Sample records for observational single-center study
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Mantke, Rene; Diener, Markus; Kropf, Siegfried; Otto, Ronny; Manger, Thomas; Vestweber, Boris; Mirow, Lutz; Winde, Günther; Lippert, Hans
2016-09-07
Increasing experience with minimally invasive surgery and the development of new instruments has resulted in a tendency toward reducing the number of abdominal skin incisions. Retrospective and randomized prospective studies could show the feasibility of single-incision surgery without any increased risk to the patient. However, large prospective multicenter observational datasets do not currently exist. This prospective multicenter observational quality study will provide a relevant dataset reflecting the feasibility and safety of single-incision surgery. This study focuses on external validity, clinical relevance, and the patients' perspective. Accordingly, the single-incision multiport/single port laparoscopic abdominal surgery (SILAP) study will supplement the existing evidence, which does not currently allow evidence-based surgical decision making. The SILAP study is an international prospective multicenter observational quality study. Mortality, morbidity, complications during surgery, complications postoperatively, patient characteristics, and technical aspects will be monitored. We expect more than 100 surgical centers to participate with 5000 patients with abdominal single-incision surgery during the study period. Funding was obtained in 2012. Enrollment began on January 01, 2013, and will be completed on December 31, 2018. As of January 2016, 2119 patients have been included, 106 German centers are registered, and 27 centers are very active (>5 patients per year). This prospective multicenter observational quality study will provide a relevant dataset reflecting the feasibility and safety of single-incision surgery. An international enlargement and recruitment of centers outside of Germany is meaningful. German Clinical Trials Register: DRKS00004594; https://drks-neu.uniklinik-freiburg.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00004594 (Archived by WebCite at http://www.webcitation.org/6jK6ZVyUs).
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Kotze, Paulo Gustavo; Abou-Rejaile, Vinícius Rezende; Uiema, Luciana Aparecida; Olandoski, Marcia; Sartor, Maria Cristina; Miranda, Eron Fábio; Kotze, Lorete Maria da Silva; Saad-Hossne, Rogério
2014-01-01
Adalimumab is a fully-human antibody that inhibits TNF alpha, with a significant efficacy for long-term maintenance of remission. Studies with this agent in Latin American Crohn's disease patients are scarce. The objective of this study was to outline clinical remission rates after 12 months of adalimumab therapy for Crohn's disease patients. Retrospective, single-center, observational study of a Brazilian case series of Crohn's disease patients under adalimumab therapy. Variables analyzed: demographic data, Montreal classification, concomitant medication, remission rates after 1, 4, 6 and 12 months. Remission was defined as Harvey-Bradshaw Index ≤ 4, and non-responder-imputation and last-observation-carried-forward analysis were used. The influence of infliximab on remission rates was analyzed by Fischer and Chi-square tests (P<0.05). Fifty patients, with median age of 35 years at therapy initiation, were included. Remission rates after 12 months of therapy were 54% under non-responder-imputation and 88% under last-observation-carried-forward analysis. After 12 months, remission on patients with previous infliximab occurred in 69.23% as compared to 94.59% in infliximab-naïve patients (P = 0.033). Adalimumab was effective in maintaining clinical remission after 12 months of therapy, with an adequate safety profile, and was also more effective in infliximab naïve patients.
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Baltà Cruz, S; Moreno Ribera, N; Estrach Panella, M T
Although Mercromina Film and other topical antiseptics are widely used, they are not included in the standard series recommended by the Spanish Contact Dermatitis and Skin Allergy Research Group for testing suspected allergic contact dermatitis (ACD). Furthermore, no recent studies have investigated the allergenic potential of merbromin. To determine the allergenic potential of merbromin and compare it with that of other topical antiseptics widely used in clinical practice, including povidone-iodine, chlorhexidine, and eosin. Prospective single-center observational safety study of 105 patients with suspected ACD seen at the dermatology department of our hospital. Of the 105 patients studied, 1.9% had a positive patch test to merbromin and 12.4% were sensitized to povidone-iodine. The differences in the proportion of patients with ACD to Betadine Solución Dérmica (povidone-iodine) compared with the rest of the antiseptics was statistically significant (McNemar test, P<.05). No adverse reactions were observed in any of the patients. Based on the patch tests conducted, Mercromina Film has very low allergenic potential. The highest allergenic potential was observed for povidone-iodine. Copyright © 2017 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.
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NASA Astrophysics Data System (ADS)
Caliskan, Betul; Caliskan, Ali Cengiz; Er, Emine
2017-09-01
Succinic anhydride single crystals were exposed to 60Co-gamma irradiation at room temperature. The irradiated single crystals were investigated at 125 K by Electron Paramagnetic Resonance (EPR) Spectroscopy. The investigation of EPR spectra of irradiated single crystals of succinic anhydride showed the presence of two succinic anhydride anion radicals. The anion radicals observed in gamma-irradiated succinic anhydride single crystal were created by the scission of the carbon-oxygen double bond. The structure of EPR spectra demonstrated that the hyperfine splittings arise from the same radical species. The reduction of succinic anhydride was identified which is formed by the addition of an electron to oxygen of the Csbnd O bond. The g values, the hyperfine structure constants and direction cosines of the radiation damage centers observed in succinic anhydride single crystal were obtained.
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Cai, Guilan; Wang, Yini; Liu, Xiaojing; Han, Yanfei; Wang, Zhao
2017-08-01
Hemophagocytic lymphohistiocytosis (HLH) is a rare multisystem disorder characterized by proliferation and diffuse infiltration multiple organs with histiocytes, including the central nervous system (CNS). Neurological manifestations of HLH have been recognized in different studies with children, but they remain relatively ill-defined in adults with HLH. From March 2008 to October 2014, 289 adult patients with HLH were admitted to our center. Clinical, radiological, and cerebral spinal fluid (CSF) data of the patients with CNS involvement were reviewed, and a retrospective study in our single-center was carried out. CNS involvement was observed in 29 patients (10%) either in their diagnosis process or during disease course. CNS symptoms included disturbance of consciousness, cranial nerve palsies, seizures, headache, limb paralysis, irritability, meningism, and memory loss. CSF analysis was conducted in 17 patients (59%). Among them, 11 patients (65%) were reported as having abnormal CSF. Neuroradiological studies were performed in 25 patients (86%). Among the 13 cases that underwent CT scan, one patient hemorrhaged. Single or multiple hypodense foci were detected in the other 2 patients. Magnetic resonance imaging (MRI) abnormalities were found in 15 patients, including focal lesions in cortical and adjacent subcortical regions with or without variable nodular or ring contrast-enhancement, multiple lesions in white matter, diffuse white matter signal changes, and meningeal enhancement. Basal ganglia, cerebellum, and brainstem lesions were also observed. CNS involvement could also be found in adult patients with HLH, but not as frequent as it was in children. The clinical manifestations could be diversified. By carrying out rigorous CNS examinations, an early diagnosis could be made and it was of the utmost importance for the prevention of further lesions.
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Zhang, Xintong; Qi, Xingshun; De Stefano, Valerio; Hou, Feifei; Ning, Zheng; Zhao, Jiancheng; Peng, Ying; Li, Jing; Deng, Han; Li, Hongyu; Guo, Xiaozhong
2016-01-01
Background Risk of venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), may be increased in liver cirrhosis. We conducted a single-center study to explore the epidemiology, risk factors, and in-hospital mortality of VTE in Chinese patients with liver cirrhosis. Material/Methods All patients with liver cirrhosis who were consecutively admitted to our hospital between January 2011 and December 2013 were retrospectively included. Results Of 2006 patients with liver cirrhosis included, 9 patients were diagnosed with or developed VTE during hospitalization, including 5 patients with a previous history of DVT, 1 patient with either a previous history of DVT or new onset of PE, and 3 patients with new onset of VTE (PE, n=1; DVT, n=2). Risk factors for VTE included a significantly higher proportion of hypertension and significantly higher red blood cells, hemoglobin, alanine aminotransferase, aspartate aminotransferase, prothrombin time (PT), international normalized ratio (INR), D-dimer, and Child-Pugh scores. The in-hospital mortality was significantly higher in patients with VTE than those without VTE (33.3% [3/9] versus 3.4% [67/1997], P<0.001). Conclusions VTE was observed in 0.4% of patients with liver cirrhosis during hospitalization and it significantly increased the in-hospital mortality. Elevated PT/INR aggravated the risk of VTE. PMID:27009380
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Bahro, Abdul; Igyarto, Zsuzsanna; Martinsen, Brad
2017-03-01
Critical hand ischemia (CHI) can be devastating and may result in amputation. Distal vessel calcification has been shown to be a major factor in causing CHI. Atherectomy in the upper extremities is not typically considered due to the small anatomy; however, the Diamondback 360° Peripheral Orbital Atherectomy System (OAS) (Cardiovascular Systems, Inc.) can access treatment areas with a reference vessel diameter of 1.5mm. A retrospective, observational, single center (Merit Health Center, Jackson, MS) analysis of 11 CHI patients with calcific disease of the radial artery treated with orbital atherectomy (OAS) was completed. Demographics and procedural to 30-day outcomes were assessed. All patients had good blood flow to the hand after intervention and none experienced complications during or immediately post-procedure. At 30-days the freedom from revascularization and amputation was 100%, and all the wounds were healed. The following important principles were followed during the use of OAS for CHI: (1) ACT was therapeutic (~250s); (2) Gentle wire manipulation; (3) Utilization of a small OAS crown (1.25mm); (4) Aggressive vasodilator use-given through the exchange catheter; (5) Angioplasty balloon was matched to the size of the vessel and long and low pressure inflations were completed. Critical hand ischemia can be treated with endovascular techniques. Obtaining good outflow to the fingers is critical for wound healing and preventing amputation. Orbital atherectomy is a useful tool in preparing vessels for balloon angioplasty; particularly in cases where calcification is present. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.
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Dynamics of Single-Photon Emission from Electrically Pumped Color Centers
NASA Astrophysics Data System (ADS)
Khramtsov, Igor A.; Agio, Mario; Fedyanin, Dmitry Yu.
2017-08-01
Low-power, high-speed, and bright electrically driven true single-photon sources, which are able to operate at room temperature, are vital for the practical realization of quantum-communication networks and optical quantum computations. Color centers in semiconductors are currently the best candidates; however, in spite of their intensive study in the past decade, the behavior of color centers in electrically controlled systems is poorly understood. Here we present a physical model and establish a theoretical approach to address single-photon emission dynamics of electrically pumped color centers, which interprets experimental results. We support our analysis with self-consistent numerical simulations of a single-photon emitting diode based on a single nitrogen-vacancy center in diamond and predict the second-order autocorrelation function and other emission characteristics. Our theoretical findings demonstrate remarkable agreement with the experimental results and pave the way to the understanding of single-electron and single-photon processes in semiconductors.
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Restless Leg Syndrome in Different Types of Demyelinating Neuropathies: A Single-Center Pilot Study
Luigetti, Marco; Del Grande, Alessandra; Testani, Elisa; Bisogni, Giulia; Losurdo, Anna; Giannantoni, Nadia Mariagrazia; Mazza, Salvatore; Sabatelli, Mario; Della Marca, Giacomo
2013-01-01
Objective: to determine the prevalence of restless legs syndrome (RLS) in a cohort of patients with demyelinating neuropathies. Methods: Patients were retrospectively recruited from our cohort of different forms of demyelinating neuropathies, including chronic inflammatory demyelinating neuropathy (CIDP), Charcot-Marie-Tooth 1A (CMT1A), and hereditary neuropathy with liability to pressure palsies (HNPP) referred to our Department of Neurology in a 10-year period. The validated 4-item RLS questionnaire was used for diagnosis of RLS. All patients with RLS who fulfilled criteria underwent a suggested immobilization test to confirm the diagnosis. A group of outpatients referred to the sleep disorders unit and data from published literature were used as controls. Results: Prevalence of RLS in demyelinating neuropathy group was higher than prevalence observed in control population (p = 0.0142) or in the literature data (p = 0.0007). In particular, in comparison with both control population and literature data, prevalence of RLS was higher in CIDP group (p = 0.0266 and p = 0.0063, respectively) and in CMT1A group (p = 0.0312 and p = 0.0105, respectively), but not in HNPP (p = 1.000 and p = 0.9320, respectively). Conclusions: our study confirms a high prevalence of RLS in inflammatory neuropathies as CIDP and, among inherited neuropathies, in CMT1A but not in HNPP. Considering that this is only a small cohort from a single-center retrospective experience, the link between RLS and neuropathy remains uncertain, and larger multicenter studies are probably needed to clarify the real meaning of the association between RLS and neuropathy. Citation: Luigetti M; Del Grande A; Testani E; Bisogni G; Losurdo A; Giannantoni NM; Mazza S; Sabatelli M; Della Marca G. Restless leg syndrome in different types of demyelinating neuropathies: a single-center pilot study. J Clin Sleep Med 2013;9(9):945-949. PMID:23997707
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Coherent control of a single nitrogen-vacancy center spin in optically levitated nanodiamond
Pettit, Robert M.; Neukirch, Levi Patrick; Zhang, Yi; ...
2017-05-12
Here, we report the first observation, to the best of our knowledge, of electron spin transients in single negatively charged nitrogen-vacancy (NV -) centers, contained within optically trapped nanodiamonds, in both atmospheric pressure and low vacuum. It is shown that, after an initial exposure to low vacuum, the trapped nanodiamonds remain at temperatures near room temperature even in low vacuum. Furthermore, the transverse coherence time of the NV - center spin, measured to be T 2=101.4 ns, is robust over the range of trapping powers considered in this study.
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Agarwal, Jatin; Jain, Pradeep; Chandra, Anil
2015-01-01
Background The ability of an endodontic instrument to remain centered in the root canal system is one of the most important characteristic influencing the clinical performance of a particular file system. Thus, it is important to assess the canal centering ability of newly introduced single file systems before they can be considered a viable replacement of full-sequence rotary file systems. Aim The aim of the study was to compare the canal transportation, centering ability, and time taken for preparation of curved root canals after instrumentation with single file systems One Shape and Wave One, using cone-beam computed tomography (CBCT). Materials and Methods Sixty mesiobuccal canals of mandibular molars with an angle of curvature ranging from 20o to 35o were divided into three groups of 20 samples each: ProTaper PT (group I) – full-sequence rotary control group, OneShape OS (group II)- single file continuous rotation, WaveOne WO – single file reciprocal motion (group III). Pre instrumentation and post instrumentation three-dimensional CBCT images were obtained from root cross-sections at 3mm, 6mm and 9mm from the apex. Scanned images were then accessed to determine canal transportation and centering ability. The data collected were evaluated using one-way analysis of variance (ANOVA) with Tukey’s honestly significant difference test. Results It was observed that there were no differences in the magnitude of transportation between the rotary instruments (p >0.05) at both 3mm as well as 6mm from the apex. At 9 mm from the apex, Group I PT showed significantly higher mean canal transportation and lower centering ability (0.19±0.08 and 0.39±0.16), as compared to Group II OS (0.12±0.07 and 0.54±0.24) and Group III WO (0.13±0.06 and 0.55±0.18) while the differences between OS and WO were not statistically significant Conclusion It was concluded that there was minor difference between the tested groups. Single file systems demonstrated average canal
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Agarwal, Rolly S; Agarwal, Jatin; Jain, Pradeep; Chandra, Anil
2015-05-01
The ability of an endodontic instrument to remain centered in the root canal system is one of the most important characteristic influencing the clinical performance of a particular file system. Thus, it is important to assess the canal centering ability of newly introduced single file systems before they can be considered a viable replacement of full-sequence rotary file systems. The aim of the study was to compare the canal transportation, centering ability, and time taken for preparation of curved root canals after instrumentation with single file systems One Shape and Wave One, using cone-beam computed tomography (CBCT). Sixty mesiobuccal canals of mandibular molars with an angle of curvature ranging from 20(o) to 35(o) were divided into three groups of 20 samples each: ProTaper PT (group I) - full-sequence rotary control group, OneShape OS (group II)- single file continuous rotation, WaveOne WO - single file reciprocal motion (group III). Pre instrumentation and post instrumentation three-dimensional CBCT images were obtained from root cross-sections at 3mm, 6mm and 9mm from the apex. Scanned images were then accessed to determine canal transportation and centering ability. The data collected were evaluated using one-way analysis of variance (ANOVA) with Tukey's honestly significant difference test. It was observed that there were no differences in the magnitude of transportation between the rotary instruments (p >0.05) at both 3mm as well as 6mm from the apex. At 9 mm from the apex, Group I PT showed significantly higher mean canal transportation and lower centering ability (0.19±0.08 and 0.39±0.16), as compared to Group II OS (0.12±0.07 and 0.54±0.24) and Group III WO (0.13±0.06 and 0.55±0.18) while the differences between OS and WO were not statistically significant. It was concluded that there was minor difference between the tested groups. Single file systems demonstrated average canal transportation and centering ability comparable to full sequence
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Employment after lung transplantation--a single-center cross-sectional study.
Suhling, Hendrik; Knuth, Christine; Haverich, Axel; Lingner, Heidrun; Welte, Tobias; Gottlieb, Jens
2015-03-27
359 lung transplantations were performed in Germany in 2013. The main goals of lung transplantation are to prolong survival and improve the quality of life. Both of these goals can be reflected in a return to employment. We report the first study of employment after lung transplantation in Germany. We evaluated the findings of a single-center, questionnaire-based cross-sectional investigation of the social and economic situation of 531 patients (September 2009 to March 2010) and obtained 5-year follow-up data in December 2014. 38% of the patients were employed after lung transplantation. They took a mean of ten sick days off from work each year; they did not have infections or organ rejection any more frequently than other patients. The fiveyear follow-up data showed no difference in the overall survival rate of employed and unemployed patients. Employment was associated with a better quality of life (80% [interquartiles: 70%, 95%]) versus 75% [interquartiles: 50%, 85%], p = 0.001). Factors associated with a return to employment included a higher educational level (odds ratio [OR] 2.6, 95%confidence interval [CI] 1.7-4, p = 0.001) and better physical fitness (OR 2, 95%CI 1.3-3.2, p = 0.001). The rate of return to work after lung transplantation in Germany is similar to the rates observed in other countries. The findings of this study imply that employment improves the quality of life and does not endanger health. Thus, patients who have received lung transplants should be advised to return to work if possible.
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Vasopressor use following traumatic injury - A single center retrospective study.
Hylands, Mathieu; Godbout, Marie-Pier; Mayer, Sandeep K; Fraser, William D; Vanasse, Alain; Leclair, Marc-André; Turgeon, Alexis F; Lauzier, François; Charbonney, Emmanuel; Trottier, Vincent; Razek, Tarek S; Roy, André; D'Aragon, Frédérick; Belley-Côté, Emilie; Day, Andrew G; Le Guillan, Soazig; Sabbagh, Robert; Lamontagne, François
2017-01-01
Vasopressors are not recommended by current trauma guidelines, but recent reports indicate that they are commonly used. We aimed to describe the early hemodynamic management of trauma patients outside densely populated urban centers. We conducted a single-center retrospective cohort study in a Canadian regional trauma center. All adult patients treated for traumatic injury in 2013 who died within 24 hours of admission or were transferred to the intensive care unit were included. A systolic blood pressure <90 mmHg, a mean arterial pressure <60 mmHg, the use of vasopressors or ≥2 L of intravenous fluids defined hemodynamic instability. Main outcome measures were use of intravenous fluids and vasopressors prior to surgical or endovascular management. Of 111 eligible patients, 63 met our criteria for hemodynamic instability. Of these, 60 (95%) had sustained blunt injury and 22 (35%) had concomitant severe traumatic brain injury. The subgroup of patients referred from a primary or secondary hospital (20 of 63, 32%) had significantly longer transport times (243 vs. 61 min, p<0.01). Vasopressors, used in 26 patients (41%), were independently associated with severe traumatic brain injury (odds ratio 10.2, 95% CI 2.7-38.5). In this cohort, most trauma patients had suffered multiple blunt injuries. Patients were likely to receive vasopressors during the early phase of trauma care, particularly if they exhibited signs of neurologic injury. While these results may be context-specific, determining the risk-benefit trade-offs of fluid resuscitation, vasopressors and permissive hypotension in specific patients subgroups constitutes a priority for trauma research going forwards.
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Wagner, Mathilde; Corcuera-Solano, Idoia; Lo, Grace; Esses, Steven; Liao, Joseph; Besa, Cecilia; Chen, Nelson; Abraham, Ginu; Fung, Maggie; Babb, James S; Ehman, Richard L; Taouli, Bachir
2017-08-01
Purpose To assess the determinants of technical failure of magnetic resonance (MR) elastography of the liver in a large single-center study. Materials and Methods This retrospective study was approved by the institutional review board. Seven hundred eighty-one MR elastography examinations performed in 691 consecutive patients (mean age, 58 years; male patients, 434 [62.8%]) in a single center between June 2013 and August 2014 were retrospectively evaluated. MR elastography was performed at 3.0 T (n = 443) or 1.5 T (n = 338) by using a gradient-recalled-echo pulse sequence. MR elastography and anatomic image analysis were performed by two observers. Additional observers measured liver T2* and fat fraction. Technical failure was defined as no pixel value with a confidence index higher than 95% and/or no apparent shear waves imaged. Logistic regression analysis was performed to assess potential predictive factors of technical failure of MR elastography. Results The technical failure rate of MR elastography at 1.5 T was 3.5% (12 of 338), while it was higher, 15.3% (68 of 443), at 3.0 T. On the basis of univariate analysis, body mass index, liver iron deposition, massive ascites, use of 3.0 T, presence of cirrhosis, and alcoholic liver disease were all significantly associated with failure of MR elastography (P < .004); but on the basis of multivariable analysis, only body mass index, liver iron deposition, massive ascites, and use of 3.0 T were significantly associated with failure of MR elastography (P < .004). Conclusion The technical failure rate of MR elastography with a gradient-recalled-echo pulse sequence was low at 1.5 T but substantially higher at 3.0 T. Massive ascites, iron deposition, and high body mass index were additional independent factors associated with failure of MR elastography of the liver with a two-dimensional gradient-recalled-echo pulse sequence. © RSNA, 2017.
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Single-center experience in double kidney transplantation.
Fontana, I; Magoni Rossi, A; Gasloli, G; Santori, G; Giannone, A; Bertocchi, M; Piaggio, F; Bocci, E; Valente, Umberto
2010-05-01
Use of organs from marginal donors for transplantation is a current strategy to expand the organ donor pool. Its efficacy is universally accepted among data from multicenter studies. Herein, we have reviewed outcomes of double kidney transplantation (DKT) over an 9-year experience in our center. The aim of this study was to evaluate possible important differences between a monocenter versus multicenter studies. Between 1999 and 2008, we performed 59 DKT. Recipient mean age was 63 +/- 5 years. Mean HLA-A, -B, and -DR mismatches were 3.69 +/- 0.922. Donor mean age was 69 +/- 7 years and mean creatinine clearance was 69.8 +/- 30.8 mL/min. Proteinuria was detected in three donors (5%). Mean cold ischemia and warm ischemia times were 1130 +/- 216 and 48 +/- 11 minutes, respectively. The right and left kidney scores were 4.18 +/- 2 and 4.21 +/- 2, respectively. Thirty patients (51%) displayed good postoperative renal function; 22 (37%), acute tubular necrosis with postoperative dialysis; 3 (5%), acute rejection episodes; 4 (7%), single-graft transplantectomy due to vascular thrombosis; 1 (2%), a retransplantation; 5 (8%), a lymphocele; 3 (5%) vescicoureteral reflux or stenosis requiring surgical correction. Cytomegalovirus infection was detected in five patients (8%). In three patients (5%) displayed de novo neoplasia. Three patients showed chronic rejection (5%), whereas we observed a cyclosporine-related toxicity in 7 (12%). Nine patients (15%) developed iatrogenic diabetes. Patient and graft survivals after 3 years from DKT were 93% and 86.3%, respectively. In this study, we applied successfully a widespread score to allocate organs to single kidney transplantation or DKT. In our experience, the score is suitable for the organ allocation but it may be overprotective, excluding potentially suitable organs for a single transplantation. Copyright (c) 2010 Elsevier Inc. All rights reserved.
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Jamshaid, Anila; Ather, M Hammad; Hussain, Ghazi; Khawaja, Karim B
2008-11-01
This study compared the efficacy and safety profile of electrohydraulic (EH) and electromagnetic (EM) lithotriptors in the treatment of 10- to 20-mm renal and proximal ureteric stones at a single center and by a single operator. Between January 2001 and December 2006, we sequentially treated patients meeting study inclusion criteria with MPL 9000 Dornier EH for the first 3 years, followed by the EM Siemens Modularis shockwave lithotripsy (SWL) unit. A single operator performed all SWL treatments under the supervision of an admitting urologist. We analyzed the demographic features and stone- and treatment-related parameters including complications for both groups. In each group, the stone-free rate and efficiency quotient was determined at 1-3 months. Of 274 patients, we sequentially treated 112 using the EH lithotriptor, and 162 the EM lithotriptor. The pre-SWL patients and stone-related parameters were similar in the two groups, except for diagnostic imaging modalities. The mean number of SWL sessions, need for ancillary procedure, retreatment rate, stone location, stone-free rate, and efficiency quotient were not significantly different between groups. The mean number of shockwaves required for complete fragmentation was 2977 and 6044 (P < .000) for the EH and EM groups, respectively. Single center, single operator experience with two types of lithotriptor indicated that both are equally efficacious, with similar safety profiles. The only significant difference was that the EH lithotriptor required fewer shockwaves for fragmentation.
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Public School Center vs. Family Home Day Care: Single Parents' Reasons for Selection.
ERIC Educational Resources Information Center
Rothschild, Maria Stupp
This study investigates the reasons single parents in San Diego had for choosing either a public day care center or a licensed day care home for their children. A sample of 30 single parents with children in school district administered children's centers was drawn and matched by a similarly geographically distributed sample of 23 parents with…
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Campylobacter bacteremia in London: A 44-year single-center study.
O'Hara, Geraldine A; Fitchett, Joseph R A; Klein, John L
2017-09-01
Campylobacter species are a well-recognized but rare cause of bloodstream infection. Here we reviewed 41 cases of Campylobacter bloodstream infection occurring at a single center in London over 44years, comprising 0.2% of all recorded episodes during this time period. Patients had a mean age of 46years and, contrasting with previous reports, nearly 50% of our patients did not have significant comorbidities. Ciprofloxacin resistance increased over the study period with 35% of isolates overall being resistant compared with only 3% exhibiting macrolide resistance. Despite a minority of patients receiving appropriate empirical antibiotic therapy, overall mortality was only 7%. Campylobacter bacteremia remains a rare but significant cause of morbidity with a low associated mortality. Underlying immunosuppressive conditions are common but by no means universal. In our setting, macrolides would be favored as empirical agents to treat suspected Campylobacter enteritis, including cases with associated bacteremia. Copyright © 2017 Elsevier Inc. All rights reserved.
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Raj, Ravi; Puri, Goverdhan Dutt; Jayant, Aveek; Thingnam, Shyam Kumar Singh; Singh, Rana Sandip; Rohit, Manoj Kumar
2016-11-01
Right ventricular (RV) function alterations are invariably present in all patients after tetralogy of Fallot (TOF) repair. Unlike the developed world where most of the patients with TOF are corrected in infancy, average age of presentation and thus surgery for these patients in the developing world may be higher. We aimed to study the correlation between RV function parameters such as tricuspid annular peak systolic excursion (TAPSE), fractional area change (FAC), and tricuspid annular peak systolic velocity (S') with early outcome variables after intracardiac repair for TOF. Fifty patients with a preoperative diagnosis of tetralogy of Fallot scheduled for corrective surgery were included in this single-center, prospective observational study. A preoperative transthoracic echocardiogram was performed to measure RV function parameters (FAC0, TAPSE0, S'0). Transthoracic echocardiography was repeated postoperatively to measure FAC1, TAPSE1, S'1 (day 1) and FAC2, TAPSE2, and S'2 (day 3). The relationship between preoperative and postoperative RV function parameters with in-hospital mortality, duration of mechanical ventilation, and intensive care unit stay was studied. The median age of patients was 6 years (range 1-14 years). Multiple stepwise logistic regression analysis showed RV FAC as best predictor of clinical outcome. Area under the receiver operating characteristic curve for postoperative RV function parameters, that is, FAC, TAPSE, and S' to predict early or delayed recovery was 0.944, 0.875, and 0.655, respectively. Among the RV function parameters studied, RV FAC best predicted the early outcome variables after TOF repair, followed by TAPSE while lateral tricuspid annular velocity S' being the least predictive. © 2016, Wiley Periodicals, Inc.
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Vasopressor use following traumatic injury – A single center retrospective study
Hylands, Mathieu; Godbout, Marie-Pier; Mayer, Sandeep K.; Fraser, William D.; Vanasse, Alain; Leclair, Marc-André; Turgeon, Alexis F.; Lauzier, François; Charbonney, Emmanuel; Trottier, Vincent; Razek, Tarek S.; Roy, André; D’Aragon, Frédérick; Belley-Côté, Emilie; Day, Andrew G.; Le Guillan, Soazig; Sabbagh, Robert
2017-01-01
Objectives Vasopressors are not recommended by current trauma guidelines, but recent reports indicate that they are commonly used. We aimed to describe the early hemodynamic management of trauma patients outside densely populated urban centers. Methods We conducted a single-center retrospective cohort study in a Canadian regional trauma center. All adult patients treated for traumatic injury in 2013 who died within 24 hours of admission or were transferred to the intensive care unit were included. A systolic blood pressure <90 mmHg, a mean arterial pressure <60 mmHg, the use of vasopressors or ≥2 L of intravenous fluids defined hemodynamic instability. Main outcome measures were use of intravenous fluids and vasopressors prior to surgical or endovascular management. Results Of 111 eligible patients, 63 met our criteria for hemodynamic instability. Of these, 60 (95%) had sustained blunt injury and 22 (35%) had concomitant severe traumatic brain injury. The subgroup of patients referred from a primary or secondary hospital (20 of 63, 32%) had significantly longer transport times (243 vs. 61 min, p<0.01). Vasopressors, used in 26 patients (41%), were independently associated with severe traumatic brain injury (odds ratio 10.2, 95% CI 2.7–38.5). Conclusions In this cohort, most trauma patients had suffered multiple blunt injuries. Patients were likely to receive vasopressors during the early phase of trauma care, particularly if they exhibited signs of neurologic injury. While these results may be context-specific, determining the risk-benefit trade-offs of fluid resuscitation, vasopressors and permissive hypotension in specific patients subgroups constitutes a priority for trauma research going forwards. PMID:28448605
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Wu, Zhenggang; Gao, Y. F.; Bei, Hongbin
2015-07-25
To understand the fundamental deformation mechanisms of compositionally complex alloys, single crystals of a multi-component equiatomic FeNiCoCr alloy with face-centered cubic (FCC) structure were grown for mechanical studies. Similarly to typical FCC pure metals, slip trace analyses indicate that dislocation slips take place on (1 1 1) planes along [11¯0] directions. The critical resolved shear stress (CRSS) obeys the Schmid law at both 77 and 293 K, and tension–compression asymmetry is not observed. Although this material slips in a normal FCC manner both at 293 and 77 K, compared to typical FCC metals the CRSS’s strong temperature dependence is abnormal.
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Observation of s-channel production of single top quarks at the Tevatron.
Aaltonen, T; Abazov, V M; Abbott, B; Acharya, B S; Adams, M; Adams, T; Agnew, J P; Alexeev, G D; Alkhazov, G; Alton, A; Amerio, S; Amidei, D; Anastassov, A; Annovi, A; Antos, J; Apollinari, G; Appel, J A; Arisawa, T; Artikov, A; Asaadi, J; Ashmanskas, W; Askew, A; Atkins, S; Auerbach, B; Augsten, K; Aurisano, A; Avila, C; Azfar, F; Badaud, F; Badgett, W; Bae, T; Bagby, L; Baldin, B; Bandurin, D V; Banerjee, S; Barbaro-Galtieri, A; Barberis, E; Baringer, P; Barnes, V E; Barnett, B A; Barria, P; Bartlett, J F; Bartos, P; Bassler, U; Bauce, M; Bazterra, V; Bean, A; Bedeschi, F; Begalli, M; Behari, S; Bellantoni, L; Bellettini, G; Bellinger, J; Benjamin, D; Beretvas, A; Beri, S B; Bernardi, G; Bernhard, R; Bertram, I; Besançon, M; Beuselinck, R; Bhat, P C; Bhatia, S; Bhatnagar, V; Bhatti, A; Bland, K R; Blazey, G; Blessing, S; Bloom, K; Blumenfeld, B; Bocci, A; Bodek, A; Boehnlein, A; Boline, D; Boos, E E; Borissov, G; Bortoletto, D; Borysova, M; Boudreau, J; Boveia, A; Brandt, A; Brandt, O; Brigliadori, L; Brock, R; Bromberg, C; Bross, A; Brown, D; Brucken, E; Bu, X B; Budagov, J; Budd, H S; Buehler, M; Buescher, V; Bunichev, V; Burdin, S; Burkett, K; Busetto, G; Bussey, P; Buszello, C P; Butti, P; Buzatu, A; Calamba, A; Camacho-Pérez, E; Camarda, S; Campanelli, M; Canelli, F; Carls, B; Carlsmith, D; Carosi, R; Carrillo, S; Casal, B; Casarsa, M; Casey, B C K; Castilla-Valdez, H; Castro, A; Catastini, P; Caughron, S; Cauz, D; Cavaliere, V; Cavalli-Sforza, M; Cerri, A; Cerrito, L; Chakrabarti, S; Chan, K M; Chandra, A; Chapon, E; Chen, G; Chen, Y C; Chertok, M; Chiarelli, G; Chlachidze, G; Cho, K; Cho, S W; Choi, S; Chokheli, D; Choudhary, B; Cihangir, S; Claes, D; Clark, A; Clarke, C; Clutter, J; Convery, M E; Conway, J; Cooke, M; Cooper, W E; Corbo, M; Corcoran, M; Cordelli, M; Couderc, F; Cousinou, M-C; Cox, C A; Cox, D J; Cremonesi, M; Cruz, D; Cuevas, J; Culbertson, R; Cutts, D; Das, A; d'Ascenzo, N; Datta, M; Davies, G; de Barbaro, P; de Jong, S J; De La Cruz-Burelo, E; Déliot, F; Demina, R; Demortier, L; Deninno, M; Denisov, D; Denisov, S P; D'Errico, M; Desai, S; Deterre, C; DeVaughan, K; Devoto, F; Di Canto, A; Di Ruzza, B; Diehl, H T; Diesburg, M; Ding, P F; Dittmann, J R; Dominguez, A; Donati, S; D'Onofrio, M; Dorigo, M; Driutti, A; Dubey, A; Dudko, L V; Duperrin, A; Dutt, S; Eads, M; Ebina, K; Edgar, R; Edmunds, D; Elagin, A; Ellison, J; Elvira, V D; Enari, Y; Erbacher, R; Errede, S; Esham, B; Evans, H; Evdokimov, V N; Farrington, S; Feng, L; Ferbel, T; Fernández Ramos, J P; Fiedler, F; Field, R; Filthaut, F; Fisher, W; Fisk, H E; Flanagan, G; Forrest, R; Fortner, M; Fox, H; Franklin, M; Freeman, J C; Frisch, H; Fuess, S; Funakoshi, Y; Galloni, C; Garbincius, P H; Garcia-Bellido, A; García-González, J A; Garfinkel, A F; Garosi, P; Gavrilov, V; Geng, W; Gerber, C E; Gerberich, H; Gerchtein, E; Gershtein, Y; Giagu, S; Giakoumopoulou, V; Gibson, K; Ginsburg, C M; Ginther, G; Giokaris, N; Giromini, P; Giurgiu, G; Glagolev, V; Glenzinski, D; Gold, M; Goldin, D; Golossanov, A; Golovanov, G; Gomez, G; Gomez-Ceballos, G; Goncharov, M; González López, O; Gorelov, I; Goshaw, A T; Goulianos, K; Gramellini, E; Grannis, P D; Greder, S; Greenlee, H; Grenier, G; Grinstein, S; Gris, Ph; Grivaz, J-F; Grohsjean, A; Grosso-Pilcher, C; Group, R C; Grünendahl, S; Grünewald, M W; Guillemin, T; Guimaraes da Costa, J; Gutierrez, G; Gutierrez, P; Hahn, S R; Haley, J; Han, J Y; Han, L; Happacher, F; Hara, K; Harder, K; Hare, M; Harel, A; Harr, R F; Harrington-Taber, T; Hatakeyama, K; Hauptman, J M; Hays, C; Hays, J; Head, T; Hebbeker, T; Hedin, D; Hegab, H; Heinrich, J; Heinson, A P; Heintz, U; Hensel, C; Heredia-De La Cruz, I; Herndon, M; Herner, K; Hesketh, G; Hildreth, M D; Hirosky, R; Hoang, T; Hobbs, J D; Hocker, A; Hoeneisen, B; Hogan, J; Hohlfeld, M; Holzbauer, J L; Hong, Z; Hopkins, W; Hou, S; Howley, I; Hubacek, Z; Hughes, R E; Husemann, U; Hussein, M; Huston, J; Hynek, V; Iashvili, I; Ilchenko, Y; Illingworth, R; Introzzi, G; Iori, M; Ito, A S; Ivanov, A; Jabeen, S; Jaffré, M; James, E; Jang, D; Jayasinghe, A; Jayatilaka, B; Jeon, E J; Jeong, M S; Jesik, R; Jiang, P; Jindariani, S; Johns, K; Johnson, E; Johnson, M; Jonckheere, A; Jones, M; Jonsson, P; Joo, K K; Joshi, J; Jun, S Y; Jung, A W; Junk, T R; Juste, A; Kajfasz, E; Kambeitz, M; Kamon, T; Karchin, P E; Karmanov, D; Kasmi, A; Kato, Y; Katsanos, I; Kehoe, R; Kermiche, S; Ketchum, W; Keung, J; Khalatyan, N; Khanov, A; Kharchilava, A; Kharzheev, Y N; Kilminster, B; Kim, D H; Kim, H S; Kim, J E; Kim, M J; Kim, S H; Kim, S B; Kim, Y J; Kim, Y K; Kimura, N; Kirby, M; Kiselevich, I; Knoepfel, K; Kohli, J M; Kondo, K; Kong, D J; Konigsberg, J; Kotwal, A V; Kozelov, A V; Kraus, J; Kreps, M; Kroll, J; Kruse, M; Kuhr, T; Kumar, A; Kupco, A; Kurata, M; Kurča, T; Kuzmin, V A; Laasanen, A T; Lammel, S; Lammers, S; Lancaster, M; Lannon, K; Latino, G; Lebrun, P; Lee, H S; Lee, H S; Lee, J S; Lee, S W; Lee, W M; Lei, X; Lellouch, J; Leo, S; Leone, S; Lewis, J D; Li, D; Li, H; Li, L; Li, Q Z; Lim, J K; Limosani, A; Lincoln, D; Linnemann, J; Lipaev, V V; Lipeles, E; Lipton, R; Lister, A; Liu, H; Liu, H; Liu, Q; Liu, T; Liu, Y; Lobodenko, A; Lockwitz, S; Loginov, A; Lokajicek, M; Lopes de Sa, R; Lucchesi, D; Lucà, A; Lueck, J; Lujan, P; Lukens, P; Luna-Garcia, R; Lungu, G; Lyon, A L; Lys, J; Lysak, R; Maciel, A K A; Madar, R; Madrak, R; Maestro, P; Magaña-Villalba, R; Malik, S; Malik, S; Malyshev, V L; Manca, G; Manousakis-Katsikakis, A; Mansour, J; Marchese, L; Margaroli, F; Marino, P; Martínez-Ortega, J; Martínez, M; Matera, K; Mattson, M E; Mazzacane, A; Mazzanti, P; McCarthy, R; McGivern, C L; McNulty, R; Mehta, A; Mehtala, P; Meijer, M M; Melnitchouk, A; Menezes, D; Mercadante, P G; Merkin, M; Mesropian, C; Meyer, A; Meyer, J; Miao, T; Miconi, F; Mietlicki, D; Mitra, A; Miyake, H; Moed, S; Moggi, N; Mondal, N K; Moon, C S; Moore, R; Morello, M J; Mukherjee, A; Mulhearn, M; Muller, Th; Murat, P; Mussini, M; Nachtman, J; Nagai, Y; Naganoma, J; Nagy, E; Nakano, I; Napier, A; Narain, M; Nayyar, R; Neal, H A; Negret, J P; Nett, J; Neu, C; Neustroev, P; Nguyen, H T; Nigmanov, T; Nodulman, L; Noh, S Y; Norniella, O; Nunnemann, T; Oakes, L; Oh, S H; Oh, Y D; Oksuzian, I; Okusawa, T; Orava, R; Orduna, J; Ortolan, L; Osman, N; Osta, J; Pagliarone, C; Pal, A; Palencia, E; Palni, P; Papadimitriou, V; Parashar, N; Parihar, V; Park, S K; Parker, W; Partridge, R; Parua, N; Patwa, A; Pauletta, G; Paulini, M; Paus, C; Penning, B; Perfilov, M; Peters, Y; Petridis, K; Petrillo, G; Pétroff, P; Phillips, T J; Piacentino, G; Pianori, E; Pilot, J; Pitts, K; Plager, C; Pleier, M-A; Podstavkov, V M; Pondrom, L; Popov, A V; Poprocki, S; Potamianos, K; Pranko, A; Prewitt, M; Price, D; Prokopenko, N; Prokoshin, F; Ptohos, F; Punzi, G; Qian, J; Quadt, A; Quinn, B; Ranjan, N; Ratoff, P N; Razumov, I; Redondo Fernández, I; Renton, P; Rescigno, M; Rimondi, F; Ripp-Baudot, I; Ristori, L; Rizatdinova, F; Robson, A; Rodriguez, T; Rolli, S; Rominsky, M; Ronzani, M; Roser, R; Rosner, J L; Ross, A; Royon, C; Rubinov, P; Ruchti, R; Ruffini, F; Ruiz, A; Russ, J; Rusu, V; Sajot, G; Sakumoto, W K; Sakurai, Y; Sánchez-Hernández, A; Sanders, M P; Santi, L; Santos, A S; Sato, K; Savage, G; Saveliev, V; Savoy-Navarro, A; Sawyer, L; Scanlon, T; Schamberger, R D; Scheglov, Y; Schellman, H; Schlabach, P; Schmidt, E E; Schwanenberger, C; Schwarz, T; Schwienhorst, R; Scodellaro, L; Scuri, F; Seidel, S; Seiya, Y; Sekaric, J; Semenov, A; Severini, H; Sforza, F; Shabalina, E; Shalhout, S Z; Shary, V; Shaw, S; Shchukin, A A; Shears, T; Shepard, P F; Shimojima, M; Shochet, M; Shreyber-Tecker, I; Simak, V; Simonenko, A; Skubic, P; Slattery, P; Sliwa, K; Smirnov, D; Smith, J R; Snider, F D; Snow, G R; Snow, J; Snyder, S; Söldner-Rembold, S; Song, H; Sonnenschein, L; Sorin, V; Soustruznik, K; St Denis, R; Stancari, M; Stark, J; Stentz, D; Stoyanova, D A; Strauss, M; Strologas, J; Sudo, Y; Sukhanov, A; Suslov, I; Suter, L; Svoisky, P; Takemasa, K; Takeuchi, Y; Tang, J; Tecchio, M; Teng, P K; Thom, J; Thomson, E; Thukral, V; Titov, M; Toback, D; Tokar, S; Tokmenin, V V; Tollefson, K; Tomura, T; Tonelli, D; Torre, S; Torretta, D; Totaro, P; Trovato, M; Tsai, Y-T; Tsybychev, D; Tuchming, B; Tully, C; Ukegawa, F; Uozumi, S; Uvarov, L; Uvarov, S; Uzunyan, S; Van Kooten, R; van Leeuwen, W M; Varelas, N; Varnes, E W; Vasilyev, I A; Vázquez, F; Velev, G; Vellidis, C; Verkheev, A Y; Vernieri, C; Vertogradov, L S; Verzocchi, M; Vesterinen, M; Vidal, M; Vilanova, D; Vilar, R; Vizán, J; Vogel, M; Vokac, P; Volpi, G; Wagner, P; Wahl, H D; Wallny, R; Wang, M H L S; Wang, S M; Warchol, J; Waters, D; Watts, G; Wayne, M; Weichert, J; Welty-Rieger, L; Wester, W C; Whiteson, D; Wicklund, A B; Wilbur, S; Williams, H H; Williams, M R J; Wilson, G W; Wilson, J S; Wilson, P; Winer, B L; Wittich, P; Wobisch, M; Wolbers, S; Wolfe, H; Wood, D R; Wright, T; Wu, X; Wu, Z; Wyatt, T R; Xie, Y; Yamada, R; Yamamoto, K; Yamato, D; Yang, S; Yang, T; Yang, U K; Yang, Y C; Yao, W-M; Yasuda, T; Yatsunenko, Y A; Ye, W; Ye, Z; Yeh, G P; Yi, K; Yin, H; Yip, K; Yoh, J; Yorita, K; Yoshida, T; Youn, S W; Yu, G B; Yu, I; Yu, J M; Zanetti, A M; Zeng, Y; Zennamo, J; Zhao, T G; Zhou, B; Zhou, C; Zhu, J; Zielinski, M; Zieminska, D; Zivkovic, L; Zucchelli, S
2014-06-13
We report the first observation of single-top-quark production in the s channel through the combination of the CDF and D0 measurements of the cross section in proton-antiproton collisions at a center-of-mass energy of 1.96 TeV. The data correspond to total integrated luminosities of up to 9.7 fb(-1) per experiment. The measured cross section is σ(s) = 1.29(-0.24)(+0.26) pb. The probability of observing a statistical fluctuation of the background to a cross section of the observed size or larger is 1.8 × 10(-10), corresponding to a significance of 6.3 standard deviations for the presence of an s-channel contribution to the production of single-top quarks.
