augmented reality-guided facet joint injections are feasible and accurate without potentially harmful needle placement in an experimental setting.

Comparison of plateletpheresis on the Fenwal Amicus, Fresenius COM.TEC, and Trima Accel Cell separators.

PubMed

Keklik, Muzaffer; Eser, Bulent; Kaynar, Leylagul; Sivgin, Serdar; Keklik, Ertugrul; Solmaz, Musa; Ozturk, Ahmet; Buyukoglan, Ruksan; Yay, Mehmet; Cetin, Mustafa; Unal, Ali

2015-06-01

Blood component donations by apheresis have become more common in modern blood transfusion practices. We compared three apheresis instruments (Fenwal Amicus, Fresenius COM.TEC, and Trima Accel) with regard to platelet (PLT) yield, collection efficiency (CE), and collection rate (CR). The single-needle or double-needle plateletpheresis procedures of the three instruments were compared in a retrospective, randomized study in 270 donors. The blood volume processed was higher in the COM.TEC compared with the Amicus and Trima. Also there was a significantly higher median volume of ACD used in collections on the COM.TEC compared with the Amicus and Trima. The PLT yield was significantly lower with the COM.TEC compared with the Amicus and Trima. Additionally, the CE was significantly lower with the COM.TEC compared with the Amicus and Trima. There was no significant difference in median separation time and CR between the three groups. When procedures were compared regarding CE by using Amicus device, it was significantly higher in single-needle than double-needle plateletpheresis. When double-needle Amicus system was compared with double-needle COM.TEC system, CE and PLT yield were significantly higher with Amicus system. When single-needle Amicus system was compared with single-needle Trima system, CE and PLT yield were significantly higher with Trima system. All instruments collected PLTs efficiently. However, the CE was lower with the COM.TEC compared with the Amicus and Trima. Also, we found Amicus single-needle system collected PLTs more efficiently compared with the double-needle system. CE and PLT yields were significantly higher with the single-needle Trima instrument compared with the single-needle Amicus device. © 2014 Wiley Periodicals, Inc.

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

Ning, Yongquan, E-mail: luckyning@nwpu.edu.cn; Huang, Shibo; Fu, M.W.

Microstructural characterization, formation mechanism and fracture behavior of the needle δ phase in Fe–Ni–Cr type superalloys with high Nb content (GH4169, equivalent to Inconel 718) have been quantitatively investigated in this research. The typical microstructures of δ phases with the stick, mixed and needle shapes obviously present in Inconel 718 after the isothermal upsetting at the temperature of 980–1060 °C with the initial strain rate of 10{sup −3}–10{sup −1} s{sup −1}. It is found that the shape of the δ phase has a great effect on the mechanical properties of the alloy, viz., the stick δ phase behaves good plasticitymore » and the needle δ phase has good strength. In addition, the needle δ phase can be used to control the grain size as it can prevent grain growth. The combined effect of the localized necking and microvoid coalescence leads to the final ductile fracture of the GH4169 components with the needle δ phase. Both dislocation motion and atom diffusion are the root-cause for the needle δ phase to be firstly separated at grain boundary and then at sub-boundary. The formation mechanism of the needle δ phase is the new finding in this research. Furthermore, it is the primary mechanism for controlling the needle δ phase in Fe–Ni–Cr type superalloys with high Nb content. - Highlights: • Shape of the δ phase takes great effect on mechanical property. • Needle δ phase plays a great role to prevent grain growth. • Needle δ phase can enhance the fracture strength. • Microstructure mechanism of the needle δ phase has been investigated. • Fracture behavior of the needle δ phase has been studied.« less

Comparison of two different size needles in endoscopic ultrasound-guided fine-needle aspiration for diagnosing solid pancreatic lesions