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Liu, Winnie; Zahr, Roula Shraiky; McCartney, Shirley; Cetas, Justin S; Dogan, Aclan; Fleseriu, Maria
2018-06-23
Lactotroph adenomas (LA) are the most frequently encountered pituitary tumors. Although more frequently observed in women, LAs in men were recently included in a more aggressive category regardless of histological grading, by the WHO. We aimed to perform a rigorous retrospective review of a single center's pre-operative evaluation, patient characteristics and outcomes of male LAs patients requiring pituitary surgery. A retrospective review, over 11 years, of patients who underwent resection of a pituitary adenoma at a single center was conducted. Predictors of persistent disease in male LAs patients along with a comparison to predictors of silent corticotroph adenomas (SCAs) patients who also underwent surgery at the center was also conducted. Thirty-one male patients with LAs were identified. When compared to SCAs patients, LAs male patients were younger (41 vs. 50 years of age, p = 0.01). Men with LAs had more invasive tumors (75% vs. 44.7% p = 0.02). More LAs in men had residual tumor after surgery than patients with SCA (92.6% vs. 42.1%, p < 0.001). Male patients with LAs and patients with SCA had similar rates of requiring additional surgery (28.9% vs. 24.1%, p = NS) and radiation therapy (18.4% vs. 19.4%, p = NS). High rates of DA resistance, invasive tumors and postoperative residual disease in male patients with LA who required surgery are shown. Surgery improved optic chiasm compression, PRL level and central hypogonadism but, not surprisingly, failed to normalize other pituitary hormones and/or eliminate need for DA therapy.
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Baffelli, Renata; Notarangelo, Lucia D; Imberti, Luisa; Hershfield, Michael S; Serana, Federico; Santisteban, Ines; Bolda, Federica; Porta, Fulvio; Lanfranchi, Arnalda
2015-10-01
We carried out a retrospective analysis of 27 patients with Adenosine Deaminase (ADA) deficiency diagnosed in a single center from 1997 to the 2013, for evaluating whether data regarding types of disease-inducing mutations, biochemical and immunological features as well as clinical outcomes of patients treated with enzyme replacement or transplantation, were comparable to those obtained in multicenter studies. The ADA deficiency diagnosis was performed with biochemical, immunological and molecular techniques. Ten patients treated with hematopoietic stem cell transplantation and three in treatment with enzyme replacement were followed up in our center. Twenty-four different mutations were identified and five were not previously reported. Identical mutations were found among patients from the same Romani ethnic group or from the same geographical region. A more rapid recovery was observed in enzyme replacement treated patients in comparison with those transplanted that, however, showed a continuous and long-lasting improvement both in terms of immune and metabolic recovery. The data obtained in our single center are comparable with those that have been reported in multicenter surveys.
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Characterizing cardiac arrest in children undergoing cardiac surgery: A single-center study.
Gupta, Punkaj; Wilcox, Andrew; Noel, Tommy R; Gossett, Jeffrey M; Rockett, Stephanie R; Eble, Brian K; Rettiganti, Mallikarjuna
2017-02-01
To characterize cardiac arrest in children undergoing cardiac surgery using single-center data from the Society of Thoracic Surgeons and Pediatric Advanced Life Support Utstein-Style Guidelines. Patients aged 18 years or less having a cardiac arrest for 1 minute or more during the same hospital stay as heart operation qualified for inclusion (2002-2014). Patients having a cardiac arrest both before or after heart operation were included. Heart operations were classified on the basis of the first cardiovascular operation of each hospital admission (the index operation). The primary outcome was survival to hospital discharge. A total of 3437 children undergoing at least 1 heart operation were included. Overall rate of cardiac arrest among these patients was 4.5% (n = 154) with survival to hospital discharge of 84 patients (66.6%). Presurgery cardiac arrest was noted among 28 patients, with survival of 21 patients (75%). Among the 126 patients with postsurgery cardiac arrest, survival was noted among 84 patients (66.6%). Regardless of surgical case complexity, the median days between heart operation and cardiac arrest, duration of cardiac arrest, and survival after cardiac arrest were similar. The independent risk factors associated with improved chances of survival included shorter duration of cardiac arrest (odds ratio, 1.12; 95% confidence interval, 1.05-1.20; P = .01) and use of defibrillator (odds ratio, 4.51; 95% confidence interval, 1.08-18.87; P = .03). This single-center study demonstrates that characterizing cardiac arrest in children undergoing cardiac surgery using definitions from 2 societies helps to increase data granularity and understand the relationship between cardiac arrest and heart operation in a better way. Copyright © 2016 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.
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Observation of s -Channel Production of Single Top Quarks at the Tevatron
DOE Office of Scientific and Technical Information (OSTI.GOV)
Aaltonen, T.; Abazov, V. M.; Abbott, B.
2014-06-01
We report the first observation of single-top-quark production in the s channel through the combination of the CDF and D0 measurements of the cross section in proton-antiproton collisions at a center-of-mass energy of 1.96 TeV. The data correspond to total integrated luminosities of up to 9.7 fb-1 per experiment. The measured cross section ismore » $$\\sigma_s = 1.29^{+0.26}_{-0.24}$$ pb. The probability of observing a statistical fluctuation of the background to a cross section of the observed size or larger is $$1.8 \\times 10^{-10}$$, corresponding to a significance of 6.3 standard deviations for the presence of an s-channel contribution to the production of single-top quarks.« less
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Infection Rate after Cranial Neurosurgical Procedures: A Prospective Single-Center Study.
Strahm, Carol; Albrich, Werner C; Zdravkovic, Vilijam; Schöbi, Barbara; Hildebrandt, Gerhard; Schlegel, Matthias
2018-03-01
To determine infection rate (IR) and to identify modifiable risk factors (RF) in cranial neurosurgery in a neurosurgical department for tertiary referral as part of an infection control surveillance to reduce surgical site infections (SSI). A prospective SSI incidence cohort study from February 2013 to January 2014 was performed in a tertiary-care neurosurgical teaching hospital and referral center. All consecutive adults undergoing any cranial neurosurgical procedure were included. Data were collected by a trained member of the infection control staff during the twice-weekly visits of the hospitalized patients. Follow-up was 30 days (procedures without implant) and 1 year (procedures involving permanent implants). SSI was diagnosed according to criteria of CDC. A total of 317 patients undergoing 333 index procedures were included. The median age was 61 years (range, 17-91 years) and 46% were female. Survival in patients with completed follow-up was 76% (196/258). Overall, IR was 7.2% (24/333 index procedures); in 96% (23/24), a neurosurgical implant was involved. The IR of extraventricular drainage (EVD) was 12.5% (13.1/1000 EVD days). The main causative pathogens were Staphylococcus aureus followed by coagulase-negative staphylococci and Propionibacterium acnes. Independent RF for neurosurgical SSI were EVD as part of the index operation and body mass index >25 kg/m 2 . IR was in accordance with recent prospective single-center studies (reported IR between 1.6% and 9%). EVD placement was identified as the strongest modifiable RF for SSI in cranial neurosurgical procedures. The need for standard infection control procedures for the insertion and maintenance of EVDs to avoid their contamination is reinforced. Copyright © 2017 Elsevier Inc. All rights reserved.
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Hao, Yinglu; Li, Yanping; Liao, Derong; Yang, Ling; Liu, Fangyan
2017-03-01
Data comparing active atrial lead fixation with passive atrial lead fixation in Chinese patients with cardiovascular implantable electronic devices (CIEDs) for atrial pacing is limited. Our study evaluated the effectiveness of active fixation versus passive fixation of atrial leads by observing the lead performance parameters. This retrospective, long-term, single-center study included a cohort of Chinese patients who underwent CIED implantation at the Department of Cardiology of People's Hospital of Yuxi City, China, from 1 March 2010 to 1 March 2015. Efficacy was determined by comparing implantation time, threshold values, incidence of lead dislocation/failure, and lead-related complications between the two groups. Of the 1217 patients, active and passive atrial lead fixation were performed in 530 (mean age, 69.37 ± 11.44 years) and 497 (mean age, 68.33 ± 10.96 years). The active fixation group reported significantly lower mean atrial implantation times (P = .0001) and threshold values (P = .044) compared with the passive atrial lead fixation group. In addition, threshold values in the active atrial lead fixation group were stable throughout the observation period. No instances of myocardial perforation, cardiac tamponade, implantation failure, or electrode dislocation/re-fixation were reported in the active atrial lead fixation group. A favorable decrease in patient comfort parameters such as bed rest time (P = .027) and duration of hospital stay (P = .038) were also observed in the active lead fixation group. Active atrial lead fixation demonstrated greater stability, steady long-term thresholds and minimal lead-related complications compared to passive lead fixation in Chinese patients with CIEDs.
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Fu, Qiang; Zhang, Yu-meng; Barbagli, Guido; Zhang, Jiong; Xie, Hong; Sa, Ying-long; Jin, San-bao; Xu, Yue-min
2015-12-01
To report the clinical features of pelvic fracture urethral injury (PFUI) and assess the real effect of factors that are believed to have adverse effects on delayed urethroplasty. An observational descriptive study in a single urological center examined 376 male patients diagnosed with PFUI who underwent open urethroplasty from 2009 to 2013. Analyzed factors included patient age at the time of injury, etiology of PFUI, type of emergency treatment, concomitant injuries, length and position of stricture, type of urethroplasty and the outcome of surgery. Univariate and multivariate logistic regression analyses were applied, together with analytical statistic methods such as t test and Chi-square test. The overall success rate of delayed urethroplasty was 80.6 %. Early realignment was associated with reduced stricture length and had beneficial effect on delayed surgery. Concomitant rectum rupture, strictures longer than 1.6 cm and strictures closer than 3 cm to the bladder neck were indicators of poor outcome. Age, type of injury, urethral fistula and bladder rupture were not significant predicators of surgery outcome. Failed direct vision internal urethrotomy and urethroplasty had no significant influence on salvage operation. The outcome of posterior urethroplasty is affected by multiple factors. Early realignment has beneficial effect; while the length and position of stricture and its distance to bladder neck plays the key role, rectum rupture at the time of injury is also an indicator of poor outcome. The effect of other factors seems insignificant.
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Storr, Ashleigh; Venetis, Christos A; Cooke, Simon; Kilani, Suha; Ledger, William
2017-02-01
What is the inter-observer and intra-observer agreement between embryologists when selecting a single Day 5 embryo for transfer? The inter-observer and intra-observer agreement between embryologists when selecting a single Day 5 embryo for transfer was generally good, although not optimal, even among experienced embryologists. Previous research on the morphological assessment of early stage (two pronuclei to Day 3) embryos has shown varying levels of inter-observer and intra-observer agreement. However, single blastocyst transfer is now becoming increasingly popular and there are no published data that assess inter-observer and intra-observer agreement when selecting a single embryo for Day 5 transfer. This was a prospective study involving 10 embryologists working at five different IVF clinics within a single organization between July 2013 and November 2015. The top 10 embryologists were selected based on their yearly Quality Assurance Program scores for blastocyst grading and were asked to morphologically grade all Day 5 embryos and choose a single embryo for transfer in a survey of 100 cases using 2D images. A total of 1000 decisions were therefore assessed. For each case, Day 5 images were shown, followed by a Day 3 and Day 5 image of the same embryo. Subgroup analyses were also performed based on the following characteristics of embryologists: the level of clinical embryology experience in the laboratory; amount of research experience; number of days per week spent grading embryos. The agreement between these embryologists and the one that scored the embryos on the actual day of transfer was also evaluated. Inter-observer and intra-observer variability was assessed using the kappa coefficient to evaluate the extent of agreement. This study showed that all 10 embryologists agreed on the embryo chosen for transfer in 50 out of 100 cases. In 93 out of 100 cases, at least 6 out of the 10 embryologists agreed. The inter-observer and intra-observer agreement among
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The adaptive observer. [liapunov synthesis, single-input single-output, and reduced observers
NASA Technical Reports Server (NTRS)
Carroll, R. L.
1973-01-01
The simple generation of state from available measurements, for use in systems for which the criteria defining the acceptable state behavior mandates a control that is dependent upon unavailable measurement is described as an adaptive means for determining the state of a linear time invariant differential system having unknown parameters. A single input output adaptive observer and the reduced adaptive observer is developed. The basic ideas for both the adaptive observer and the nonadaptive observer are examined. A survey of the Liapunov synthesis technique is taken, and the technique is applied to adaptive algorithm for the adaptive observer.
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Wildemeersch, Davina; Bernaerts, Lisa; D'Hondt, Michiel; Hans, Guy
2018-05-31
Preoperative anxiety and depression are predominant risk factors for increased postoperative pain. Thoracic wall deformities in adolescents often cause low self-esteem, which contributes to psychological concerns. Several studies have suggested a relationship between preoperative mental health support and enhanced recovery after surgery. This study investigated the validity of screening questionnaires concerning psychological trait and state characteristics via a patient-specific online platform. Patients scheduled for elective pectus surgery between June 2017 and August 2017 were invited to participate in clinical interviews and online self-report questionnaires. All patients were recruited in the Anesthesiology Department, Antwerp University Hospital, Belgium. This single-center observational cohort study was performed in accordance with the ethical standards of the International Council for Harmonisation-Good Clinical Practice guidelines and the Declaration of Helsinki after obtaining study approval by the Institutional Review Board and Ethics Committee of the Antwerp University Hospital, Belgium (study identifier: 17/08/082). An online preoperative psychological inventory was performed using the Rosenberg Self-Esteem Scale, Hospital Anxiety and Depression Scale, and State-Trait Anxiety Inventory. Postoperatively, pain intensity and interference were assessed using the Multidisciplinary Pain Inventory, Coping With Pain Questionnaire, and numeric pain rating scale assessment. Patient satisfaction of the Web-based platform was evaluated. A total of 21 adolescent patients used our Web-based psychological perioperative screening platform. Patients rated the mobile phone app, usability, and accessibility of the digital platform as good or excellent in 85% (17/20), 89% (17/19), and 95% (20/21) of the cases, respectively. A total of 89% (17/19) of the patients rated the effort of generating answers to the online questionnaires as low. The results from the completed
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Prevalence of malnutrition in hemodialysis patients: A single-center study in Palestine.
Rezeq, Hinar Abu; Khdair, Lubna N; Hamdan, Zakaria I; Sweileh, Waleed M
2018-01-01
Only a few studies have been published on the nutritional status of hemodialysis (HD) patients in Arab countries. The aim of this study was to determine the nutritional status and prevalence of malnutrition and its predictors among HD patients at An-Najah National University Hospital, Nablus, Palestine. A cross-sectional study was carried out on HD patients in this hospital. Seven-Point Subjective Global Assessment (7-point SGA) was used to assess the nutritional state of HD patients. Biochemical tests were obtained during the study period from medical files of the studied patients. A total of 106 HD patients were recruited for this study and assessed for nutritional status. More than half (60, 56.6%) of the recruited patients were males. The majority of the patients (86.8%) were above 45 years of age. Hypertension (65, 61.3%) was the most common comorbid conditions followed by diabetes mellitus (51, 48.1%). The median SGA score was 5.57 (5-6). More than half of the HD patients (56; 52.8%) were well-nourished while the remaining (50, 47.2%) had mild-to-moderate malnourishment. Univariate analysis indicated that SGA score was significantly higher in HD patients with college education (P = 0.026), nondiabetic (P = 0.044), nonhypertensive (P = 0.037), and those with current occupation (P = 0.025). No significant correlation was found between SGA score and potassium level (P = 0.134), calcium level (P = 0.883), albumin (P = 0.282), and phosphate level (P = 0.419). However, significant positive correlation was found between SGA core and hemoglobin level (P = 0.019; r = 0.227). Multivariate analysis showed no significant predictors of SGA score. In this pilot single-center study, malnutrition was detected in almost half of HD patients using SGA scale. Development of nutritional assessment protocols for HD is an important issue and needs to be followed up by health-care teams in HD centers.
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Jacob, R Lorie; Geddes, Jonah; McCartney, Shirley; Burchiel, Kim J
2016-05-01
OBJECT The objective of this study was to compare the cost of deep brain stimulation (DBS) performed awake versus asleep at a single US academic health center and to compare costs across the University HealthSystem Consortium (UHC) Clinical Database. METHODS Inpatient and outpatient demographic and hospital financial data for patients receiving a neurostimulator lead implant (from the first quarter of 2009 to the second quarter of 2014) were collected and analyzed. Inpatient charges included those associated with International Classification of Diseases, Ninth Revision (ICD-9) procedure code 0293 (implantation or replacement of intracranial neurostimulator lead). Outpatient charges included all preoperative charges ≤ 30 days prior to implant and all postoperative charges ≤ 30 days after implant. The cost of care based on reported charges and a cost-to-charge ratio was estimated. The UHC database was queried (January 2011 to March 2014) with the same ICD-9 code. Procedure cost data across like hospitals (27 UHC hospitals) conducting similar DBS procedures were compared. RESULTS Two hundred eleven DBS procedures (53 awake and 158 asleep) were performed at a single US academic health center during the study period. The average patient age ( ± SD) was 65 ± 9 years old and 39% of patients were female. The most common primary diagnosis was Parkinson's disease (61.1%) followed by essential and other forms of tremor (36%). Overall average DBS procedure cost was $39,152 ± $5340. Asleep DBS cost $38,850 ± $4830, which was not significantly different than the awake DBS cost of $40,052 ± $6604. The standard deviation for asleep DBS was significantly lower (p ≤ 0.05). In 2013, the median cost for a neurostimulator implant lead was $34,052 at UHC-affiliated hospitals that performed at least 5 procedures a year. At Oregon Health & Science University, the median cost was $17,150 and the observed single academic health center cost for a neurostimulator lead implant was
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Liebermeister, Lars, E-mail: lars.liebermeister@physik.uni-muenchen.de; Petersen, Fabian; Münchow, Asmus v.
2014-01-20
A diamond nano-crystal hosting a single nitrogen vacancy (NV) center is optically selected with a confocal scanning microscope and positioned deterministically onto the subwavelength-diameter waist of a tapered optical fiber (TOF) with the help of an atomic force microscope. Based on this nano-manipulation technique, we experimentally demonstrate the evanescent coupling of single fluorescence photons emitted by a single NV-center to the guided mode of the TOF. By comparing photon count rates of the fiber-guided and the free-space modes and with the help of numerical finite-difference time domain simulations, we determine a lower and upper bound for the coupling efficiency ofmore » (9.5 ± 0.6)% and (10.4 ± 0.7)%, respectively. Our results are a promising starting point for future integration of single photon sources into photonic quantum networks and applications in quantum information science.« less
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Cooperative observation data center for planets: starting with the Mars 2009-2010 observation
NASA Astrophysics Data System (ADS)
Nakakushi, T.; Okyudo, M.; Tomita, A.
2009-12-01
We propose in this paper a plan to construct a planetary image data center on the internet, which links professional researchers and amateur observers all over the world. Such data archive projects have worked, at least for Mars. Since 2003, one of the authors (T. N.) have started a project to summarize Mars observations using such cooperative network observation data archives and to publish the summary as professional research papers (Nakakushi et al., 2004, 2005, and 2008). Planetary atmosphere varies in various timescales, which requires temporarily continuous observations. Cooperative observation which amateur observers join can keep the observation continuous and sustainable, so that it can be a strong weapon to reveal planetary climate and meteorology. For outer planets, in particular, we don't know synoptic "seasonal" variations because of their long periods of revolution. We need steady and persistent effort to accumulate observations. That is why we need amateur observers' high-level observation techniques. To do so, we also needs systems to provide (and reproduce) data for users in an appropriate manner. We start from Mars with our own new date archive website, because we have much experience in terms of Mars. Next, we will expand the system for all the planets. Roughly said, there will be 3 steps to expand the project to all the planets: (1) to construct our own Mars cooperative observation data center, (2) to link it with professional studies, (3) to construct cooperative observation data center for all planets. And 4 problems to tackle: (1) to develop web interfaces for users to submit data, (2) to develop interfaces for managers, (3) to secure finances, (4) to secure professional researchers. 2009 and 2010 are a good apparition for Mars observation. We manage the Mars image data website, find problems and solutions in detail, and search for ways to expand it to all the planet and to enable sustainable management.
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Restless leg syndrome in different types of demyelinating neuropathies: a single-center pilot study.
Luigetti, Marco; Del Grande, Alessandra; Testani, Elisa; Bisogni, Giulia; Losurdo, Anna; Giannantoni, Nadia Mariagrazia; Mazza, Salvatore; Sabatelli, Mario; Della Marca, Giacomo
2013-09-15
to determine the prevalence of restless legs syndrome (RLS) in a cohort of patients with demyelinating neuropathies. Patients were retrospectively recruited from our cohort of different forms of demyelinating neuropathies, including chronic inflammatory demyelinating neuropathy (CIDP), Charcot-Marie-Tooth 1A (CMT1A), and hereditary neuropathy with liability to pressure palsies (HNPP) referred to our Department of Neurology in a 10-year period. The validated 4-item RLS questionnaire was used for diagnosis of RLS. All patients with RLS who fulfilled criteria underwent a suggested immobilization test to confirm the diagnosis. A group of outpatients referred to the sleep disorders unit and data from published literature were used as controls. Prevalence of RLS in demyelinating neuropathy group was higher than prevalence observed in control population (p = 0.0142) or in the literature data (p = 0.0007). In particular, in comparison with both control population and literature data, prevalence of RLS was higher in CIDP group (p = 0.0266 and p = 0.0063, respectively) and in CMT1A group (p = 0.0312 and p = 0.0105, respectively), but not in HNPP (p = 1.000 and p = 0.9320, respectively). our study confirms a high prevalence of RLS in inflammatory neuropathies as CIDP and, among inherited neuropathies, in CMT1A but not in HNPP. Considering that this is only a small cohort from a single-center retrospective experience, the link between RLS and neuropathy remains uncertain, and larger multicenter studies are probably needed to clarify the real meaning of the association between RLS and neuropathy.
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New single-aircraft integrated atmospheric observation capabilities
NASA Astrophysics Data System (ADS)
Wang, Z.
2011-12-01
Improving current weather and climate model capabilities requires better understandings of many atmospheric processes. Thus, advancing atmospheric observation capabilities has been regarded as the highest imperatives to advance the atmospheric science in the 21st century. Under the NSF CAREER support, we focus on developing new airborne observation capabilities through the developments of new instrumentations and the single-aircraft integration of multiple remote sensors with in situ probes. Two compact Wyoming cloud lidars were built to work together with a 183 GHz microwave radiometer, a multi-beam Wyoming cloud radar and in situ probes for cloud studies. The synergy of these remote sensor measurements allows us to better resolve the vertical structure of cloud microphysical properties and cloud scale dynamics. Together with detailed in situ data for aerosol, cloud, water vapor and dynamics, we developed the most advanced observational capability to study cloud-scale properties and processes from a single aircraft (Fig. 1). A compact Raman lidar was also built to work together with in situ sampling to characterize boundary layer aerosol and water vapor distributions for many important atmospheric processes studies, such as, air-sea interaction and convective initialization. Case studies will be presented to illustrate these new observation capabilities.
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Scientist, Single Cell Analysis Facility | Center for Cancer Research
The Cancer Research Technology Program (CRTP) develops and implements emerging technology, cancer biology expertise and research capabilities to accomplish NCI research objectives. The CRTP is an outward-facing, multi-disciplinary hub purposed to enable the external cancer research community and provides dedicated support to NCI’s intramural Center for Cancer Research (CCR). The dedicated units provide electron microscopy, protein characterization, protein expression, optical microscopy and nextGen sequencing. These research efforts are an integral part of CCR at the Frederick National Laboratory for Cancer Research (FNLCR). CRTP scientists also work collaboratively with intramural NCI investigators to provide research technologies and expertise. KEY ROLES AND RESPONSIBILITIES We are seeking a highly motivated Scientist II to join the newly established Single Cell Analysis Facility (SCAF) of the Center for Cancer Research (CCR) at NCI. The SCAF will house state of the art single cell sequencing technologies including 10xGenomics Chromium, BD Genomics Rhapsody, DEPPArray, and other emerging single cell technologies. The Scientist: Will interact with close to 200 laboratories within the CCR to design and carry out single cell experiments for cancer research Will work on single cell isolation/preparation from various tissues and cells and related NexGen sequencing library preparation Is expected to author publications in peer reviewed scientific journals
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Torok, Kathryn S.; Arkachaisri, Thaschawee
2013-01-01
Objective To evaluate the effectiveness of a uniform single-center treatment protocol composed of high-dose methotrexate (MTX) and oral corticosteroids in a pediatric localized scleroderma (LS) cohort. Methods Thirty-six patients with LS were recruited. Patients with active disease, defined as erythematous lesions and/or new lesions, or expansion of existing lesions, were started on oral prednisone 2 mg/kg/day (maximum 60 mg/day) and subcutaneous (SC) MTX at 1 mg/kg/week (maximum 25 mg/week). Prednisone was tapered and kept at 0.25 mg/kg/day for 12 months. MTX SC was continued for 24 months, and then switched to oral administration to complete 36 months of therapy. Modified LS Skin Severity Index (mLoSSI) and the physician global assessment of disease activity (PGA-A) were used as outcome measures. Results Twenty-five patients with LS were female with a median age at onset of 7.86 years [interquartile range (IQR) 4.63–11.91]. Median disease duration from onset until start of this treatment regimen was 19.2 months (IQR 8.96–35.35). Median duration of followup was 36.40 months (IQR 29.39–45.36). All patients demonstrated significant improvement in mLoSSI at median 1.77 months (IQR 0.76–2.37, 95% CI 1.54, 2.01). PGA-A followed the same trend. No significant adverse reactions or flares were observed during therapy. Conclusion This single-center LS treatment protocol was effective and well tolerated. Clinical outcome in LS is affected by dose and route of administration of immunosuppressive regimens. Daily tapering dose of corticosteroids and parenteral MTX were effective in controlling LS activity without significant adverse reaction. This regimen should be considered as one of the therapies for LS clinical trials. PMID:22247357
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Single Pulse Searches for Pulsars in the Galactic Center
NASA Astrophysics Data System (ADS)
Cushey, Daniel Joseph; Majid, Walid A.; Prince, Thomas Allen
2017-01-01
The discovery of the magnetar J1745-2900 within 3'' of Sgr A* by Mori et al. (2013) has renewed strong interest in Galactic Center (GC) pulsars and motivated expanded searches for their pulses due to their extensive applications to gravitational and plasma physics. There are currently 5 known pulsars within 15' of the Sgr A*; however, gamma ray excesses from the GC suggest a source population of 102-103 millisecond pulsars within the same region. Although this discrepancy is readily explained by the hyper-strong scattering environment of the GC which obscures pulses, the discovery of J1745-2900 challenges this attribution and further observations and analysis are needed to reconcile the observed GC pulsar population with theory. We present a pipeline developed to search for these "missing" GC pulsars using a single pulse search algorithm. Observations of the GC using the Deep Space Network 70m antenna were taken in the high frequency regime in order to minimize scattering, and search parameters were calibrated using pulses from RRAT J1819-1458. Any detected pulses that are distinct from those of J1745-2900 warrant extensive follow-up observations and analysis, and confirmed new members of the elusive GC pulsar population would be incredibly valuable as probes of the GC's magnetic and potential fields.
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Appraising stroke risk in maintenance hemodialysis patients: a large single-center cohort study.
Power, Albert; Chan, Kakit; Singh, Seema K; Taube, David; Duncan, Neill
2012-02-01
Stroke incidence in hemodialysis patients is up to 10 times greater than in the general population and is associated with a worse prognosis. Factors influencing stroke risk by subtype and subsequent prognosis are poorly described in the literature. Retrospective single-center cohort study. 2,384 established maintenance hemodialysis patients at a single center from January 1, 2002, to June 1, 2009. Patient demographics, comorbid conditions. Incidence of acute stroke (International Classification of Diseases, 9th Revision codes 430, 431, 432.9, 433.1, and 434.1 with evidence of compatible neuroimaging), patient survival. Cumulative patient survival, incidence of acute fatal and nonfatal stroke. 127 strokes occurred during 9,541 total patient-years of follow-up. First (incident) stroke occurred at a rate of 14.9/1,000 patient years (95% CI, 12.2-17.9) with a predominance of ischemic compared with hemorrhagic subtypes (11.2 vs 3.7/1,000 patient-years). 54% of hemorrhagic strokes occurred in patients of South Asian ethnicity compared with ischemic strokes, which occurred predominantly in white patients (45% of events). Diabetes mellitus (HR, 1.92; 95% CI, 1.29-2.85; P = 0.001) and prior cerebrovascular disease (HR, 4.54; 95% CI, 3.07-6.72; P < 0.001) were independently associated with incident cerebrovascular accident on multivariate analysis. Acute stroke was associated with worse patient survival (HR, 3.26; 95% CI, 2.47-4.30; P < 0.001) and overall 1-year mortality of 24%, which was significantly worse in patients with hemorrhagic events (39% vs 19% mortality for ischemic subtypes). Serum albumin level >3.5 g/L (HR, 0.38; 95% CI, 0.19-0.76; P = 0.007) and C-reactive protein level >3.0 mg/l (HR, 1.36; 95% CI, 1.12-1.64; P = 0.002) influenced survival after stroke on multivariate analysis. Retrospective analysis of data cannot prove causality. The high incidence of stroke in hemodialysis patients is associated with high mortality, especially hemorrhagic subtypes. Strict
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Su, Wei; Zhang, Yisen; Chen, Junfan; Liu, Jian; Rajah, Gary; Yang, Xinjian
2018-04-23
Background For the treatment of intracranial aneurysms, the low-profile visualized intraluminal support (LVIS) stent is a new generation of highly visible-braided stent that was recently introduced in China. Here, we report our single-center retrospective experience of safety and efficacy utilizing LVIS for stent-assisted coiling of intracranial aneurysms. Methods We included 218 patients with intracranial aneurysms consecutively treated with LVIS SR stents at our center in this study. Postoperative and follow-up embolization scores, procedural complications, clinical and angiographic findings at mid-term follow-up, as well as recurrence rate, preoperative and follow-up mRS scores were analyzed. Results Two hundred and eighteen patients with two hundred and twenty five intracranial aneurysms were enrolled. The locations and distribution were ICA (125, 55.6%), PcomA (47, 20.9%), VA (38, 16.8%), and BA (15, 6.7%). Two hundred and eighteen aneurysms were treated with the stent-assisted coiling and seven patients with LVIS stents alone. Angiographic follow-up was available for 115 (51.1%) aneurysms, 8 (7.0%) of which had recurrences including 7 (6.5%) unruptured aneurysms and 1(14.3%) ruptured aneurysm. The procedural complication rate was 2.75% in total, including distal hemorrhage (1, 0.45%; SAH), ischemic events (5, 2.3%). Conclusions Our single-center retrospective experience is one of the larger studies to date assessing the LVIS device. Compared with many laser-cut stent studies, the LVIS device had a higher aneurysm complete occlusion rate at follow-up coupled with low complication rates. However, this study was our initial experience with LVIS, larger patient numbers, and longer follow-up will be needed to fully assess the long-term efficacy of LVIS in treating intracranial aneurysms.
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The Universe Observation Center: an educational center devoted to Astronomy in Catalonia
NASA Astrophysics Data System (ADS)
Fernández, D.
The Universe Observation Center (in Catalan language, Centre d'Observació de l'Univers, COU) is located in close proximity to the Montsec Astronomical Observatory (Observatori Astronòmic del Montsec, OAM), in eastern Catalonia (Spain). Both centers comprise the Montsec Astronomical Park (Parc Astronòmic Montsec, PAM), managed by the Consorci del Montsec. Montsec Mountain remains the finest location for astronomical observation in Catalonia, as demonstrated by a site-testing campaign conducted by the Astronomy and Meteorology Department of the University of Barcelona. The COU consists of a Central Building (including a permanent exhibition and three classrooms possessing broadband Internet access), the Telescope Park (two astronomical domes equipped with medium-size telescopes, a coelostat for solar observation, and a portable telescope park), the Eye of Montsec (a digital planetarium and, at the same time, an extremely innovative platform for sky observation) and the Garden of the Universe (a tour of the land surrounding the COU, visiting several areas within it). The COU will offer to the Spanish academic community a host of fascinating and unique activities in the fields of astronomy and geology. The Center is open not only to students (from primary school through university), but also to amateur astronomers, people interested in science and the general public.
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Direct experimental observation of nonclassicality in ensembles of single-photon emitters
NASA Astrophysics Data System (ADS)
Moreva, E.; Traina, P.; Forneris, J.; Degiovanni, I. P.; Ditalia Tchernij, S.; Picollo, F.; Brida, G.; Olivero, P.; Genovese, M.
2017-11-01
In this work we experimentally demonstrate a recently proposed criterion addressed to detect nonclassical behavior in the fluorescence emission of ensembles of single-photon emitters. In particular, we apply the method to study clusters of nitrogen-vacancy centers in diamond characterized with single-photon-sensitive confocal microscopy. Theoretical considerations on the behavior of the parameter at any arbitrary order in the presence of Poissonian noise are presented and, finally, the opportunity of detecting manifold coincidences is discussed.
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2011 Year in review - Earth Resources Observation and Science Center
Johnson, Rebecca L.
2012-01-01
The USGS Earth Resources Observation and Science (EROS) Center's 2011 Year in Review is an annual report recounting the broad scope of the Center's 2011 accomplishments. The report covers preparations for the Landsat Data Continuity Mission (LDCM) launch, the ever-increasing use of free Landsat data, monitoring the effects of natural hazards, and more to emphasize the importance of innovation in using satellite data to study change over time.
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Bright nanowire single photon source based on SiV centers in diamond
Marseglia, L.; Saha, K.; Ajoy, A.; ...
2018-01-01
The practical implementation of quantum technologies such as quantum commu- nication and quantum cryptography relies on the development of indistinguishable, robust, and bright single photon sources that works at room temperature. The silicon- vacancy (SiV -) center in diamond has emerged as a possible candidate for a single photon source with all these characteristics. Unfortunately, due to the high refraction index mismatch between diamond and air, color centers in diamond show low photon out-coupling. This drawback can be overcome by fabrication of photonic structures that improve the in-coupling of excitation laser to the diamond defect as well as the out-couplingmore » emission from the color centers. An additional shortcoming is due to the random localization of native defects in the diamond sample. Here we demonstrate deterministic implantation of Si ions with high conversion effciency to single SiV -, targeted to fabricated nanowires. The co-localization of single SiV - defects with the nanostructures yields a ten times higher light coupling effciency as compared to single SiV - in the bulk. This result, with its intrinsic scalability, enables a new class of devices for integrated photonics and quantum information processing.« less
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Long-term single-center experience of defibrillator therapy in children and adolescents.
Frommeyer, Gerrit; Feder, Sebastian; Bettin, Markus; Debus, Volker; Köbe, Julia; Reinke, Florian; Uebing, Anselm; Eckardt, Lars; Kehl, Hans Gerd
2018-06-01
Implantable cardioverter-defibrillator (ICD) systems are established therapy for prevention of sudden cardiac death. Long-term data on ICD systems in children and adolescents is rare. The present study displays a long-term single-center follow-up of children and adolescents with ICD systems. The present study represents a single-center experience of patients younger than 18 years who received an ICD (n = 58). Follow-up data included in-house follow-up as well as examinations of collaborating specialists. Mean age at implantation was 14.0 ± 3.3 years and 33 patients (56.9%) were male. A transvenous ICD system was implanted in 54 patients (93.1%). In 33 patients (56.9%) electrical heart disease or idiopathic ventricular fibrillation represented the underlying condition of ICD implantation. Median follow-up duration was 70 months (45; 94). 3 patients (5.2%) died during the observation period. None of these deaths was associated with ICD failure. Appropriate shocks occurred in 32 patients (55.2%). Inappropriate shock delivery was recorded in 17 patients (29.3%). Supraventricular tachycardia represented the most frequent cause of inappropriate shock delivery (9 patients, 52.9%). T-wave oversensing led to inappropriate shock delivery in 3 patients (17.6%). In 5 patients (29.4%), lead failure caused inappropriate shock delivery. Of note, during follow-up lead failure was reported in 15 patients (25.9%) leading to surgical revision. ICD therapy in children and adolescents is effective for prevention of sudden cardiac death. The rate of appropriate shock deliveries was significantly higher as compared with large ICD trials. Inappropriate therapies occurred frequently. In particular supraventricular tachycardia, T-wave oversensing and lead failures were responsible for these episodes. Copyright © 2017 Elsevier B.V. All rights reserved.
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Impaired health-related quality of life in acute myeloid leukemia survivors: a single-center study.
Leunis, Annemieke; Redekop, William K; Uyl-de Groot, Carin A; Löwenberg, Bob
2014-09-01
The purpose of this study was to assess the impact of acute myeloid leukemia (AML) and its treatment on health-related quality of life (HRQOL) by comparing the HRQOL of AML survivors with the HRQOL in the general population. Two HRQOL questionnaires (EQ-5D and QLQ-C30) were sent to patients diagnosed with AML between 1999 and 2011 at a single academic hospital and still alive in 2012. HRQOL in AML survivors was compared with general population reference values. Multivariate analysis was used to identify factors associated with HRQOL in AML survivors. Questionnaires were returned by 92 of the 103 patients (89%). AML survivors reported significantly worse functioning, more fatigue, pain, dyspnea, appetite loss, and financial difficulties and lower EQ-VAS scores than the general population (P < 0.05). Impaired HRQOL in AML survivors was mainly found in survivors without a paid job. Other factors associated with a poor HRQOL were allogeneic hematopoietic stem cell transplantation and the absence of social support. This single-center study showed that the HRQOL in AML survivors is worse than the HRQOL in the general population. HRQOL in these patients can be improved by adequately treating and preventing fatigue, pain, dyspnea, and appetite loss. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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Alexander, Paul E; Bonner, Ashley J; Agarwal, Arnav; Li, Shelly-Anne; Hariharan, Abishek; Izhar, Zain; Bhatnagar, Neera; Alba, Carolina; Akl, Elie A; Fei, Yutong; Guyatt, Gordon H; Beyene, Joseph
2016-06-01
Prior studies regarding whether single-center trial estimates are larger than multi-center are equivocal. We examined the extent to which single-center trials yield systematically larger effects than multi-center trials. We searched the 119 core clinical journals and the Cochrane Database of Systematic Reviews for meta-analyses (MAs) of randomized controlled trials (RCTs) published during 2012. In this meta-epidemiologic study, for binary variables, we computed the pooled ratio of ORs (RORs), and for continuous outcomes mean difference in standardized mean differences (SMDs), we conducted weighted random-effects meta-regression and random-effects MA modeling. Our primary analyses were restricted to MAs that included at least five RCTs and in which at least 25% of the studies used each of single trial center (SC) and more trial center (MC) designs. We identified 81 MAs for the odds ratio (OR) and 43 for the SMD outcome measures. Based on our analytic plan, our primary analysis (core) is based on 25 MAs/241 RCTs (binary outcome) and 18 MAs/173 RCTs (continuous outcome). Based on the core analysis, we found no difference in magnitude of effect between SC and MC for binary outcomes [RORs: 1.02; 95% confidence interval (CI): 0.83, 1.24; I(2) 20.2%]. Effect sizes were systematically larger for SC than MC for the continuous outcome measure (mean difference in SMDs: -0.13; 95% CI: -0.21, -0.05; I(2) 0%). Our results do not support prior findings of larger effects in SC than MC trials addressing binary outcomes but show a very similar small increase in effect in SC than MC trials addressing continuous outcomes. Authors of systematic reviews would be wise to include all trials irrespective of SC vs. MC design and address SC vs. MC status as a possible explanation of heterogeneity (and consider sensitivity analyses). Copyright © 2015 Elsevier Inc. All rights reserved.
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NASA Astrophysics Data System (ADS)
O'Brien, K.; Hankin, S.; Mendelssohn, R.; Simons, R.; Smith, B.; Kern, K. J.