PubMed Central

Xu, Mei-Mei; Jia, Hong-Yu; Yan, Li-Li; Li, Shan-Shan; Zheng, Yue

2017-01-01

Abstract Background: This meta-analysis aimed to provide a pooled analysis of prospective controlled trials comparing the diagnostic accuracy of 22-G and 25-G needles on endoscopic ultrasonography (EUS-FNA) of the solid pancreatic mass. Methods: We established a rigorous study protocol according to Cochrane Collaboration recommendations. We systematically searched the PubMed and Embase databases to identify articles to include in the meta-analysis. Sensitivity, specificity, and corresponding 95% confidence intervals were calculated for 22-G and 25-G needles of individual studies from the contingency tables. Results: Eleven prospective controlled trials included a total of 837 patients (412 with 22-G vs 425 with 25-G). Our outcomes revealed that 25-G needles (92% [95% CI, 89%–95%]) have higher sensitivity than 22-G needles (88% [95% CI, 84%–91%]) on solid pancreatic mass EUS-FNA (P = 0.046). However, there were no significant differences between the 2 groups in overall diagnostic specificity (P = 0.842). The pooled positive and negative likelihood ratio of the 22-G needle were 12.61 (95% CI, 5.65–28.14) and 0.16 (95% CI, 0.12–0.21), respectively. The pooled positive likelihood ratio was 12.61 (95% CI, 5.65–28.14), and the negative likelihood ratio was 0.16 (95% CI, 0.12–0.21) for the 22-G needle. The pooled positive likelihood ratio was 8.44 (95% CI, 3.87–18.42), and the negative likelihood ratio was 0.13 (95% CI, 0.09–0.18) for the 25-G needle. The area under the summary receiver operating characteristic curve was 0.97 for the 22-G needle and 0.96 for the 25-G needle. Conclusion: Compared to the study of 22-G EUS-FNA needles, our study showed that 25-G needles have superior sensitivity in the evaluation of solid pancreatic lesions by EUS–FNA. PMID:28151856

Comparison of cutting and pencil-point spinal needle in spinal anesthesia regarding postdural puncture headache

PubMed Central

Xu, Hong; Liu, Yang; Song, WenYe; Kan, ShunLi; Liu, FeiFei; Zhang, Di; Ning, GuangZhi; Feng, ShiQing

2017-01-01

Abstract Background: Postdural puncture headache (PDPH), mainly resulting from the loss of cerebral spinal fluid (CSF), is a well-known iatrogenic complication of spinal anesthesia and diagnostic lumbar puncture. Spinal needles have been modified to minimize complications. Modifiable risk factors of PDPH mainly included needle size and needle shape. However, whether the incidence of PDPH is significantly different between cutting-point and pencil-point needles was controversial. Then we did a meta-analysis to assess the incidence of PDPH of cutting spinal needle and pencil-point spinal needle. Methods: We included all randomly designed trials, assessing the clinical outcomes in patients given elective spinal anesthesia or diagnostic lumbar puncture with either cutting or pencil-point spinal needle as eligible studies. All selected studies and the risk of bias of them were assessed by 2 investigators. Clinical outcomes including success rates, frequency of PDPH, reported severe PDPH, and the use of epidural blood patch (EBP) were recorded as primary results. Results were evaluated using risk ratio (RR) with 95% confidence interval (CI) for dichotomous variables. Rev Man software (version 5.3) was used to analyze all appropriate data. Results: Twenty-five randomized controlled trials (RCTs) were included in our study. The analysis result revealed that pencil-point spinal needle would result in lower rate of PDPH (RR 2.50; 95% CI [1.96, 3.19]; P < 0.00001) and severe PDPH (RR 3.27; 95% CI [2.15, 4.96]; P < 0.00001). Furthermore, EBP was less used in pencil-point spine needle group (RR 3.69; 95% CI [1.96, 6.95]; P < 0.0001). Conclusions: Current evidences suggest that pencil-point spinal needle was significantly superior compared with cutting spinal needle regarding the frequency of PDPH, PDPH severity, and the use of EBP. In view of this, we recommend the use of pencil-point spinal needle in spinal anesthesia and lumbar puncture. PMID:28383416

New Perspectives on the Origin of Korean Acupuncture: Based on Materials from Xiaoyingzi Tomb, Yanji and Neighbouring Region.