2013-12-01
The Observing System Monitoring Center (OSMC), a project funded by the National Oceanic and Atmospheric Administration's Climate Observations Division (COD), exists to join the discrete 'networks' of In Situ ocean observing platforms -- ships, surface floats, profiling floats, tide gauges, etc. - into a single, integrated system. The OSMC is addressing this goal through capabilities in three areas focusing on the needs of specific user groups: 1) it provides real time monitoring of the integrated observing system assets to assist management in optimizing the cost-effectiveness of the system for the assessment of climate variables; 2) it makes the stream of real time data coming from the observing system available to scientific end users into an easy-to-use form; and 3) in the future, it will unify the delayed-mode data from platform-focused data assembly centers into a standards- based distributed system that is readily accessible to interested users from the science and education communities. In this presentation, we will be focusing on the efforts of the OSMC to provide interoperable access to the near real time data stream that is available via the Global Telecommunications System (GTS). This is a very rich data source, and includes data from nearly all of the oceanographic platforms that are actively observing. We will discuss how the data is being served out using a number of widely used 'web services' (including OPeNDAP and SOS) and downloadable file formats (KML, csv, xls, netCDF), so that it can be accessed in web browsers and popular desktop analysis tools. We will also be discussing our use of the Environmental Research Division's Data Access Program (ERDDAP), available from NOAA/NMFS, which has allowed us to achieve our goals of serving the near real time data. From an interoperability perspective, it's important to note that access to the this stream of data is not just for humans, but also for machine-to-machine requests. We'll also delve into how we
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Bura, Maciej; Michalak, Michał; Chojnicki, Michał K; Kowala-Piaskowska, Arleta; Mozer-Lisewska, Iwona
2015-01-01
Hepatitis A is related to significant morbidity and occasional mortality. Based on data from the Polish National Institute of Hygiene, from 2000 to 2013 a mean of 213 hepatitis A cases were reported yearly. The aim of the study was to assess selected data in adults hospitalized for symptomatic hepatitis A during an eight-year period in a single center in the Wielkopolska Region of Poland. All the hepatitis A patients hospitalized in the center from 2005 to 2013 were analyzed retrospectively. Data were extracted from the medical records of these individuals. The disease was confirmed by anti-HAV IgM testing. In total, 108 patients (71 men and 37 women), aged 18-65 years, were identified. All but 1 patient recovered (99.1%) and in 6 cases (5.6%) a relapse occurred. Risk factors for hepatitis A were identified in 56 patients (52%), with travel abroad being the most common one (32 patients); 19 cases were secondary and 5 patients were men who have sex with men. One hepatitis A outbreak was noted in the region during the study period. Acalculous cholecystitis was found in 33.3% of the patients who underwent abdominal ultrasound. This tended to be more common among older individuals (47.8% in patients over 40 vs. 22.6% in patients aged 18-40, p=0.0521). Patients with this finding had significantly higher mean peak ALT in comparison to those with no gallbladder abnormalities. Although hepatitis A in adults is typically a benign, self-limited disease, it can occasionally have a fatal course. In a significant proportion of patients with an evident risk factor for hepatitis A, the possibility of active prophylaxis was not used. Hepatitis A should be regarded as a sexually transmitted infection. Acalculous cholecystitis is a frequent finding among adults with symptomatic hepatitis A.
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Crucibleless crystal growth and Radioluminescence study of calcium tungstate single crystal fiber
NASA Astrophysics Data System (ADS)
Silva, M. S.; Jesus, L. M.; Barbosa, L. B.; Ardila, D. R.; Andreeta, J. P.; Silva, R. S.
2014-11-01
In this article, single phase and high optical quality scheelite calcium tungstate single crystal fibers were grown by using the crucibleless laser heated pedestal growth technique. The as-synthesized calcium tungstate powders used for shaping seed and feed rods were investigated by X-ray diffraction technique. As-grown crystals were studied by Raman spectroscopy and Radioluminescence measurements. The results indicate that in both two cases, calcined powder and single crystal fiber, only the expected scheelite CaWO4 phase was observed. It was verified large homogeneity in the crystal composition, without the presence of secondary phases. The Radioluminescence spectra of the as-grown single crystal fibers are in agreement with that present in Literature for bulk single crystals, presented a single emission band centered at 420 nm when irradiated with β-rays.
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NASA Astrophysics Data System (ADS)
Caliskan, Betul; Caliskan, Ali Cengiz
2017-06-01
Bis(cyclopentadienyl)zirconium dichloride (BCZD; zirconocene dichloride) single crystals were exposed to 60Co-γ irradiation at room temperature. The irradiated single crystals were investigated between 125 and 470 K by electron paramagnetic resonance spectroscopy. The spectra of the crystals were found to be temperature independent. The paramagnetic center was attributed to the cyclopentadienyl radical. The g values of the radiation damage center observed in BCZD single crystal and the hyperfine structure constants of the free electron with nearby protons were obtained.
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Supernovae as seen by off-center observers in a local void
DOE Office of Scientific and Technical Information (OSTI.GOV)
Blomqvist, Michael; Mörtsell, Edvard, E-mail: michaelb@astro.su.se, E-mail: edvard@fysik.su.se
2010-05-01
Inhomogeneous universe models have been proposed as an alternative explanation for the apparent acceleration of the cosmic expansion that does not require dark energy. In the simplest class of inhomogeneous models, we live within a large, spherically symmetric void. Several studies have shown that such a model can be made consistent with many observations, in particular the redshift-luminosity distance relation for type Ia supernovae, provided that the void is of Gpc size and that we live close to the center. Such a scenario challenges the Copernican principle that we do not occupy a special place in the universe. We usemore » the first-year Sloan Digital Sky Survey-II supernova search data set as well as the Constitution supernova data set to put constraints on the observer position in void models, using the fact that off-center observers will observe an anisotropic universe. We first show that a spherically symmetric void can give good fits to the supernova data for an on-center observer, but that the two data sets prefer very different voids. We then continue to show that the observer can be displaced at least fifteen percent of the void scale radius from the center and still give an acceptable fit to the supernova data. When combined with the observed dipole anisotropy of the cosmic microwave background however, we find that the data compells the observer to be located within about one percent of the void scale radius. Based on these results, we conclude that considerable fine-tuning of our position within the void is needed to fit the supernova data, strongly disfavouring the model from a Copernican principle point of view.« less
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The Universe Observing Center a modern center to teach and communicate astronomy
NASA Astrophysics Data System (ADS)
Ribas, Salvador J.
2011-06-01
The Universe Observing Center is one of the parts of the Parc Astronòmic Montsec (PAM). PAM is an initiative of the Catalan government, through the Consorci del Montsec (Montsec Consortium), to take advantage of the capabilities and potential of the Montsec region to develop scientific research, training and outreach activities, particularly in the field of Astronomy. The choice of the Montsec mountains to install the PAM was motivated by the magnificent conditions for observing the sky at night; the sky above Montsec is the best (natural sky free of light pollution) in Catalonia for astronomical observations. The PAM has two main parts: the Observatori Astronòmic del Montsec (OAdM) and the Universe Observing Center (COU). The OAdM is a professional observatory with an 80-cm catadioptric telescope (Joan Oró Telescope). This telescope is a robotic telescope that can be controlled from anywhere in the world via the Internet. The COU is a large multipurpose center which is intended to become an educational benchmark for teaching and communicate astronomy and other sciences in Catalonia. The management of the COU has three main goals: 1) Teach primary and secondary school students in our Educational Training Camp. 2) Teach university students housing the practical astronomy lectures of the universities. 3) Communicate astronomy to the general public. The COU comprises special areas for these purposes: the Telescopes Park with more than 20 telescopes, a coelostat for solar observations and two dome containing full-automated telescopes. The most special equipment is ``The Eye of Montsec'', with its 12m dome containing a multimedia digital planetarium and a platform for direct observation of the sky and the environment. During 2009 we expect around 10000 visitors in Montsec area to enjoy science with Montsec dark skies and an special natural environment.
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NASA Astrophysics Data System (ADS)
Fathy, Adel; Ghamry, Essam
2017-03-01
Though the Equatorial Ionospheric Anomaly (EIA) is represented by two crests within ±15° latitude, a single crest is also observed in the entire ionosphere. Few studies have addressed single crest phenomena. A statistical study of 2237 single crest phenomenon from the in situ electron density measurements of Swarm A satellite was investigated during December 2013-December 2015. Our analysis focused on local time, seasonal, and both geographic and geomagnetic latitudinal variations. Our results show the following observations: 1 - The maximum number of events peaks mainly in the dayside region around 0800-1200 LT and these occur mainly within the magnetic equator. 2 - The maximum amplitude of the single crests take place most prominently during equinoxes. 3 - The majority of single crests occur in the northern hemisphere. 4 - The seasonal distribution of the events shows that the summer events are located further from the magnetic equator in the northern hemisphere and shift their locations into the southern hemisphere in winter, while spring events are centered along the magnetic equator. 5 - Dayside single crest events appear close to the magnetic equator and more centered on the equator in winter season. 6 - Dawn, night and dusk side events reverse their location from northern hemisphere in summer to southern hemisphere in winter.
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Bone metabolism in oxalosis: a single-center study using new imaging techniques and biomarkers.
Bacchetta, Justine; Fargue, Sonia; Boutroy, Stéphanie; Basmaison, Odile; Vilayphiou, Nicolas; Plotton, Ingrid; Guebre-Egziabher, Fitsum; Dohin, Bruno; Kohler, Rémi; Cochat, Pierre
2010-06-01
The deposition of calcium oxalate crystals in the kidney and bone is a hallmark of primary hyperoxaluria type 1 (PH1). We report here an evaluation of the bone status of 12 PH1 children based on bone biomarkers [parathyroid hormone, vitamin D, fibroblast growth factor 23 (FGF23)] and radiological assessments (skeletal age, three-dimensional high-resolution peripheral quantitative computed tomography, HR-pQCT) carried out within the framework of a cross-sectional single-center study. The controls consisted of healthy and children with chronic kidney disease already enrolled in local bone and mineral metabolism studies. The mean age (+ or - standard deviation) age of the patients was 99 (+ or - 63) months. Six children suffered from fracture. Bone maturation was accelerated in five patients, four of whom were <5 years. The combination of new imaging techniques and biomarkers highlighted new and unexplained features of PH1: advanced skeletal age in young PH1 patients, increased FGF23 levels and decreased total volumetric bone mineral density with bone microarchitecture alteration.
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Stern, Gretchen; Rimsans, Jessica; Qamar, Arman; Vaduganathan, Muthiah; Bhatt, Deepak L
2018-03-13
Oral antiplatelet therapy may require interruption soon after percutaneous coronary intervention (PCI) or acute coronary syndrome. The optimal parenteral antiplatelet bridge strategy with glycoprotein IIb/IIIa inhibitors or cangrelor, a P2Y12 inhibitor, is unclear. We explore real-world use of cangrelor or eptifibatide for antiplatelet bridging at a large tertiary-care center. Thirty-one patients (9 eptifibatide, 20 cangrelor, and 2 both) received bridge therapy from October 2015 to June 2017. Primary bridge therapy indications included surgery (68%), limited enteral access/absorption (16%), and high-perceived bleed risk (16%). Median duration of bridge therapy was 61 (20-100) hours for cangrelor and 83 (19-98) hours for eptifibatide. Severe/life-threatening bleeding or stent thrombosis was not observed. GUSTO-defined bleeding occurred in 30% (cangrelor) and 27% (eptifibatide). Initial dosing errors occurred in 23% of patients. Death during hospitalization occurred in 16% of patients. Parenteral antiplatelet bridging was used for ~3 days in this single-center, tertiary care experience, commonly for unplanned surgery following PCI. Despite high-risk presentations with >15% in-hospital mortality, efficacy profiles were reassuring with no identified stent thrombosis, but bleeding and dosing errors were common. Antiplatelet bridging should only be used in well-selected patients at the appropriate dose for the minimal necessary duration.
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Bona, Stefano; Molteni, Mattia; Rosati, Riccardo; Elmore, Ugo; Bagnoli, Pietro; Monzani, Roberta; Caravaca, Monica; Montorsi, Marco
2014-01-01
AIM: To study the implementation of an enhanced recovery after surgery (ERAS) program at a large University Hospital from “pilot study” to “standard of care”. METHODS: The study was designed as a prospective single centre cohort study. A prospective evaluation of compliance to a protocol based on full application of all ERAS principles, through the progressive steps of its implementation, was performed. Results achieved in the initial pilot study conducted by a dedicated team (n = 47) were compared to those achieved in the shared protocol phase (n = 143) three years later. Outcomes were length of postoperative hospital stay, readmission rate, compliance to the protocol and morbidity. Primary endpoint was the description of the results and the identification of critical issues of large scale implementation of an ERAS program in colorectal surgery emerged in the experience of a single center. Secondary endpoint was the identification of interventions that have been proven to be effective for facilitating the transition from traditional care pathways to a multimodal management protocol according to ERAS principles in colorectal surgery at a single center. RESULTS: During the initial pilot study (March 2009 to December 2010; 47 patients) conducted by a dedicated multidisciplinary team, compliance to the items of ERAS protocol was 93%, with a median length of hospital stay (LOS) of 3 d. Early anastomotic fistulas were observed in 2 cases (4.2%), which required reoperation (Clavien-Dindo grade IIIb). None of the patients had been discharged before the onset of the complication, which could therefore receive prompt treatment. There were also four (8.5%) minor complications (Clavien-Dindo grade II). Thirty days readmission rate was 4%. Perioperative mortality was nil. After implementation of the protocol throughout the Hospital in unselected patients (May 2012 to December 2012; 147 patients) compliance was 74%, with a median LOS of 6 d. Early anastomotic fistulas
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Rubio-Lago, L.; Zaouris, D.; Sakellariou, Y.
The photolysis of pyrrole has been studied in a molecular beam at wavelengths of 250, 240, and 193.3 nm, using two different carrier gases, He and Xe. A broad bimodal distribution of H-atom fragment velocities has been observed at all wavelengths. Near threshold at both 240 and 250 nm, sharp features have been observed in the fast part of the H-atom distribution. Under appropriate molecular beam conditions, the entire H-atom loss signal from the photolysis of pyrrole at both 240 and 250 nm (including the sharp features) disappear when using Xe as opposed to He as the carrier gas. Wemore » attribute this phenomenon to cluster formation between Xe and pyrrole, and this assumption is supported by the observation of resonance enhanced multiphoton ionization spectra for the (Xe{center_dot}{center_dot}{center_dot}pyrrole) cluster followed by photofragmentation of the nascent cation cluster. Ab initio calculations are presented for the ground states of the neutral and cationic (Xe{center_dot}{center_dot}{center_dot}pyrrole) clusters as a means of understanding their structural and energetic properties.« less
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Localized scleroderma: a clinical study at a single center in Korea.
Noh, Jung Won; Kim, Jinseok; Kim, Jae-Wang
2013-08-01
Localized scleroderma (morphea) is a rare autoimmune disease limited to the skin, characterized by cutaneous fibrosing and obstructive vasculopathy. Localized scleroderma may invade into the subcutaneous fat layer and cause permanent functional disability. Because of its rarity, there have been few clinical surveys of patients with localized scleroderma in Korea. The aim of this study was to elucidate the clinical presentation, serological data, and clinical outcomes of localized scleroderma. This was a retrospective survey conducted by reviewing available medical records during a 7 year-period from 2004 to 2010 in a single medical center in Jeju Island, South Korea. In total 43 patients with localized scleroderma were included. Localized scleroderma occurred primarily in females (female to male ratio 2.6 : 1.0). Most patients were between 10 and 29 years of age and the mean age at diagnosis was 26.2 years. Plaque (51.2%) and linear morphea (37.2%) were most common. No case was associated with systemic scleroderma (systemic sclerosis). The most common site of plaque morphea was the trunk (47.8%). In the linear type, the most common site was head-neck (52.9%). Fluorescent antinuclear antibody was positive in 23.3% of all cases. Treatment included systemic corticosteroids, colchicine, anti-malarial agents, D-penicillamine or intralesional triamcinolone injection. Clinical improvement, including significant and partial response, was seen in only 62.8% of treated patients. Localized scleroderma is a chronic inflammatory condition confined to the skin. In order to exclude other conditions, thorough history taking, physical examination, serologic studies and histopathologic examinations should be conducted. © 2013 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.
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Observations of Undergraduate Geoscience Instruction in the US: Measuring Student Centered Teaching
NASA Astrophysics Data System (ADS)
Teasdale, R.; Manduca, C. A.; Mcconnell, D. A.; Bartley, J. K.; Bruckner, M. Z.; Farthing, D.; Iverson, E. A. R.; Viskupic, K. M.
2014-12-01
The Reformed Teaching Observation Protocol (RTOP; Swada, et al., 2002) has been used by a trained team of On the Cutting Edge (CE) observers to characterize the degree of student-centered teaching in US college and university geoscience classrooms. Total RTOP scores are derived from scores on 25 rubric items used to characterize teaching practices in categories of lesson design, content delivery, student-instructor and student-student interactions. More than 200 classroom observations have been completed by the RTOP team in undergraduate courses at a variety of US institution types (e.g., community colleges, research universities). A balanced mix of early career, mid-career, and veteran faculty are included, and the study examines class sizes ranging from small (<30) to large (>80 students). Observations are limited to one class session and do not include laboratories or field activities. Data include RTOP scores determined by a trained observer during the classroom observation and an online survey in which the observed instructors report on their teaching practices. RTOP scores indicate that the observed geoscience classes feature varying degrees of student-centered teaching, with 30% of observed classes categorized as teacher-centered (RTOP scores ≤30), 45% of observed classes categorized as transitional classrooms (RTOP scores 31-49) and 25% are student-centered (RTOP scores ≥ 50). Instructor self-report survey data and RTOP scores indicate that geoscience faculty who have participated in one or more CE professional development event and use the CE website have an average RTOP score of 49, which is significantly higher (> 15 points) than the average score of faculty who have not participated in CE events and have not used the website. Approximately 60% of student-centered classes (those with high RTOP scores) use some traditional lecture nearly every day, but are also are likely to include an in-class activity or group discussion (e.g. Think
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The black hole at the Galactic Center: Observations and models
NASA Astrophysics Data System (ADS)
Zakharov, Alexander F.
One of the most interesting astronomical objects is the Galactic Center. It is a subject of intensive astronomical observations in different spectral bands in recent years. We concentrate our discussion on a theoretical analysis of observational data of bright stars in the IR-band obtained with large telescopes. We also discuss the importance of VLBI observations of bright structures which could characterize the shadow at the Galactic Center. If we adopt general relativity (GR), there are a number of theoretical models for the Galactic Center, such as a cluster of neutron stars, boson stars, neutrino balls, etc. Some of these models were rejected or the range of their parameters is significantly constrained with consequent observations and theoretical analysis. In recent years, a number of alternative theories of gravity have been proposed because there are dark matter (DM) and dark energy (DE) problems. An alternative theory of gravity may be considered as one possible solution for such problems. Some of these theories have black hole solutions, while other theories have no such solutions. There are attempts to describe the Galactic Center with alternative theories of gravity and in this case one can constrain parameters of such theories with observational data for the Galactic Center. In particular, theories of massive gravity are intensively developing and theorists have overcome pathologies presented in the initial versions of these theories. In theories of massive gravity, a graviton is massive in contrast with GR where a graviton is massless. Now these theories are considered as an alternative to GR. For example, the LIGO-Virgo collaboration obtained the graviton mass constraint of about 1.2 × 10‑22 eV in their first publication about the discovery of the first gravitational wave detection event that resulted of the merger of two massive black holes. Surprisingly, one could obtain a consistent and comparable constraint of graviton mass at a level around mg
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Joint Center Estimation Using Single-Frame Optimization: Part 1: Numerical Simulation.
Frick, Eric; Rahmatalla, Salam
2018-04-04
The biomechanical models used to refine and stabilize motion capture processes are almost invariably driven by joint center estimates, and any errors in joint center calculation carry over and can be compounded when calculating joint kinematics. Unfortunately, accurate determination of joint centers is a complex task, primarily due to measurements being contaminated by soft-tissue artifact (STA). This paper proposes a novel approach to joint center estimation implemented via sequential application of single-frame optimization (SFO). First, the method minimizes the variance of individual time frames’ joint center estimations via the developed variance minimization method to obtain accurate overall initial conditions. These initial conditions are used to stabilize an optimization-based linearization of human motion that determines a time-varying joint center estimation. In this manner, the complex and nonlinear behavior of human motion contaminated by STA can be captured as a continuous series of unique rigid-body realizations without requiring a complex analytical model to describe the behavior of STA. This article intends to offer proof of concept, and the presented method must be further developed before it can be reasonably applied to human motion. Numerical simulations were introduced to verify and substantiate the efficacy of the proposed methodology. When directly compared with a state-of-the-art inertial method, SFO reduced the error due to soft-tissue artifact in all cases by more than 45%. Instead of producing a single vector value to describe the joint center location during a motion capture trial as existing methods often do, the proposed method produced time-varying solutions that were highly correlated ( r > 0.82) with the true, time-varying joint center solution.
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Resonance fluorescence and quantum interference of a single NV center
NASA Astrophysics Data System (ADS)
Ma, Yong-Hong; Zhang, Xue-Feng; Wu, E.
2017-11-01
The detection of a single nitrogen-vacancy center in diamond has attracted much interest, since it is expected to lead to innovative applications in various domains of quantum information, including quantum metrology, information processing and communications, as well as in various nanotechnologies, such as biological and subdiffraction limit imaging, and tests of entanglement in quantum mechanics. We propose a novel scheme of a single NV center coupled with a multi-mode superconducting microwave cavity driven by coherent fields in squeezed vacuum. We numerically investigate the spectra in-phase quadrature and out-of-phase quadrature for different driving regimes with or without detunings. It shows that the maximum squeezing can be obtained for optimal Rabi fields. Moreover, with the same parameters, the maximum squeezing is greatly increased when the detunings are nonzero compared to the resonance case.
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Unintentional Epinephrine Auto-injector Injuries: A National Poison Center Observational Study.
Anshien, Marco; Rose, S Rutherfoord; Wills, Brandon K
2016-11-24
Epinephrine is the only first-line therapeutic agent used to treat life-threatening anaphylaxis. Epinephrine auto-injectors are commonly carried by patients at risk for anaphylaxis, and reported cases of unintentional auto-injector injury have increased over the last decade. Modifications of existing designs and release of a new style of auto-injector are intended to reduce epinephrine auto-injector misuse. The aim of the study was to characterize reported cases of unintentional epinephrine auto-injector exposures from 2013 to 2014 and compare demographics, auto-injector model, and anatomical site of such exposures. The American Association of Poison Control Center's National Poison Data System was searched from January 1, 2013, to December 31, 2014, for cases of unintentional epinephrine auto-injector exposures. Anatomical site data were obtained from all cases reported to the Virginia Poison Center and participating regional poison center for Auvi-Q cases. A total of 6806 cases of unintentional epinephrine auto-injector exposures were reported to US Poison Centers in 2013 and 2014. Of these cases, 3933 occurred with EpiPen, 2829 with EpiPen Jr, 44 with Auvi-Q, and no case reported of Adrenaclick. The most common site of unintentional injection for traditional epinephrine auto-injectors was the digit or thumb, with 58% of cases for EpiPen and 39% of cases with EpiPen Jr. With Auvi-Q, the most common site was the leg (78% of cases). The number of unintentional epinephrine auto-injector cases reported to American Poison Centers in 2013-2014 has increased compared with previous data. Most EpiPen exposures were in the digits, whereas Auvi-Q was most frequently in the leg. Because of the limitations of Poison Center data, more research is needed to identify incidence of unintentional exposures and the effectiveness of epinephrine auto-injector redesign.
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Beniwal, Pankaj; Pursnani, Lalit; Sharma, Sanjeev; Garsa, R K; Mathur, Mohit; Dharmendra, Prasad; Malhotra, Vinay; Agarwal, Dhanajai
2016-01-01
Studies published from centers across India have reported different and contradicting patterns of glomerular disease. In this retrospective study, we report our experience from a Tertiary Care Center in Northwest India. A total of 702 renal biopsies performed between 2008 and 2013 were reviewed of which 80 were excluded from the study because of having insufficient records or if the biopsies were taken from an allograft. The study included 411 males (66.1 %) and 211 females (33.9%) with an age range of 12-70 years (mean 30.34 ± 7.04 years). Majority of the biopsies (93.9%) showed some form of glomerulonephritis (GN), either primary (79.4%) or secondary glomerular disease (SGD) (14.5%). Minimal change disease (MCD) was the most common type of primary GN (26.5% of primary GN), followed by membranous nephropathy (MN; 18.8%) and focal and segmental glomerulosclerosis (FSGS; 13.2%). Lupus nephritis (LN) was the most frequent SGD (52.2% of secondary GN). Amyloidosis was found in 41.1% and diabetic glomerulosclerosis in 4.4%. LN was also the second most common diagnosis in females after MCD, seen in 19.4% of females. MCD followed by membranoproliferative GN and diffuse proliferative GN were the most common entities in individuals <20 years of age. In the 20-39 years age group, MN was the most common pathology seen. MN was again the most common pathology seen in patients aged above 40 years followed by amyloidosis and FSGS. In this study, MCD was the most common primary GN observed overall from this part of India. MN was the most common GN in individuals above 20 years of age presenting with the nephrotic syndrome. The geographical and regional differences in the pattern of GNs point to the necessity of having a central biopsy registry.
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Rice University observations of the galactic center
NASA Technical Reports Server (NTRS)
Meegan, C. A.
1978-01-01
The most sensitive of the four balloon fight observations of the galactic center made by Rice University was conducted in 1974 from Rio Cuarto, Argentina at a float altitude of 4 mbar. The count rate spectrum of the observed background and the energy spectrum of the galactic center region are discussed. The detector used consists of a 6 inch Nal(T 1ambda) central detector collimated to approximately 15 deg FWHM by a Nal(T lamdba) anticoincidence shield. The shield in at least two interaction mean free paths thick at all gamma ray energies. The instrumental resolution is approximately 11% FWHM at 662 keV. Pulses from the central detector are analyzed by two 256 channel PHA's covering the energy range approximately 20 keV to approximately 12 MeV. The detector is equatorially mounted and pointed by command from the ground. Observations are made by measuring source and background alternately for 10 minute periods. Background is measured by rotating the detector 180 deg about the azimuthal axis.
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Koakutsu, Tomoaki; Sato, Tetsuya; Aizawa, Toshimi; Itoi, Eiji; Kushimoto, Shigeki
2018-04-15
Single-institutional, prospective observational study. To elucidate the perioperative kinetics of presepsin (PSEP) in patients undergoing spinal surgery, and to evaluate the possibility of PSEP in the early diagnosis of surgical site infection (SSI). Early diagnosis of SSI after spinal surgery is important. Although several biomarkers have been used as early indicators of SSI, the specificity of these markers in SSI diagnosis was not high. PSEP was found as a novel diagnostic marker for bacterial sepsis in 2004. However, its kinetics after spinal surgery and its usefulness in early diagnosis of SSI have never been evaluated. A total of 118 patients who underwent elective spinal surgery were enrolled. PSEP was measured before, immediately after, 1 day after, and 1 week after surgery. In patients without postoperative infection, perioperative kinetics of PSEP were analyzed. PSEP levels in patients with postoperative infection were also recorded separately, and their utility in SSI diagnosis was evaluated. In the 115 patients without postoperative infection, the median PSEP value was 126, 171, 194, and 147 pg/mL before, immediately after, 1 day after, and 1 week after surgery, respectively. Compared with the preoperative value, PSEP was significantly higher immediately after surgery and the next day, and return to the preoperative level 1 week after surgery. The estimated reference value for 95 percentile in patients without postoperative infection was 297 pg/mL 1 week after surgery. In three patients with postoperative infection, higher levels (>300 pg/mL) were observed 1 week after surgery. In patients after spinal surgery without infectious complications, blood levels of PSEP may immediately increase and return to preoperative levels 1 week after surgery. The PSEP value of 300 pg/mL 1 week after surgery might be used as a novel indicator for suspected SSI. 4.
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Getahun, Belete; Nkosi, Zethu Zerish
2017-01-01
The directly observed treatment, short course (DOTS) strategy has been considered as an efficacious approach for better tuberculosis (TB) treatment adherence and outcome. However, its level of patient centerdness has not been studied and documented well. Hence, the study aimed to determine the level of patient centeredness' of the DOTS. The study used explanatory sequential mixed method design in Addis Ababa, Ethiopia. The study employed an interviewer-administered questionnaire with 601 patients with TB, focus group discussions with 23 TB experts, and telephonic-interview with 25 persons lost to follow-up from TB treatment. Descriptive and multivariable analyses carried out for the quantitative data while thematic analysis was used for the qualitative data. Forty percent of patients with TB had not received patient-centered TB care (PC-TB care) with DOTS. Male gender (AOR = 0.45, 95% CI 0.3, 0.7), good communication (AOR = 3.2, 95%CI 1.6, 6.1), and health care providers as a treatment supporter (AOR = 3.4, 95% CI 2.1, 5.48) had significant associations with PC-TB care. All persons lost to follow-up and TB experts perceived that DOTS is merely patient-centered. The identified categories were patient preferences, treatment supporter choice, integration of DOTS with nutritional support, mental health, and transport services, provider's commitment and communication skills. DOTS is limited to provide patient-centered TB care. Hence, DOTS needs a model that enhances effectiveness towards patient centeredness of TB care.
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Jabur, W L; Nasa, P; Mohammed, K A; Kulkarni, A; Tomaraei, S N
2018-01-01
Exercise-induced rhabdomyolysis (EIR) is an uncommon cause of severe rhabdomyolysis and a very rare cause of acute kidney injury (AKI). A prospective observational study of 25 patients diagnosed with EIR was conducted in a multispecialty hospital in Dubai, from 2009 to 2015. Five out of 25 patients experienced AKI necessitating temporary renal replacement therapy. The initial presentation, biochemical parameters, and clinical course of patients were monitored, to understand epidemiology and risk factors for the development of AKI. There was male preponderance (4 out of 5 patients), higher rate of systemic symptoms (all 5 patients) versus 60% in NRAKI), oligo-anuria (all 5 patients), compartment syndrome (3 out \\of 5) and severe dehydration seen in patients with RAKI group. On laboratory evaluation, there was higher rise in creatinine kinase (CK) enzyme, serum and urine myoglobin levels impaired renal function on presentation, hyperuricemia, high D-dimer level, PCV of more than 55%, found to be associated with RAKI as compared to NRAKI group. Hematuria by positive urine dipstick with absent red blood cells on urinalysis, is an insensitive tool as was present in only 62% and 43% of RAKI and NRAKI groups, respectively. It was also observed that delayed pesentation for medical care, metabolic acidosis, were commonly associated with AKI. All patients with RAKI required RRT for a comparable period of time (3-4 weeks). In all of them, no deterioration or relapse reported on follow-up of 3 months.
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Obstructive Sleep Apnea in Obese Hospitalized Patients: A Single Center Experience
Sharma, Sunil; Mather, Paul J.; Efird, Jimmy T.; Kahn, Daron; Shiue, Kristin Y.; Cheema, Mohammed; Malloy, Raymond; Quan, Stuart F.
2015-01-01
Study Objectives: Obstructive sleep apnea (OSA) is an important health problem associated with significant morbidity and mortality. This condition often is underrecognized in hospitalized patients. The aim of this study was to conduct a clinical pathway evaluation (CPE) among obese patients admitted to a tertiary care hospital. We also assessed oxygen desaturation index (ODI, measured by overnight pulse oximetry) as a potential low-cost screening tool for identifying OSA. Methods: This was a prospective study of 754 patients admitted to an academic medical center between February 2013 and February 2014. Consecutive obese patients (body mass index ≥ 30) admitted to the hospital (medical services) were screened and evaluated for OSA with the snoring, tiredness during daytime, observed apnea, high blood pressure (STOP) questionnaire. The admitting team was advised to perform follow-up evaluation, including polysomnography, if the test was positive. Results: A total of 636 patients were classified as high risk and 118 as low risk for OSA. Within 4 w of discharge, 149 patients underwent polysomnography, and of these, 87% (129) were shown to have OSA. An optimal screening cutoff point for OSA (apnea-hypopnea index ≥ 10/h) was determined to be ODI ≥ 10/h [Matthews correlation coefficient = 0.36, 95% confidence interval = 0.24–0.47]. Significantly more hospitalized patients were identified and underwent polysomnography compared with the year prior to introduction of the CPE. Conclusions: Our results indicate that the CPE increased the identification of OSA in this population. Furthermore, ODI derived from overnight pulse oximetry may be a cost-effective strategy to screen for OSA in hospitalized patients. Citation: Sharma S, Mather PJ, Efird JT, Kahn D, Shiue KY, Cheema M, Malloy R, Quan SF. Obstructive sleep apnea in obese hospitalized patients: a single center experience. J Clin Sleep Med 2015;11(7):717–723. PMID:25766715
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Cancer Therapy Directed by Comprehensive Genomic Profiling: A Single Center Study.
Wheler, Jennifer J; Janku, Filip; Naing, Aung; Li, Yali; Stephen, Bettzy; Zinner, Ralph; Subbiah, Vivek; Fu, Siqing; Karp, Daniel; Falchook, Gerald S; Tsimberidou, Apostolia M; Piha-Paul, Sarina; Anderson, Roosevelt; Ke, Danxia; Miller, Vincent; Yelensky, Roman; Lee, J Jack; Hong, David S; Kurzrock, Razelle
2016-07-01
Innovative molecular diagnostics deployed in the clinic enable new ways to stratify patients into appropriate treatment regimens. These approaches may resolve a major challenge for early-phase clinical trials, which is to recruit patients who, while having failed previous treatments, may nevertheless respond to molecularly targeted drugs. We report the findings of a prospective, single-center study conducted in patients with diverse refractory cancers who underwent comprehensive genomic profiling (CGP; next-generation sequencing, 236 genes). Of the 500 patients enrolled, 188 (37.6%) received either matched (N = 122/188, 65%) or unmatched therapy (N = 66/188, 35%). The most common reasons that patients were not evaluable for treatment included insufficient tissue, death, or hospice transfer. The median number of molecular alterations per patient was five (range, 1-14); median number of prior therapies, four. The most common diagnoses were ovarian cancer (18%), breast cancer (16%), sarcoma (13%), and renal cancer (7%). Of the 339 successfully profiled patients, 317 (93.5%) had at least one potentially actionable alteration. By calculating matching scores, based on the number of drug matches and genomic aberrations per patient, we found that high scores were independently associated with a greater frequency of stable disease ≥6 months/partial/complete remission [22% (high scores) vs. 9% (low scores), P = 0.024], longer time-to-treatment failure [hazard ratio (HR) = 0.52; 95% confidence interval (CI) = 0.36-0.74; P = 0.0003], and survival (HR = 0.65; 95% CI = 0.43-1.0; P = 0.05). Collectively, this study offers a clinical proof of concept for the utility of CGP in assigning therapy to patients with refractory malignancies, especially in those patients with multiple genomic aberrations for whom combination therapies could be implemented. Cancer Res; 76(13); 3690-701. ©2016 AACR. ©2016 American Association for Cancer Research.
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In, Juneho; Yoo, Youngdong; Kim, Jin-Gyu; Seo, Kwanyong; Kim, Hyunju; Ihee, Hyotchel; Oh, Sang Ho; Kim, Bongsoo
2010-11-10
Laterally epitaxial single crystalline Ag2Te nanowires (NWs) are synthesized on sapphire substrates by the vapor transport method. We observed the phase transitions of these Ag2Te NWs via in situ transmission electron microscopy (TEM) after covering them with Pt layers. The constrained NW shows phase transition from monoclinic to a body-centered cubic (bcc) structure near the interfaces, which is ascribed to the thermal stress caused by differences in the thermal expansion coefficients. Furthermore, we observed the nucleation and growth of bcc phase penetrating into the face-centered cubic matrix at 200 °C by high-resolution TEM in real time. Our results would provide valuable insight into how compressive stresses imposed by overlayers affect behaviors of nanodevices.
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Ames Research Center SR&T program and earth observations
NASA Technical Reports Server (NTRS)
Poppoff, I. G.
1972-01-01
An overview is presented of the research activities in earth observations at Ames Research Center. Most of the tasks involve the use of research aircraft platforms. The program is also directed toward the use of the Illiac 4 computer for statistical analysis. Most tasks are weighted toward Pacific coast and Pacific basin problems with emphasis on water applications, air applications, animal migration studies, and geophysics.
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Outcomes of Kidney Transplantation Abroad: A Single-Center Canadian Cohort Study.
Quach, Kevin; Sultan, Heebah; Li, Yanhong; Famure, Olusegun; Kim, S Joseph
2016-03-01
An increasing demand for kidney transplantation has enticed some patients with end-stage renal disease (ESRD) to venture outside their country of residence, but their posttransplant outcomes may be suboptimal. We compared the risks and clinical outcomes among tourists, or patients who pursue a kidney transplant abroad, versus patients who received a transplant at the Toronto General Hospital (TGH). A single-center, 1:3 matched (based on age at transplant, time on dialysis, and year of transplant) cohort study was conducted. Forty-five tourists were matched with 135 domestic transplant recipients between January 1, 2000, and December 31, 2011. Multivariable Cox proportional hazards models were fitted to assess graft and patient outcomes. Among the 45 tourists, the majority (38 of 45) traveled to the Middle East or Far East Asia, and most received living donor kidney transplants (35 of 45). Multivariable Cox proportional hazards models showed that tourists had a higher risk for the composite outcome of acute rejection, death-censored graft failure, or death with graft function (DWGF; hazard ratio [HR] 2.08, 95% confidence interval [CI]: 1.06-4.07). Tourists also showed a higher risk for the individual end points of acute rejection, DWGF, and posttransplant hospitalizations. Patients going abroad for kidney transplantation may have inferior outcomes compared to domestic patients receiving kidney transplants. Patients who are contemplating an overseas transplant need to be aware of the increased risk of adverse posttransplant outcomes and should be appropriately counseled by transplant professionals during the pretransplant evaluation process. © 2016, NATCO.
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In situ TEM observation of preferential amorphization in single crystal Si nanowire
NASA Astrophysics Data System (ADS)
Su, Jiangbin; Zhu, Xianfang
2018-06-01
The nanoinstability of a single crystal Si nanowire under electron beam irradiation was in situ investigated at room temperature by the transmission electron microscopy technique. It was observed that the Si nanowire amorphized preferentially from the surface towards the center, with the increasing of the electron dose. In contrast, in the center of the Si nanowire the amorphization seemed much more difficult, being accompanied by the rotation of crystal grains and the compression of d-spacing. Such a preferential amorphization, which is athermally induced by the electron beam irradiation, can be well accounted for by our proposed concepts of the nanocurvature effect and the energetic beam-induced athermal activation effect, while the classical knock-on mechanism and the electron beam heating effect seem inadequate to explain these processes. Furthermore, the findings revealed the difference of amorphization between a Si nanowire and a Si film under electron beam irradiation. Also, the findings have important implications for the nanoinstability and nanoprocessing of future Si nanowire-based devices.
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In situ TEM observation of preferential amorphization in single crystal Si nanowire.
Su, Jiangbin; Zhu, Xianfang
2018-06-08
The nanoinstability of a single crystal Si nanowire under electron beam irradiation was in situ investigated at room temperature by the transmission electron microscopy technique. It was observed that the Si nanowire amorphized preferentially from the surface towards the center, with the increasing of the electron dose. In contrast, in the center of the Si nanowire the amorphization seemed much more difficult, being accompanied by the rotation of crystal grains and the compression of d-spacing. Such a preferential amorphization, which is athermally induced by the electron beam irradiation, can be well accounted for by our proposed concepts of the nanocurvature effect and the energetic beam-induced athermal activation effect, while the classical knock-on mechanism and the electron beam heating effect seem inadequate to explain these processes. Furthermore, the findings revealed the difference of amorphization between a Si nanowire and a Si film under electron beam irradiation. Also, the findings have important implications for the nanoinstability and nanoprocessing of future Si nanowire-based devices.
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Getahun, Belete; Nkosi, Zethu Zerish
2017-01-01
Introduction The directly observed treatment, short course (DOTS) strategy has been considered as an efficacious approach for better tuberculosis (TB) treatment adherence and outcome. However, its level of patient centerdness has not been studied and documented well. Hence, the study aimed to determine the level of patient centeredness’ of the DOTS. Method The study used explanatory sequential mixed method design in Addis Ababa, Ethiopia. The study employed an interviewer-administered questionnaire with 601 patients with TB, focus group discussions with 23 TB experts, and telephonic-interview with 25 persons lost to follow-up from TB treatment. Descriptive and multivariable analyses carried out for the quantitative data while thematic analysis was used for the qualitative data. Result Forty percent of patients with TB had not received patient-centered TB care (PC-TB care) with DOTS. Male gender (AOR = 0.45, 95% CI 0.3, 0.7), good communication (AOR = 3.2, 95%CI 1.6, 6.1), and health care providers as a treatment supporter (AOR = 3.4, 95% CI 2.1, 5.48) had significant associations with PC-TB care. All persons lost to follow-up and TB experts perceived that DOTS is merely patient-centered. The identified categories were patient preferences, treatment supporter choice, integration of DOTS with nutritional support, mental health, and transport services, provider’s commitment and communication skills. Conclusion DOTS is limited to provide patient-centered TB care. Hence, DOTS needs a model that enhances effectiveness towards patient centeredness of TB care. PMID:28763456
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Zhang, Jingyuan Linda; Lagoudakis, Konstantinos G.; Tzeng, Yan -Kai; ...
2017-10-23
Arrays of identical and individually addressable qubits lay the foundation for the creation of scalable quantum hardware such as quantum processors and repeaters. Silicon-vacancy (SiV) centers in diamond offer excellent physical properties such as low inhomogeneous broadening, fast photon emission, and a large Debye–Waller factor. The possibility for all-optical ultrafast manipulation and techniques to extend the spin coherence times makes them promising candidates for qubits. Here, we have developed arrays of nanopillars containing single (SiV) centers with high yield, and we demonstrate ultrafast all-optical complete coherent control of the excited state population of a single SiV center at the opticalmore » transition frequency. The high quality of the chemical vapor deposition (CVD) grown SiV centers provides excellent spectral stability, which allows us to coherently manipulate and quasi-resonantly read out the excited state population of individual SiV centers on picosecond timescales using ultrafast optical pulses. Furthermore, this work opens new opportunities to create a scalable on-chip diamond platform for quantum information processing and scalable nanophotonics applications.« less
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Zhang, Jingyuan Linda; Lagoudakis, Konstantinos G.; Tzeng, Yan -Kai
Arrays of identical and individually addressable qubits lay the foundation for the creation of scalable quantum hardware such as quantum processors and repeaters. Silicon-vacancy (SiV) centers in diamond offer excellent physical properties such as low inhomogeneous broadening, fast photon emission, and a large Debye–Waller factor. The possibility for all-optical ultrafast manipulation and techniques to extend the spin coherence times makes them promising candidates for qubits. Here, we have developed arrays of nanopillars containing single (SiV) centers with high yield, and we demonstrate ultrafast all-optical complete coherent control of the excited state population of a single SiV center at the opticalmore » transition frequency. The high quality of the chemical vapor deposition (CVD) grown SiV centers provides excellent spectral stability, which allows us to coherently manipulate and quasi-resonantly read out the excited state population of individual SiV centers on picosecond timescales using ultrafast optical pulses. Furthermore, this work opens new opportunities to create a scalable on-chip diamond platform for quantum information processing and scalable nanophotonics applications.« less
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Peters, Shannon E; Laxer, Ronald M; Connolly, Bairbre L; Parra, Dimitri A
2017-04-11
The aims of this study were to: (a) Identify tendon sheaths most commonly treated with steroid injections in a pediatric patient population with Juvenile Idiopathic Arthritis (JIA); (b) Describe technical aspects of the procedure; (c) Characterize sonographic appearance of tenosynovitis in JIA; (d) Assess agreement between clinical request and sites injected. This was a 10 year single-center retrospective study (May 2006-April 2016) of patients with JIA referred by Rheumatology for ultrasound-guided tendon sheath injections. Patient demographics, clinical referral information, sonographic appearance of the tendon sheaths and technical aspects of the procedure were analyzed. There were 308 procedures of 244 patients (75% female, mean age 9.6 years) who underwent a total of 926 tendon sheath injections. Ankle tendons were most commonly injected (84.9%), specifically the tendon sheaths of tibialis posterior (22.3%), peroneus longus (20%) and brevis (19.7%). The majority of treated sites (91.9%) showed peritendinous fluid and sheath thickening on ultrasound. There were 2 minor intra-procedure complications without sequelae. A good agreement between clinical request and sites injected was observed. Ultrasound-guided tendon sheath injections with steroids are used frequently to treat patients with JIA. It is a safe intervention with a high technical success rate. The ankle region, specifically the medial compartment, is the site most commonly injected in this group of patients. The most common sonographic finding is peritendinous fluid and sheath thickening. These findings might assist clinicians and radiologists to characterize and more effectively manage tenosynovitis in patients with JIA.
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Single transverse mode laser in a center-sunken and cladding-trenched Yb-doped fiber.
Liu, Yehui; Zhang, Fangfang; Zhao, Nan; Lin, Xianfeng; Liao, Lei; Wang, Yibo; Peng, Jinggang; Li, Haiqing; Yang, LuYun; Dai, NengLi; Li, Jinyan
2018-02-05
We report a novel center-sunken and cladding-trenched Yb-doped fiber, which was fabricated by a modified chemical vapor deposition process with a solution-doping technique. The simulation results showed that the fiber with a core diameter of 40 µm and a numerical aperture of 0.043 has a 1217 µm 2 effective mode area at 1080 nm. It is also disclosed that the leakage loss can be reduced lower than 0.01 dB/m for the LP 01 mode, while over 80 dB/m for the LP 11 mode by optimizing the bending radius as 14 cm. A 456 W laser output was observed in a MOPA structure. The laser slope efficiency was measured to be 79% and the M 2 was less than 1.1, which confirmed the single mode operation of the large mode area center-sunken cladding-trenched Yb-doped fiber.
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MRI evaluation following partial HIFU therapy for localized prostate cancer: A single-center study.
Hoquetis, L; Malavaud, B; Game, X; Beauval, J B; Portalez, D; Soulie, M; Rischmann, P
2016-09-01
To evaluate the value of MRI for surveillance of primary hemi-HIFU therapy for localized PCa in a single-center. Patients with localized prostate cancer were treated with hemi-HIFU from October 2009 to March 2014. All patients performed MRI before focal therapy, the reader was blinded to the treatment. Oncological failure was defined as positive biopsy or biochemical recurrence (Phoenix). Twenty-five patients were treated with hemi-HIFU in one center. The median nadir PSA was 1.45±1.4ng/mL. Prostate volume decreased from 45 cc to 25 cc on MRI findings. At 20 months, none of the patients had histological recurrence. Biochemical-free survival rate was 88%. MRI evaluation had a negative predictive value of 100% on the treated area and 81% on the untreated area. PSAd≥0.1ng/mL(2) was a predictive factor for cancer on untreated area (P=0.042). MRI control at 6 months is a potentially effective evaluation of treated area after hemi-HIFU and may replace randomized biopsies if PSAd<0.1ng/mL(2) during follow-up. 4. Copyright © 2016 Elsevier Masson SAS. All rights reserved.
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The role of CEUS in characterization of superficial lymph nodes: a single center prospective study
de Stefano, Giorgio; Scognamiglio, Umberto; Di Martino, Filomena; Parrella, Roberto; Scarano, Francesco; Signoriello, Giuseppe; Farella, Nunzia
2016-01-01
Accurate lymph node characterization is important in a large number of clinical settings. We evaluated the usefulness of Contrast Enhanced Ultrasound (CEUS) in distinguishing between benign and malignant lymph nodes compared with conventional ultrasonography in the differential diagnosis of superficial lymphadenopathy. We present our experience for 111 patients enrolled in a single center. 111 superficial lymph nodes were selected and only 1 lymph node per patient underwent CEUS. A definitive diagnosis for all lymph nodes was obtained by ultrasonographically guided biopsy and/or excision biopsy. The size of the lymph nodes, the site (neck, axilla, inguinal region) being easily accessible for biopsy, and the US and color Doppler US characteristics guided us in selecting the nodes to be evaluated by CEUS. In our study we identified different enhancement patterns in benign and malignant lymph nodes, with a high degree of diagnostic accuracy for superficial lymphadenopathy in comparison with conventional US. PMID:27191746
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Rashid, Aafia; Bhat, Javaid Ahmad; Ganie, Mohd Ashraf; Wani, Imtiyaz Ahmad; Bhat, Moomin Hussain; Shah, Zaffar Amin; Masoodi, Shariq R; Marwaha, R K
2018-05-07
Polycystic ovary syndrome (PCOS), a major endocrinopathy is associated with barrage of metabolic aberrations. Reports in literature on association of PCOS and autoimmunity are conflicting. We aim to evaluate serum levels of anti-nuclear antibody (ANA) among Indian women with PCOS. In this hospital-based single center cross-sectional study, women qualifying a diagnosis of PCOS by Rotterdam criteria 2003 were recruited. Eighty-nine eligible women who consented were enrolled. All these women along with 87 age-matched, healthy controls underwent, clinical (menstrual history, anthropometry, hirsutism scoring), biochemical, hormonal assessment and serum ANA estimation. OGTT after overnight (8-12 h) fast with 75 g oral glucose load was done for 1 h, 2 h glucose and insulin measurements. The mean age of cases and controls was comparable (22.67 ± 5.53 vs. 22.84 ± 3.64 years). The prevalence of ANA positivity was significantly higher among women with PCOS (18.4% vs. 2.29%; p < .001). Though significant correlation was observed between ANA positivity and clinical signs of hyperandrogenism and plasma glucose, no significant correlation was noted between ANA status and other hormonal parameters. Higher prevalence of ANA positivity among women with PCOS, being a marker of autoimmunity, suggests a possible role of autoimmunity in causation of PCOS and needs further elucidation.
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Complete Quantum Control of a Single Silicon-Vacancy Center in a Diamond Nanopillar
NASA Astrophysics Data System (ADS)
Zhang, Jingyuan Linda; Lagoudakis, Konstantinos G.; Tzeng, Yan-Kai; Dory, Constantin; Radulaski, Marina; Kelaita, Yousif; Shen, Zhi-Xun; Melosh, Nicholas A.; Chu, Steven; Vuckovic, Jelena
Coherent quantum control of a quantum bit (qubit) is an important step towards its use in a quantum network. SiV- center in diamond offers excellent physical qualities such as low inhomogeneous broadening, fast photon emission, and a large Debye-Waller factor, while the fast spin manipulation and techniques to extend the spin coherence time are under active investigation. Here, we demonstrate full coherent control over the state of a single SiV- center in a diamond nanopillar using ultrafast optical pulses. The high quality of the chemical vapor deposition grown SiV- centers allows us to coherently manipulate and quasi-resonantly read out the state of the single SiV- center. Moreover, the SiV- centers being coherently controlled are integrated into diamond nanopillar arrays in a site-controlled, individually addressable manner with high yield, low strain, and high spectral stability, which paves the way for scalable on chip optically accessible quantum system in a quantum photonic network. Financial support is provided by the DOE Office of Basic Energy Sciences, Division of Materials Sciences through Stanford Institute for Materials and Energy Sciences (SIMES) under contract DE-AC02-76SF00515.
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Faklaris, Orestis; Garrot, Damien; Joshi, Vandana; Druon, Frédéric; Boudou, Jean-Paul; Sauvage, Thierry; Georges, Patrick; Curmi, Patrick A; Treussart, François
2008-12-01
Diamond nanoparticles are promising photoluminescent probes for tracking intracellular processes, due to embedded, perfectly photostable color centers. In this work, the spontaneous internalization of such nanoparticles (diameter 25 nm) in HeLa cancer cells is investigated by confocal microscopy and time-resolved techniques. Nanoparticles are observed inside the cell cytoplasm at the single-particle and single-color-center level, assessed by time-correlation intensity measurements. Improvement of the nanoparticle signal-to-noise ratio inside the cell is achieved using a pulsed-excitation laser and time-resolved detection taking advantage of the long radiative lifetime of the color-center excited state as compared to cell autofluorescence. The internalization pathways are also investigated, with endosomal marking and colocalization analyses. The low colocalization ratio observed proves that nanodiamonds are not trapped in endosomes, a promising result in prospect of drug delivery by these nanoparticles. Low cytotoxicity of these nanoparticles in this cell line is also shown.
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NASA Astrophysics Data System (ADS)
Khramtsov, Igor A.; Vyshnevyy, Andrey A.; Fedyanin, Dmitry Yu.
2018-03-01
Practical applications of quantum information technologies exploiting the quantum nature of light require efficient and bright true single-photon sources which operate under ambient conditions. Currently, point defects in the crystal lattice of diamond known as color centers have taken the lead in the race for the most promising quantum system for practical non-classical light sources. This work is focused on a different quantum optoelectronic material, namely a color center in silicon carbide, and reveals the physics behind the process of single-photon emission from color centers in SiC under electrical pumping. We show that color centers in silicon carbide can be far superior to any other quantum light emitter under electrical control at room temperature. Using a comprehensive theoretical approach and rigorous numerical simulations, we demonstrate that at room temperature, the photon emission rate from a p-i-n silicon carbide single-photon emitting diode can exceed 5 Gcounts/s, which is higher than what can be achieved with electrically driven color centers in diamond or epitaxial quantum dots. These findings lay the foundation for the development of practical photonic quantum devices which can be produced in a well-developed CMOS compatible process flow.
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Ebstein's anomaly in children: a single-center study in Angola.
Manuel, Valdano; Morais, Humberto; Magalhães, Manuel Pedro; Nunes, Maria Ana Sampaio; Leon, Gilberto; Ferreira, Manuel; Filipe Júnior, António Pedro
2015-10-01
Ebstein's anomaly is a rare complex congenital heart defect of the tricuspid valve. We aimed to describe the frequency, clinical profile, and early and short-term post-operative results in patients under the age of 18 years operated for this anomaly in a tertiary center in Angola. A retrospective cross-sectional study was conducted over a period of 37 months. We analyzed all patients diagnosed with congenital heart defects. Of the 1362 patients studied, eight (0.6%) had Ebstein's anomaly; six patients (75%) were female. Mean age was 69±59 months. Five patients were in NYHA functional class III or IV. Mean cardiothoracic index was 0.72. Seven patients (87.5%) had severe tricuspid regurgitation and five (62.5%) had another associated congenital heart defect. All patients were operated: two had complications and one (12.5%) died in the early post-operative period. The mean follow-up time was 1.22±0.6 years, and mortality during follow-up was 12.5% (n=1). At the end of the study, of the five patients in whom cone reconstruction was performed, four (80%) were in functional class I. Mean cardiothoracic index decreased to 0.64. Three patients had mild and two had moderate tricuspid regurgitation. The patient who underwent cone reconstruction and a Glenn procedure was in functional class I. The frequency of Ebstein's anomaly was similar to that in other centers. Cone reconstruction was viable in the majority of patients, with good early and short-term results. Copyright © 2015 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.
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Center-to-limb observations and modeling of the Ca I 4227 Å line
DOE Office of Scientific and Technical Information (OSTI.GOV)
Supriya, H. D.; Smitha, H. N.; Nagendra, K. N.
2014-09-20
The observed center-to-limb variation (CLV) of the scattering polarization in different lines of the Second Solar Spectrum can be used to constrain the height variation of various atmospheric parameters, in particular the magnetic fields, via the Hanle effect. Here we attempt to model the nonmagnetic CLV observations of the Q/I profiles of the Ca I 4227 Å line recorded with the Zurich Imaging Polarimeter-3 at IRSOL. For modeling, we use the polarized radiative transfer with partial frequency redistribution with a number of realistic one-dimensional (1D) model atmospheres. We find that all the standard Fontenla-Avrett-Loeser (FAL) model atmospheres, which we used,more » fail to simultaneously fit the observed (I, Q/I) at all the limb distances (μ). However, an attempt is made to find a single model which can provide a fit to at least the CLV of the observed Q/I instead of a simultaneous fit to the (I, Q/I) at all μ. To this end we construct a new 1D model by combining two of the standard models after modifying their temperature structures in the appropriate height ranges. This new combined model closely reproduces the observed Q/I at all μ but fails to reproduce the observed rest intensity at different μ. Hence we find that no single 1D model atmosphere succeeds in providing a good representation of the real Sun. This failure of 1D models does not, however, cause an impediment to the magnetic field diagnostic potential of the Ca I 4227 Å line. To demonstrate this we deduce the field strength at various μ positions without invoking the use of radiative transfer.« less
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Lenz, Philipp; Roggel, Moritz; Domagk, Dirk
2013-09-01
This study aims to compare double- (DBE) and single-balloon enteroscopy (SBE) in small bowel disorders with respect to procedural performance and clinical impact. This retrospective analysis at a tertial referral center included 1,052 DBEs and 515 SBEs performed in 904 patients over 7 years. Procedural and patients' characteristics were precisely analyzed. Significantly more patients with anemia and gastrointestinal bleeding were investigated by DBE (P < 0.01). Oral insertion depth and length of investigated small bowel in the combined approach were significantly higher in the DBE compared to the SBE group (245 ± 65.3 vs. 218 ± 62.6 and 355 ± 101.9 vs. 319 ± 91.2, respectively; P < 0.001, each). By analyzing only recent years of enteroscopy (2008-2011), no difference in small bowel visualization could be observed. The anal insertion depths and complete enteroscopy rates (CER) were comparable. Procedure times were significantly shorter within the SBE procedure (oral: 50 vs. 40 min; anal: 55 vs. 46 min, P < 0.001) and the usage of sedation was significantly less (propofol: P < 0.001; pethidine: P < 0.05). Diagnostic yield was significantly higher in the SBE, compared to the DBE group (61.7 vs. 48.2 %; P < 0.001). The rate of severe adverse events was close to zero. Both enteroscopy techniques are safe diagnostic tools and proved to be indispensable in the daily gastroenterological practice. The lower insertion depths, but higher diagnostic yield, of SBE may reflect the more focused selection of patients scheduled for small bowel diagnostics in recent years.
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Variation of Static-PPP Positioning Accuracy Using GPS-Single Frequency Observations (Aswan, Egypt)
NASA Astrophysics Data System (ADS)
Farah, Ashraf
2017-06-01
Precise Point Positioning (PPP) is a technique used for position computation with a high accuracy using only one GNSS receiver. It depends on highly accurate satellite position and clock data rather than broadcast ephemeries. PPP precision varies based on positioning technique (static or kinematic), observations type (single or dual frequency) and the duration of collected observations. PPP-(dual frequency receivers) offers comparable accuracy to differential GPS. PPP-single frequency receivers has many applications such as infrastructure, hydrography and precision agriculture. PPP using low cost GPS single-frequency receivers is an area of great interest for millions of users in developing countries such as Egypt. This research presents a study for the variability of single frequency static GPS-PPP precision based on different observation durations.
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Compactly supported linearised observables in single-field inflation
DOE Office of Scientific and Technical Information (OSTI.GOV)
Fröob, Markus B.; Higuchi, Atsushi; Hack, Thomas-Paul, E-mail: mbf503@york.ac.uk, E-mail: thomas-paul.hack@itp.uni-leipzig.de, E-mail: atsushi.higuchi@york.ac.uk
We investigate the gauge-invariant observables constructed by smearing the graviton and inflaton fields by compactly supported tensors at linear order in general single-field inflation. These observables correspond to gauge-invariant quantities that can be measured locally. In particular, we show that these observables are equivalent to (smeared) local gauge-invariant observables such as the linearised Weyl tensor, which have better infrared properties than the graviton and inflaton fields. Special cases include the equivalence between the compactly supported gauge-invariant graviton observable and the smeared linearised Weyl tensor in Minkowski and de Sitter spaces. Our results indicate that the infrared divergences in the tensormore » and scalar perturbations in single-field inflation have the same status as in de Sitter space and are both a gauge artefact, in a certain technical sense, at tree level.« less
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Lai, Lillian; Liddy, Clare; Keely, Erin; Afkham, Amir; Kurzawa, Julia; Abdeen, Nishard; Audcent, Tobey; Bromwich, Matthew; Brophy, Jason; Carsen, Sasha; Fournier, Annick; Fraser-Roberts, Leigh; Gandy, Hazen; Hui, Charles; Johnston, Donna; Keely, Kathryn; Kontio, Ken; Lamontagne, Christine; Major, Nathalie; O'Connor, Michael; Radhakrishnan, Dhenuka; Reisman, Joe; Robb, Marjorie; Samson, Lindy; Sell, Erick; Splinter, William; van Stralen, Judy; Venkateswaran, Sunita; Murto, Kimmo
2018-01-01
Champlain BASE™ (Building Access to Specialists through eConsultation) is a web-based asynchronous electronic communication service that allows primary-care- practitioners (PCPs) to submit "elective" clinical questions to a specialist. For adults, PCPs have reported improved access and timeliness to specialist advice, averted face-to-face specialist referrals in up to 40% of cases and high provider satisfaction. To determine whether the expansion of eConsult to a pediatric setting would result in similar measures of improved healthcare system process and high provider acceptance reported in adults. Prospective observational cohort study. Single Canadian tertiary-care academic pediatric hospital (June 2014-16) servicing 1.2 million people. 1. PCPs already using eConsult. 2.Volunteer pediatric specialists provided services in addition to their regular workload. 3.Pediatric patients (< 18 years-old) referred for none-acute care conditions. Specialty service utilization and access, impact on PCP course-of-action and referral-patterns and survey-based provider satisfaction data were collected. 1064 eConsult requests from 367 PCPs were answered by 23 pediatric specialists representing 14 specialty-services. The top three specialties represented were: General Pediatrics 393 cases (36.9%), Orthopedics 162 (15.2%) and Psychiatry 123 (11.6%). Median specialist response time was 0.9 days (range <1 hour-27 days), most consults (63.2%) required <10minutes to complete and 21/21(100%) specialist survey-respondents reported minimal workload burden. For 515/1064(48.4%) referrals, PCPs received advice for a new or additional course of action; 391/1064(36.7%) referrals resulted in an averted face-to-face specialist visit. In 9 specialties with complete data, the median wait-time was significantly less (p<0.001) for an eConsult (1 day, 95%CI:0.9-1.2) compared with a face-to-face referral (132 days; 95%CI:127-136). The majority (>93.3%) of PCPs rated eConsult as very good
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Gibbons, Raymond J; Askew, J Wells; Hodge, David; Miller, Todd D
2010-03-01
The purpose of this study was to apply published appropriateness criteria for single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) in a single academic medical center to determine if the percentage of inappropriate studies was changing over time. In a previous study, we applied the American College of Cardiology Foundation/American Society of Nuclear Cardiology (ASNC) appropriateness criteria for stress SPECT MPI and reported that 14% of stress SPECT studies were performed for inappropriate reasons. Using similar methodology, we retrospectively examined 284 patients who underwent stress SPECT MPI in October 2006 and compared the findings to the previous cohort of 284 patients who underwent stress SPECT MPI in May 2005. The indications for testing in the 2 cohorts were very similar. The overall level of agreement in characterizing categories of appropriateness between 2 experienced cardiovascular nurse abstractors was good (kappa = 0.68), which represented an improvement from our previous study (kappa = 0.56). There was a significant change between May 2005 and October 2006 in the overall classification of categories for appropriateness (P = .024 by chi(2) statistic). There were modest, but insignificant, increases in the number of patients who were unclassified (15% in the current study vs 11% previously), appropriate (66% vs 64%), and uncertain (12% vs 11%). Only 7% of the studies in the current study were inappropriate, which represented a significant (P = .004) decrease from the 14% reported in the 2005 cohort. In the absence of any specific intervention, there was a significant change in the overall classification of SPECT appropriateness in an academic medical center over 17 months. The only significant difference in individual categories was a decrease in inappropriate studies. Additional measurements over time will be required to determine if this trend is sustainable or generalizable.
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Single-spin observables and orbital structures in hadronic distributions
NASA Astrophysics Data System (ADS)
Sivers, Dennis
2006-11-01
Single-spin observables in scattering processes (either analyzing powers or polarizations) are highly constrained by rotational invariance and finite symmetries. For example, it is possible to demonstrate that all single-spin observables are odd under the finite transformation O=PAτ where P is parity and Aτ is a finite symmetry that can be designated “artificial time reversal”. The operators P, O and Aτ all have eigenvalues ±1 so that all single-spin observables can be classified into two distinct categories: (1) P-odd and Aτ-even, (2) P-even and Aτ-odd. Within the light-quark sector of the standard model, P-odd observables are generated from pointlike electroweak processes while Aτ-odd observables (neglecting quark mass parameters) come from dynamic spin-orbit correlations within hadrons or within larger composite systems, such as nuclei. The effects of Aτ-odd dynamics can be inserted into transverse-momentum dependent constituent distribution functions and, in this paper, we construct the contribution from an orbital quark to the Aτ-odd quark parton distribution ΔNGq/p↑front(x,kTN;μ2). Using this distribution, we examine the crucial role of initial- and final-state interactions in the observation of the scattering asymmetries in different hard-scattering processes. This construction provides a geometrical and dynamical interpretation of the Collins conjugation relation between single-spin asymmetries in semi-inclusive deep inelastic scattering and the asymmetries in Drell-Yan production. Finally, our construction allows us to display a significant difference between the calculation of a spin asymmetry generated by a hard-scattering mechanism involving color-singlet exchange (such as a photon) and a calculation of an asymmetry with a hard-scattering exchange involving gluons. This leads to an appreciation of the process-dependence inherent in measurements of single-spin observables.
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Distinct Molecular Phenotypes of Direct vs Indirect ARDS in Single-Center and Multicenter Studies
Janz, David R.; Bernard, Gordon R.; May, Addison K.; Kangelaris, Kirsten N.; Matthay, Michael A.; Ware, Lorraine B.
2015-01-01
BACKGROUND: ARDS is a heterogeneous syndrome that encompasses lung injury from both direct and indirect sources. Direct ARDS (pneumonia, aspiration) has been hypothesized to cause more severe lung epithelial injury than indirect ARDS (eg, nonpulmonary sepsis); however, this hypothesis has not been well studied in humans. METHODS: We measured plasma biomarkers of lung epithelial and endothelial injury and inflammation in a single-center study of 100 patients with ARDS and severe sepsis and in a secondary analysis of 853 patients with ARDS drawn from a multicenter randomized controlled trial. Biomarker levels in patients with direct vs indirect ARDS were compared in both cohorts. RESULTS: In both studies, patients with direct ARDS had significantly higher levels of a biomarker of lung epithelial injury (surfactant protein D) and significantly lower levels of a biomarker of endothelial injury (angiopoietin-2) than those with indirect ARDS. These associations were robust to adjustment for severity of illness and ARDS severity. In the multicenter study, patients with direct ARDS also had lower levels of von Willebrand factor antigen and IL-6 and IL-8, markers of endothelial injury and inflammation, respectively. The prognostic value of the biomarkers was similar in direct and indirect ARDS. CONCLUSIONS: Direct lung injury in humans is characterized by a molecular phenotype consistent with more severe lung epithelial injury and less severe endothelial injury. The opposite pattern was identified in indirect lung injury. Clinical trials of novel therapies targeted specifically at the lung epithelium or endothelium may benefit from preferentially enrolling patients with direct and indirect ARDS, respectively. PMID:26033126
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Distinct molecular phenotypes of direct vs indirect ARDS in single-center and multicenter studies.
Calfee, Carolyn S; Janz, David R; Bernard, Gordon R; May, Addison K; Kangelaris, Kirsten N; Matthay, Michael A; Ware, Lorraine B
2015-06-01
ARDS is a heterogeneous syndrome that encompasses lung injury from both direct and indirect sources. Direct ARDS (pneumonia, aspiration) has been hypothesized to cause more severe lung epithelial injury than indirect ARDS (eg, nonpulmonary sepsis); however, this hypothesis has not been well studied in humans. We measured plasma biomarkers of lung epithelial and endothelial injury and inflammation in a single-center study of 100 patients with ARDS and severe sepsis and in a secondary analysis of 853 patients with ARDS drawn from a multicenter randomized controlled trial. Biomarker levels in patients with direct vs indirect ARDS were compared in both cohorts. In both studies, patients with direct ARDS had significantly higher levels of a biomarker of lung epithelial injury (surfactant protein D) and significantly lower levels of a biomarker of endothelial injury (angiopoietin-2) than those with indirect ARDS. These associations were robust to adjustment for severity of illness and ARDS severity. In the multicenter study, patients with direct ARDS also had lower levels of von Willebrand factor antigen and IL-6 and IL-8, markers of endothelial injury and inflammation, respectively. The prognostic value of the biomarkers was similar in direct and indirect ARDS. Direct lung injury in humans is characterized by a molecular phenotype consistent with more severe lung epithelial injury and less severe endothelial injury. The opposite pattern was identified in indirect lung injury. Clinical trials of novel therapies targeted specifically at the lung epithelium or endothelium may benefit from preferentially enrolling patients with direct and indirect ARDS, respectively.
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Choi, Kyunghak; Han, Youngjin; Ko, Gi-Young; Cho, Yong-Pil; Kwon, Tae-Won
2018-06-09
The objective of the study was to compare the treatment outcomes and cost of endovascular aortic aneurysm repair (EVAR) and open surgical repair (OSR) in patients with an abdominal aortic aneurysm (AAA) at a single center. Patients treated for an AAA at a single center between January 2007 and December 2012 were retrospectively identified and classified based on the treatment they received (EVAR or OSR). Patient demographics and in-hospital costs were recorded. Long-term survival was calculated using the Kaplan-Meier method. During the study period, 401 patients with AAA were treated at Asan Medical Center. Among these cases, 226 were treated with EVAR (56%) and 175 received OSR (44%). The mean age of the EVAR group was higher than that of the OSR group (71.25 ± 7.026 vs. 61.26 ± 8.175, P < 0.001). The need for intraoperative transfusion and total length of in-hospital stay were significantly lower in the EVAR group (P < 0.001). The OSR group showed significantly reduced rates of overall mortality (P = 0.003), overall reintervention (P = 0.001), and long-term survival (63.98 ± 1.86 vs. 99.54 ± 3.17, P < 0.001). The OSR group was charged significantly less than the EVAR group ($12,879.21 USD vs. $18,057.78 USD, P < 0.001). EVAR has advantages over OSR in terms of short-term mortality, in-hospital length of stay, and rates of perioperative transfusion. However, OSR is associated with better long-term survival, lower reintervention rates, and lower costs. Copyright © 2018 Elsevier Inc. All rights reserved.
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Ramamurthy, M.K.; Xu, T.Y.
1993-11-01
The current major expansion in observational capability of the National Weather Service is principally in the volume of asynchronous data rather than synchronous observations at the standard synoptic times. Hence, the National Meteorological Center is considering a continuous data assimilation system to replace at some time the intermittent system now used by its regional and global operational models. We describe this system, based on the Newtonian relaxation technique, as developed for the eta model. Experiments are performed for the first intensive observing period of the Genesis of Atlantic Lows Experiment (GALE) in January 1986, when strong upper-level cyclogenesis occurred, withmore » a pronounced tropopause fold but only modest surface development. The GALE level IIIb dataset was used for initializing and updating the model. Issues addressed in the experiments include choice of update variable, number, and length of update segments; need for updating moisture and surface pressure information; nudging along boundaries; and noise control. Assimilation of data from a single level was also studied. Use of a preforecast assimilation cycle was found to eliminate the spinup problem almost entirely. Multiple, shorter assimilation segments produced better forecasts than a single, longer cycle. Updating the mass field was less effective than nudging the wind field but assimilating both was best. Assimilation of moisture data, surprisingly, affected the spinup adversely, but nudging the surface pressure information reduced the spurious pillow effect. Assimilation of single-level information was ineffective unless accompanied by increased vertical coupling, obtained from a control integration. 52 refs., 19 figs., 1 tab.« less
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33 Years of Peritoneal Dialysis-Associated Peritonitis: A Single-Center Study in Japan.
Nakao, Masatsugu; Yamamoto, Izumi; Maruyama, Yukio; Nakashima, Akio; Matsuo, Nanae; Tanno, Yudo; Ohkido, Ichiro; Ikeda, Masato; Yamamoto, Hiroyasu; Yokoyama, Keitaro; Yokoo, Takashi
2016-02-01
Peritoneal dialysis-associated peritonitis (PD-associated peritonitis) could influence the outcome of PD patients, including technique survival. Although the use of the twin-bag system has decreased the incidence of peritonitis, the effects of biocompatible PD solutions are controversial. Additionally, since both infection-causing microorganisms and antimicrobial therapies have changed over time, the duration of treatment of peritonitis (the duration of peritonitis) seems to have changed. The study included 527 patients who received PD between January 1980 and December 2012 at a single center. We divided patients undergoing PD into three groups according to the type of PD system used, namely single-bag and conventional PD solutions (S+C group, N = 145), twin-bag and conventional PD solutions (T+C group, N = 171) and twin-bag and biocompatible PD solutions (T+B group, N = 211), and analyzed PD-associated peritonitis incidences. Incidences of PD-associated peritonitis (times per patient-months) and peritonitis-free time were 1/59.4, 1/70.6 and 1/103.1, and 52, 97, and 100 months for the S+C, T+C and T+B groups, respectively. The duration of peritonitis, has thus, become dramatically shorter in recent years. Streptococcus sp. were associated with shortest and fungi with longest durations of peritonitis. Staphylococcus sp. and Pseudomonas aeruginosa were predominant in the S+C group. The twin-bag system has made a greater contribution to reductions in PD-associated peritonitis than biocompatible PD solutions. Furthermore, changes in microorganisms, antimicrobial therapies, patient education and improved PD system devices have presumably affected the reduction in the duration of peritonitis. © 2015 International Society for Apheresis, Japanese Society for Apheresis, and Japanese Society for Dialysis Therapy.
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Coupling a single nitrogen-vacancy center with a superconducting qubit via the electro-optic effect
NASA Astrophysics Data System (ADS)
Li, Chang-Hao; Li, Peng-Bo
2018-05-01
We propose an efficient scheme for transferring quantum states and generating entangled states between two qubits of different nature. The hybrid system consists of a single nitrogen-vacancy (NV) center and a superconducting (SC) qubit, which couple to an optical cavity and a microwave resonator, respectively. Meanwhile, the optical cavity and the microwave resonator are coupled via the electro-optic effect. By adjusting the relative parameters, we can achieve high-fidelity quantum state transfer as well as highly entangled states between the NV center and the SC qubit. This protocol is within the reach of currently available techniques, and may provide interesting applications in quantum communication and computation with single NV centers and SC qubits.
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Nanoscale magnetic imaging with a single nitrogen-vacancy center in diamond
NASA Astrophysics Data System (ADS)
Hong, Sungkun
Magnetic imaging has been playing central roles not only in fundamental sciences but also in engineering and industry. Their numerous applications can be found in various areas, ranging from chemical analysis and biomedical imaging to magnetic data storage technology. An outstanding problem is to develop new magnetic imaging techniques with improved spatial resolutions down to nanoscale, while maintaining their magnetic sensitivities. For instance, if detecting individual electron or nuclear spins with nanomter spatial resolution is possible, it would allow for direct imaging of chemical structures of complex molecules, which then could bring termendous impacts on biological sciences. While realization of such nanoscale magnetic imaging still remains challenging, nitrogen-vacancy (NV) defects in diamond have recently considered as promising magnetic field sensors, as their electron spins show exceptionally long coherence even at room temperature. This thesis presents experimental progress in realizing a nanoscale magnetic imaging apparatus with a single nitrogen-vacancy (NV) color center diamond. We first fabricated diamond nanopillar devices hosting single NV centers at their ends, and incorporated them to a custom-built atomic force microscope (AFM). Our devices showed unprecedented combination of magnetic field sensitivity and spatial resolution for scanning NV systems. We then used these devices to magnetically image a single isolated electronic spin with nanometer resolution, for the first time under ambient condition. We also extended our study to improve and generalize the application of the scanning NV magnetometer we developed. We first introduced magnetic field gradients from a strongly magnetized tip, and demonstrated that the spatial resolution can be further improved by spectrally distinguishing identical spins at different locations. In addition, we developed a method to synchronize the periodic motion of an AFM tip and pulsed microwave sequences
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[Pheochromocytoma in 8-year observation at a single endocrinological center in Wroclaw].
Bednarek-Tupikowska, Grazyna; Bucyk, Barbara; Daroszewski, Jacek; Bidzińska-Speichert, Bozena; Bohdanowicz-Pawlak, Anna; Szymczak, Jadwiga; Bednorz, Włodzimierz; Podgórski, Franciszek; Zareba-Bogdał, Elzbieta; Kuliczkowska-Płaksej, Justyna; Lenarcik, Agnieszka; Filus, Alicja; Kałuzny, Marcin; Kubicka, Eliza; Syrycka, Joanna; Tupikowska, Małgorzata; Lizurej, Oskar; Bolanowski, Marek; Milewicz, Andrzej
2009-01-01
Pheochromocytoma is rare tumor with a highly variable clinical presentation. This report provides clinical picture, efficiency of diagnostics and treatment of pheochromocytoma in 8-years in the endocrinological center in Wroclaw. The records of 37 patients with pheochromocytoma were identified, who were treated in 2000-2007 in the Department of Endocrinology, Diabetology and Isotope Treatment in Wroclaw. There were 23 women (age 23-75 year) and 14 men (age 17-74). We studied frequency of clinical signs, usefulness of diagnostic methods and efficacy of treatment. The duration of the clinical history ranged from 2 months to 16 years. The most frequent symptoms were: hypertension paroxysmal and constant, palpitations, headache, sweating and anxiety. The most sensitive diagnostic method was increased concentration of urinary metanephrine in 24-hour urine. Computed tomography was the most widely used method for tumor localization. Adrenal pheochromocytoma was detecting by CT in all patients, predominated in right adrenal, in 1 case in urinary bladder. Surgery caused remission of hypertension in 59%, improvement in 26.8%, and no changes in 13.9% of patients. Malignancy was reported in 2 cases, 1 woman died after surgery. MEN 2A occur in 21.6%. The diagnosis of pheochromocytma is usually made after long duration of the disease. The study confirms that clinical presentation of pheochromocytoma is variable and nonspecific, this finding makes the diagnosis very difficult. The most typical symptom is paroxysmal hypertension, which is present only in 40%, other symptoms are nonspecific. The measurement of 24-hour urinary metanephrines was the best indicator. CT was almost always successful in localizing the tumor. Patients with pheochromocytoma should be consider for other endocrine diseases especially medullary carcinoma, primary hyperparathyroidism and other component of MEN 2A.
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Kute, Vivek B; Godara, Suraj M; Shah, Pankaj R; Jain, Siddharth H; Engineer, D P; Patel, Himanshu V; Gumber, Manoj R; Munjappa, Bipin C; Sainaresh, V V; Vanikar, Aruna V; Modi, Pranjal R; Shah, Veena R; Trivedi, Hargovind L
2012-02-01
Type 2 diabetes mellitus (DM) is the commonest cause of end-stage renal disease (ESRD) worldwide. Renal transplantation (RTx) is the best therapeutic modality for such patients. First-degree relatives of patients with type 2 DM have high risk of diabetes/pre-diabetes. Parents are often too old to be suitable donors, and siblings/children/spouse are either not suitable/acceptable or do not come forward for organ donation. This leaves deceased donation (DD) as only suitable donors. Data scarcity on DDRTx outcome in diabetic nephropathy (DN) prompted us to review our experience. This retrospective single-center 10-year study was undertaken to evaluate patient/graft survival, graft function, rejection episodes, and mortality in these patients. Between January 2001 and March 2011, thirty-five DN-ESRD patients underwent DDRTx in our center following cardiac fitness assessment of recipients. All patients received single-dose rabbit-anti-thymocyte globulin for induction and steroids, calcineurin inhibitor, and mycophenolate mofetil/azathioprine for maintenance immunosuppression. Mean recipient age was 49.66 ± 6.76 years, and 25 were men. Mean donor age was 50 ± 16.45 years, 23 were men. Over a mean follow-up of 2.28 ± 2.59 years, patient and graft survival rates were 68.5% and 88.5%, respectively, with mean SCr of 1.9 ± 0.62 mg/dl. Delayed graft function was observed in 34.3% patients, and 25.7% had biopsy-proven acute rejection; 31.5% patients died, mainly because of infections (22.8%), coronary artery disease (2.86%), and cerebrovascular events (5.7%). DDRTx in patients with DN has acceptable graft function and patient/graft survival over 10-year follow-up in our center and, therefore, we believe it should be encouraged.
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Family Support Center Village: A Unique Approach for Low-Income Single Women with Children
ERIC Educational Resources Information Center
Graber, Helen V.; Wolfe, Jayne L.
2004-01-01
The Family Support Center, recognizing the need for single women with children to maintain stability, has developed a program referred to as the Family Support Center Village, which incorporates a service enriched co-housing model. The "Village" will be the catalyst for these mothers' self-sufficiency and will provide opportunities to develop…
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NASA Astrophysics Data System (ADS)
Cross, L. E.; Newnham, R. E.; Biggers, J. V.
1984-05-01
This report focuses upon the parts of the Center program which have drawn most extensively upon Navy funds. In the basic study of polarization processes in high K dielectrics, major progress has been made in understanding the mechanisms in relaxor ferroelectric in the perovskite structure families. A new effort is also being mounted to obtain more precise evaluation of the internal stress effects in fine grained barium titanate. Related to reliability, studies of the effects of induced macro-defects are described, and preparation for the evaluation of space charge by internal potential distribution measurements discussed. To develop new processing methods for very thin dielectric layers, a new type of single barrier layer multilayer is discussed, and work on the thermal evaporation of oriented crystalline antimony sulphur iodide describe.
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Amouyal, Gregory, E-mail: gregamouyal@hotmail.com; Thiounn, Nicolas, E-mail: nicolas.thiounn@aphp.fr; Pellerin, Olivier, E-mail: olivier.pellerin@aphp.fr
BackgroundProstatic artery embolization (PAE) has been performed for a few years, but there is no report on PAE using the PErFecTED technique outside from the team that initiated this approach.ObjectiveThis single-center retrospective open label study reports our experience and clinical results on patients suffering from symptomatic BPH, who underwent PAE aiming at using the PErFecTED technique.Materials and MethodsWe treated 32 consecutive patients, mean age 65 (52–84 years old) between December 2013 and January 2015. Patients were referred for PAE after failure of medical treatment and refusal or contra-indication to surgery. They were treated using the PErFecTED technique, when feasible, with 300–500 µmmore » calibrated microspheres (two-night hospital stay or outpatient procedure). Follow-up was performed at 3, 6, and 12 months.ResultsWe had a 100 % immediate technical success of embolization (68 % of feasibility of the PErFecTED technique) with no immediate complications. After a mean follow-up of 7.7 months, we observed a 78 % rate of clinical success. Mean IPSS decreased from 15.3 to 4.2 (p = .03), mean QoL from 5.4 to 2 (p = .03), mean Qmax increased from 9.2 to 19.2 (p = .25), mean prostatic volume decreased from 91 to 62 (p = .009) mL. There was no retrograde ejaculation and no major complication.ConclusionPAE using the PErFecTED technique is a safe and efficient technique to treat bothersome LUTS related to BPH. It is of interest to note that the PErFecTED technique cannot be performed in some cases for anatomical reasons.« less
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NASA Astrophysics Data System (ADS)
Han, Minah; Jang, Hanjoo; Baek, Jongduk
2018-03-01
We investigate lesion detectability and its trends for different noise structures in single-slice and multislice CBCT images with anatomical background noise. Anatomical background noise is modeled using a power law spectrum of breast anatomy. Spherical signal with a 2 mm diameter is used for modeling a lesion. CT projection data are acquired by the forward projection and reconstructed by the Feldkamp-Davis-Kress algorithm. To generate different noise structures, two types of reconstruction filters (Hanning and Ram-Lak weighted ramp filters) are used in the reconstruction, and the transverse and longitudinal planes of reconstructed volume are used for detectability evaluation. To evaluate single-slice images, the central slice, which contains the maximum signal energy, is used. To evaluate multislice images, central nine slices are used. Detectability is evaluated using human and model observer studies. For model observer, channelized Hotelling observer (CHO) with dense difference-of-Gaussian (D-DOG) channels are used. For all noise structures, detectability by a human observer is higher for multislice images than single-slice images, and the degree of detectability increase in multislice images depends on the noise structure. Variation in detectability for different noise structures is reduced in multislice images, but detectability trends are not much different between single-slice and multislice images. The CHO with D-DOG channels predicts detectability by a human observer well for both single-slice and multislice images.
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Single-Center Experience With Venovenous ECMO for Influenza-Related ARDS.
Buchner, Jessica; Mazzeffi, Michael; Kon, Zachary; Menaker, Jay; Rubinson, Lewis; Bittle, Gregory; Pasrija, Chetan; Herr, Daniel
2018-06-01
This study was designed to determine whether venovenous extracorporeal membrane oxygenation (VV ECMO) reduced mortality in patients with influenza-related acute respiratory distress syndrome (ARDS). A retrospective cohort study was performed. Baseline characteristics of participants were compared and Kaplan-Meier survival analysis was used to compare survival at last medical center follow-up. Cox proportional hazards modeling also was performed to test for univariate associations between salient variables and mortality. A single-center ECMO referral university hospital. All patients admitted with influenza-related ARDS during the 2015 to 2016 influenza season. Mechanical ventilation alone versus mechanical ventilation and ECMO cannulation. A total of 26 patients with influenza-related ARDS were included in the cohort. Thirteen patients were treated with VV ECMO while 13 were not. Twelve of the ECMO patients and 8 of the non-ECMO patients were transferred from outside hospitals. Patients treated with ECMO were younger and had less hypertension and diabetes mellitus. There was no difference in baseline sequential organ failure assessment score between the 2 groups. In-hospital mortality for ECMO patients was 15.4% versus 46.7% for patients not treated with ECMO. Survival at last medical center follow-up was better in patients treated with ECMO (p = 0.02). Age, highest blood carbon dioxide level, and treatment without ECMO were all associated with increased mortality. Influenza-related ARDS has a high mortality rate and patients treated only with mechanical ventilation have worse outcome than those managed with VV ECMO. More liberal use of ECMO should be considered in patients with influenza-related ARDS. Copyright © 2017 Elsevier Inc. All rights reserved.