PubMed

Kang, In Uk; Cha, Wung Seok

2017-12-01

This article discusses the development of early acupuncture needles as demonstrated by the artifacts excavated from the Northern part of the Yanji district, Jilin, China, during the Japanese colonial era (reported in 1941). Numerous bone needles, stone needles, and other medical devices were found in the Xiaoyingzi excavation. The stone needles from Xiaoyingzi can be categorized into three grades, based on length, of 8cm, 12-15cm, and 18cm. A set of round stones for massage were also discovered, along with obsidian blades. These relics were carefully stored in the middle of the body in the stone coffin. In addition to Xiaoyingzi, stone needles were also excavated along the lower valley region of the Tuman (Tumen, ) River. These facts indicate that the owner was involved in medical practice, and that medical procedures using stone needles were quite popular at the time. This article carefully investigates that the relics have nothing to do with weaving textile or military use. Current research on the origin of acupuncture has been confined either to stone needles from the prehistoric age or to bronze needles, as well as to literature from the Warring States period to the Han China, during which acupuncture technology was considerably expanded. However, substantial knowledge on the "gap" between stone needles and metal needles has been procured through the analysis of Xiaoyingzi, Yanji. The findings of Xiaoyingzi are also significant in providing a more detailed reconstruction of the development of acupuncture in East Asia and emergence of acupuncture throughout history. A large amount of medical items (stone and bone needles, cases for needles, massage stone type bianshi, and etc.), have been excavated from Xiaoyingzi and other neighbouring sites, Along with geographic and ecological factors, this archeological data strongly suggests the medical tradition of using acupuncture needles was practiced around Tumen River basin in the Bronze Age (10th century B.C.).

Arterial puncture using insulin needle is less painful than with standard needle: a randomized crossover study.

PubMed

Ibrahim, Irwani; Yau, Ying Wei; Ong, Lizhen; Chan, Yiong Huak; Kuan, Win Sen

2015-03-01

Arterial punctures are important procedures performed by emergency physicians in the assessment of ill patients. However, arterial punctures are painful and can create anxiety and needle phobia in patients. The pain score of radial arterial punctures were compared between the insulin needle and the standard 23-gauge hypodermic needle. In a randomized controlled crossover design, healthy volunteers were recruited to undergo bilateral radial arterial punctures. They were assigned to receive either the insulin or the standard needle as the first puncture, using blocked randomization. The primary outcome was the pain score measured on a 100-mm visual analogue scale (VAS) for pain, and secondary outcomes were rate of hemolysis, mean potassium values, and procedural complications immediately and 24 hours postprocedure. Fifty healthy volunteers were included in the study. The mean (±standard deviation) VAS score in punctures with the insulin needle was lower than the standard needle (23 ± 22 mm vs. 39 ± 24 mm; mean difference = -15 mm; 95% confidence interval = -22 mm to -7 mm; p < 0.001). The rates of hemolysis and mean potassium value were greater in samples obtained using the insulin needle compared to the standard needle (31.3% vs. 11.6%, p = 0.035; and 4.6 ±0.7 mmol/L vs. 4.2 ±0.5 mmol/L, p = 0.002). Procedural complications were lower in punctures with the insulin needle both immediately postprocedure (0% vs. 24%; p < 0.001) and at 24 hours postprocedure (5.4% vs. 34.2%; p = 0.007). Arterial punctures using insulin needles cause less pain and fewer procedural complications compared to standard needles. However, due to the higher rate of hemolysis, its use should be limited to conditions that do not require a concurrent potassium value in the same blood sample. © 2015 by the Society for Academic Emergency Medicine.

Experimental analysis of robot-assisted needle insertion into porcine liver.