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Liddy, Clare; Keely, Erin; Afkham, Amir; Kurzawa, Julia; Abdeen, Nishard; Audcent, Tobey; Bromwich, Matthew; Brophy, Jason; Carsen, Sasha; Fournier, Annick; Fraser-Roberts, Leigh; Gandy, Hazen; Hui, Charles; Johnston, Donna; Keely, Kathryn; Kontio, Ken; Lamontagne, Christine; Major, Nathalie; O’Connor, Michael; Radhakrishnan, Dhenuka; Reisman, Joe; Robb, Marjorie; Samson, Lindy; Sell, Erick; Splinter, William; van Stralen, Judy; Venkateswaran, Sunita; Murto, Kimmo
2018-01-01
Background Champlain BASE™ (Building Access to Specialists through eConsultation) is a web-based asynchronous electronic communication service that allows primary-care- practitioners (PCPs) to submit “elective” clinical questions to a specialist. For adults, PCPs have reported improved access and timeliness to specialist advice, averted face-to-face specialist referrals in up to 40% of cases and high provider satisfaction. Objective To determine whether the expansion of eConsult to a pediatric setting would result in similar measures of improved healthcare system process and high provider acceptance reported in adults. Design Prospective observational cohort study. Setting Single Canadian tertiary-care academic pediatric hospital (June 2014–16) servicing 1.2 million people. Participants 1. PCPs already using eConsult. 2.Volunteer pediatric specialists provided services in addition to their regular workload. 3.Pediatric patients (< 18 years-old) referred for none-acute care conditions. Main outcomes and measures Specialty service utilization and access, impact on PCP course-of-action and referral-patterns and survey-based provider satisfaction data were collected. Results 1064 eConsult requests from 367 PCPs were answered by 23 pediatric specialists representing 14 specialty-services. The top three specialties represented were: General Pediatrics 393 cases (36.9%), Orthopedics 162 (15.2%) and Psychiatry 123 (11.6%). Median specialist response time was 0.9 days (range <1 hour-27 days), most consults (63.2%) required <10minutes to complete and 21/21(100%) specialist survey-respondents reported minimal workload burden. For 515/1064(48.4%) referrals, PCPs received advice for a new or additional course of action; 391/1064(36.7%) referrals resulted in an averted face-to-face specialist visit. In 9 specialties with complete data, the median wait-time was significantly less (p<0.001) for an eConsult (1 day, 95%CI:0.9–1.2) compared with a face-to-face referral (132
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Marginal ulcer perforation: a single center experience.
Natarajan, S K; Chua, D; Anbalakan, K; Shelat, V G
2017-10-01
Marginal ulcer (MU) is defined as ulcer on the jejunal side of the gastrojejunostomy (GJ) anastomosis. Most MUs are managed medically but those with complications like bleeding or perforation require intervention. It is recommended that GJ anastomosis be revised in patients with MU perforation (MUP). The aim of this case series is to study the clinical presentation and management of MUP. Three hundred and thirty-two patients who underwent emergency surgery for perforated peptic ulcer at a single center were studied over a period of 5 years. Nine patients (2.7 %) presented with MUP. GJ was previously done for either complicated peptic ulcer (n = 4) or for suspected gastric malignancy (n = 5). Two patients had previously completed H. pylori therapy. None of the patients presented with septic shock. MU was on the jejunal side of GJ in all patients. The median MUP size was 10 mm. Four patients (44.4 %) had omental patch repair, three (33.3 %) had primary closure, and one each had revision of GJ and jejunal serosal patch repair. There were no leaks, intra-abdominal abscess or reoperation and no malignancies. MUP patients do not present with septic shock. Omental patch repair or primary closure is sufficient enough. Revision of Billroth-II-GJ into Roux-en-Y-GJ is not mandatory.
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Hunter, Jacob B.; Francis, David O.; O’Connell, Brendan P.; Kabagambe, Edmond K.; Bennett, Marc L.; Wanna, George B.; Rivas, Alejandro; Thompson, Reid C.; Haynes, David S.
2016-01-01
Objective To characterize the risk and predictors of growth during observation of vestibular schwannomas (VS). Study Design Retrospective case series. Setting Single academic, tertiary care center. Patients 564 consecutive VS patients who underwent at least two MRI studies prior to intervention. Intervention(s) Serial MRI studies Main outcome measure(s) Tumor growth, defined as a ≥2 mm increase in the maximum tumor diameter between consecutive MRI studies, or between the first and last study. Results A total of 1,296 patients (1995–2015) with VS were identified. Of those, 564 patients (median age 59.2 years; 53.5% female) were initially observed and underwent multiple MRI studies (median follow-up 22.9 months, interquartile range [IQR] 11.7 – 42.7). The median maximum tumor diameter at presentation was 1.00 cm (IQR 0.6 – 1.51 cm). In all, 40.8% of tumors demonstrated growth and 32.1% underwent intervention (21.5% microsurgery, 10.5% radiation) during the surveillance period. Multivariable Cox regression analysis showed that for each tumor, the risk of growth or intervention was significantly increased for larger initial VS diameters (HR=2.22; 95% CI: 1.90 – 2.61) and when disequilibrium was a presenting symptom (HR=1.70; 95% CI: 1.30 – 2.23). Patient age, gender, aspirin use and presenting symptoms of asymmetric hearing loss, tinnitus, and vertigo, were not associated with tumor growth. Conclusions To date, this is the largest series of observed VS reported in the literature. Risk of VS growth is significantly increased among patients who present with larger tumors and who have concomitant disequilibrium. IRB 151481 Define Professional Practice Gap & Educational Need No cohort with this sample size has assessed vestibular schwannoma growth rates in conjunction with this number of variables. Learning Objective To characterize vestibular schwannoma growth rates and predictors of growth. PMID:27668793
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Simultaneous 13 cm/3 cm Single-pulse Observations of PSR B0329+54
NASA Astrophysics Data System (ADS)
Yan, Zhen; Shen, Zhi-Qiang; Manchester, R. N.; Ng, C.-Y.; Weltevrede, P.; Wang, Hong-Guang; Wu, Xin-Ji; Yuan, Jian-Ping; Wu, Ya-Jun; Zhao, Rong-Bing; Liu, Qing-Hui; Zhao, Ru-Shuang; Liu, Jie
2018-03-01
We have investigated the mode changing properties of PSR B0329+54 using 31 epochs of simultaneous 13 cm/3 cm single-pulse observations obtained with the Shanghai Tian Ma 65 m telescope. The pulsar was found in the abnormal emission mode 17 times, accounting for ∼13% of the 41.6 hr total observation time. Single-pulse analyses indicate that mode changes took place simultaneously at 13 cm/3 cm within a few rotational periods. We detected occasional bright and narrow pulses whose peak flux densities were 10 times higher than that of the integrated profile in both bands. At 3 cm, about 0.66% and 0.27% of single pulses were bright in the normal mode and abnormal mode, respectively, but at 13 cm the occurrence rate was only about 0.007%. We divided the pulsar radiation window into three components (C1, C2, and C3) corresponding to the main peaks of the integrated profile. The bright pulses preferentially occurred at pulse phases corresponding to the peaks of C2 and C3. Fluctuation spectra showed that C2 had excess red noise in the normal mode, but broad quasi-periodic features with central frequencies around 0.12 cycles/period in the abnormal mode. At 3 cm, C3 had a stronger quasi-periodic modulation centered around 0.06 cycles/period in the abnormal mode. Although there were some asymmetries in the two-dimensional fluctuation spectra, we found no clear evidence for systematic subpulse drifting. Consistent with previous low-frequency observations, we found a very low nulling probability for B0329+54, with upper limits of 0.13% and 1.68% at 13 cm/3 cm, respectively.
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The black hole at the Galactic Center: observations and models in a nutshell
NASA Astrophysics Data System (ADS)
Zakharov, Alexander
2017-12-01
The Galactic Center (Sgr A*) is a peculiar place in our Galaxy (Milky Way). Our Solar system is located at a distance around 8 kpc from the Galactic Center (GC). There were a number of different including exotic ones such as boson stars, fermion balls, neutrino balls, a cluster of neutron stars. Some of these models are significantly constrained with consequent observations and now supermassive black hole with mass around 4 × 106 M ⊙ is the preferable model for GC. Moreover, one can test alternative theories of gravity with observations of bright stars near the Galactic Center and and observations of bright structures near the black hole at the Galactic Center to reconstruct shadow structure around the black hole with current and future observational VLBI facilities such as the Event Horizon Telescope. In particular, we got a graviton mass constraint which is comparable and consistent with constraints obtained recently by the LIGO-Virgo collaboration.
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Santori, G; Fontana, I; Bertocchi, M; Gasloli, G; Valente, U
2010-05-01
Following the example of many Western countries, where a "minimum volume rule" policy has been adopted as a quality parameter for complex surgical procedures, the Italian National Transplant Centre set the minimum number of kidney transplantation procedures/y at 30/center. The number of procedures performed in a single center over a large period may be treated as a time series to evaluate trends, seasonal cycles, and nonsystematic fluctuations. Between January 1, 1983, and December 31, 2007, we performed 1376 procedures in adult or pediatric recipients from living or cadaveric donors. The greatest numbers of cases/y were performed in 1998 (n = 86) followed by 2004 (n = 82), 1996 (n = 75), and 2003 (n = 73). A time series analysis performed using R Statistical Software (Foundation for Statistical Computing, Vienna, Austria), a free software environment for statistical computing and graphics, showed a whole incremental trend after exponential smoothing as well as after seasonal decomposition. However, starting from 2005, we observed a decreased trend in the series. The number of kidney transplants expected to be performed for 2008 by using the Holt-Winters exponential smoothing applied to the period 1983 to 2007 suggested 58 procedures, while in that year there were 52. The time series approach may be helpful to establish a minimum volume/y at a single-center level. Copyright (c) 2010 Elsevier Inc. All rights reserved.
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NASA Astrophysics Data System (ADS)
Mysore, Abhishek Arun Babu
A medium data center consists of servers performing operations such as file sharing, collaboration and email. There are a large number of small and medium data centers across the world which consume more energy and are less efficient when compared to large data center facilities of companies such as GOOGLE, APPLE and FACEBOOK. Such companies are making their data center facilities more environmental friendly by employing renewable energy solutions such as wind and solar to power the data center or in data center cooling. This not only reduces the carbon footprint significantly but also decreases the costs incurred over a period of time. Cooling of data center play a vital role in proper functioning of the servers. It is found that cooling consumes about 50% of the total power consumed by the data center. Traditional method of cooling includes the use of mechanical compression chillers which consume lot of power and is not desirable. In order to eliminate the use of mechanical compressor chillers renewable energy resources such as solar and wind should be employed. One such technology is solar thermal cooling by means of absorption chiller which is powered by solar energy. The absorption chiller unit can be coupled with either flat plate or evacuated tube collectors in order to achieve the required inlet temperature for the generator of the absorption chiller unit. In this study a modular data center is considered having a cooling load requirement of 23kw. The performance characteristics of a single stage Lithium Bromide/ water refrigeration is presented in this study considering the cooling load of 23kw. Performance characteristics of each of the 4 heat exchangers within the unit is discussed which helps in customizing the unit according to the users' specific needs. This analysis helps in studying the importance of different properties such as the effect of inlet temperatures of hot water for generator, inlet temperatures of cooling water for absorber and
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Bone-level implants placed in the anterior maxilla: an open-label, single-arm observational study
2017-01-01
Purpose This study assessed marginal bone remodeling and soft tissue esthetics after the loading of single bone-level implants in the anterior maxilla. Methods An open, single-arm observational clinical trial with 3 years of follow-up was performed, including 22 implants. The patients presented with a single tooth gap in the anterior maxilla (tooth positions 14–24), with natural or restored adjacent teeth. An implant was placed at least 8 weeks post-extraction and healed submerged for 6 weeks. After the second-stage operation, a fixed provisional prosthesis was provided. The final restoration was placed 6 months after the provisional restoration. The time of the provisional crown connection was considered to be the baseline in this study. Esthetic parameters and the marginal bone level were assessed at 6, 12, 24, and 36 months. Results All implants were well integrated in the bone. A statistically significant increase was found in the mean implant stability quotient between the time of the provisional prosthesis and the time of the final prosthesis. Most implants (95.5%) revealed marginal bone resorption (<0.5 mm), and just 1 implant (4.5%) showed a change of 2.12 mm from baseline to 36 months (mean 0.07±0.48 mm), while the crestal bone level decreased significantly, from 2.34±0.93 mm at baseline to 1.70±1.10 mm at 36 months. The facial gingival margin and papilla were stable and the esthetic scores indicated high patient and dentist satisfaction. Conclusions Platform-switching bone-level implants placed in maxillary single-tooth gaps resulted in successful osseointegration with minimal marginal bone resorption. The peri-implant soft tissue was also esthetically satisfying and stable. PMID:29093988
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Hack, Nawaz; Akbar, Umer; Thompson-Avila, Amanda; Fayad, Sarah M; Hastings, Erin M; Moro, Elena; Nestor, Kelsey; Ward, Herbert; York, Michele; Okun, Michael S
2014-01-01
Impulse control disorders (ICDs), dopamine dysregulation syndrome (DDS), and dopamine agonist withdrawal syndrome (DAWS) have been reported commonly in Parkinson's disease (PD) populations. The treatment approaches may be widely variable and there is not much information on these syndromes in the setting of deep brain stimulation (DBS). To evaluate (1) ICDs, DAWS and DDS pre- and post DBS in PD and (2) to investigate pre-DBS treatment strategies regarding these behaviors among Parkinson Study Group (PSG) centers. Forty-eight PSG centers were surveyed on ICDs, DAWS and DDS, as well as on potential relationships to DBS and treatment approaches. Sixty-seven percent of PSG centers reported that they served a population of over 500 PD patients per year, and 94% of centers performed DBS surgery. Most centers (92%) reported screening for ICDs, DAWS and DDS. Of the centers screening for these symptoms, 13% reported always employing a formal battery of pre-operative tests, 46% of sites inconsistently used a formal battery, while 23% of sites reported never using a formal battery to screen for these symptoms. The estimated numbers of centers observing ICDs, DAWS and DDS pre-operatively in individuals with PD were 71%, 69%, and 69%, respectively. PSG DBS centers observing at least one case of a new de novo occurrence of an ICD, DAWS or DDS after DBS surgery were 67%, 65% and 65%, respectively. The results suggest that addiction-like syndromes and withdrawal syndromes are prevalent in expert PSG centers performing DBS. Most centers reported screening for these issues without the use of a formal battery, and there were a large number of centers reporting ICDs, DAWS and DDS post-DBS. A single treatment strategy did not emerge.
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NASA Astrophysics Data System (ADS)
Volz, T.; Schwaiger, R.; Wang, J.; Weygand, S. M.
2018-05-01
Tungsten is a promising material for plasma facing components in future nuclear fusion reactors. In the present work, we numerically investigate the deformation behavior of unirradiated tungsten (a body-centered cubic (bcc) single crystal) underneath nanoindents. A finite element (FE) model is presented to simulate wedge indentation. Crystal plasticity finite element (CPFE) simulations were performed for face-centered and body-centered single crystals accounting for the slip system family {110} <111> in the bcc crystal system and the {111} <110> slip family in the fcc system. The 90° wedge indenter was aligned parallel to the [1 ¯01 ]-direction and indented the crystal in the [0 1 ¯0 ]-direction up to a maximum indentation depth of 2 µm. In both, the fcc and bcc single crystals, the activity of slip systems was investigated and compared. Good agreement with the results from former investigations on fcc single crystals was observed. Furthermore, the in-plane lattice rotation in the material underneath an indent was determined and compared for the fcc and bcc single crystals.
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NASA Technical Reports Server (NTRS)
Freeman, D. C., Jr.; Powell, R. W.
1979-01-01
Aft center-of-gravity locations dictated by the large number of rocket engines required has been a continuing problem of single-stage-to-orbit vehicles. Recent work at Langley has demonstrated that these aft center-of-gravity problems become more pronounced for the proposed heavy-lift mission, creating some unique design problems for both the SSTO and staged vehicle systems. During the course of this study, an effort was made to bring together automated vehicle design, wind-tunnel tests, and flight control analyses to assess the impact of longitudinal and lateral-directional instability, and control philosophy on entry vehicle design technology.
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Uzunoglu, Faik G; Reeh, Matthias; Wollstein, Romy; Melling, Nathaniel; Perez, Daniel; Vashist, Yogesh K; Bogoevski, Dean; Izbicki, Jakob R; Bockhorn, Maximilian
2014-12-01
The aim of this study was to analyze the impact of single Roux-en-Y reconstruction (RYR) and double Roux-en-Y reconstruction (dRYR) on intraoperative outcome and postoperative morbidity and mortality after pancreaticoduodenectomy (PD) or pylorus-preserving pancreaticoduodenectomy (PPPD). All patients who underwent surgery between 2000 and 2005 for dRYR and RYR after PD or PPPD at the study hospital were evaluated for inclusion. Comparison of categorical patient characteristics was performed using the χ (2) test. Data were reported as median and range. Differences were analyzed with the Mann-Whitney U test. Postoperative complications were graded according to the Clavien-Dindo classification scheme and the recommendations of the International Study Group of Pancreatic Surgery (ISGPS). A total of 319 patients were included in final analysis. The median time of surgery was significantly shorter when performing a single Roux-en-Y loop reconstruction (55 min in PD and 50 min in PPPD) (p < 0.001). Saved time had a significant effect on the cost of surgery (p < 0.001). No impact on postoperative outcome according to the Clavien-Dindo classification, the ISGPS definitions of pancreatic fistulas, and delayed gastric emptying was evident. The relaparotomy rate due to severe postoperative hemorrhage was significantly higher in the dRYR PD cohort (2.2 vs. 11.9 %, p < 0.001). Double Roux-en-Y reconstruction of the alimentary tract is not beneficial in terms of surgical outcome and postoperative morbidity and mortality and should be avoided due to unnecessarily prolonged surgery.
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Anderson, Daren R; St Hilaire, Daniel; Flinter, Margaret
2012-05-31
Care coordination is a core element of the Patient-Centered Medical Home and requires an effective, well educated nursing staff. A greater understanding of roles and tasks currently being carried out by nurses in primary care is needed to help practices determine how best to implement care coordination and transform into PCMHs. We conducted an observational study of primary care nursing in a Community Health Center by creating a classification schema for nursing responsibilities, directly observing and tracking nurses' work, and categorizing their activities. Ten nurses in eight different practice sites were observed for a total of 61 hours. The vast majority of nursing time was spent in vaccine and medication administration; telephone work; and charting and paper work, while only 15% of their time was spent in activity that was classified broadly as care coordination. Care coordination work appeared to be subsumed by other daily tasks, many of which could have been accomplished by other, lesser trained members of the health care team. Practices looking to implement care coordination need a detailed look at work flow, task assignments, and a critical assessment of staffing, adhering to the principal of each team member working to the highest level of his or her education and license. Care coordination represents a distinct responsibility that requires dedicated nursing time, separate from the day to day tasks in a busy practice. To fully support these new functions, reimbursement models are needed that support such non visit-based work and provide incentives to coordinate and manage complex cases, achieve improved clinical outcomes and enhance efficiency of the health system. This article describes our study methods, data collection, and analysis, results, and discussion about reorganizing nursing roles to promote care coordination.
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Martino, Massimo; Gori, Mercedes; Pitino, Annalisa; Gentile, Massimo; Dattola, Antonia; Pontari, Antonella; Vigna, Ernesto; Moscato, Tiziana; Recchia, Anna Grazia; Barilla', Santina; Tripepi, Giovanni; Morabito, Fortunato
2017-07-01
A longitudinal, prospective, observational, single-center, cohort study on healthy donors (HDs) was designed to identify predictors of CD34 + cells on day 5 with emphasis on the predictive value of the basal CD34 + cell count. As potential predictors of mobilization, age, sex, body weight, height, blood volume as well as white blood cell count, peripheral blood (PB) mononuclear cells, platelet count, hematocrit, and hemoglobin levels were considered. Two different evaluations of CD34 + cell counts were determined for each donor: baseline (before granulocyte colony-stimulating factor [G-CSF] administration) and in PB after G-CSF administration on the morning of the fifth day (day 5). A total of 128 consecutive HDs (66 males) with a median age of 43 years were enrolled. CD34 + levels on day 5 displayed a non-normal distribution, with a median value of 75.5 cells/µL. To account for the non-normal distribution of the dependent variable, a quantile regression analysis to predict CD34 + on day 5 using the baseline value of CD34 + as the key predictor was performed. On crude analysis, a baseline value of CD34 + ranging from .5 cells/µL to 1 cells/µL predicts a median value of 50 cells/µL on day 5; a value of 2 cells/µL predicts a median value of 70.7 cells/µL; a value of 3 cells/µL to 4 cells/µL predicts a median value of 91.3 cells/µL, and a value ≥ 5 predicts a median value of 112 cells/µL. In conclusion, the baseline PB CD34 + cell count correlates with the effectiveness of allogeneic PB stem cell mobilization and could be useful to plan the collection. Copyright © 2017 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.
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Ito, Hiroaki; Inoue, Haruhiro; Odaka, Noriko; Satodate, Hitoshi; Suzuki, Michitaka; Mukai, Shumpei; Takehara, Yusuke; Omoto, Tomokatsu; Kudo, Shin-ei
2013-01-01
Background. This study addresses clinicopathological differences between patients with gastric cardia and subcardial cancer with and without esophagogastric junctional invasion. Methods. We performed a single-center, retrospective cohort study. We studied patients who underwent curative surgery for gastric cardia and subcardial cancers. Tumors centered in the proximal 5 cm of the stomach were classed into two types, according to whether they did (Ge) or did not (G) invade the esophagogastric junction. Results. A total of 80 patients were studied; 19 (73.1%) of 26 Ge tumors and 16 (29.6%) of 54 G tumors had lymph nodes metastases. Incidence of nodal metastasis in pT1 tumors was significantly higher in the Ge tumor group. No nodal metastasis in cervical lymph nodes was recognized. Only two patients with Ge tumors had mediastinal lymph node metastases. Incidence of perigastric lymph node metastasis was significantly higher in those with Ge tumors. Ge tumors tended to be staged as progressive disease using the esophageal cancer staging manual rather than the gastric cancer staging manual. Conclusion. Because there are some differences in clinicopathological characteristics, it is thought to be adequate to distinguish type Ge from type G tumor. PMID:23365732
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Factor VII deficiency: a single-center experience.
Salcioglu, Zafer; Akcay, Arzu; Sen, Hulya Sayilan; Aydogan, Gonul; Akici, Ferhan; Tugcu, Deniz; Ayaz, Nuray Aktay; Baslar, Zafer
2012-11-01
Congenital factor VII deficiency is the most common form of rare coagulation factor deficiencies. This article presents a retrospective evaluation of 73 factor VII deficiency cases that had been followed at our center. The study consisted of 48 males and 25 females (2 months-19 years). Thirty-one (42.5%) of them were asymptomatic. Out of symptomatic patients, 17 had severe clinical symptoms, whereas 8 presented with moderate and 17 with mild symptoms. The symptoms listed in order of frequency were as follows: epistaxis, petechia or ecchymose, easy bruising, and oral cavity bleeding. The genotype was determined in 8 patients. Recombinant activated factor VII (rFVIIa) was used to treat 49 bleeding episodes in 8 patients after 2002. In 2 patients with repeated central nervous system bleeding prophylaxis with rFVIIa was administered. No allergic and thrombotic events were observed during both treatment and prophylaxis courses. Antibody occurrence was not detected in the patients during treatment.
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Cournac, Jean Marie; Karkowski, Ludovic; Bordes, Julien; Aletti, Marc; Duron, Sandrine; Janvier, Frédéric; Foissaud, Vincent; Savini, Hélène; de Greslan, Thierry; Rousseau, Claire; Billhot, Magali; Gagnon, Nicolas; Mac Nab, Christine; Dubrous, Philippe; Moroge, Sophie; Broto, Helene; Cotte, Jean; Maugey, Nancy; Cordier, Pierre-Yves; Sagui, Emmanuel; Merens, Audrey; Rapp, Christophe; Quentin, Benoit; Granier, Hervé; Carmoi, Thierry; Cellarier, Gilles
2016-01-01
The pathogenesis of Ebola virus disease (EVD) remains unclear. The sporadic nature of Ebola outbreaks and their occurrence in resource-limited settings have precluded the acquisition of extensive clinical and laboratory data. Rhabdomyolysis during EVD has been suggested to occur in previous studies showing increased aspartate aminotransferase-alanine aminotransferase ratios, but, to date, has not been confirmed with creatine kinase (CK) assays. We performed an observational study of 38 patients admitted to an Ebola treatment center from January to April 2015. CK values from patients with confirmed EVD were compared with those in patients without confirmed EVD. A panel of other analyses were also performed. In patients with EVD, characteristics were compared between survivors and nonsurvivors. High levels of CK were more frequent in patients with EVD than in those without (P = .002), and rhabdomyolysis was more frequent (59% vs 19%, respectively; P = .03). CK levels >5000 U/L were observed in 36% of patients with EVD. Also in patients with EVD, fatal outcome was significantly associated with higher creatinine and bilirubin levels, international normalized ratio, and viral load. Rhabdomyolysis is a frequent disorder in EVD and seems to be more common than in other viral infections. It may contribute to the renal failure observed in nonsurviving patients. More studies are needed to determine the impact of rhabdomyolysis on EVD outcome. © The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.
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TEV GAMMA-RAY OBSERVATIONS OF THE GALACTIC CENTER RIDGE BY VERITAS
DOE Office of Scientific and Technical Information (OSTI.GOV)
Archer, A.; Buckley, J. H.; Bugaev, V.
2016-04-20
The Galactic Center ridge has been observed extensively in the past by both GeV and TeV gamma-ray instruments revealing a wealth of structure, including a diffuse component and the point sources G0.9+0.1 (a composite supernova remnant) and Sgr A* (believed to be associated with the supermassive black hole located at the center of our Galaxy). Previous very high energy (VHE) gamma-ray observations with the H.E.S.S. experiment have also detected an extended TeV gamma-ray component along the Galactic plane in the >300 GeV gamma-ray regime. Here we report on observations of the Galactic Center ridge from 2010 to 2014 by themore » VERITAS telescope array in the >2 TeV energy range. From these observations we (1) provide improved measurements of the differential energy spectrum for Sgr A* in the >2 TeV gamma-ray regime, (2) provide a detection in the >2 TeV gamma-ray emission from the composite SNR G0.9+0.1 and an improved determination of its multi-TeV gamma-ray energy spectrum, and (3) report on the detection of VER J1746-289, a localized enhancement of >2 TeV gamma-ray emission along the Galactic plane.« less
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Transient Events in Archival Very Large Array Observations of the Galactic Center
NASA Astrophysics Data System (ADS)
Chiti, Anirudh; Chatterjee, Shami; Wharton, Robert; Cordes, James; Lazio, T. Joseph W.; Kaplan, David L.; Bower, Geoffrey C.; Croft, Steve
2016-12-01
The Galactic center has some of the highest stellar densities in the Galaxy and a range of interstellar scattering properties, which may aid in the detection of new radio-selected transient events. Here, we describe a search for radio transients in the Galactic center, using over 200 hr of archival data from the Very Large Array at 5 and 8.4 GHz. Every observation of Sgr A* from 1985 to 2005 has been searched using an automated processing and detection pipeline sensitive to transients with timescales between 30 s and 5 minutes with a typical detection threshold of ˜100 mJy. Eight possible candidates pass tests to filter false-positives from radio-frequency interference, calibration errors, and imaging artifacts. Two events are identified as promising candidates based on the smoothness of their light curves. Despite the high quality of their light curves, these detections remain suspect due to evidence of incomplete subtraction of the complex structure in the Galactic center, and apparent contingency of one detection on reduction routines. Events of this intensity (˜100 mJy) and duration (˜100 s) are not obviously associated with known astrophysical sources, and no counterparts are found in data at other wavelengths. We consider potential sources, including Galactic center pulsars, dwarf stars, sources like GCRT J1745-3009, and bursts from X-ray binaries. None can fully explain the observed transients, suggesting either a new astrophysical source or a subtle imaging artifact. More sensitive multiwavelength studies are necessary to characterize these events, which, if real, occur with a rate of {14}-12+32 {{hr}}-1 {\\deg }-2 in the Galactic center.
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The World Trade Center attack. Observations from New York's Bellevue Hospital.
Roccaforte, J D
2001-12-01
This report describes selected aspects of the response by Bellevue Hospital Center to the World Trade Center attack of 11 September 2001. The hospital is 2.5 miles (4 km) from the site of the attack. These first-hand observations and this analysis may aid in future preparations. Key issues described relate to communication, organization, injuries treated, staffing, and logistics.
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The World Trade Center Attack: Observations from New York's Bellevue Hospital
Roccaforte, J David
2001-01-01
This report describes selected aspects of the response by Bellevue Hospital Center to the World Trade Center attack of 11 September 2001. The hospital is 2.5 miles (4 km) from the site of the attack. These first-hand observations and this analysis may aid in future preparations. Key issues described relate to communication, organization, injuries treated, staffing, and logistics. PMID:11737913
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Anomalous Aortic Origin of Coronary Arteries: A Single-Center Experience.
Fabozzo, Assunta; DiOrio, Matthew; Newburger, Jane W; Powell, Andrew J; Liu, Hua; Fynn-Thompson, Francis; Sanders, Stephen P; Pigula, Frank A; Del Nido, Pedro J; Nathan, Meena
2016-01-01
The aim of this article is to determine the clinical course and outcomes in subjects with anomalous aortic origin of coronary arteries (AAOCA), particularly after surgical repair. A single-center, retrospective review of patients with AAOCA with right or left interarterial or IM (IA or IM) or intraconal course from 1996-2014. Among 155 patients, median age at diagnosis was 8.5 (range: 0.1-50) years, and 65% were male. The AAOCA course was IA or IM in 151 (97%) and intraconal in 4 (3%). Anomalous right coronary artery (CA) was present in 127 (82%), of whom 52 (42%) had repair. Anomalous left CA (ALCA) was present in 28 (18%), of whom 20 (71%) had repair. In the surgical group, 70 (97%) had IA or IM CAs; CA unroofing was performed in 62 (86%). In univariable analysis, surgical management was associated with ALCA (28% vs 10%, P = 0.003), age > 10 years (median 11 vs 6 years, P < 0.001), symptoms (63% vs 13%, P < 0.001), and exercise restriction at the time of diagnosis (47% vs 13%, P < 0.001). In multivariable modeling, surgery was associated with chest pain or syncope (P < 0.001) and older age (P = 0.03). Major perioperative complications occurred in 4 cases (6%) and 1 patient had late aortic valve repair. In the surgical group, no patients died; in the observed group, 2 patients with anomalous right CA (2.3%) died of severe noncardiac comorbidities. In our center, surgery for AAOCA was not associated with mortality, and surgery was recommended in patients with ALCA with IA or IM course. Rare but serious surgical complications highlight the importance of long-term follow up of patients with AAOCA to develop evidence-based management guidelines. Copyright © 2016 Elsevier Inc. All rights reserved.
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Patient Satisfaction with Spanish Pain Centers: Observational Study with More than 3,000 Patients
Hernández-Puiggròs, Patricia; Tesedo Nieto, Javier; Acín Lázaro, María Pilar; Carrera González, Alfredo; Soler, Miguel José Arranz; Maldonado Vega, Sergio
2016-01-01
Chronic pain is a serious problem in Spain. This multicenter, epidemiological 3-month follow-up study investigates pain management efficacy in Spanish centers using patient satisfaction criteria. 3,414 eligible adult patients (65,6% female) with moderate to severe chronic pain from 146 pain centers were included. Patient satisfaction was assessed based onto question 18 of Spanish healthcare barometer-CSI. Pain evolution (Brief Pain Inventory-Short Form (BPI-SF) and visual analog scale (VAS)), quality of life/EuroQol-5, and pain control expectations fulfillment were also assessed. Mean age was 61.3 years. 64.4% of participating centers employed multidisciplinary pain management approach. After 3 months, mean patient satisfaction was 7.8 (1–10) on the CIS barometer. Medical staff received the highest scores, whereas waiting for tests, appointment request to appointment date time, and waiting times at the center the lowest. Mean pain decreased from 7.4 to 4.0; BPI-SF intensity decreased from 6.5 to 3.8; pain control expectations were met in 78.7% of patients; EuroQoL-5D utility index increased from 0.37 to 0.62, p < 0.001, and health status (VAS) from 40.6 to 61.9, p < 0.001. Chronic pain patients (90%) are satisfied with Spanish centers care; 80% had their pain control expectations met. Quality of life improved remarkably: 71% felt moderately to significantly better. However, waiting times need improvement. PMID:27516902
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AIP mutations in Brazilian patients with sporadic pituitary adenomas: a single-center evaluation
Kasuki, Leandro; de Azeredo Lima, Carlos Henrique; Ogino, Liana; Camacho, Aline H S; Chimelli, Leila; Korbonits, Márta
2017-01-01
Aryl hydrocarbon receptor-interacting protein (AIP) gene mutations (AIPmut) are the most frequent germline mutations found in apparently sporadic pituitary adenomas (SPA). Our aim was to evaluate the frequency of AIPmut among young Brazilian patients with SPA. We performed an observational cohort study between 2013 and 2016 in a single referral center. AIPmut screening was carried out in 132 SPA patients with macroadenomas diagnosed up to 40 years or in adenomas of any size diagnosed until 18 years of age. Twelve tumor samples were also analyzed. Leukocyte DNA and tumor tissue DNA were sequenced for the entire AIP-coding region for evaluation of mutations. Eleven (8.3%) of the 132 patients had AIPmut, comprising 9/74 (12%) somatotropinomas, 1/38 (2.6%) prolactinoma, 1/10 (10%) corticotropinoma and no non-functioning adenomas. In pediatric patients (≤18 years), AIPmut frequency was 13.3% (2/15). Out of the 5 patients with gigantism, two had AIPmut, both truncating mutations. The Y268* mutation was described in Brazilian patients and the K273Rfs*30 mutation is a novel mutation in our patient. No somatic AIP mutations were found in the 12 tumor samples. A tumor sample from an acromegaly patient harboring the A299V AIPmut showed loss of heterozygosity. In conclusion, AIPmut frequency in SPA Brazilian patients is similar to other populations. Our study identified two mutations exclusively found in Brazilians and also shows, for the first time, loss of heterozygosity in tumor DNA from an acromegaly patient harboring the A299V AIPmut. Our findings corroborate previous observations that AIPmut screening should be performed in young patients with SPA. PMID:29074612
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Hydrogen centers and the conductivity of In 2O 3 single crystals
DOE Office of Scientific and Technical Information (OSTI.GOV)
Yin, Weikai; Smithe, Kirby; Weiser, Philip
2015-02-24
A series of infrared absorption experiments and complementary theory have been performed in order to determine the properties of OH and OD centers in In 2O 3 single crystals. Annealing In 2O 3 samples in H 2 or D 2 at temperatures near 450°C produces an n-type layer ≈0.06mm thick with an n-type doping of 1.6×1019 cm -3. The resulting free-carrier absorption is correlated with an OH center with a vibrational frequency of 3306 cm -1 that we associate with interstitial H +. Additional O-H (O-D) vibrational lines are assigned to metastable configurations of the interstitial H +(D +) centermore » and complexes of H (D) with In vacancies. In addition, unlike other oxides studied recently where H trapped at an oxygen vacancy is the dominant shallow donor (ZnO and SnO 2, for example), interstitial H + is found to be the dominant H-related shallow donor in In 2O 3.« less
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The Integrated Ocean Observing System Data Assembly Center
NASA Astrophysics Data System (ADS)
Bouchard, R. H.; Henderson, D.; Burnett, W.; Hervey, R. V.; Crout, R.
2008-05-01
The Integrated Ocean Observing System (IOOS) is the U.S. contribution to the Global Ocean Observing System and the Global Earth Observing System of Systems (GEOSS). As the Integrated Ocean Observing System Data Assembly Center (IOOS DAC), the National Oceanic and Atmospheric Administration`s (NOAA) National Data Buoy Center (NDBC) collects data from ocean observing systems and performs quality control on the data. Once the IOOS DAC performs the quality control, it distributes them in real-time: (1) in World Meteorological Organization alphanumeric data formats via the Global Telecommunications System (GTS) that provides instant availability to national and international users (2) in text files via its website (http://www.ndbc.noaa.gov) that provide easy access and use, and (3) in netCDF format via its OPeNDAP/DODS Server (http://dods.ndbc.noaa.gov) that provides higher resolution data than available in WMO alphanumeric or text file formats. The IOOS DAC routinely checks and distributes data from about 200 NDBC stations that include meteorological and oceanographic observations from buoys and coastal stations, water-level estimations from tsunameters (DART), and climate monitoring from buoys (Tropical Atmosphere Ocean array (TAO)). The IOOS DAC operates continuously - 24 hours per day, 7 days per week. In addition to data from NDBC`s platforms, the IOOS DAC applies its scientific expertise and data management and communications capabilities to facilitate partnerships for the exchange and application of data and to coordinate and leverage regional assets and resources from about 350 IOOS Partner stations. The IOOS DAC through its quality control process provides feedback to its partners on the quality of their observation that can lead to improved quality of the observations. The NDBC-IOOS Data Partnerships span the Western Hemisphere with data collection from the Beaufort Sea to the Peru Current, from the International Date Line to the central Atlantic Ocean, and
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ERIC Educational Resources Information Center
Williams, Dianne McAfee
In order to focus on important contributions of elementary school instructional media centers (IMC's) to the educational program, a study was conducted to determine the presence of conditions of positive self-concept--cooperation, independence, success, positive atmosphere, challenge, feeling of value or acceptance--in such centers. A descriptive,…
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Catalytic reduction of dinitrogen to ammonia at a single molybdenum center
Weare, Walter W.; Dai, Xuliang; Byrnes, Matthew J.; Chin, Jia Min; Schrock, Richard R.; Müller, Peter
2006-01-01
Since our discovery of the catalytic reduction of dinitrogen to ammonia at a single molybdenum center, we have embarked on a variety of studies designed to further understand this complex reaction cycle. These include studies of both individual reaction steps and of ligand variations. An important step in the reaction sequence is exchange of ammonia for dinitrogen in neutral molybdenum(III) compounds. We have found that this exchange reaction is first order in dinitrogen and relatively fast (complete in <1 h) at 1 atm of dinitrogen. Variations of the terphenyl substituents in the triamidoamine ligand demonstrate that the original ligand is not unique in its ability to yield successful catalysts. However, complexes that contain sterically less demanding ligands fail to catalyze formation of ammonia from dinitrogen; it is proposed as a consequence of a base-catalyzed decomposition of a diazenido (MoNNH) intermediate. PMID:17085586
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Cander, Soner; Gul, Ozen Oz; Gul, Cuma B; Keles, Saadet B; Yavas, Sibel; Ersoy, Canan
2014-12-01
This study evaluated the impact of patient education on adherence to a diabetes care plan (e.g., anthropometric, lipidemic, and glycemic parameters) among adults with type II diabetes mellitus without adequate glycemic control. A total of 61 ambulatory adults with type II diabetes mellitus (mean age: 53.6 ± 8.2 years, 70.5% female) were evaluated for anthropometrics, duration of diabetes mellitus, type of anti-diabetic treatment, blood biochemistry, and glycemic parameters in this 3-month prospective observational single-center study. During the course of the study, participants demonstrated a significant decrease in body weight and fat percentage and HbA1c (p < .001 for each). None of the factors evaluated was a significant determinant for glycemic parameters. These findings revealed that adults with type II diabetes mellitus who received education on adherence to routine self-monitoring of blood glucose, standard diabetic diet, and an exercise program delivered by certified diabetes educators had better glycemic control and significant decrease in body weight and fat percentage over a 3-month monitoring period. Copyright 2014, SLACK Incorporated.
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NASA Astrophysics Data System (ADS)
White, S. M.; Iwai, K.; Phillips, N. M.; Hills, R. E.; Hirota, A.; Yagoubov, P.; Siringo, G.; Shimojo, M.; Bastian, T. S.; Hales, A. S.; Sawada, T.; Asayama, S.; Sugimoto, M.; Marson, R. G.; Kawasaki, W.; Muller, E.; Nakazato, T.; Sugimoto, K.; Brajša, R.; Skokić, I.; Bárta, M.; Kim, S.; Remijan, A. J.; de Gregorio, I.; Corder, S. A.; Hudson, H. S.; Loukitcheva, M.; Chen, B.; De Pontieu, B.; Fleishmann, G. D.; Gary, D. E.; Kobelski, A.; Wedemeyer, S.; Yan, Y.
2017-07-01
The Atacama Large Millimeter/submillimeter Array (ALMA) radio telescope has commenced science observations of the Sun starting in late 2016. Since the Sun is much larger than the field of view of individual ALMA dishes, the ALMA interferometer is unable to measure the background level of solar emission when observing the solar disk. The absolute temperature scale is a critical measurement for much of ALMA solar science, including the understanding of energy transfer through the solar atmosphere, the properties of prominences, and the study of shock heating in the chromosphere. In order to provide an absolute temperature scale, ALMA solar observing will take advantage of the remarkable fast-scanning capabilities of the ALMA 12 m dishes to make single-dish maps of the full Sun. This article reports on the results of an extensive commissioning effort to optimize the mapping procedure, and it describes the nature of the resulting data. Amplitude calibration is discussed in detail: a path that uses the two loads in the ALMA calibration system as well as sky measurements is described and applied to commissioning data. Inspection of a large number of single-dish datasets shows significant variation in the resulting temperatures, and based on the temperature distributions, we derive quiet-Sun values at disk center of 7300 K at λ = 3 mm and 5900 K at λ = 1.3 mm. These values have statistical uncertainties of about 100 K, but systematic uncertainties in the temperature scale that may be significantly larger. Example images are presented from two periods with very different levels of solar activity. At a resolution of about 25'', the 1.3 mm wavelength images show temperatures on the disk that vary over about a 2000 K range. Active regions and plages are among the hotter features, while a large sunspot umbra shows up as a depression, and filament channels are relatively cool. Prominences above the solar limb are a common feature of the single-dish images.
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Multimode and single-mode fibers for data center and high-performance computing applications
NASA Astrophysics Data System (ADS)
Bickham, Scott R.
2016-03-01
Data center (DC) and high performance computing (HPC) applications have traditionally used a combination of copper, multimode fiber and single-mode fiber interconnects with relative percentages that depend on factors such as the line rate, reach and connectivity costs. The balance between these transmission media has increasingly shifted towards optical fiber due to the reach constraints of copper at data rates of 10 Gb/s and higher. The percentage of single-mode fiber deployed in the DC has also grown slightly since 2014, coinciding with the emergence of mega DCs with extended distance needs beyond 100 m. This trend will likely continue in the next few years as DCs expand their capacity from 100G to 400G, increase the physical size of their facilities and begin to utilize silicon-photonics transceiver technology. However there is a still a need for the low-cost and high-density connectivity, and this is sustaining the deployment of multimode fiber for links <= 100 m. In this paper, we discuss options for single-mode and multimode fibers in DCs and HPCs and introduce a reduced diameter multimode fiber concept which provides intra-and inter-rack connectivity as well as compatibility with silicon-photonic transceivers operating at 1310 nm. We also discuss the trade-offs between single-mode fiber attributes such as bend-insensitivity, attenuation and mode field diameter and their roles in capacity and connectivity in data centers.
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Are drowned donors marginal donors? A single pediatric center experience.
Kumm, Kayla R; Galván, N Thao N; Koohmaraie, Sarah; Rana, Abbas; Kueht, Michael; Baugh, Katherine; Hao, Liu; Yoeli, Dor; Cotton, Ronald; O'Mahony, Christine A; Goss, John A
2017-09-01
Drowning, a common cause of death in the pediatric population, is a potentially large donor pool for OLT. Anecdotally, transplant centers have deemed these organs high risk over concerns for infection and graft dysfunction. We theorized drowned donor liver allografts do not portend worse outcomes and therefore should not be excluded from the donation pool. We reviewed our single-center experience of pediatric OLTs between 1988 and 2015 and identified 33 drowned donor recipients. These OLTs were matched 1:2 to head trauma donor OLTs from our center. A chart review assessed postoperative peak AST and ALT, incidence of HAT, graft and recipient survival. Recipient survival at one year between patients with drowned donor vs head trauma donor allografts was not statistically significant (94% vs 97%, P=.63). HAT incidence was 6.1% in the drowned donor group vs 7.6% in the control group (P=.78). Mean postoperative peak AST and ALT was 683 U/L and 450 U/L for drowned donors vs 1119 U/L and 828 U/L in the matched cohort. These results suggest drowned donor liver allografts do not portend worse outcomes in comparison with those procured from head trauma donors. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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Wang, Rui-Xia; Cai, Kang; Yin, Zhang-Qi; Long, Gui-Lu
2017-11-27
In a diamond, the mechanical vibration-induced strain can lead to interaction between the mechanical mode and the nitrogen-vacancy (NV) centers. In this work, we propose to utilize the strain-induced coupling for the quantum non-demolition (QND) single phonon measurement and memory in a diamond. The single phonon in a diamond mechanical resonator can be perfectly absorbed and emitted by the NV centers ensemble (NVE) with adiabatically tuning the microwave driving. An optical laser drives the NVE to the excited states, which have much larger coupling strength to the mechanical mode. By adiabatically eliminating the excited states under large detuning limit, the effective coupling between the mechanical mode and the NVE can be used for QND measurement of the single phonon state. Under realistic experimental conditions, we numerically simulate the scheme. It is found that the fidelity of the absorbing and emitting process can reach a much high value. The overlap between the input and the output phonon shapes can reach 98.57%.
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Observing the Heterogeneous Electro-redox of Individual Single-Layer Graphene Sheets.
Chen, Tao; Zhang, Yuwei; Xu, Weilin
2016-09-27
Electro-redox-induced heterogeneous fluorescence of an individual single-layer graphene sheet was observed in real time by a total internal reflection fluorescence microscope. It was found that the fluorescence intensity of an individual sheet can be tuned reversibly by applying periodic voltages to control the redox degree of graphene sheets. Accordingly, the oxidation and reduction kinetics of an individual single-layer graphene sheet was studied at different voltages. The electro-redox-induced reversible variation of fluorescence intensity of individual sheets indicates a reversible band gap tuning strategy. Furthermore, correlation analysis of redox rate constants on individual graphene sheets revealed a redox-induced spatiotemporal heterogeneity or dynamics of graphene sheets. The observed controllable redox kinetics can rationally guide the precise band gap tuning of individual graphene sheets and then help their extensive applications in optoelectronics and devices for renewable energy.
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Single, transcervical insemination using frozen-thawed semen in the Greyhound: a case series study.
Pretzer, S D; Lillich, R K; Althouse, G C
2006-04-01
Transcervical insemination (TCI) has generated recent interest as an assisted reproductive technique in the dog. A case series study was performed to determine if TCI using frozen-thawed semen was a viable technique to offer in a general veterinary practice setting. Over a period exceeding 28 months, 137 Greyhound bitches were presented for assisted breeding. A single, timed insemination using a rigid cystoscope to aid in transcervical deposition of a frozen-thawed semen dose was given within 72 h after the behaviorally estrual bitch had a > 4 ng/mL serum progesterone concentration and estrus-categorized vaginal cytology. Litter size, pregnancy and whelping rate were collected; their association to semen center and stud dog were quantified. Of the 137 bitches, 117 were bred for one cycle and 20 were bred for two or more cycles, giving a total of 161 single, timed inseminations. Pregnancy rate was 89.4%, with 141 (87.5%) whelping. Litter size was 6.9+/-2.7 (mean+/-S.D.) pups. Semen center (P=0.84) and stud (P=0.79) had no effect on pregnancy. These results were quite favorable when compared to prior TCI studies, and are possibly due to the use of a single breed (i.e., Greyhound) with good fertility. This study supported the application of TCI, in Greyhounds, as a successful and viable service to offer in private practice. Additionally, these results have value in their use for benchmarking future breed-specific and TCI research. Serendipitously, the apparent fecundity results obtained in this observational study suggests a possible greater appreciation be given to breed composition and choice in assisted reproductive technique studies.
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Hydroxyapatite ceramic implants for cranioplasty in children: a single-center experience.
Zaccaria, Laura; Tharakan, Sasha Job; Altermatt, Stefan
2017-02-01
The use of hydroxyapatite ceramic (HAC) implants for the treatment of skull defects in pediatric patients started 2010 at our institution. Ceramic implants facilitate osteoblast migration and therefore optimize osteointegration with the host bone. The purpose of this study is to report a single-center experience with this treatment modality. A retrospective review of all patients from July 2010 through June 2014 undergoing a cranioplasty using hydroxyapatite ceramic implant and managed at a single institution was performed. Indication for cranioplasty, the hospital course, and follow-up were reviewed. Bone density was measured in Hounsfield Units (HU) and osteointegration was calculated using Mimics Software® (Mimics Innovation Suite v17.0 Medical, Materialize, Leuven, Belgium). Over the 4-year period, six patients met criteria for the study. Five patients had an osteointegration of nearly 100%. One patient had an incomplete osteointegration with a total bone-implant contact area of 69%. The mean bone density was 2800 HU (2300-3000 HU). Bone density alone is estimated to have a Hounsfield value between 400 and 2000 HU depending on the body region and bone quality. There were no major complications, and the patients were highly satisfied with the esthetical result. Hydroxyapatite ceramic implants for cranioplasty in pediatric patients are a good choice for different indications. The implants show excellent osteointegration and esthetical results.
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Safety of intravenous metoprolol use in unmonitored wards: a single-centre observational study.
Kelly, D; Hawdon, G; Reeves, J; Morris, A; Cunningham, M; Barrett, J
2015-09-01
This study aims to examine and quantify the risks associated with the use of intravenous metoprolol on unmonitored wards. This study was a retrospective single-centre observational study from 1 January 2009 to 31 December 2013. The study hospital was a 415-bed, private hospital in Melbourne, Victoria. The study population was all patients who received intravenous metoprolol on an unmonitored ward. The primary outcome measure was the rate of serious adverse events (SAE), defined as a complication of intravenous metoprolol resulting in transfer to a critical-care environment, a medical emergency team call or death. Six hundred and nine patients received a total of 8260 doses of intravenous metoprolol. Seven cases were identified with a SAE deemed possibly related to beta-blocker use and there was one death. All SAE were hypotension, giving an overall rate of hypotension of 7/609 or 1.1% (95% confidence interval (CI), 0.5 to 2.4%) with a rate per dose delivered of 0.8/1000 doses (95% CI 0.3 to 1.7). The death occurred in a 94-year-old woman with abdominal sepsis. After case file review, consensus opinion deemed this to be unrelated to intravenous metoprolol. The use of intravenous metoprolol on unmonitored wards appears to be safe. The complication rate was low, suggesting that this may be a sensible approach to the management of in-hospital populations at risk of beta-blocker withdrawal. © 2015 Royal Australasian College of Physicians.
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NASA Astrophysics Data System (ADS)
Rong, Youying; Ma, Jianhui; Chen, Lingxiao; Liu, Yan; Siyushev, Petr; Wu, Botao; Pan, Haifeng; Jelezko, Fedor; Wu, E.; Zeng, Heping
2018-05-01
We report a method with high time resolution to measure the excited-state lifetime of silicon vacancy centers in bulk diamond avoiding timing jitter from the single-photon detectors. Frequency upconversion of the fluorescence emitted from silicon vacancy centers was achieved from 738 nm to 436 nm via sum frequency generation with a short pump pulse. The excited-state lifetime can be obtained by measuring the intensity of upconverted light while the pump delay changes. As a probe, a pump laser with pulse duration of 11 ps provided a high temporal resolution of the measurement. The lifetime extracted from the pump–probe curve was 0.755 ns, which was comparable to the timing jitter of the single-photon detectors.
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Aghdassi, Ali; Christoph, Agnes; Dombrowski, Frank; Döring, Paula; Barth, Christoph; Christoph, Jan; Lerch, Markus M; Simon, Peter
2018-06-05
Gastrointestinal stromal tumors (GISTs) are rare malignancies but the most common mesenchymal tumors of the digestive tract. Recent advances in diagnostic imaging and an increasing incidence will confront us more frequently with stromal tumors. This single center study aimed to characterize GIST patients in terms of tumor location, clinical presentation, metastasis formation, as well as associated secondary malignancies. In a retrospective study, 104 patients with a histologically confirmed diagnosis of GIST, collected between 1993 and 2011, were characterized for several clinical features. The most common GIST location was the stomach (67.6%) followed by the small intestine (16.2%). Gastrointestinal bleeding (55.8%) and abdominal pain (38.5%) were the most frequently reported symptoms whereas about one-third of patients remained clinically asymptomatic (31.6%); 14.4% of patients had either synchronous or metachronous metastases and there was a significant prevalence also in the low risk group. The proportion of secondary malignant associated neoplasms was 31% in our GIST cohort, among which gastrointestinal, genitourinary tumors, and breast cancer were the most prevalent. There was a considerable risk for metastasis formation and the development of secondary neoplasias that should encourage discussion about the appropriate surveillance strategy after surgery for GIST. © 2018 S. Karger AG, Basel.
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Single-center prospective study of Plummer-Vinson syndrome.
Goel, A; Lakshmi, C P; Bakshi, S S; Soni, N; Koshy, S
2016-10-01
Post-cricoid web is an uncommon cause for dysphagia and is most frequently reported in middle-aged women. Triad of web, iron deficiency anemia (IDA), and dysphagia is known as Plummer-Vinson syndrome (PVS). Literature on PVS is very limited. Here we report the first prospective study of PVS with predefined diagnostic criteria and management plan. Adults with dysphagia or those incidentally found to have esophageal web were prospectively enrolled between July 2011 and June 2013. Participants were evaluated with hemogram, barium swallow, and esophagogastroduodenoscopy. PVS was diagnosed if a person had IDA and a post-cricoid web in barium swallow and/or endoscopy. Patients were managed with dilation using through-the-scope controlled radial expansion balloon followed by oral iron and folic acid supplementation. Thirty-seven patients (age, median [range] 40 [19-65] years; 32 [86%] women) were enrolled. Thirty-one symptomatic patients had dysphagia grade 1 (n = 12, 39%), 2 (n = 13, 42%), and 3 (n = 6, 19%) for a median (range) duration of 24 (4-324) months. Barium swallow, done in 29, showed web in 25 which were either circumferential or anterior in position. Twenty-nine (29/31, 94%) patients had complete and two had partial response after the first session of endoscopic dilatation without any complication. Dysphagia recurred in three (10%) of the 30 patients who were followed for a median (range) of 10 (1-24) months. Esophageal-web related dysphagia in patients with PVS responds favorably after single session of endoscopic dilation. © 2015 International Society for Diseases of the Esophagus.
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2012-01-01
Background Aseptic loosening is one of the greatest problems in hip replacement surgery. The rotation center of the hip is believed to influence the longevity of fixation. The aim of this study was to compare the influence of cemented and cementless cup fixation techniques on the position of the center of rotation because cemented cup fixation requires the removal of more bone for solid fixation than the cementless technique. Methods We retrospectively compared pre- and post-operative positions of the hip rotation center in 25 and 68 patients who underwent artificial hip replacements in our department in 2007 using cemented or cementless cup fixation, respectively, with digital radiographic image analysis. Results The mean horizontal and vertical distances between the rotation center and the acetabular teardrop were compared in radiographic images taken pre- and post-operatively. The mean horizontal difference was −2.63 mm (range: -11.00 mm to 10.46 mm, standard deviation 4.23 mm) for patients who underwent cementless fixation, and −2.84 mm (range: -10.87 to 5.30 mm, standard deviation 4.59 mm) for patients who underwent cemented fixation. The mean vertical difference was 0.60 mm (range: -20.15 mm to 10.00 mm, standard deviation 3.93 mm) and 0.41 mm (range: -9.26 mm to 6.54 mm, standard deviation 3.58 mm) for the cementless and cemented fixation groups, respectively. The two fixation techniques had no significant difference on the position of the hip rotation center in the 93 patients in this study. Conclusions The hip rotation center was similarly restored using either the cemented or cementless fixation techniques in this patient cohort, indicating that the fixation technique itself does not interfere with the position of the center of rotation. To completely answer this question further studies with more patients are needed. PMID:22686355
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Koyama, Daisuke; Nishiwaki, Satoshi; Harada, Yasuhiko; Yamamoto, Satomi; Kurahashi, Shingo; Sugimoto, Takumi; Iwasaki, Toshihiro; Sugiura, Isamu
2017-09-01
Autologous stem cell transplantation is an important strategy for patients with relapsed or refractory lymphoma. Although various regimens for peripheral blood stem cell collection have been used, the optimal regimen has not yet been established. We aimed to evaluate the mobilization efficacy and safety of the regimen consisted of etoposide and cytarabine (EC regimen). We retrospectively analyzed the clinical data of 46 lymphoma patients who received peripheral blood stem cell mobilization with the EC regimen [etoposide (100 mg/m2/day, days 1-4) and cytarabine (100 mg/m2/day, days 1-4)] at Toyohashi municipal hospital from 2004 to 2013. The median age of the patients was 55 years. The most common underlying diseases were diffuse large B-cell lymphoma (46%) and follicular lymphoma (26%). Three-quarters of patients were in their second complete or partial remission. The median total number of collected CD34+ cells was 10.6 × 106 kg-1. Forty-two patients (91%) yielded at least 2 × 106 kg-1 CD34+ cells within a median of 2 apheresis days, and 33 patients (72%) achieved it with only one apheresis. Successful mobilization was observed in five of six patients who failed to mobilize previously. Although febrile neutropenia occurred in 22 patients (48%), no fatal infection was observed. The EC regimen was highly effective in lymphoma patients, including patients who mobilized poorly with other regimens. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.
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Direct observation of the residual plastic deformation caused by a single tensile overload
DOE Office of Scientific and Technical Information (OSTI.GOV)
Bichler, C.; Pippan, R.
1999-07-01
The fatigue crack growth behavior following single tensile overloads at high stress intensity ranges in a cold-rolled austenitic steel has been studied experimentally. After tensile overloads, fatigue cracks initially accelerate, followed by significant retardation, before the growth rates return to their baseline level. The initial acceleration was attributed to an immediate reduction in near-tip closure. Scanning electron micrography and stereophotogrammetric reconstruction of the fracture surface were applied to study the residual plastic deformation caused by a single tensile overload in the mid-thickness of the specimen. The measured residual opening displacement of the crack as a function of the overload ismore » presented and compared with simple estimations. Also, free specimen surface observations of the residual plastic deformation and crack growth rate were performed. In the midsection of the specimens the striation spacing-length, i.e., the microscopic growth rates, were measured before and after the applied overload. It will be shown that the measured plasticity-induced wedges from the single overload and the observed propagation behavior support the significance of the concept of crack closure.« less
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Direct observation of single flexible polymers using single stranded DNA†
Brockman, Christopher; Kim, Sun Ju
2012-01-01
Over the last 15 years, double stranded DNA (dsDNA) has been used as a model polymeric system for nearly all single polymer dynamics studies. However, dsDNA is a semiflexible polymer with markedly different molecular properties compared to flexible chains, including synthetic organic polymers. In this work, we report a new system for single polymer studies of flexible chains based on single stranded DNA (ssDNA). We developed a method to synthesize ssDNA for fluorescence microscopy based on rolling circle replication, which generates long strands (>65 kb) of ssDNA containing “designer” sequences, thereby preventing intramolecular base pair interactions. Polymers are synthesized to contain amine-modified bases randomly distributed along the backbone, which enables uniform labelling of polymer chains with a fluorescent dye to facilitate fluorescence microscopy and imaging. Using this approach, we synthesized ssDNA chains with long contour lengths (>30 μm) and relatively low dye loading ratios (~1 dye per 100 bases). In addition, we used epifluorescence microscopy to image single ssDNA polymer molecules stretching in flow in a microfluidic device. Overall, we anticipate that ssDNA will serve as a useful model system to probe the dynamics of polymeric materials at the molecular level. PMID:22956981
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NASA Astrophysics Data System (ADS)
Kim, Kiho; Yun, Jiwon; Lee, Donghyuck; Kim, Dohun
2018-02-01
A simple and convenient design enables real-time three-dimensional position tracking of nitrogen-vacancy (NV) centers in diamond. The system consists entirely of commercially available components (a single-photon counter, a high-speed digital-to-analog converter, a phase-sensitive detector-based feedback device, and a piezo stage), eliminating the need for custom programming or rigorous optimization processes. With a large input range of counters and trackers combined with high sensitivity of single-photon counting, high-speed position tracking (upper bound recovery time of 0.9 s upon 250 nm of step-like positional shift) not only of bright ensembles, but also of low-photon-collection-efficiency single to few NV centers (down to 103 s-1) is possible. The tracking requires position modulation of only 10 nm, which allows simultaneous position tracking and pulsed measurements in the long term. Therefore, this tracking system enables measuring a single-spin magnetic resonance and Rabi oscillations at a very high resolution even without photon collection optimization. The system is widely applicable to various fields related to NV center quantum manipulation research such as NV optical trapping, NV tracking in fluid dynamics, and biological sensing using NV centers inside a biological cell.
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Kamperman, Tom; Henke, Sieger; Visser, Claas Willem; Karperien, Marcel; Leijten, Jeroen
2017-06-01
Single-cell-laden microgels support physiological 3D culture conditions while enabling straightforward handling and high-resolution readouts of individual cells. However, their widespread adoption for long-term cultures is limited by cell escape. In this work, it is demonstrated that cell escape is predisposed to off-center encapsulated cells. High-speed microscopy reveals that cells are positioned at the microgel precursor droplets' oil/water interface within milliseconds after droplet formation. In conventional microencapsulation strategies, the droplets are typically gelled immediately after emulsification, which traps cells in this off-center position. By delaying crosslinking, driving cells toward the centers of microgels is succeeded. The centering of cells in enzymatically crosslinked microgels prevents their escape during at least 28 d. It thereby uniquely enables the long-term culture of individual cells within <5-µm-thick 3D uniform hydrogel coatings. Single cell analysis of mesenchymal stem cells in enzymatically crosslinked microgels reveals unprecedented high cell viability (>90%), maintained metabolic activity (>70%), and multilineage differentiation capacity (>60%) over a period of 28 d. The facile nature of this microfluidic cell-centering method enables its straightforward integration into many microencapsulation strategies and significantly enhances control, reproducibility, and reliability of 3D single cell cultures. © 2017 The Authors. Published by WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
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Enhancing Cultural Adaptation through Friendship Training: A Single-Case Study.
ERIC Educational Resources Information Center
Liu, Yi-Ching; Baker, Stanley B.
1993-01-01
Four-year-old girl from mainland China experienced culture shock when attending American university day-care center. Counseling intern from Taiwan designed friendship training program based on assumptions concerning adaptation, acculturation, and peer relationships. Evaluated as intensive single-case study, findings indicated the program may be…
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Optical Modification of a Single Impurity Molecule in a Solid
1991-10-17
have led to direct observations of the lifetime-limited homogeneous Iinewidth of a single pentacene molecule as well as the surprising observation of...advances in the optical detection and spectroscopy of single impurity centers in solids. For the system composed of pentacene impurity molecules in the...limited homogcncous linewidth of a single pentacene molecule as well as the surprising observation of spontaneous spectral diffusion in a crystal
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Preston, Richard A; Karim, Aziz; Dudkowski, Caroline; Zhao, Zhen; Garg, Dyal; Lenz, Oliver; Sica, Domenic A
2013-05-01
Azilsartan medoxomil (AZL-M) is a potent angiotensin II receptor blocker that decreases blood pressure in a dose-dependent manner. It is a pro-drug and not detected in blood after oral administration because of rapid hydrolysis to the active moiety, azilsartan (AZL). AZL undergoes further metabolism to the major metabolite M-II and minor metabolites. The objective of this study was to determine the effect of renal impairment on the pharmacokinetics of AZL and its major metabolite. This was a single-center, open-label, phase I parallel-group study which examined the single-dose (40-mg) pharmacokinetics of AZL and M-II in 24 subjects with mild, moderate, or severe renal impairment or end-stage renal disease requiring hemodialysis (n = 6 per group), respectively, and healthy matched subjects (n = 24). Renal impairment/disease did not cause clinically meaningful increases in exposure to AZL. M-II exposure was higher in all renally impaired subjects and highest in those with severe impairment (approx fivefold higher vs. control). M-II is pharmacologically inactive; increased exposure was not considered important in dose selection for AZL-M in subjects with renal impairment. Hemodialysis did not significantly remove AZL or M-II. Renal impairment had no clinically meaningful effect on the plasma protein binding of AZL or M-II. Single doses of AZL-M 40 mg were well tolerated in all subject groups. Based on the pharmacokinetic and tolerability findings, no dose adjustment of AZL-M is required for subjects with any degree of renal impairment, including end-stage renal disease.
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Riordan, Coleman P; Orbach, Darren B; Smith, Edward R; Scott, R Michael
2018-06-01
OBJECTIVE The most significant adverse outcome of intracranial hemorrhage from an arteriovenous malformation (AVM) is death. This study reviews a single-center experience with pediatric AVMs to quantify the incidence and characterize clinical and radiographic factors associated with sudden death from the hemorrhage of previously undiagnosed AVMs in children. METHODS A single-center database review of the period from 2006 to 2017 identified all patients with a first-time intracranial hemorrhage from a previously undiagnosed AVM. Clinical and radiographic data were collected and compared between patients who survived to hospital discharge and those who died at presentation. RESULTS A total of 57 patients (average age 10.8 years, range 0.1-19 years) presented with first-time intracranial hemorrhage from a previously undiagnosed AVM during the study period. Of this group, 7/57 (12%) patients (average age 11.5 years, range 6-16 years) suffered hemorrhages that led directly to their deaths. Compared to the cohort of patients who survived their hemorrhage, patients who died were 4 times more likely to have an AVM in the posterior fossa. No clear pattern of antecedent triggering activity (sports, trauma, etc.) was identified, and 3/7 (43%) experienced cardiac arrest in the prehospital setting. Surviving patients were ultimately treated with resection of the AVM in 42/50 (84%) of cases. CONCLUSIONS Children who present with hemorrhage from a previously undiagnosed intracranial AVM had a 12% chance of sudden death in our single-institution series of pediatric cerebrovascular cases. Clinical triggers of hemorrhage are unpredictable, but subsequent radiographic evidence of a posterior fossa AVM was present in 57% of fatal cases, and all fatal cases were in locations with high risk of potential herniation. These data support a proactive, aggressive approach toward definitive treatment of AVMs in children.
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Observation of electroweak single top-quark production.
Aaltonen, T; Adelman, J; Akimoto, T; Alvarez González, B; Amerio, S; Amidei, D; Anastassov, A; Annovi, A; Antos, J; Apollinari, G; Apresyan, A; Arisawa, T; Artikov, A; Ashmanskas, W; Attal, A; Aurisano, A; Azfar, F; Badgett, W; Barbaro-Galtieri, A; Barnes, V E; Barnett, B A; Barria, P; Bartsch, V; Bauer, G; Beauchemin, P-H; Bedeschi, F; Beecher, D; Behari, S; Bellettini, G; Bellinger, J; Benjamin, D; Beretvas, A; Beringer, J; Bhatti, A; Binkley, M; Bisello, D; Bizjak, I; Blair, R E; Blocker, C; Blumenfeld, B; Bocci, A; Bodek, A; Boisvert, V; Bolla, G; Bortoletto, D; Boudreau, J; Boveia, A; Brau, B; Bridgeman, A; Brigliadori, L; Bromberg, C; Brubaker, E; Budagov, J; Budd, H S; Budd, S; Burke, S; Burkett, K; Busetto, G; Bussey, P; Buzatu, A; Byrum, K L; Cabrera, S; Calancha, C; Campanelli, M; Campbell, M; Canelli, F; Canepa, A; Carls, B; Carlsmith, D; Carosi, R; Carrillo, S; Carron, S; Casal, B; Casarsa, M; Castro, A; Catastini, P; Cauz, D; Cavaliere, V; Cavalli-Sforza, M; Cerri, A; Cerrito, L; Chang, S H; Chen, Y C; Chertok, M; Chiarelli, G; Chlachidze, G; Chlebana, F; Cho, K; Chokheli, D; Chou, J P; Choudalakis, G; Chuang, S H; Chung, K; Chung, W H; Chung, Y S; Chwalek, T; Ciobanu, C I; Ciocci, M A; Clark, A; Clark, D; Compostella, G; Convery, M E; Conway, J; Cordelli, M; Cortiana, G; Cox, C A; Cox, D J; Crescioli, F; Cuenca Almenar, C; Cuevas, J; Culbertson, R; Cully, J C; Dagenhart, D; Datta, M; Davies, T; de Barbaro, P; De Cecco, S; Deisher, A; De Lorenzo, G; Dell'orso, M; Deluca, C; Demortier, L; Deng, J; Deninno, M; Derwent, P F; Di Canto, P; di Giovanni, G P; Dionisi, C; Di Ruzza, B; Dittmann, J R; D'Onofrio, M; Donati, S; Dong, P; Donini, J; Dorigo, T; Dube, S; Efron, J; Elagin, A; Erbacher, R; Errede, D; Errede, S; Eusebi, R; Fang, H C; Farrington, S; Fedorko, W T; Feild, R G; Feindt, M; Fernandez, J P; Ferrazza, C; Field, R; Flanagan, G; Forrest, R; Frank, M J; Franklin, M; Freeman, J C; Furic, I; Gallinaro, M; Galyardt, J; Garberson, F; Garcia, J E; Garfinkel, A F; Garosi, P; Genser, K; Gerberich, H; Gerdes, D; Gessler, A; Giagu, S; Giakoumopoulou, V; Giannetti, P; Gibson, K; Gimmell, J L; Ginsburg, C M; Giokaris, N; Giordani, M; Giromini, P; Giunta, M; Giurgiu, G; Glagolev, V; Glenzinski, D; Gold, M; Goldschmidt, N; Golossanov, A; Gomez, G; Gomez-Ceballos, G; Goncharov, M; González, O; Gorelov, I; Goshaw, A T; Goulianos, K; Gresele, A; Grinstein, S; Grosso-Pilcher, C; Grundler, U; Guimaraes da Costa, J; Gunay-Unalan, Z; Haber, C; Hahn, K; Hahn, S R; Halkiadakis, E; Han, B-Y; Han, J Y; Happacher, F; Hara, K; Hare, D; Hare, M; Harper, S; Harr, R F; Harris, R M; Hartz, M; Hatakeyama, K; Hays, C; Heck, M; Heijboer, A; Heinrich, J; Henderson, C; Herndon, M; Heuser, J; Hewamanage, S; Hidas, D; Hill, C S; Hirschbuehl, D; Hocker, A; Hou, S; Houlden, M; Hsu, S-C; Huffman, B T; Hughes, R E; Husemann, U; Hussein, M; Huston, J; Incandela, J; Introzzi, G; Iori, M; Ivanov, A; James, E; Jang, D; Jayatilaka, B; Jeon, E J; Jha, M K; Jindariani, S; Johnson, W; Jones, M; Joo, K K; Jun, S Y; Jung, J E; Junk, T R; Kamon, T; Kar, D; Karchin, P E; Kato, Y; Kephart, R; Keung, J; Khotilovich, V; Kilminster, B; Kim, D H; Kim, H S; Kim, H W; Kim, J E; Kim, M J; Kim, S B; Kim, S H; Kim, Y K; Kimura, N; Kirsch, L; Klimenko, S; Knuteson, B; Ko, B R; Kondo, K; Kong, D J; Konigsberg, J; Korytov, A; Kotwal, A V; Kreps, M; Kroll, J; Krop, D; Krumnack, N; Kruse, M; Krutelyov, V; Kubo, T; Kuhr, T; Kulkarni, N P; Kurata, M; Kwang, S; Laasanen, A T; Lami, S; Lammel, S; Lancaster, M; Lander, R L; Lannon, K; Lath, A; Latino, G; Lazzizzera, I; LeCompte, T; Lee, E; Lee, H S; Lee, S W; Leone, S; Lewis, J D; Lin, C-S; Linacre, J; Lindgren, M; Lipeles, E; Liss, T M; Lister, A; Litvintsev, D O; Liu, C; Liu, T; Lockyer, N S; Loginov, A; Loreti, M; Lovas, L; Lucchesi, D; Luci, C; Lueck, J; Lujan, P; Lukens, P; Lungu, G; Lyons, L; Lys, J; Lysak, R; MacQueen, D; Madrak, R; Maeshima, K; Makhoul, K; Maki, T; Maksimovic, P; Malde, S; Malik, S; Manca, G; Manousakis-Katsikakis, A; Margaroli, F; Marino, C; Marino, C P; Martin, A; Martin, V; Martínez, M; Martínez-Ballarín, R; Maruyama, T; Mastrandrea, P; Masubuchi, T; Mathis, M; Mattson, M E; Mazzanti, P; McFarland, K S; McIntyre, P; McNulty, R; Mehta, A; Mehtala, P; Menzione, A; Merkel, P; Mesropian, C; Miao, T; Miladinovic, N; Miller, R; Mills, C; Milnik, M; Mitra, A; Mitselmakher, G; Miyake, H; Moggi, N; Moon, C S; Moore, R; Morello, M J; Morlock, J; Movilla Fernandez, P; Mülmenstädt, J; Mukherjee, A; Muller, Th; Mumford, R; Murat, P; Mussini, M; Nachtman, J; Nagai, Y; Nagano, A; Naganoma, J; Nakamura, K; Nakano, I; Napier, A; Necula, V; Nett, J; Neu, C; Neubauer, M S; Neubauer, S; Nielsen, J; Nodulman, L; Norman, M; Norniella, O; Nurse, E; Oakes, L; Oh, S H; Oh, Y D; Oksuzian, I; Okusawa, T; Orava, R; Osterberg, K; Pagan Griso, S; Palencia, E; Papadimitriou, V; Papaikonomou, A; Paramonov, A A; Parks, B; Pashapour, S; Patrick, J; Pauletta, G; Paulini, M; Paus, C; Peiffer, T; Pellett, D E; Penzo, A; Phillips, T J; Piacentino, G; Pianori, E; Pinera, L; Pitts, K; Plager, C; Pondrom, L; Potamianos, K; Poukhov, O; Pounder, N; Prakoshyn, F; Pronko, A; Proudfoot, J; Ptohos, F; Pueschel, E; Punzi, G; Pursley, J; Rademacker, J; Rahaman, A; Ramakrishnan, V; Ranjan, N; Redondo, I; Renton, P; Renz, M; Rescigno, M; Richter, S; Rimondi, F; Ristori, L; Robson, A; Rodrigo, T; Rodriguez, T; Rogers, E; Rolli, S; Roser, R; Rossi, M; Rossin, R; Roy, P; Ruiz, A; Russ, J; Rusu, V; Rutherford, B; Saarikko, H; Safonov, A; Sakumoto, W K; Saltó, O; Santi, L; Sarkar, S; Sartori, L; Sato, K; Savoy-Navarro, A; Schlabach, P; Schmidt, A; Schmidt, E E; Schmidt, M A; Schmidt, M P; Schmitt, M; Schwarz, T; Scodellaro, L; Scribano, A; Scuri, F; Sedov, A; Seidel, S; Seiya, Y; Semenov, A; Sexton-Kennedy, L; Sforza, F; Sfyrla, A; Shalhout, S Z; Shears, T; Shepard, P F; Shimojima, M; Shiraishi, S; Shochet, M; Shon, Y; Shreyber, I; Sinervo, P; Sisakyan, A; Slaughter, A J; Slaunwhite, J; Sliwa, K; Smith, J R; Snider, F D; Snihur, R; Soha, A; Somalwar, S; Sorin, V; Spalding, J; Spreitzer, T; Squillacioti, P; Stanitzki, M; St Denis, R; Stelzer, B; Stelzer-Chilton, O; Stentz, D; Strologas, J; Strycker, G L; Stuart, D; Suh, J S; Sukhanov, A; Suslov, I; Suzuki, T; Taffard, A; Takashima, R; Takeuchi, Y; Tanaka, R; Tecchio, M; Teng, P K; Terashi, K; Thom, J; Thompson, A S; Thompson, G A; Thomson, E; Tipton, P; Ttito-Guzmán, P; Tkaczyk, S; Toback, D; Tokar, S; Tollefson, K; Tomura, T; Tonelli, D; Torre, S; Torretta, D; Totaro, P; Tourneur, S; Trovato, M; Tsai, S-Y; Tu, Y; Turini, N; Ukegawa, F; Vallecorsa, S; van Remortel, N; Varganov, A; Vataga, E; Vázquez, F; Velev, G; Vellidis, C; Vidal, M; Vidal, R; Vila, I; Vilar, R; Vine, T; Vogel, M; Volobouev, I; Volpi, G; Wagner, P; Wagner, R G; Wagner, R L; Wagner, W; Wagner-Kuhr, J; Wakisaka, T; Wallny, R; Wang, S M; Warburton, A; Waters, D; Weinberger, M; Weinelt, J; Wester, W C; Whitehouse, B; Whiteson, D; Wicklund, A B; Wicklund, E; Wilbur, S; Williams, G; Williams, H H; Wilson, P; Winer, B L; Wittich, P; Wolbers, S; Wolfe, C; Wright, T; Wu, X; Würthwein, F; Xie, S; Yagil, A; Yamamoto, K; Yamaoka, J; Yang, U K; Yang, Y C; Yao, W M; Yeh, G P; Yoh, J; Yorita, K; Yoshida, T; Yu, G B; Yu, I; Yu, S S; Yun, J C; Zanello, L; Zanetti, A; Zhang, X; Zheng, Y; Zucchelli, S
2009-08-28
We report the observation of single top-quark production using 3.2 fb(-1) of pp[over ] collision data with sqrt[s]=1.96 TeV collected by the Collider Detector at Fermilab. The significance of the observed data is 5.0 standard deviations, and the expected sensitivity for standard model production and decay is in excess of 5.9 standard deviations. Assuming m(t) = 175 GeV/c(2), we measure a cross section of 2.3(-0.5);(+0.6)(stat + syst) pb, extract the CKM matrix-element value |V(tb)| = 0.91 + or - 0.11(stat + syst) + or - 0.07(theory), and set the limit |V(tb)| > 0.71 at the 95% C.L.
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100 Multivisceral Transplants at a Single Center
Tzakis, Andreas G.; Kato, Tomoaki; Levi, David M.; DeFaria, Werviston; Selvaggi, Gennaro; Weppler, Debbie; Nishida, Seigo; Moon, Jang; Madariaga, Juan R.; David, Andre I.; Gaynor, Jeffrey J.; Thompson, John; Hernandez, Erick; Martinez, Enrique; Cantwell, G Patricia; Augenstein, Jeffrey S.; Gyamfi, Anthony; Pretto, Ernesto A.; Dowdy, Lorraine; Tryphonopoulos, Panagiotis; Ruiz, Phillip
2005-01-01
Objective: The objective of this study was to summarize the evolution of multivisceral transplantation over a decade of experience and evaluate its current status. Summary Background Data: Multivisceral transplantation can be valuable for the treatment of patients with massive abdominal catastrophes. Its major limitations have been technical and rejection of the intestinal graft. Methods: This study consisted of an outcome analysis of 98 consecutive patients who received multivisceral transplantation at our institution. This represents the largest single center experience to date. Results: The most common diseases in our population before transplant were intestinal gastroschisis and intestinal dysmotility syndromes in children, and mesenteric thrombosis and trauma in adults. Kaplan Meier estimated patient and graft survivals for all cases were 65% and 63% at 1 year, 49% and 47% at 3 years, and 49% and 47% at 5 years. Factors that adversely influenced patient survival included transplant before 1998 (P = 0.01), being hospitalized at the time of transplant (P = 0.05), and being a child who received Campath-1H induction (P = 0.03). Among 37 patients who had none of these 3 factors (15 adults and 22 children), estimated 1- and 3-year survivals were 89% and 71%, respectively. Patients transplanted since 2001 had significantly less moderate and severe rejections (31.6% vs 67.6%, P = 0.0005) with almost half of these patients never developing rejection. Conclusions: Multivisceral transplantation is now an effective treatment of patients with complex abdominal pathology. The incidences of serious acute rejection and patient survival have improved in the most recent experience. Our results show that the multivisceral graft seems to facilitate engraftment of transplanted organs and raises the possibility that there is a degree of immunologic protection afforded by this procedure. PMID:16192808
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Microsecond protein dynamics observed at the single-molecule level
NASA Astrophysics Data System (ADS)
Otosu, Takuhiro; Ishii, Kunihiko; Tahara, Tahei
2015-07-01
How polypeptide chains acquire specific conformations to realize unique biological functions is a central problem of protein science. Single-molecule spectroscopy, combined with fluorescence resonance energy transfer, is utilized to study the conformational heterogeneity and the state-to-state transition dynamics of proteins on the submillisecond to second timescales. However, observation of the dynamics on the microsecond timescale is still very challenging. This timescale is important because the elementary processes of protein dynamics take place and direct comparison between experiment and simulation is possible. Here we report a new single-molecule technique to reveal the microsecond structural dynamics of proteins through correlation of the fluorescence lifetime. This method, two-dimensional fluorescence lifetime correlation spectroscopy, is applied to clarify the conformational dynamics of cytochrome c. Three conformational ensembles and the microsecond transitions in each ensemble are indicated from the correlation signal, demonstrating the importance of quantifying microsecond dynamics of proteins on the folding free energy landscape.
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Microsecond protein dynamics observed at the single-molecule level
Otosu, Takuhiro; Ishii, Kunihiko; Tahara, Tahei
2015-01-01
How polypeptide chains acquire specific conformations to realize unique biological functions is a central problem of protein science. Single-molecule spectroscopy, combined with fluorescence resonance energy transfer, is utilized to study the conformational heterogeneity and the state-to-state transition dynamics of proteins on the submillisecond to second timescales. However, observation of the dynamics on the microsecond timescale is still very challenging. This timescale is important because the elementary processes of protein dynamics take place and direct comparison between experiment and simulation is possible. Here we report a new single-molecule technique to reveal the microsecond structural dynamics of proteins through correlation of the fluorescence lifetime. This method, two-dimensional fluorescence lifetime correlation spectroscopy, is applied to clarify the conformational dynamics of cytochrome c. Three conformational ensembles and the microsecond transitions in each ensemble are indicated from the correlation signal, demonstrating the importance of quantifying microsecond dynamics of proteins on the folding free energy landscape. PMID:26151767
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Elander, Johanna; Nekludov, Michael; Larsson, Agneta; Nordlander, Britt; Eksborg, Staffan; Hydman, Jonas
2016-12-01
To provide retrospective, descriptive information on patients with cervical necrotizing fasciitis treated at a single center during the years 1998-2014, and to evaluate the outcome of a newly introduced treatment strategy. Retrospective analysis of clinical data obtained from medical records. Mortality, pre-morbidity, severity of illness, primary site of infection, type of bacteria, time parameters. The observed 3-month mortality was 6/59 (10 %). The most common initial foci of the infection were pharyngeal, dental or hypopharyngeal. The most common pathogen was Streptococcus milleri bacteria within the Streptococcus anginosus group (66 % of the cases). Using a combined treatment with early surgical debridement combined with hyperbaric oxygen treatment, it is possible to reduce the mortality rate among patients suffering from cervical necrotizing fasciitis, compared to the expected mortality rate and to previous historical reports. Data indicated that early onset of hyperbaric oxygen treatment may have a positive impact on survival rate, but no identifiable factor was found to prognosticate outcome.
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Circuit model for single-energy-level trap centers in FETs
NASA Astrophysics Data System (ADS)
Albahrani, Sayed Ali; Parker, Anthony; Heimlich, Michael
2016-12-01
A circuit implementation of a single-energy-level trap center in an FET is presented. When included in transistor models it explains the temperature-potential-dependent time constants seen in the circuit manifestations of charge trapping, being gate lag and drain overshoot. The implementation is suitable for both time-domain and harmonic-balance simulations. The proposed model is based on the Shockley-Read-Hall (SRH) statistics of the trapping process. The results of isothermal pulse measurements performed on a GaN HEMT are presented. These measurement allow characterizing charge trapping in isolation from the effect of self-heating. These results are used to obtain the parameters of the proposed model.
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Catalytic reduction of dinitrogen to ammonia at a single molybdenum center.
Yandulov, Dmitry V; Schrock, Richard R
2003-07-04
Dinitrogen (N2) was reduced to ammonia at room temperature and 1 atmosphere with molybdenum catalysts that contain tetradentate [HIPTN3N]3- triamidoamine ligands (such as [HIPTN3N]Mo(N2), where [HIPTN3N]3- is [(3,5-(2,4,6-i-Pr3C6H2)2C6H3NCH2CH2)3N]3-) in heptane. Slow addition of the proton source [(2,6-lutidinium)(BAr'4), where Ar' is 3,5-(CF3)2C6H3]and reductant (decamethyl chromocene) was critical for achieving high efficiency ( approximately 66% in four turnovers). Numerous x-ray studies, along with isolation and characterization of six proposed intermediates in the catalytic reaction under noncatalytic conditions, suggest that N2 was reduced at a sterically protected, single molybdenum center that cycled from Mo(III) through Mo(VI) states.
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Observation of two-center interference effects for electron impact ionization of N2
NASA Astrophysics Data System (ADS)
Chaluvadi, Hari; Nur Ozer, Zehra; Dogan, Mevlut; Ning, Chuangang; Colgan, James; Madison, Don
2015-08-01
In 1966, Cohen and Fano (1966 Phys. Rev. 150 30) suggested that one should be able to observe the equivalent of Young’s double slit interference if the double slits were replaced by a diatomic molecule. This suggestion inspired many experimental and theoretical studies searching for double slit interference effects both for photon and particle ionization of diatomic molecules. These effects turned out to be so small for particle ionization that this work proceeded slowly and evidence for interference effects were only found by looking at cross section ratios. Most of the early particle work concentrated on double differential cross sections for heavy particle scattering and the first evidence for two-center interference for electron-impact triple differential cross section (TDCS) did not appear until 2006 for ionization of H2. Subsequent work has now firmly established that two-center interference effects can be seen in the TDCS for electron-impact ionization of H2. However, in spite of several experimental and theoretical studies, similar effects have not been found for electron-impact ionization of N2. Here we report the first evidence for two-center interference for electron-impact ionization of N2.