PubMed

Wang, Wendong; Shi, Yikai; Goldenberg, Andrew A; Yuan, Xiaoqing; Zhang, Peng; He, Lijing; Zou, Yingjie

2015-01-01

How to improve placement accuracy of needle insertion into liver tissue is of paramount interest to physicians. A robot-assisted system was developed to experimentally demonstrate its advantages in needle insertion surgeries. Experiments of needle insertion into porcine liver tissue were performed with conic tip needle (diameter 8 mm) and bevel tip needle (diameter 1.5 mm) in this study. Manual operation was designed to compare the performance of the presented robot-assisted system. The real-time force curves show outstanding advantages of robot-assisted operation in improving the controllability and stability of needle insertion process by comparing manual operation. The statistics of maximum force and average force further demonstrates robot-assisted operation causes less oscillation. The difference of liver deformation created by manual operation and robot-assisted operation is very low, 1 mm for average deformation and 2 mm for maximum deformation. To conclude, the presented robot-assisted system can improve placement accuracy of needle by stably control insertion process.

Needle lost in minimally invasive surgery: management proposal and literature review.

PubMed

Medina, Luis G; Martin, Oscar; Cacciamani, Giovannni E; Ahmadi, Nariman; Castro, Juan C; Sotelo, Rene

2018-03-19

The reported incidence of intraoperative retained instruments, such as needles, hangs around 0.06-0.11%. Leaving a needle inside the abdominal cavity can have significant medical and legal consequences. In addition, the retrieval can be hampered due to the limited visualization of the scope during minimally invasive surgery. Factors associated with an increased probability for NL have been described. Prevention for this situation includes: having one needle at a time inside the cavity, effective communication between all personnel in the operating room, evaluation of the strength of the suture-needle connection, avoid parking of needles intraoperatively, and a proper needle withdrawal. Notwithstanding, no agreement has been made regarding NL management. Herein, we present a literature review, and a management proposal in which through a series of systematic steps, the surgical team can efficiently locate and retrieve a lost needle such as: examination of the surgical field, trocar visualization, trocar disassembly, and revision of the suction device. Finally, intraoperative or postoperative imaging can be utilized.

In vivo Monitoring of Serotonin by Nanomaterial Functionalized Acupuncture Needle

NASA Astrophysics Data System (ADS)

Li, Yu-Tao; Tang, Li-Na; Ning, Yong; Shu, Qing; Liang, Feng-Xia; Wang, Hua; Zhang, Guo-Jun

2016-06-01

Acupuncture treatment is amazing but controversial. Up to now, the mechanism of treating diseases by acupuncture and moxibustion is still unclear, especially the occurrence of the molecular events in local acupoints. Herein, we report an extremely stable microsensor by modifying carbon nanotube (CNT) to the tip surface of acupuncture needle and applying this CNT-modified acupuncture needle for real time monitoring of serotonin (5-HT) in vivo. To stabilize CNT modification on the needle tip surface, poly(3,4-ethylenedioxythiophene)(PEDOT) was employed as glue water to stick CNT on the needle. The detection limit of the CNT-modified needle was found to be approximately 50 nM and 78 nM in the PBS and the cell medium, respectively. In addition, the needle showed good selectivity to some inflammatory mediators and some electroactive molecules. For the first time, the CNT-modified needle could be directly probed into rat body for real time monitoring of 5-HT in vivo, showing a great potential for better understanding the mechanism of acupuncture treatment.

On-line monitoring of multi-component strain development in a tufting needle using optical fibre Bragg grating sensors

NASA Astrophysics Data System (ADS)

Chehura, Edmon; Dell'Anno, Giuseppe; Huet, Tristan; Staines, Stephen; James, Stephen W.; Partridge, Ivana K.; Tatam, Ralph P.