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Availability of Earth observations data from the U.S. Geological Survey's EROS data center
Holm, Thomas M.; Draeger, William C.; Risty, Ronald R.
1993-01-01
For decades federal and state agencies have been collecting regional, continental, and global Earth observations data acquired by satellites, aircraft, and other information-gathering systems. These data include photographic and digital remotely sensed images of the Earth's surface, as well as earth science, cartographic, and geographic data. Since 1973, the U.S. Geological Survey's Earth Resources Observation Systems (EROS) Data Center (EDC) in Sioux Falls, South Dakota, has been a data management, production, dissemination, and research center for these data. Currently, the Data Center holds over 10 million satellite images and aerial photographs, in photographic and digital formats. Users are able to place inquiries and orders for these holdings via a nationwide computer network. In addition to cataloging the data stored in its archives, the Data Center provides users with rapid access to information on many data collections held by other facilities.
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Schwartz, J.; Aloni, S.; Ogletree, D. F.; ...
2012-04-20
Exposure to beams of low-energy electrons (2-30 keV) in a scanning electron microscope locally induces formation of NV-centers without thermal annealing in diamonds that have been implanted with nitrogen ions. In this study, we find that non-thermal, electron-beam-induced NV-formation is about four times less efficient than thermal annealing. But NV-center formation in a consecutive thermal annealing step (800°C) following exposure to low-energy electrons increases by a factor of up to 1.8 compared to thermal annealing alone. Finally, these observations point to reconstruction of nitrogen-vacancy complexes induced by electronic excitations from low-energy electrons as an NV-center formation mechanism and identify localmore » electronic excitations as a means for spatially controlled room-temperature NV-center formation.« less
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Phonon Self-Energy Corrections to Nonzero Wave-Vector Phonon Modes in Single-Layer Graphene
NASA Astrophysics Data System (ADS)
Araujo, P. T.; Mafra, D. L.; Sato, K.; Saito, R.; Kong, J.; Dresselhaus, M. S.
2012-07-01
Phonon self-energy corrections have mostly been studied theoretically and experimentally for phonon modes with zone-center (q=0) wave vectors. Here, gate-modulated Raman scattering is used to study phonons of a single layer of graphene originating from a double-resonant Raman process with q≠0. The observed phonon renormalization effects are different from what is observed for the zone-center q=0 case. To explain our experimental findings, we explored the phonon self-energy for the phonons with nonzero wave vectors (q≠0) in single-layer graphene in which the frequencies and decay widths are expected to behave oppositely to the behavior observed in the corresponding zone-center q=0 processes. Within this framework, we resolve the identification of the phonon modes contributing to the G⋆ Raman feature at 2450cm-1 to include the iTO+LA combination modes with q≠0 and also the 2iTO overtone modes with q=0, showing both to be associated with wave vectors near the high symmetry point K in the Brillouin zone.
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Confidence intervals from single observations in forest research
Harry T. Valentine; George M. Furnival; Timothy G. Gregoire
1991-01-01
A procedure for constructing confidence intervals and testing hypothese from a single trial or observation is reviewed. The procedure requires a prior, fixed estimate or guess of the outcome of an experiment or sampling. Two examples of applications are described: a confidence interval is constructed for the expected outcome of a systematic sampling of a forested tract...
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Predictors of Default from Treatment for Tuberculosis: a Single Center Case–Control Study in Korea
2016-01-01
Default from tuberculosis (TB) treatment could exacerbate the disease and result in the emergence of drug resistance. This study identified the risk factors for default from TB treatment in Korea. This single-center case–control study analyzed 46 default cases and 100 controls. Default was defined as interrupting treatment for 2 or more consecutive months. The reasons for default were mainly incorrect perception or information about TB (41.3%) and experience of adverse events due to TB drugs (41.3%). In univariate analysis, low income (< 2,000 US dollars/month, 88.1% vs. 68.4%, P = 0.015), absence of TB stigma (4.3% vs. 61.3%, P < 0.001), treatment by a non-pulmonologist (74.1% vs. 25.9%, P < 0.001), history of previous treatment (37.0% vs. 19.0%, P = 0.019), former defaulter (15.2% vs. 2.0%, P = 0.005), and combined extrapulmonary TB (54.3% vs. 34.0%, P = 0.020) were significant risk factors for default. In multivariate analysis, the absence of TB stigma (adjusted odd ratio [aOR]: 46.299, 95% confidence interval [CI]: 8.078–265.365, P < 0.001), treatment by a non-pulmonologist (aOR: 14.567, 95% CI: 3.260–65.089, P < 0.001), former defaulters (aOR: 33.226, 95% CI: 2.658–415.309, P = 0.007), and low income (aOR: 5.246, 95% CI: 1.249–22.029, P = 0.024) were independent predictors of default from TB treatment. In conclusion, patients with absence of disease stigma, treated by a non-pulmonologist, who were former defaulters, and with low income should be carefully monitored during TB treatment in Korea to avoid treatment default. PMID:26839480
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Predictors of Default from Treatment for Tuberculosis: a Single Center Case-Control Study in Korea.
Park, Cheol-Kyu; Shin, Hong-Joon; Kim, Yu-Il; Lim, Sung-Chul; Yoon, Jeong-Sun; Kim, Young-Su; Kim, Jung-Chul; Kwon, Yong-Soo
2016-02-01
Default from tuberculosis (TB) treatment could exacerbate the disease and result in the emergence of drug resistance. This study identified the risk factors for default from TB treatment in Korea. This single-center case-control study analyzed 46 default cases and 100 controls. Default was defined as interrupting treatment for 2 or more consecutive months. The reasons for default were mainly incorrect perception or information about TB (41.3%) and experience of adverse events due to TB drugs (41.3%). In univariate analysis, low income (< 2,000 US dollars/month, 88.1% vs. 68.4%, P = 0.015), absence of TB stigma (4.3% vs. 61.3%, P < 0.001), treatment by a non-pulmonologist (74.1% vs. 25.9%, P < 0.001), history of previous treatment (37.0% vs. 19.0%, P = 0.019), former defaulter (15.2% vs. 2.0%, P = 0.005), and combined extrapulmonary TB (54.3% vs. 34.0%, P = 0.020) were significant risk factors for default. In multivariate analysis, the absence of TB stigma (adjusted odd ratio [aOR]: 46.299, 95% confidence interval [CI]: 8.078-265.365, P < 0.001), treatment by a non-pulmonologist (aOR: 14.567, 95% CI: 3.260-65.089, P < 0.001), former defaulters (aOR: 33.226, 95% CI: 2.658-415.309, P = 0.007), and low income (aOR: 5.246, 95% CI: 1.249-22.029, P = 0.024) were independent predictors of default from TB treatment. In conclusion, patients with absence of disease stigma, treated by a non-pulmonologist, who were former defaulters, and with low income should be carefully monitored during TB treatment in Korea to avoid treatment default.
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NASA Astrophysics Data System (ADS)
Lee, Harim; Moon, Y.-J.; Na, Hyeonock; Jang, Soojeong; Lee, Jae-Ok
2015-12-01
To prepare for when only single-view observations are available, we have made a test whether the 3-D parameters (radial velocity, angular width, and source location) of halo coronal mass ejections (HCMEs) from single-view observations are consistent with those from multiview observations. For this test, we select 44 HCMEs from December 2010 to June 2011 with the following conditions: partial and full HCMEs by SOHO and limb CMEs by twin STEREO spacecraft when they were approximately in quadrature. In this study, we compare the 3-D parameters of the HCMEs from three different methods: (1) a geometrical triangulation method, the STEREO CAT tool developed by NASA/CCMC, for multiview observations using STEREO/SECCHI and SOHO/LASCO data, (2) the graduated cylindrical shell (GCS) flux rope model for multiview observations using STEREO/SECCHI data, and (3) an ice cream cone model for single-view observations using SOHO/LASCO data. We find that the radial velocities and the source locations of the HCMEs from three methods are well consistent with one another with high correlation coefficients (≥0.9). However, the angular widths by the ice cream cone model are noticeably underestimated for broad CMEs larger than 100° and several partial HCMEs. A comparison between the 3-D CME parameters directly measured from twin STEREO spacecraft and the above 3-D parameters shows that the parameters from multiview are more consistent with the STEREO measurements than those from single view.
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Sudo, Takeshi; Murakami, Yoshiaki; Uemura, Kenichiro; Hashimoto, Yasushi; Kondo, Naru; Nakagawa, Naoya; Sueda, Taijiro
2014-06-01
The study aim was to determine the short- and long-term results of lateral pancreaticojejunostomy for chronic pancreatitis at a single center in Japan. The records of 64 consecutive patients were retrospectively reviewed. All patients underwent surgery at Hiroshima University Hospital between December 1996 and April 2013. Long-term follow-up was performed in 58 patients (91%) for a median period of 34 months. The 53 men (83%) and 11 women (17%) had a mean age of 55 years. The etiology of pancreatitis was chronic alcohol abuse in 44 patients (69%). The major indication for surgery was acute pancreatitis exacerbation (80%). There was no postoperative mortality. Postoperative morbidity occurred in 21 patients (33%), with severe complications requiring non-surgical intervention in four (6%). The percentage of pain-free patients after surgery was 91%, and further acute exacerbation was prevented in 95%. Four patients (7%) required subsequent surgery for pancreatitis-related complications. Of the patients that completed follow-up, 33 (57%) had diabetes mellitus, including 11 patients (19%) with new-onset diabetes; 30 patients (56%) developed pancreatic exocrine insufficiency. Full-length lateral pancreaticojejunostomy is safe, feasible, and effective for managing chronic pancreatitis. The technique prevents further exacerbations and maintains appropriate pancreatic endocrine and exocrine function. © 2013 Japanese Society of Hepato-Biliary-Pancreatic Surgery.
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Direct Observation of Quantum Coherence in Single-Molecule Magnets
NASA Astrophysics Data System (ADS)
Schlegel, C.; van Slageren, J.; Manoli, M.; Brechin, E. K.; Dressel, M.
2008-10-01
Direct evidence of quantum coherence in a single-molecule magnet in a frozen solution is reported with coherence times as long as T2=630±30ns. We can strongly increase the coherence time by modifying the matrix in which the single-molecule magnets are embedded. The electron spins are coupled to the proton nuclear spins of both the molecule itself and, interestingly, also to those of the solvent. The clear observation of Rabi oscillations indicates that we can manipulate the spin coherently, an essential prerequisite for performing quantum computations.
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Nakatani, Tomotaka; Yoshiasa, Akira; Nakatsuka, Akihiko; Hiratoko, Tatsuya; Mashimo, Tsutomu; Okube, Maki; Sasaki, Satoshi
2016-02-01
A variable-temperature single-crystal X-ray diffraction study of a synthetic BaTiO3 perovskite has been performed over the temperature range 298-778 K. A transition from a tetragonal (P4mm) to a cubic (Pm3m) phase has been revealed near 413 K. In the non-centrosymmetric P4mm symmetry group, both Ti and O atoms are displaced along the c-axis in opposite directions with regard to the Ba position fixed at the origin, so that Ti(4+) and Ba(2+) cations occupy off-center positions in the TiO6 and BaO12 polyhedra, respectively. Smooth temperature-dependent changes of the atomic coordinates become discontinuous with the phase transition. Our observations imply that the cations remain off-center even in the high-temperature cubic phase. The temperature dependence of the mean-square displacements of Ti in the cubic phase includes a significant static component which means that Ti atoms are statistically distributed in the off-center positions.
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Activities of JAXA's Innovative Technology Center on Space Debris Observation
NASA Astrophysics Data System (ADS)
Yanagisawa, T.; Kurosaki, H.; Nakajima, A.
The innovative technology research center of JAXA is developing observational technologies for GEO objects in order to cope with the space debris problem. The center had constructed the optical observational facility for space debris at Mt. Nyukasa, Nagano in 2006. As observational equipments such as CCD cameras and telescopes were set up, the normal observation started. In this paper, the detail of the facilities and its activities are introduced. The observational facility contains two telescopes and two CCD cameras. The apertures of the telescopes are 35cm and 25 cm, respectively. One CCD camera in which 2K2K chip is installed can observe a sky region of 1.3 times 1.3-degree using the 35cm telescope. The other CCD camera that contains two 4K2K chips has an ability to observe 2.6 times 2.6-degree's region with the 25cm telescope. One of our main objectives is to detect faint GEO objects that are not catalogued. Generally, the detection limit of GEO object is determined by the aperture of the telescope. However, by improving image processing techniques, the limit may become low. We are developing some image processing methods that use many CCD frames to detect faint objects. We are trying to use FPGA (Field Programmable Gate Array) system to reduce analyzing time. By applying these methods to the data taken by a large telescope, the detection limit will be significantly lowered. The orbital determination of detected GEO debris is one of the important things to do. Especially, the narrow field view of an optical telescope hinders us from re-detection of the GEO debris for the orbital determination. Long observation time is required for one GEO object for the orbital determination that is inefficient. An effective observation strategy should be considered. We are testing one observation method invented by Umehara that observes one inertia position in the space. By observing one inertia position for two nights, a GEO object that passed through the position in the
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Economic Burden of Road Traffic Accidents; Report from a Single Center from South Eastern Iran
Sargazi, Aliyeh; Sargazi, Atefeh; Nadakkavukaran Jim, Prigil Kumar; Danesh, HoseinAli; Aval, ForoughSargolzaee; Kiani, Zohre; Lashkarinia, AmirHosein; Sepehri, Zahra
2016-01-01
Objective: To determine the economic burden of road traffic accidents (RTAs) in patients admitted to a single center in south eastern Iran. Methods: This cross-sectional study was conducted in Amir-Al-Momenin hospital of Zabol affiliated with Zabol University of Medical Sciences during a 12-month period from April 2012 to April 2013. All the RTAs patients who were admitted to our emergency department were included. The direct expenses of hospital care were recorded according to their medical charts and the accountant registration information. Data are presented according to different RTAs characteristics. Results: Overall 1155 patients were included in the current study with mean age of 36.7 ± 5.14 years among whom there were 673(58.3%) men and 482 (41.7%) women. The annual incidence of RTAs were calculated to be 288 per 100,000 population. The RTAs economic burden in our center was 589,448.49 USD which accounted for 10.4% of total hospital expenses during the study period. The money spend on RTAs in our center was 130 times more than gross national income per capita. Cost of each patient in road traffic was 15 times more than cost of an average patient of the hospital in other sections. Conclusion: With considerable high ratio of accidents in Zabol, proper intervention is needed for controlling and preventing RTAs in order to decrease its injuries, impact and the associated economic burden. PMID:27162926
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Economic Burden of Road Traffic Accidents; Report from a Single Center from South Eastern Iran.
Sargazi, Aliyeh; Sargazi, Atefeh; Nadakkavukaran Jim, Prigil Kumar; Danesh, HoseinAli; Aval, ForoughSargolzaee; Kiani, Zohre; Lashkarinia, AmirHosein; Sepehri, Zahra
2016-01-01
To determine the economic burden of road traffic accidents (RTAs) in patients admitted to a single center in south eastern Iran. This cross-sectional study was conducted in Amir-Al-Momenin hospital of Zabol affiliated with Zabol University of Medical Sciences during a 12-month period from April 2012 to April 2013. All the RTAs patients who were admitted to our emergency department were included. The direct expenses of hospital care were recorded according to their medical charts and the accountant registration information. Data are presented according to different RTAs characteristics. Overall 1155 patients were included in the current study with mean age of 36.7 ± 5.14 years among whom there were 673(58.3%) men and 482 (41.7%) women. The annual incidence of RTAs were calculated to be 288 per 100,000 population. The RTAs economic burden in our center was 589,448.49 USD which accounted for 10.4% of total hospital expenses during the study period. The money spend on RTAs in our center was 130 times more than gross national income per capita. Cost of each patient in road traffic was 15 times more than cost of an average patient of the hospital in other sections. With considerable high ratio of accidents in Zabol, proper intervention is needed for controlling and preventing RTAs in order to decrease its injuries, impact and the associated economic burden.
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Congenital heart defects: the 10-year experience at a single center.
Aydin, Emine; Aypar, Ebru; Oktem, Ahmet; Ozyuncu, Ozgur; Yurdakok, Murat; Guvener, Murat; Demircin, Metin; Beksac, M Sinan
2018-06-18
We aimed to evaluate congenital heart disease (CHD) cases according to EUROCAT subgroup classification that were diagnosed during the prenatal period in our center. CHDs that were prenatally diagnosed using ultrasonography and confirmed by fetal echocardiography were reviewed over a 10-year period. Subgroup classification was finalized at the post-partum period in terms of the EUROCAT guide 1.3. Congenital heart defect subtypes and obstetric outcomes (gestational week at delivery, birth weight, gender, extracardiac structural abnormalities, karyotype results if performed) were analyzed. The data of 180 cases with CHD was examined. Left ventricular outflow tract obstruction (LVOT) was the most common CHD subtype (57/180; 31.6%), which included 48, five, and four cases of hypoplastic left heart syndrome (HLHS), coarctation of the aorta, and aortic valve atresia/stenosis, respectively. Eighteen pregnancies were terminated; the most common CHD subtype among patients of terminated pregnancies was hypoplastic left heart syndrome (HLHS) (n = 7, 38.8%). The most common extracardiac malformations were a single umbilical artery, esophageal atresia, and situs inversus in our study group. Eighteen of the 96 (18.75%) neonates with CHD died during the neonatal period. The most common CHD subtype was HLHS (7/18; 38%) among the newborns who died after birth. Prenatal diagnosis of a CHD and subgroup classification is very important for clinical decision making, including prenatal management, recommendations for termination of the pregnancy, postnatal management of the patient, and for early referral to pediatric cardiology and cardiovascular surgery centers.
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Using Evidence-Centered Design to Create a Special Educator Observation System
ERIC Educational Resources Information Center
Johnson, Evelyn S.; Crawford, Angela R.; Moylan, Laura A.; Zheng, Yuzhu
2018-01-01
The Evidence-Centered Design (ECD) framework was used to create a special education teacher observation system, Recognizing Effective Special Education Teachers (RESET). Extensive reviews of research informed the domain analysis and modeling stages, and led to the conceptual framework in which effective special education teaching is…
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Yunus, Mahira; Aziz, Tahir; Mubarak, Muhammed
2012-01-01
To study the incidence, types and distribution pattern of malignant tumors in renal transplant recipients at a single center in Pakistan. This retrospective study was conducted at Sindh Institute of Urology and Transplantation (SIUT) and included all transplant patients on regular follow-up from November 1986 to December 2008. The original biopsy reports and case files of all patients who developed posttransplant malignancies were reviewed and relevant demographic, clinical, radiological, and histopathological data were retrieved and analyzed. SPSS version 10.0 was used for statistical analysis. Over 22 years of study period, 1816 renal transplants were carried out at our center. Among these, 44 patients developed malignancies constituting an overall incidence rate of 2.4%. All patients in this study were males with a mean age of 34.9±9.5 years (range: 9 to 60 years). The most common type of malignancy was lymphoma (27 patients, 61.4%), followed by Kaposi's sarcoma (11 patients, 25%) and skin malignancies (3 patients, 6.8%). One case each of adenocarcinoma of the gallbladder, acute myeloid leukemia (AML), conjunctival carcinoma-in-situ and seminoma were also diagnosed. Posttransplant malignancies occurring in our renal transplant recipients show different incidence rates and patterns as compared with western studies.
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NASA Astrophysics Data System (ADS)
Fuchs, Gregory
2011-03-01
Nitrogen vacancy (NV) center spins in diamond have emerged as a promising solid-state system for quantum information processing and precision metrology at room temperature. Understanding and developing the built-in resources of this defect center for quantum logic and memory is critical to achieving these goals. In the first case, we use nanosecond duration microwave manipulation to study the electronic spin of single NV centers in their orbital excited-state (ES). We demonstrate ES Rabi oscillations and use multi-pulse resonant control to differentiate between phonon-induced dephasing, orbital relaxation, and coherent electron-nuclear interactions. A second resource, the nuclear spin of the intrinsic nitrogen atom, may be an ideal candidate for a quantum memory due to both the long coherence of nuclear spins and their deterministic presence. We investigate coherent swaps between the NV center electronic spin state and the nuclear spin state of nitrogen using Landau-Zener transitions performed outside the asymptotic regime. The swap gates are generated using lithographically fabricated waveguides that form a high-bandwidth, two-axis vector magnet on the diamond substrate. These experiments provide tools for coherently manipulating and storing quantum information in a scalable solid-state system at room temperature. We gratefully acknowledge support from AFOSR, ARO, and DARPA.
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Shim, Myungsun; Park, Hyung Keun
2014-08-01
To document the experiences of a single institution in evaluating the clinical courses and treatment outcomes of patients with cystine stones. The clinical data of 14 patients with cystine stones who were treated at our institution from March 1994 to July 2012 were reviewed. These data included age at first visit, gender, family history, body mass index, presence of a single kidney, stone locations, stone burden, routine urinalysis, and culture. In addition, we also analyzed data on surgery, shock wave lithotripsy, medical treatment, stone recurrence or regrowth, and overall treatment success rates. The mean age of our patients at their first visit was 19.6±5.0 years, and eight patients were males. The median stone burden and mean urine pH before each surgery were 6.5 cm(2) and 6.5±0.9, respectively. Two patients had a family history of cystine stones. Patients underwent surgery an average of 2.7 times. The median interval between surgeries was 27.3 months, and 1 open surgery, 12 percutaneous nephrolithotomies, and 25 ureterorenoscopies were performed. Potassium citrate or sodium bicarbonate was used in nine cases. D-Penicillamine was continuously used in three patients. Patients had an average incidence of 3.2 recurrences or regrowth of stones during the median follow-up period of 60.5 months. Patients with cystine stones have high recurrence or regrowth rates and relatively large stone burdens. Adequate treatment schedules must therefore be established in these cases to prevent possible deterioration of renal function.
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Single-bubble and multibubble cavitation in water triggered by laser-driven focusing shock waves
NASA Astrophysics Data System (ADS)
Veysset, D.; Gutiérrez-Hernández, U.; Dresselhaus-Cooper, L.; De Colle, F.; Kooi, S.; Nelson, K. A.; Quinto-Su, P. A.; Pezeril, T.
2018-05-01
In this study a single laser pulse spatially shaped into a ring is focused into a thin water layer, creating an annular cavitation bubble and cylindrical shock waves: an outer shock that diverges away from the excitation laser ring and an inner shock that focuses towards the center. A few nanoseconds after the converging shock reaches the focus and diverges away from the center, a single bubble nucleates at the center. The inner diverging shock then reaches the surface of the annular laser-induced bubble and reflects at the boundary, initiating nucleation of a tertiary bubble cloud. In the present experiments, we have performed time-resolved imaging of shock propagation and bubble wall motion. Our experimental observations of single-bubble cavitation and collapse and appearance of ring-shaped bubble clouds are consistent with our numerical simulations that solve a one-dimensional Euler equation in cylindrical coordinates. The numerical results agree qualitatively with the experimental observations of the appearance and growth of large bubble clouds at the smallest laser excitation rings. Our technique of shock-driven bubble cavitation opens interesting perspectives for the investigation of shock-induced single-bubble or multibubble cavitation phenomena in thin liquids.
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Di Nardo, Giovanni; Rossi, Paolo; Oliva, Salvatore; Aloi, Marina; Cozzi, Denis A; Frediani, Simone; Redler, Adriano; Mallardo, Saverio; Ferrari, Federica; Cucchiara, Salvatore
2012-11-01
The use of pneumatic dilation (PD) is well established in adults with achalasia; however, it is less commonly used in children. To evaluate the efficacy of PD in pediatric achalasia and to define predictive factors for its treatment failure. Single-center, prospective cohort study. Academic tertiary referral center. Twenty-four patients with achalasia were enrolled from January 2004 to November 2009 and were followed for a median of 6 years. PD was performed with the patients under general anesthesia. Efficacy and safety of PD. Follow-up was performed by using the Eckardt score, barium swallow contrast studies, and esophageal manometry at baseline; 1, 3, and 6 months after dilation; and every year thereafter. A Cox regression model was used to identify independent predictors of failure after the first PD. The PD success rate was 67%. In 8 patients, the first PD failed, but the parents of one patient refused a second PD and requested surgery. Of the 7 patients who underwent repeated treatment, the second PD failed in 3 (43%). Overall, only 3 of the 24 patients underwent surgery (overall success rate after a maximum of 3 PDs was 87%). Multivariate analysis showed that only older age was independently associated with a higher probability of the procedure success (hazard ratio [HR] 0.66; 95% CI, 0.45-0.97). Small sample size, single-center study. PD is a safe and effective technique in the management of pediatric achalasia. Young age is an independent negative predictive factor for successful clinical outcome. Copyright © 2012 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.
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Sprenger, Norbert; Lee, Le Ye; De Castro, Carlos Antonio; Steenhout, Philippe; Thakkar, Sagar K
2017-01-01
Human milk is the recommended and sole nutrient source for newborns. One of the largest components of human milk is oligosaccharides (HMOs) with major constituents determined by the mother genotype for the fucosyltransferase 2 (FUT2, secretor) gene. HMO variation has been related with infant microbiota establishment, diarrhea incidence, morbidity and mortality, IgE associated eczema and body composition. We investigated the (i) dependence of several major representative HMOs on the FUT2 status assessed through breast milk 2'Fucosyllactose (2'FL) and (ii) the relation of the 2'FL status with infant growth up to 4 months of life. From an open observatory, single center, longitudinal cohort study with quantitative human milk collection at 30, 60, and 120 days postpartum from 50 mothers, who gave birth to 25 female and 25 male singleton infants, we collected a representative sample of human milk. We quantified the following 5 representative HMOs: 2'FL, Lacto-N-tetraose (LNT), Lacto-N-neotetraose (LNnT), 3'Sialyllactose (3'SL) and 6'Sialyllactose (6'SL). We grouped the milk samples and corresponding infants according to the measured milk 2'FL concentrations at 30 days of lactation, which clustered around low concentrations (95% CI of mean 12-42 mg/L) and high concentrations (95% CI of mean 1880-2460 mg/L) with the former likely representing Secretor negative mothers. Infant anthropometric measures were recorded at birth, 1, 2 and 4 months of age. Relations among the quantified HMOs and the relation of the high and low 2'FL HMOs groups with infant growth parameters were investigated via linear mixed models. The milk samples with low 2'FL concentration had higher LNT and lower LNnT concentrations compared to the samples with high 2'FL. The milk 3'- and 6'SL concentrations were independent of 2'FL. Over lactation time we observed a drop in the concentration of 2'FL, LNT, LNnT and 6'SL, especially from 1 to 2 months, while 3'SL remained at relatively constant concentration
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2015-01-01
Peptidylglycine monooxygenase (PHM) catalyzes the final step in the biosynthesis of amidated peptides that serve as important signaling molecules in numerous endocrine pathways. The catalytic mechanism has attracted much attention because of a number of unique attributes, including the presence of a pair of uncoupled copper centers separated by 11 Å (termed CuH and CuM), an unusual Cu(I)SMet interaction at the oxygen binding M-site, and the postulated Cu(II)–superoxo intermediate. Understanding the mechanism requires determining the catalytic roles of the individual copper centers and how they change during catalysis, a task made more difficult by the overlapping spectral signals from each copper center in the wild-type (WT) protein. To aid in this effort, we constructed and characterized two PHM variants that bound metal at only one site. The H242A variant bound copper at the H-center, while the H107AH108A double mutant bound copper at the M-center; both mutants were devoid of catalytic activity. Oxidized Cu(II) forms showed electron paramagnetic resonance and extended X-ray absorption fine structure (EXAFS) spectra consistent with their previously determined Cu(II)His3O and Cu(II)His2O2 ligand sets for the H- and M-centers, respectively. Cu(I) forms, on the other hand, showed unique chemistry. The M-center bound two histidines and a methionine at all pHs, while the H-center was two-coordinate at neutral pH but coordinated a new methionine S ligand at low pH. Fourier transform infrared studies confirmed and extended previous assignments of CO binding and showed unambiguously that the 2092 cm–1 absorbing species observed in the WT and many variant forms is an M-site Cu(I)–CO adduct. Silver binding was also investigated. When H107AH108A and M109I (a WT analogue with both sites intact) were incubated with excess AgNO3, each variant bound a single Ag(I) ion, from which it was inferred that Ag(I) binds selectively at the M-center with little or no affinity for
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Color center annealing and ageing in electron and ion-irradiated yttria-stabilized zirconia
NASA Astrophysics Data System (ADS)
Costantini, Jean-Marc; Beuneu, François
2005-04-01
We have used X-band electron paramagnetic resonance (EPR) measurements at room-temperature (RT) to study the thermal annealing and RT ageing of color centers induced in yttria-stabilized zirconia (YSZ), i.e. ZrO2:Y with 9.5 mol% Y2O3, by swift electron and ion-irradiations. YSZ single crystals with the <1 0 0> orientation were irradiated with 2.5 MeV electrons, and implanted with 100 MeV 13C ions. Electron and ion beams produce the same two color centers, namely an F+-type center (singly ionized oxygen vacancy) and the so-called T-center (Zr3+ in a trigonal oxygen local environment) which is also produced by X-ray irradiations. Isochronal annealing was performed in air up to 973 K. For both electron and ion irradiations, the defect densities are plotted versus temperature or time at various fluences. The influence of a thermal treatment at 1373 K of the YSZ single crystals under vacuum prior to the irradiations was also investigated. In these reduced samples, color centers are found to be more stable than in as-received samples. Two kinds of recovery processes are observed depending on fluence and heat treatment.
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NASA Astrophysics Data System (ADS)
Lai, Yen-Yu; Lin, Guin-Dar; Twamley, Jason; Goan, Hsi-Sheng
2018-05-01
We propose a quantum memory scheme to transfer and store the quantum state of a superconducting flux qubit (FQ) into the electron spin of a single nitrogen-vacancy (NV) center in diamond via yttrium iron garnet (YIG), a ferromagnet. Unlike an ensemble of NV centers, the YIG moderator can enhance the effective FQ-NV-center coupling strength without introducing additional appreciable decoherence. We derive the effective interaction between the FQ and the NV center by tracing out the degrees of freedom of the collective mode of the YIG spins. We demonstrate the transfer, storage, and retrieval procedures, taking into account the effects of spontaneous decay and pure dephasing. Using realistic experimental parameters for the FQ, NV center and YIG, we find that a combined transfer, storage, and retrieval fidelity higher than 0.9, with a long storage time of 10 ms, can be achieved. This hybrid system not only acts as a promising quantum memory, but also provides an example of enhanced coupling between various systems through collective degrees of freedom.
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An analytical and experimental study of crack extension in center-notched composites
NASA Technical Reports Server (NTRS)
Beuth, Jack L., Jr.; Herakovich, Carl T.
1987-01-01
The normal stress ratio theory for crack extension in anisotropic materials is studied analytically and experimentally. The theory is applied within a microscopic-level analysis of a single center notch of arbitrary orientation in a unidirectional composite material. The bulk of the analytical work of this study applies an elasticity solution for an infinite plate with a center line to obtain critical stress and crack growth direction predictions. An elasticity solution for an infinite plate with a center elliptical flaw is also used to obtain qualitative predictions of the location of crack initiation on the border of a rounded notch tip. The analytical portion of the study includes the formulation of a new crack growth theory that includes local shear stress. Normal stress ratio theory predictions are obtained for notched unidirectional tensile coupons and unidirectional Iosipescu shear specimens. These predictions are subsequently compared to experimental results.
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Hong, Jeong-Ho; Kang, Jihoon; Yeo, Min-Ju
PurposeCarotid endarterectomy and stenting are used to treat carotid stenosis, with the volume of carotid artery procedures increasing over the past decade. We investigated the 10-year trend of periprocedural complications with an increasing procedure volume of carotid stenting at a single tertiary hospital.MethodsWe collected 416 consecutive cases (384 patients) of carotid artery stenting performed for either symptomatic (231 cases, 55.5 %) or asymptomatic (185 cases, 44.5 %) internal carotid artery stenosis at a single center. Periprocedural complication was defined as any stroke, myocardial infarction, or death. Procedure-related outcome included any dissection, hemodynamic event, or periprocedural complication.ResultsThe mean age was 68.8 years (82.8 % males;more » range of 20–89 years); 23.9 % were older than 75 years. Before the procedure, 99.3 and 56.0 % of patients received antiplatelet and lipid-lowering medication, respectively. The overall periprocedural complication rate was 3.6 % (1.6 and 5.2 % in the asymptomatic and symptomatic group, respectively). The composite outcome of any stroke or death was 3.4 %. Periprocedural complication and procedure-related outcome showed a decremental trend with increasing procedure volume, and this trend remained after adjusting for confounders.ConclusionsOur study suggests that carotid stenting at an experienced center might reduce the periprocedural complications. Our periprocedural complication rate of carotid artery stenting may be comparable to, or somewhat lower than, that reported in other clinical trials.« less
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Single-molecule studies of multi-protein machines
NASA Astrophysics Data System (ADS)
van Oijen, Antoine
2010-03-01
Advances in optical imaging and molecular manipulation techniques have made it possible to observe individual enzymes and record molecular movies that provide new insight into their dynamics and reaction mechanisms. In a biological context, most of these enzymes function in concert with other enzymes in multi-protein complexes, so an important future direction will be the utilization of single-molecule techniques to unravel the orchestration of large macromolecular assemblies. Our group is developing the single-molecule tools that will make it possible to study biochemical pathways of arbitrary complexity at the single-molecule level. I will discuss results of single-molecule experiments on the replisome, the molecular machinery that is responsible for replication of DNA. We stretch individual DNA molecules and use their elastic properties to obtain dynamic information on the proteins that unwind the double helix and copy its genetic information. Furthermore, we visualize fluorescently labeled components of the replisome and thus obtain information on stochiometry and exchange kinetics. This simultaneous observation of catalytic activity and composition allows us to gain deeper insight into the structure-function relationship of the replisome.
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Observation of Spectral Diffusion in Crystals Using Single Impurity Molecules
1990-10-31
from 12pentacene photophysical parameters including intersystem crossing . Apparently (and not surprisingly), the local pentacene environment this... pentacene molecules inp-terphenyl, both stable as well as spectrally diffusing single molecules can be observed. 20 DISTRIBUTION/AVAILABILITY OF ABSTRACT 121...with ultrathin sublimed crystals have removed this obstacle. For the case of pentacene impurities in crystals of p-terphenyl, we observe two radically
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Choi, Sang Kyu; Kim, Cheol Keun; Jo, Dong In; Lee, Myung Chul; Kim, Jee Nam; Choi, Hyun Gon; Shin, Dong Hyeok; Kim, Soon Heum
2017-01-01
Background We conducted this study to identify factors that may prolong the length of the hospital stay (LHS) in patients with diabetic foot (DF) in a single-institution setting. Methods In this single-center retrospective study, we evaluated a total of 164 patients with DF, and conducted an intergroup comparison of their baseline demographic and clinical characteristics, including sex, age, duration of diabetes, smoking status, body mass index, underlying comorbidities (e.g., hypertension or diabetic nephropathy), wound characteristics,type of surgery, the total medical cost, white blood cell (WBC) count, C-reactive protein (CRP) levels, erythrocyte sedimentation rate, and albumin, protein, glycated hemoglobin, and 7-day mean blood glucose (BG) levels. Results Pearson correlation analysis showed that an LHS of >5 weeks had a significant positive correlation with the severity of the wound (r=0.647), WBC count (r=0.571), CRP levels (r=0.390), DN (r=0.020), and 7-day mean BG levels (r=0.120) (P<0.05). In multiple regression analysis, an LHS of >5 weeks had a significant positive correlation with the severity of the wound (odds ratio [OR]=3.297; 95% confidence interval [CI], 1.324–10.483; P=0.020), WBC count (OR=1.423; 95% CI, 0.046–0.356; P=0.000), CRP levels (OR=1.079; 95% CI, 1.015–1.147; P=0.014), albumin levels (OR=0.263; 95% CI, 0.113–3.673; P=0.007), and 7-day mean BG levels (OR=1.018; 95% CI, 1.001–1.035; P=0.020). Conclusions Surgeons should consider the factors associated with a prolonged LHS in the early management of patients with DF. Moreover, this should also be accompanied by a multidisciplinary approach to reducing the LHS. PMID:29121708
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Choi, Sang Kyu; Kim, Cheol Keun; Jo, Dong In; Lee, Myung Chul; Kim, Jee Nam; Choi, Hyun Gon; Shin, Dong Hyeok; Kim, Soon Heum
2017-11-01
We conducted this study to identify factors that may prolong the length of the hospital stay (LHS) in patients with diabetic foot (DF) in a single-institution setting. In this single-center retrospective study, we evaluated a total of 164 patients with DF, and conducted an intergroup comparison of their baseline demographic and clinical characteristics, including sex, age, duration of diabetes, smoking status, body mass index, underlying comorbidities (e.g., hypertension or diabetic nephropathy), wound characteristics,type of surgery, the total medical cost, white blood cell (WBC) count, C-reactive protein (CRP) levels, erythrocyte sedimentation rate, and albumin, protein, glycated hemoglobin, and 7-day mean blood glucose (BG) levels. Pearson correlation analysis showed that an LHS of >5 weeks had a significant positive correlation with the severity of the wound (r=0.647), WBC count (r=0.571), CRP levels (r=0.390), DN (r=0.020), and 7-day mean BG levels (r=0.120) (P<0.05). In multiple regression analysis, an LHS of >5 weeks had a significant positive correlation with the severity of the wound (odds ratio [OR]=3.297; 95% confidence interval [CI], 1.324-10.483; P=0.020), WBC count (OR=1.423; 95% CI, 0.046-0.356; P=0.000), CRP levels (OR=1.079; 95% CI, 1.015-1.147; P=0.014), albumin levels (OR=0.263; 95% CI, 0.113-3.673; P=0.007), and 7-day mean BG levels (OR=1.018; 95% CI, 1.001-1.035; P=0.020). Surgeons should consider the factors associated with a prolonged LHS in the early management of patients with DF. Moreover, this should also be accompanied by a multidisciplinary approach to reducing the LHS.
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Virtual Visits and Patient-Centered Care: Results of a Patient Survey and Observational Study
2017-01-01
Background Virtual visits are clinical interactions in health care that do not involve the patient and provider being in the same room at the same time. The use of virtual visits is growing rapidly in health care. Some health systems are integrating virtual visits into primary care as a complement to existing modes of care, in part reflecting a growing focus on patient-centered care. There is, however, limited empirical evidence about how patients view this new form of care and how it affects overall health system use. Objective Descriptive objectives were to assess users and providers of virtual visits, including the reasons patients give for use. The analytic objective was to assess empirically the influence of virtual visits on overall primary care use and costs, including whether virtual care is with a known or a new primary care physician. Methods The study took place in British Columbia, Canada, where virtual visits have been publicly funded since October 2012. A survey of patients who used virtual visits and an observational study of users and nonusers of virtual visits were conducted. Comparison groups included two groups: (1) all other BC residents, and (2) a group matched (3:1) to the cohort. The first virtual visit was used as the intervention and the main outcome measures were total primary care visits and costs. Results During 2013-2014, there were 7286 virtual visit encounters, involving 5441 patients and 144 physicians. Younger patients and physicians were more likely to use and provide virtual visits (P<.001), with no differences by sex. Older and sicker patients were more likely to see a known provider, whereas the lowest socioeconomic groups were the least likely (P<.001). The survey of 399 virtual visit patients indicated that virtual visits were liked by patients, with 372 (93.2%) of respondents saying their virtual visit was of high quality and 364 (91.2%) reporting their virtual visit was “very” or “somewhat” helpful to resolve their
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Virtual Visits and Patient-Centered Care: Results of a Patient Survey and Observational Study.
McGrail, Kimberlyn Marie; Ahuja, Megan Alyssa; Leaver, Chad Andrew
2017-05-26
Virtual visits are clinical interactions in health care that do not involve the patient and provider being in the same room at the same time. The use of virtual visits is growing rapidly in health care. Some health systems are integrating virtual visits into primary care as a complement to existing modes of care, in part reflecting a growing focus on patient-centered care. There is, however, limited empirical evidence about how patients view this new form of care and how it affects overall health system use. Descriptive objectives were to assess users and providers of virtual visits, including the reasons patients give for use. The analytic objective was to assess empirically the influence of virtual visits on overall primary care use and costs, including whether virtual care is with a known or a new primary care physician. The study took place in British Columbia, Canada, where virtual visits have been publicly funded since October 2012. A survey of patients who used virtual visits and an observational study of users and nonusers of virtual visits were conducted. Comparison groups included two groups: (1) all other BC residents, and (2) a group matched (3:1) to the cohort. The first virtual visit was used as the intervention and the main outcome measures were total primary care visits and costs. During 2013-2014, there were 7286 virtual visit encounters, involving 5441 patients and 144 physicians. Younger patients and physicians were more likely to use and provide virtual visits (P<.001), with no differences by sex. Older and sicker patients were more likely to see a known provider, whereas the lowest socioeconomic groups were the least likely (P<.001). The survey of 399 virtual visit patients indicated that virtual visits were liked by patients, with 372 (93.2%) of respondents saying their virtual visit was of high quality and 364 (91.2%) reporting their virtual visit was "very" or "somewhat" helpful to resolve their health issue. Segmented regression analysis
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Chatrchyan, Serguei; et al.
Jet production in PbPb collisions at a nucleon-nucleon center-of-mass energy of 2.76 TeV was studied with the CMS detector at the LHC, using a data sample corresponding to an integrated luminosity of 6.7 inverse microbarns. Jets are reconstructed using the energy deposited in the CMS calorimeters and studied as a function of collision centrality. With increasing collision centrality, a striking imbalance in dijet transverse momentum is observed, consistent with jet quenching. The observed effect extends from the lower cut-off used in this study (jet transverse momentum = 120 GeV/c) up to the statistical limit of the available data sample (jetmore » transverse momentum approximately 210 GeV/c). Correlations of charged particle tracks with jets indicate that the momentum imbalance is accompanied by a softening of the fragmentation pattern of the second most energetic, away-side jet. The dijet momentum balance is recovered when integrating low transverse momentum particles distributed over a wide angular range relative to the direction of the away-side jet.« less
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Observation of hydration of single, modified carbon aerosols
NASA Technical Reports Server (NTRS)
Wyslouzil, B. E.; Carleton, K. L.; Sonnenfroh, D. M.; Rawlins, W. T.; Arnold, S.