2014-07-01

Dynamic loadings induced on a tufting needle during the tufting of dry carbon fibre preform via a commercial robot-controlled tufting head were investigated in situ and in real-time using optical fibre Bragg grating (FBG) sensors bonded to the needle shaft. The sensors were configured such that the axial strain and bending moments experienced by the needle could be measured. A study of the influence of thread and thread type on the strain imparted to the needle revealed axial strain profiles which had equivalent trends but different magnitudes. The mean of the maximum axial compression strains measured during the tufting of a 4-ply quasi-isotropic carbon fibre dry preform were - 499 ± 79 μɛ, - 463 ± 51 μɛ and - 431 ± 59 μɛ for a needle without thread, with metal wire and with Kevlar® thread, respectively. The needle similarly exhibited bending moments of different magnitude when the different needle feeding configurations were used.

45 CFR 152.45 - Transition to the exchanges.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Transition to the exchanges. 152.45 Section 152.45...-EXISTING CONDITION INSURANCE PLAN PROGRAM Transition to Exchanges § 152.45 Transition to the exchanges... the Exchanges, established under sections 1311 or 1321 of the Affordable Care Act, to ensure that...

Discrimination accuracy between real and sham press needles in the hands.

PubMed

Kim, Sungha; Lee, Sanghun; Choi, Sunmi; Park, Jeonghwan; Kim, Sungchul

2015-08-01

To evaluate the blinding effectiveness of a modified blunt sham press needle on the basis of the ability of subjects to discriminate between real and sham acupuncture needles compared with their discrimination ability based on pure guessing, and to define differences between senses (touch and vision) in the rates of correctly identified needles. Sixty-three healthy students and staff members were recruited through convenience sampling. First, real or sham acupuncture was randomly administered to the left LI4 point while subjects could not observe the needle tip. A real or sham needle tip was then shown to the subjects. Finally, a random combination of real or sham acupuncture needles were randomly administered to the left and right LI4 points, this time with the subjects observing the procedure. In all conditions the subjects gave their judgement as Yes or No in response to questions asking them to identify the needle type. The proportion of correct judgements (P(C)) was computed for the last part of the trial in left and right LI4 points, and the rates of correctly identified needles for each trial were obtained. The subjects' accuracy of discrimination between the real and sham acupuncture needles in left and right LI4 points was not significantly different from that based on pure guess (P(C)=0.50 (chance level)), which indicates complete inability to discriminate between needles. The rates of correctly identified needles using touch, vision and a combination of both senses were not significantly different (p=0.807). The findings from this study show that this sham acupuncture device successfully blinded subjects to real and sham press needles, suggesting that it is effective for subject blinding in studies on acupuncture using press needles, and facilitating evaluation of the effects of acupuncture in placebo-controlled trials using a rigorous scientific research methodology. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

[Transplant cross-over, an attractive option].

PubMed

Maddalena, Emanuela

2013-01-01

Kidney transplant from living donors is an excellent option for patients with end- stage renal disease: around the world approximately 10-20% of patients on waiting lists have intended living donors incompatible by blood type or for the presence of donor-specific antibodies. Current strategies to overcome these barriers are desensitization protocols and the recent option of the kidney exchange programs. In this work we describe the types of donor exchange programs, from the two-way Kidney Paired Donation, where two incompatible donor-recipient couples exchange donors, to complex chains of transplants where the altruistic donation of a kidney (Living Non-direct Donor, or non-specific donation) is associated to a Kidney Paired Exchange Program (Domino Kidney Paired Donation, NEAD chains). The thesis also discusses some related ethical topics that have become international matters of debate, as well as some important cultural and social arguments for and against the application of kidney exchanges in Italy.

17 CFR 240.3a12-9 - Exemption of certain direct participation program securities from the arranging provisions of...

Code of Federal Regulations, 2010 CFR

2010-04-01

... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Exemption of certain direct participation program securities from the arranging provisions of sections 7(c) and 11(d)(1). 240.3a12-9 Section 240.3a12-9 Commodity and Securities Exchanges SECURITIES AND EXCHANGE COMMISSION (CONTINUED) GENERAL...