1994-01-01
We have compared the hydration behavior of single carbon particles that have been treated by exposure to gaseous H2SO4 with that of untreated particles. Untreated carbon particles did not hydrate as the relative humidity varied from 0 to 80% at 23 C. In contrast, treated particles hydrated under subsaturation conditions; mass increases of up to 30% were observed. The mass increase is consistent with sulfuric acid equilibration with the ambient relative humidity in the presence of inert carbon. For the samples studied, the average amount of absorbed acid was 14% +/- 6% by weight, which corresponds to a surface coverage of approximately 0.1 monolayer. The mass fraction of surface-absorbed acid is comparable to the soluble mass fraction observed by Whitefield et al. (1993) in jet aircraft engine aerosols. Estimates indicate this mass fraction corresponds to 0.1% of the available SO2 exiting an aircraft engine ending up as H2SO4 on the carbon aerosol. If this heterogeneous process occurs early enough in the exhaust plume, it may compete with homogeneous nucleation as a mechanism for producing sulfuric acid rich aerosols.
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The retrospective analysis of patients with uterine sarcomas: A single-center experience.
Terek, Mustafa Cosan; Akman, Levent; Hursitoglu, Behiye Seda; Sanli, Ulus Ali; Ozsaran, Zeynep; Tekindal, Mustafa Agah; Dikmen, Yilmaz; Zekioglu, Osman; Ozsaran, Ahmet Aydin
2016-01-01
Uterine sarcomas are rare, malignant, gynecological tumors and show diverse histopathological features. Therefore, there is no consensus on risk factors for poor outcome and optimal treatment. The aim of this retrospective analysis is to report the clinical outcome of patients with uterine sarcoma treated at a single center. The data was obtained regarding the patient's demographic characteristics, pathological results, treatments given, survival, and complications of all uterine sarcoma patients treated in a single center between the years 2000 and 2012. The 80.month overall survival. (OS) was determined with respect to prognostic factors including age, stage of disease, histopathological type, and adjuvant treatment. A total of 57 case records are retrieved for this retrospective analysis. The mean age of the patients is 62.5 ± 11.2 years. International Federation of Gynecology and Obstetrics (FIGO) stage distribution is stage I: 29; stage II: 13; stage III: 9; stage IV: 6. Fifty-seven patients underwent surgery, 33 received postoperative radiotherapy (PORT), and 32 received chemotherapy. Median follow-up period was 25 months (range 2-85 months). The 80-month OS for the entire group of patients was 36.7%. The significant prognostic factors for survival are age under 50 years, stage of disease, and adjuvant chemotherapy. Although limited by small sample size and retrospective nature, age under 50 years, stage of disease, and adjuvant chemotherapy are significant prognostic factors for survival for uterine sarcomas.
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Superresolution Microscopy of Single Rare-Earth Emitters in YAG and H 3 Centers in Diamond
NASA Astrophysics Data System (ADS)
Kolesov, R.; Lasse, S.; Rothfuchs, C.; Wieck, A. D.; Xia, K.; Kornher, T.; Wrachtrup, J.
2018-01-01
We demonstrate superresolution imaging of single rare-earth emitting centers, namely, trivalent cerium, in yttrium aluminum garnet crystals by means of stimulated emission depletion (STED) microscopy. The achieved all-optical resolution is ≈50 nm . Similar results were obtained on H 3 color centers in diamond. In both cases, STED resolution is improving slower than the conventional inverse square-root dependence on the depletion beam intensity. In the proposed model of this effect, the anomalous behavior is caused by excited state absorption and the interaction of the emitter with nonfluorescing crystal defects in its local surrounding.
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Serramonte Transit Center Study
DOT National Transportation Integrated Search
1983-06-01
The purposes of the study are to determine, from this particular case -- the : Serramonte Center Plan -- guidelines for achieving the successful design and : operation of a bus station and bus access arrangement on a shopping center site, : including...
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Barnes, James C H; Goodyear, Stephen J; Imray, Caitlin E A; Lam, For Tai; Kashi, Habib S; Tan, Lam Chin; Higgins, Robert; Imray, Christopher H E
2017-11-01
The demand for kidney retransplantation following graft failure is rising. Repeat transplantation is often associated with poorer outcomes due to both immunological and surgical challenges. The aim of this study was to compare surgical and functional outcomes of kidney retransplantation in recipients that had previously had at least two kidney transplants with a focus on those with antibody incompatibility. We analyzed 66 patients who underwent renal transplantation at a single center between 2003 and 2011. Consecutive patients receiving their 3rd or 4th kidney were case-matched with an equal number of 1st and 2nd transplants. Twenty-two 3rd and 4th kidney transplants were matched with 22 first and 22 seconds transplants. Operative times and length of stay were equivalent between the subgroups. Surgical complication rates were similar in all groups (22.7% in 1st and 2nd transplants, and 27.2% in 3rd/4th transplants). There was no significant difference in patient or graft survival over 5 years. Graft function was similar between transplant groups at 1, 3, and 5 years. Third and fourth kidney transplants can be performed safely with similar outcomes to 1st and 2nd transplants. Kidney retransplantation from antibody-incompatible donors may be appropriate for highly sensitized patients. © 2017 The Authors Clinical Transplantation Published by John Wiley & Sons Ltd.
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Comparison of a single-channel EEG sleep study to polysomnography
Lucey, Brendan P.; McLeland, Jennifer S.; Toedebusch, Cristina D.; Boyd, Jill; Morris, John C.; Landsness, Eric C.; Yamada, Kelvin; Holtzman, David M.
2016-01-01
Summary An accurate home sleep study to assess electroencephalography (EEG)-based sleep stages and EEG power would be advantageous for both clinical and research purposes, such as for longitudinal studies measuring changes in sleep stages over time. The purpose of this study was to compare sleep scoring of a single-channel EEG recorded simultaneously on the forehead against attended polysomnography. Participants were recruited from both a clinical sleep center and a longitudinal research study investigating cognitively-normal aging and Alzheimer's disease. Analysis for overall epoch-by-epoch agreement found strong and substantial agreement between the single-channel EEG compared to polysomnography (kappa=0.67). Slow wave activity in the frontal regions was also similar when comparing the single-channel EEG device to polysomnography. As expected, stage N1 showed poor agreement (sensitivity 0.2) due to lack of occipital electrodes. Other sleep parameters such as sleep latency and REM onset latency had decreased agreement. Participants with disrupted sleep consolidation, such as from obstructive sleep apnea, also had poor agreement. We suspect that disagreement in sleep parameters between the single-channel EEG and polysomnography is partially due to altered waveform morphology and/or poorer signal quality in the single-channel derivation. Our results show that single-channel EEG provides comparable results to polysomnography in assessing REM, combined stages N2 and N3 sleep, and several other parameters including frontal slow wave activity. The data establish that single-channel EEG can be a useful research tool. PMID:27252090
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Sunflower domestication alleles support single domestication center in eastern North America
Blackman, Benjamin K.; Scascitelli, Moira; Kane, Nolan C.; Luton, Harry H.; Rasmussen, David A.; Bye, Robert A.; Lentz, David L.; Rieseberg, Loren H.
2011-01-01
Phylogenetic analyses of genes with demonstrated involvement in evolutionary transitions can be an important means of resolving conflicting hypotheses about evolutionary history or process. In sunflower, two genes have previously been shown to have experienced selective sweeps during its early domestication. In the present study, we identified a third candidate early domestication gene and conducted haplotype analyses of all three genes to address a recent, controversial hypothesis about the origin of cultivated sunflower. Although the scientific consensus had long been that sunflower was domesticated once in eastern North America, the discovery of pre-Columbian sunflower remains at archaeological sites in Mexico led to the proposal of a second domestication center in southern Mexico. Previous molecular studies with neutral markers were consistent with the former hypothesis. However, only two indigenous Mexican cultivars were included in these studies, and their provenance and genetic purity have been questioned. Therefore, we sequenced regions of the three candidate domestication genes containing SNPs diagnostic for domestication from large, newly collected samples of Mexican sunflower landraces and Mexican wild populations from a broad geographic range. The new germplasm also was genotyped for 12 microsatellite loci. Our evidence from multiple evolutionarily important loci and from neutral markers supports a single domestication event for extant cultivated sunflower in eastern North America. PMID:21844335
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The Galactic Center observed with H.E.S.S.
NASA Astrophysics Data System (ADS)
Jouvin, Lea
2017-08-01
The Galactic Center region has been a prime target region for the H.E.S.S. Imaging Atmospheric Cherenkov Telescope Array observations since da ta taking started in 2003. H.E.S.S. has revealed the presence of a very high energy gamma-ray diffuse emission in the central 200 pc, in addition to the detection of a point like source coincident with the supermassive black hole SgrA*. With more than 250 hours of H.E.S.S. data and the continuous improvement of the analysis techniques, a detailed morphology and spectral analysis of the region is now possible. We will report on the new characterisation of the spectrum of the central source down to 100 GeV energies taking advantage of the H.E.S.S. II data, obtained after the inclusion of the large 28-meter CT5 telescope in the array centre. We will present the recent discovery of a powerful cosmic PeVatron accelerator at the center of our Galaxy as well as a new characterization of the diffuse gamma-ray emission in the central 200 pc of our Galaxy through a detailed morphology study. By analysing the nature of the various components of this emission, the existence of a strong cosmic-ray gradient and thus the presence of a strong cosmic-ray accelerator at the very centre of our Galaxy was found. We will also report on the discovery of an additional point-like source HESS J1746-285 in this region possibly associated with the pulsar wind nebula candidate G0.13-0.11.
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Rotational Spectroscopy of Reactive Species at the Center for Astrochemical Studies.
NASA Astrophysics Data System (ADS)
Lattanzi, Valerio; Spezzano, Silvia; Caselli, Paola
2017-06-01
The Center for Astrochemical Studies at the Max Planck Institute for Extraterrestrial Physics in Garching, is a recently established group which collects scientists with very diverse backgrounds. In the same group observers, theoreticians, chemists and molecular astrophysicists join their efforts with the ultimate goal of properly interpreting observations with the new generation telescopes and unveiling our astrochemical/physical heritage. Among these tasks, the gas-phase spectroscopic characterisation of molecular species of astrophysical relevance is one of the main goals of the laboratory sub-group. This talk will mainly focus on the first experiment built in our center, the CASAC (CAS Absorption Cell) spectrometer: this experiment has been optimised on the production and probe of small molecular ions and radicals. The main laboratory techniques along with the more prominent outcomes of recent studies will be presented. Finally, a brief update on the status of the other instruments available in our center will be given, including their planned upgrades.
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DOT National Transportation Integrated Search
2010-12-01
The purpose of this qualitative case study was to identify the types of obstacles and patterns experienced by a single heavy rail transit agency located in North America that embedded a Reliability Centered Maintenance (RCM) Process. The outcome of t...
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Bradac, Ondrej; Steklacova, Anna; Nebrenska, Katerina; Vrana, Jiri; de Lacy, Patricia; Benes, Vladimir
2017-08-01
Frameless stereotactic brain biopsy systems are widely used today. VarioGuide (VG) is a relatively novel frameless system. Its accuracy was studied in a laboratory setting but has not yet been studied in the clinical setting. The purpose of this study was to determine its accuracy and diagnostic yield and to compare this with frame-based (FB) stereotaxy. Overall, 53 patients (33 males and 20 females, 60 ± 15 years old) were enrolled into this prospective, randomized, single-center study. Twenty-six patients were randomized into the FB group and 27 patients into the VG group. Real trajectory was pointed on intraoperative magnetic resonance. The distance of the targets and angle deviation between the planned and real trajectories were computed. The overall discomfort of the patient was subjectively assessed by the visual analog scale score. The median lesion volume was 5 mL (interquartile range [IQR]: 2-16 mL) (FB) and 16 mL (IQR: 2-27 mL) (VG), P = 0.133. The mean distance of the targets was 2.7 ± 1.1 mm (FB) and 2.9 ± 1.3 mm (VG), P = 0.456. Mean angle deviation was 2.6 ± 1.3 deg (FB) and 3.5 ± 2.1 deg (VG), P = 0.074. Diagnostic yield was 93% (25/27) in VG and 96% (25/26) in FB, P = 1.000. Mean operating time was 47 ± 26 minutes (FB) and 59 ± 31 minutes (VG), P = 0.140. One minor bleeding was encountered in the VG group. Overall patient discomfort was significantly higher in the FB group (visual analog scale score 2.5 ± 2.1 vs. 1.2 ± 0.6, P = 0,004). The VG system proved to be comparable in terms of the trajectory accuracy, rate of complications and diagnostic yield compared with the "gold standard" represented by the traditional FB stereotaxy for patients undergoing brain biopsy. VG is also better accepted by patients. Copyright © 2017 Elsevier Inc. All rights reserved.
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Observation of entanglement of a single photon with a trapped atom.
Volz, Jürgen; Weber, Markus; Schlenk, Daniel; Rosenfeld, Wenjamin; Vrana, Johannes; Saucke, Karen; Kurtsiefer, Christian; Weinfurter, Harald
2006-01-27
We report the observation of entanglement between a single trapped atom and a single photon at a wavelength suitable for low-loss communication over large distances, thereby achieving a crucial step towards long range quantum networks. To verify the entanglement, we introduce a single atom state analysis. This technique is used for full state tomography of the atom-photon qubit pair. The detection efficiency and the entanglement fidelity are high enough to allow in a next step the generation of entangled atoms at large distances, ready for a final loophole-free Bell experiment.
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The artificial satellite observation chronograph controlled by single chip microcomputer.
NASA Astrophysics Data System (ADS)
Pan, Guangrong; Tan, Jufan; Ding, Yuanjun
1991-06-01
The instrument specifications, hardware structure, software design, and other characteristics of the chronograph mounting on a theodolite used for artificial satellite observation are presented. The instrument is a real time control system with a single chip microcomputer.
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ERIC Educational Resources Information Center
Flores, Raymond; Krutka, Daniel G.; Mason, Katherine; Bergman, Daniel J.
2014-01-01
In efforts to promote a more learner-centered approach to supervision, faculty members at a Midwestern U.S. university piloted a new digital classroom observation form. Participants included middle/secondary teacher candidates (N = 28) in their final semester of their programs. The overall goal of this study was to gather teacher candidates'…
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Lin, Chun-Yu; Lin, Tseng-Hsi; Chen, Chou-Chen; Chen, Ming-Cheng
2018-01-01
Background Regorafenib has been demonstrated as effective in refractory metastatic colorectal cancer. Combination use with chemotherapy has not been reported. We examined the efficacy and safety of adding chemotherapy to Regorafenib for the treatment of metastatic colorectal cancer(mCRC) patients. Methods We recruited mCRC patients at our institute who received either regorafenib monotherapy or regorafenib in combination with other chemotherapies. All patients had received chemo and target therapies and presented with disease progression before regorafenib treatment. The primary end point was overall survival. Findings Between September1, 2015 and May 31, 2017, 100 mCRC patients at our institute received regorafenib treatment. 39 patients were excluded due to poor performance, lack of timely treatment, or inadequate clinical data. A total of 34 patients received regorafenib combined with other chemotherapies, and 27 patients received regorafenib alone. Median follow up time was 10.4 and 6.1 months, respectively. The primary end point of median OS was higher in the combination group than in the single use group (20.9m vs 10.3m, p = 0.015). The most frequent adverse events were hand-foot skin reactions(16[47.1%]vs 12[44.4%]), fatigue(6[17.6%] vs 7[25.9%]), gastrointestinal discomfort (7[20.6%] vs 6[22.2%]), neutropenia (4[11.8%] vs 1[3.7%]), diarrhea(4[11.8%] vs 1[3.7%]), and mucositis(5[14.7%] vs 1[3.7%]). Conclusion The present study showed the efficacy and side effects of regorafenib combination treatment. Superiority in median OS and median PFS was noted in the combination group. The sampling difference between the study and observation groups effects justifies the comparison. Further clinical evidence of combination therapy efficacy is pending future studies. PMID:29304109
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Wang, Furan; Shou, Tiejun; Zhong, Hongji
2018-02-01
Although T-LESS is increasingly being used to treat pediatric inguinal hernia, there is no study regarding T-LESS for pediatric hydrocele. To further evaluate the feasibility of T-LESS and present our single-center experience for repair of pediatric hydroceles. From January 2016 to July 2016, all boys undergoing T-LESS for hydrocele in our institute were retrospectively reviewed. A laparoscope and a needle-holding forceps were introduced at umbilicus. A round needle with silk suture was stabbed through the abdominal wall. The peritoneum around the internal ring was sutured continuously in a clockwise direction. After a complete purse-string suture, a triple knot was performed by using a single-instrument tie technique. The contralateral patent processus vaginalis (PPV) was repaired simultaneously if present. Overall, 59 boys with hydrocele were included (22 on the left side, 32 on the right side, and 5 bilaterally) (Table). During the procedure, all hydroceles were observed with a PPV but the fluid needed to be aspired in 39 boys. A contralateral PPV was present in 24 boys with unilateral hydrocele, and finally 88 repairs were performed. Mean operative time was 18.3 min for unilateral repair and 27.5 min for bilateral repair, respectively. All procedures were uneventful besides a minor injury to the inferior epigastric vessels. After a mean follow-up of 10.7 months, neither recurrence nor other postoperative complication was observed. There were no visible scars on the abdominal wall. Compared with open repair of pediatric inguinal hernia and hydrocele, laparoscopic surgery had several advantages, such as exploration of contralateral PPV, identification of rare hernias, diminished postoperative pain, improved cosmesis, faster recovery, and fewer complications. Differing from the laparoscopic retroperitoneal approach, T-LESS included no subcutaneous tissue in the ligature, and its knot was completely in the peritoneal cavity which could radically prevent the
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Choi, Inyoung; Choi, Ran; Lee, Jonghyun
2010-01-01
Objectives The objective of this research is to introduce the unique approach of the Catholic Medical Center (CMC) integrate network hospitals with organizational and technical methodologies adopted for seamless implementation. Methods The Catholic Medical Center has developed a new hospital information system to connect network hospitals and adopted new information technology architecture which uses single source for multiple distributed hospital systems. Results The hospital information system of the CMC was developed to integrate network hospitals adopting new system development principles; one source, one route and one management. This information architecture has reduced the cost for system development and operation, and has enhanced the efficiency of the management process. Conclusions Integrating network hospital through information system was not simple; it was much more complicated than single organization implementation. We are still looking for more efficient communication channel and decision making process, and also believe that our new system architecture will be able to improve CMC health care system and provide much better quality of health care service to patients and customers. PMID:21818432
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NASA Astrophysics Data System (ADS)
Kumar, Shailesh; Lausen, Jens L.; Garcia-Ortiz, Cesar E.; Andersen, Sebastian K. H.; Roberts, Alexander S.; Radko, Ilya P.; Smith, Cameron L. C.; Kristensen, Anders; Bozhevolnyi, Sergey I.
2016-02-01
Nitrogen-vacancy (NV) centers in diamonds are interesting due to their remarkable characteristics that are well suited to applications in quantum-information processing and magnetic field sensing, as well as representing stable fluorescent sources. Multiple NV centers in nanodiamonds (NDs) are especially useful as biological fluorophores due to their chemical neutrality, brightness and room-temperature photostability. Furthermore, NDs containing multiple NV centers also have potential in high-precision magnetic field and temperature sensing. Coupling NV centers to propagating surface plasmon polariton (SPP) modes gives a base for lab-on-a-chip sensing devices, allows enhanced fluorescence emission and collection which can further enhance the precision of NV-based sensors. Here, we investigate coupling of multiple NV centers in individual NDs to the SPP modes supported by silver surfaces protected by thin dielectric layers and by gold V-grooves (VGs) produced via the self-terminated silicon etching. In the first case, we concentrate on monitoring differences in fluorescence spectra obtained from a source ND, which is illuminated by a pump laser, and from a scattering ND illuminated only by the fluorescence-excited SPP radiation. In the second case, we observe changes in the average NV lifetime when the same ND is characterized outside and inside a VG. Fluorescence emission from the VG terminations is also observed, which confirms the NV coupling to the VG-supported SPP modes.
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Post-operative outcomes in older patients: a single-centre observational study.
Tang, Benjamin; Green, Cameron; Yeoh, Aun Chian; Husain, Faisal; Subramaniam, Ashwin
2018-05-01
Improved life-expectancies have seen increased rates of older patients undergoing surgery worldwide. These patients are at increased risk of post-operative complications. Australian evidence is limited regarding the association between age and post-operative outcomes, especially rapid response calls (RRCs) as indicators of adverse outcomes. The aim was to compare the post-operative outcomes of older patients (≥80 years) to younger patients. Specifically, 30-day in-hospital mortality; unplanned intensive care unit (ICU) admission; and RRC activation within 72 h post-operatively. Single-centre retrospective observational study conducted over 12 months in a metropolitan Australian hospital. All adult patients (≥16 years) undergoing surgical procedures were included, excluding cardiac and obstetric/gynaecological surgeries. Patient co-morbidities were quantified using Charlson co-morbidity index (CCI) and American Society of Anesthesiologists physical status classification. Seven thousand four hundred and seventy-nine patients met inclusion criteria, 14.5% (n = 1086) aged ≥80 years. Most procedures (65%) were elective; and general surgical procedures were most common (24.2%). Compared to younger patients, older patients had significantly higher 30-day mortality (2.3% versus 0.2%; P < 0.001), increased post-operative RRC rates (7.3% versus 1.2%; P < 0.001), and unplanned ICU admissions (3.2% versus 1.6%; P < 0.001). Increasing age was associated with increased risk of post-operative RRC, unplanned ICU admission, and in-hospital mortality (all P < 0.01), with associations remaining significant after controlling for surgery type and CCI. Older patients are at increased risk of adverse post-operative outcomes, including post-operative RRC, unplanned ICU admission, and mortality, especially if they underwent emergency procedures. This has implications for preoperative risk stratification and post-operative management. Incidence of post
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Continuous throughput and long-term observation of single-molecule FRET without immobilization.
Tyagi, Swati; VanDelinder, Virginia; Banterle, Niccolò; Fuertes, Gustavo; Milles, Sigrid; Agez, Morgane; Lemke, Edward A
2014-03-01
We present an automated microfluidic platform that performs multisecond observation of single molecules with millisecond time resolution while bypassing the need for immobilization procedures. With this system, we confine biomolecules to a thin excitation field by reversibly collapsing microchannels to nanochannels. We demonstrate the power of our method by studying a variety of complex nucleic acid and protein systems, including DNA Holliday junctions, nucleosomes and human transglutaminase 2.
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Nanjappa, Veena; Aniyathodiyil, Gopi; Keshava, R
2016-01-01
Gender disparity, with respect to women receiving less medical therapy, undergoing fewer invasive procedures, and experiencing worse outcome than men, has been noted in various observational and randomized trials, though guidelines on acute coronary syndrome (ACS) are gender-neutral. Indian data with focus on women with ACS are lacking. This study was undertaken to give us an insight on the clinical presentation, risk factors, and in-hospital outcome of ACS in women and at 30 days. 133 successive cases of women presenting with ACS, who met the inclusion criteria between 2012 and 2014, were included. Cases were grouped into ST elevation myocardial infarction (STEMI), non ST elevation myocardial infarction (NSTEMI), and unstable angina (UA). The mean age was 64.4±11 years. The mean BMI was 23.64±3.23kg/m(2). Diabetes was present in 58.3% in NSTEMI, 65.1% in STEMI, and 57.1% in UA group. Hypertension was found in 75% of NSTEMI, 60.2% of STEMI, and 71.4% of UA group. Severe MR was found in 11.1% of NSTEMI and 3.6% of STEMI patients. 8.3% of NSTEMI and 15.7% of STEMI patients presented in Killips class IV. Single vessel disease was most commonly found across the spectrum of ACS. 68.7% patients in STEMI group underwent primary angioplasty. 5.6% of NSTEMI and 7.2% in STEMI group had contrast-induced nephropathy (CIN). All deaths were noted in STEMI group with eight in-hospital deaths and three during 30-day follow-up period. Killips class III and IV and higher grace score (>150) were predictors of in-hospital mortality. Chronic kidney disease, ischemic mitral regurgitation, LV clot, and in-hospital cardiac arrest were associated with higher risk. Copyright © 2016. Published by Elsevier B.V.
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Pediatric Liver Transplant For Hepatoblastoma: A Single-Center Experience.
Kirnap, Mahir; Ayvazoglu Soy, Ebru; Ozcay, Figen; Moray, Gokhan; Ozdemir, Binnaz Handan; Haberal, Mehmet
2017-02-01
Our aim was to analyze our experience with orthotopic liver transplant for hepatoblastoma patients. We performed a single-center retrospective analysis of 6 orthotopic liver transplant cases in children with hepatoblastoma from 2001 to March 2015. We evaluated patient demographic features, pretreatment extent of disease stage, type of transplant, change in serum alpha-fetoprotein levels, complications, and follow-up results. Orthotopic liver transplant was performed for pretreatment extent of disease stage III with a central location (n = 3) and pretreatment extent of disease stage IV (n = 3). All children underwent living-donor orthotopic liver transplant. Postoperative serum alpha-fetoprotein levels remained below 10 ng/mL during the follow-up period in 3 patients who were free of recurrences or metastases. Five patients were free of tumor recurrences at a median follow-up of 29.9 months. The limited number of cases we present without long-term follow-up of orthotopic liver transplant for unresectable hepatoblastoma seemed to show good clinical results.
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Shin, Hyun Phil; Burman, Blaire; Kozarek, Richard A.; Zeigler, Amy; Wang, Chia; Lee, Houghton; Zehr, Troy; Edwards, Alicia M.; Siddique, Asma
2017-01-01
Background/Aims The approval of sofosbuvir (SOF), a direct-acting antiviral, has revolutionized the treatment of chronic hepatitis C virus (HCV). Methods We assessed the sustained virological response (SVR) of SOF-based regimens in a real-world single-center setting for the treatment of chronic HCV genotype 1 (G1) patients. This was a retrospective review of chronic HCV G1 adult patients treated with a SOF-based regimen at Virginia Mason Medical Center between December 2013 and August 2015. Results The cohort comprised 343 patients. Patients received SOF+ledipasvir (LDV) (n=155), SOF+simeprevir (SIM) (n=154), or SOF+peginterferon (PEG)+ribavirin (RBV) (n=34). Of the patients, 50.1% (n=172) had cirrhosis. The SVR rate was 92.2% for SOF/LDV, 87.0% for SOF/SIM, and 82.4% for SOF/PEG/RBV. Compared with the cirrhotic patients, the patients without cirrhosis had a higher SVR (96.8% vs 85.5%, p=0.01, SOF/LDV; 98.2% vs 80.6%, p=0.002, SOF/SIM; 86.4% vs 75.0%, p=0.41, SOF/PEG/RBV). In this study, prior treatment experience adversely affected the response rate in subjects treated with SOF/PEG/RBV. Conclusions In this single-center, real-world setting, the treatment of chronic HCV G1 resulted in a high rate of SVR, especially in patients without cirrhosis. PMID:28651301
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Shin, Hyun Phil; Burman, Blaire; Kozarek, Richard A; Zeigler, Amy; Wang, Chia; Lee, Houghton; Zehr, Troy; Edwards, Alicia M; Siddique, Asma
2017-09-15
The approval of sofosbuvir (SOF), a direct-acting antiviral, has revolutionized the treatment of chronic hepatitis C virus (HCV). We assessed the sustained virological response (SVR) of SOF-based regimens in a real-world single-center setting for the treatment of chronic HCV genotype 1 (G1) patients. This was a retrospective review of chronic HCV G1 adult patients treated with a SOF-based regimen at Virginia Mason Medical Center between December 2013 and August 2015. The cohort comprised 343 patients. Patients received SOF+ledipasvir (LDV) (n=155), SOF+simeprevir (SIM) (n=154), or SOF+peginterferon (PEG)+ribavirin (RBV) (n=34). Of the patients, 50.1% (n=172) had cirrhosis. The SVR rate was 92.2% for SOF/LDV, 87.0% for SOF/SIM, and 82.4% for SOF/PEG/RBV. Compared with the cirrhotic patients, the patients without cirrhosis had a higher SVR (96.8% vs 85.5%, p=0.01, SOF/LDV; 98.2% vs 80.6%, p=0.002, SOF/SIM; 86.4% vs 75.0%, p=0.41, SOF/PEG/RBV). In this study, prior treatment experience adversely affected the response rate in subjects treated with SOF/PEG/RBV. In this single-center, real-world setting, the treatment of chronic HCV G1 resulted in a high rate of SVR, especially in patients without cirrhosis.
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Yamashina, Takeshi; Takeuchi, Yoji; Nagai, Kengo; Matsuura, Noriko; Ito, Takashi; Fujii, Mototsugu; Hanaoka, Noboru; Higashino, Koji; Uedo, Noriya; Ishihara, Ryu; Iishi, Hiroyasu
2017-05-01
Colorectal endoscopic submucosal dissection (C-ESD) is recognized as a difficult procedure. Recently, scissors-type knives were launched to reduce the difficulty of C-ESD. The aim of this study was to evaluate the efficacy and safety of the combined use of a scissors-type knife and a needle-type knife with a water-jet function (WJ needle-knife) for C-ESD compared with using the WJ needle-knife alone. This was a prospective randomized controlled trial in a referral center. Eighty-five patients with superficial colorectal neoplasms were enrolled and randomly assigned to undergo C-ESD using a WJ needle-knife alone (Flush group) or a scissor-type knife-supported WJ needle-knife (SB Jr group). Procedures were conducted by two supervised residents. Primary endpoint was self-completion rate by the residents. Self-completion rate was 67% in the SB Jr group, which was significantly higher than that in the Flush group (39%, P = 0.01). Even after exclusion of four patients in the SB Jr group in whom C-ESD was completed using the WJ needle-knife alone, the self-completion rate was significantly higher (63% vs 39%; P = 0.03). Median procedure time among the self-completion cases did not differ significantly between the two groups (59 vs 51 min; P = 0.14). No fatal adverse events were observed in either group. In this single-center phase II trial, scissor-type knife significantly improved residents' self-completion rate for C-ESD, with no increase in procedure time or adverse events. A multicenter trial would be warranted to confirm the validity of the present study. © 2016 Japan Gastroenterological Endoscopy Society.
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Hoefnagel, Daphna; Kwee, Lesley E; van Putten, Erik H P; Kros, Johan M; Dirven, Clemens M F; Dammers, Ruben
2014-08-01
Patients with meningiomas carry an increased risk for postoperative venous thromboembolic complications (VTE) including deep venous thrombosis (DVT) and pulmonary embolism (PE). In the present retrospective study we investigated the incidence of VTE and the risk factors involved, in a large cohort of patients surgically treated for an intracranial meningioma at our institution. During the period from January 1997 to January 2009, 581 consecutive patients underwent craniotomy for intracranial meningioma. All patients received low-molecular weight heparins as thromboembolism prophylaxis. Patient demographics and tumor characteristics were gathered via retrospective chart review. Postoperative VTE and hemorrhages were noted. Backward stepwise logistic regression was used to determine the risk factors. 80.6% of meningiomas were WHO grade 1; 15.1% WHO grade 2; 4.3% WHO grade 3. Postoperative VTE were observed in 41 patients (7.2%). Of these, DVT was seen in 20 (3.5%) and PE in 26 patients (4.6%). The thromboembolic complication appeared on average 21.1±29.2 days post surgery. The 90-day mortality rate after VTE was 11.2% (23.1% for PE and 5.0% for DVT). Postoperative hemorrhages requiring surgical treatment were found in 2.9% of patients. Risk factors for VTE were body mass index (p=0.015) for DVT; weight (p=0.001) and bedridden postoperatively (p=0.001) for PE; and weight (p=0.004) and bedridden postoperatively (p=0.003) for VTE in general. There was no relation between tumor grade and thromboembolic complications. The major risk factors for postoperative VTE found in our single center study are patient weight and a bedridden status postoperatively. Prophylactic intervention for this potentially fatal complication should be evaluated against the relative lower risk of postoperative hemorrhages. Copyright © 2014 Elsevier B.V. All rights reserved.
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Interactions between C and Cu atoms in single-layer graphene: direct observation and modelling.
Kano, Emi; Hashimoto, Ayako; Kaneko, Tomoaki; Tajima, Nobuo; Ohno, Takahisa; Takeguchi, Masaki
2016-01-07
Metal doping into the graphene lattice has been studied recently to develop novel nanoelectronic devices and to gain an understanding of the catalytic activities of metals in nanocarbon structures. Here we report the direct observation of interactions between Cu atoms and single-layer graphene by transmission electron microscopy. We document stable configurations of Cu atoms in the graphene sheet and unique transformations of graphene promoted by Cu atoms. First-principles calculations based on density functional theory reveal a reduction of energy barrier that caused rotation of C-C bonds near Cu atoms. We discuss two driving forces, electron irradiation and in situ heating, and conclude that the observed transformations were mainly promoted by electron irradiation. Our results suggest that individual Cu atoms can promote reconstruction of single-layer graphene.
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Poletti, Michele; Logi, Chiara; Lucetti, Claudio; Del Dotto, Paolo; Baldacci, Filippo; Vergallo, Andrea; Ulivi, Martina; Del Sarto, Simone; Rossi, Giuseppe; Ceravolo, Roberto; Bonuccelli, Ubaldo
2013-10-01
The current study aimed at establishing the prevalence of impulse control disorders (ICDs) in patients with Parkinson disease (PD) and their association with demographic, drug-related, and disease-related characteristics. We performed a single-center cross-sectional study of 805 PD patients. Impulse control disorders were investigated with the Questionnaire for Impulsive Compulsive Disorders in Parkinson's Disease; also comorbid neuropsychiatric complications (dementia, delusions, visual hallucinations) were investigated with clinical interviews and ad hoc instruments (Parkinson Psychosis Questionnaire and Neuropsychiatry Inventory). Impulse control disorders were identified in 65 patients (prevalence, 8.1%), with pathological gambling and hypersexuality the most frequent. Impulse control disorders were present in 57 of 593 cognitively preserved patients (prevalence, 9.6%) and in 8 of 212 demented patients (prevalence, 3.8%). Impulse control disorders were significantly associated with dopamine agonists (odds ratio [OR], 5.50; 95% confidence interval [CI], 2.60-12.46; P < 0.0001) and levodopa (OR, 2.43; 95% CI, 1.06-6.35; P = 0.034). Impulse control disorders frequency was similar for pramipexole and ropinirole (16.6% vs 12.5%; OR, 1.45; 95% CI, 0.79-2.74; P = 0.227). Additional variables associated with ICDs were male sex and younger age. These findings suggested that dopaminergic treatments in PD are associated with increased odds of having an ICD, but also other demographic and clinical variables are associated with ICDs, suggesting the multifactorial nature of the ICD phenomenon in PD.
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Lee, Le Ye; De Castro, Carlos Antonio; Steenhout, Philippe; Thakkar, Sagar K.
2017-01-01
Background Human milk is the recommended and sole nutrient source for newborns. One of the largest components of human milk is oligosaccharides (HMOs) with major constituents determined by the mother genotype for the fucosyltransferase 2 (FUT2, secretor) gene. HMO variation has been related with infant microbiota establishment, diarrhea incidence, morbidity and mortality, IgE associated eczema and body composition. Objectives We investigated the (i) dependence of several major representative HMOs on the FUT2 status assessed through breast milk 2’Fucosyllactose (2’FL) and (ii) the relation of the 2’FL status with infant growth up to 4 months of life. Design From an open observatory, single center, longitudinal cohort study with quantitative human milk collection at 30, 60, and 120 days postpartum from 50 mothers, who gave birth to 25 female and 25 male singleton infants, we collected a representative sample of human milk. We quantified the following 5 representative HMOs: 2’FL, Lacto-N-tetraose (LNT), Lacto-N-neotetraose (LNnT), 3’Sialyllactose (3’SL) and 6’Sialyllactose (6’SL). We grouped the milk samples and corresponding infants according to the measured milk 2’FL concentrations at 30 days of lactation, which clustered around low concentrations (95% CI of mean 12–42 mg/L) and high concentrations (95% CI of mean 1880–2460 mg/L) with the former likely representing Secretor negative mothers. Infant anthropometric measures were recorded at birth, 1, 2 and 4 months of age. Relations among the quantified HMOs and the relation of the high and low 2’FL HMOs groups with infant growth parameters were investigated via linear mixed models. Results The milk samples with low 2’FL concentration had higher LNT and lower LNnT concentrations compared to the samples with high 2’FL. The milk 3’- and 6’SL concentrations were independent of 2’FL. Over lactation time we observed a drop in the concentration of 2’FL, LNT, LNnT and 6’SL, especially
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Extending single molecule fluorescence observation time by amplitude-modulated excitation
Kisley, Lydia; Chang, Wei-Shun; Cooper, David; Mansur, Andrea P; Landes, Christy F
2014-01-01
We present a hardware-based method that can improve single molecule fluorophore observation time by up to 1500% and super-localization by 47% for the experimental conditions used. The excitation was modulated using an acousto-optic modulator (AOM) synchronized to the data acquisition and inherent data conversion time of the detector. The observation time and precision in super-localization of four commonly used fluorophores were compared under modulated and traditional continuous excitation, including direct total internal reflectance excitation of Alexa 555 and Cy3, non-radiative Förster resonance energy transfer (FRET) excited Cy5, and direct epi-fluorescence wide field excitation of Rhodamine 6G. The proposed amplitude-modulated excitation does not perturb the chemical makeup of the system or sacrifice signal and is compatible with multiple types of fluorophores. Amplitude-modulated excitation has practical applications for any fluorescent study utilizing an instrumental setup with time-delayed detectors. PMID:24587894
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Li, Xufan; Budai, John D.; Liu, Feng
2013-01-01
Phosphor-converted white light-emitting diodes for indoor illumination need to be warm-white (i.e., correlated color temperature <4000 K) with good color rendition (i.e., color rendering index >80). However, no single-phosphor, single-emitting-center-converted white light-emitting diodes can simultaneously satisfy the color temperature and rendition requirements due to the lack of sufficient red spectral component in the phosphors’ emission spectrum. Here, we report a new yellow Ba 0.93Eu 0.07Al 2O 4 phosphor that has a new orthorhombic lattice structure and exhibits a broad yellow photoluminescence band with sufficient red spectral component. Warm-white emissions with correlated color temperature <4000 K and color rendering index >80more » were readily achieved when combining the Ba 0.93Eu 0.07Al 2O 4 phosphor with a blue light-emitting diode (440–470 nm). This study demonstrates that warm-white light-emitting diodes with high color rendition (i.e., color rendering index >80) can be achieved based on single-phosphor, single-emitting-center conversion.« less
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Deep neck infections: A single-center analysis of 63 cases
Cordesmeyer, Robert; Tröltzsch, Markus; Sömmer, Christian; Laskawi, Rainer
2017-01-01
Background and Purpose With the use of antibiotic therapy, the incidence of deep neck infections has decreased in recent decades. The aim of this investigation was to review the clinical course and the management of deep neck infections in our department, compare them to the experiences of the common literature and identify predisposing factors for lethal complications. Material and Methods In this single-center analysis, 63 patients with deep neck infections were treated surgically. The following clinical data were analyzed and compared: age, gender, laboratory data, spatial manifestation, therapeutic modalities, comorbidities, length of hospitalization and complications. Results There was a predominance of male patients (58.7%) and a mean age of 57.9 years. The most common symptoms at diagnosis were sore throat (96.8%) and neck swelling (92.0%). Cardio/pulmonary diseases and diabetes mellitus were the most common comorbidities. There was a significantly longer hospital stay for patients with diabetes mellitus. The most common manifestation was a parapharyngeal abscess in 24 patients (38.1%), followed by peri-/retrotonsillar infections in 19 patients (30.2%). In 29 patients, a multiple space infection was observed, with a significantly longer duration of hospitalization and a higher rate of complications. The main life-threatening complication was the development of airway obstruction in 20 patients (31.7%), who all received a tracheostomy. The duration of hospitalization for patients with complications was significantly longer. Conclusions Close attention must be paid to the management of patients with deep neck infections, especially patients with diabetes mellitus and cardio/pulmonary diseases or patients with multiple space infections. Key words:Deep neck infections, comorbidities, surgical treatment, tracheostomy, diabetes mellitus. PMID:28809368
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Zhao, Jiong; Deng, Qingming; Avdoshenko, Stanislav M.; Fu, Lei; Eckert, Jürgen; Rümmeli, Mark H.
2014-01-01
Single-atom catalysts are of great interest because of their high efficiency. In the case of chemically deposited sp2 carbon, the implementation of a single transition metal atom for growth can provide crucial insight into the formation mechanisms of graphene and carbon nanotubes. This knowledge is particularly important if we are to overcome fabrication difficulties in these materials and fully take advantage of their distinct band structures and physical properties. In this work, we present atomically resolved transmission EM in situ investigations of single Fe atoms at graphene edges. Our in situ observations show individual iron atoms diffusing along an edge either removing or adding carbon atoms (viz., catalytic action). The experimental observations of the catalytic behavior of a single Fe atom are in excellent agreement with supporting theoretical studies. In addition, the kinetics of Fe atoms at graphene edges are shown to exhibit anomalous diffusion, which again, is in agreement with our theoretical investigations. PMID:25331874
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Direct observation of frequency modulated transcription in single cells using light activation
Larson, Daniel R; Fritzsch, Christoph; Sun, Liang; Meng, Xiuhau; Lawrence, David S; Singer, Robert H
2013-01-01
Single-cell analysis has revealed that transcription is dynamic and stochastic, but tools are lacking that can determine the mechanism operating at a single gene. Here we utilize single-molecule observations of RNA in fixed and living cells to develop a single-cell model of steroid-receptor mediated gene activation. We determine that steroids drive mRNA synthesis by frequency modulation of transcription. This digital behavior in single cells gives rise to the well-known analog dose response across the population. To test this model, we developed a light-activation technology to turn on a single steroid-responsive gene and follow dynamic synthesis of RNA from the activated locus. DOI: http://dx.doi.org/10.7554/eLife.00750.001 PMID:24069527
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Direct observation of vast off-stoichiometric defects in single crystalline SnSe
DOE Office of Scientific and Technical Information (OSTI.GOV)
Wu, Di; Wu, Lijun; He, Dongsheng
Single crystalline tin selenide (SnSe) recently emerged as a very promising thermoelectric material for waste heat harvesting and thermoelectric cooling, due to its record high figure of merit ZT in mediate temperature range. The most striking feature of SnSe lies in its extremely low lattice thermal conductivity as ascribed to the anisotropic and highly distorted Sn-Se bonds as well as the giant bond anharmonicity by previous studies, yet no theoretical models so far can give a quantitative explanation to such low a lattice thermal conductivity. Here, we presented direct observation of an astonishingly vast number of off-stoichiometric Sn vacancies andmore » Se interstitials, using sophisticated aberration corrected scanning transmission electron microscope; and credited the previously reported ultralow thermal conductivity of the SnSe single crystalline samples partly to their off-stoichiometric feature. In order to further validate the conclusion, we also synthesized stoichiometric SnSe single crystalline samples, and illustrated that the lattice thermal conductivity is deed much higher as compared with the off-stoichiometric single crystals. Finally, the scattering efficiency of individual point defect on heat-carrying phonons was then discussed in the state-of-art Debye-Callaway model.« less
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Direct observation of vast off-stoichiometric defects in single crystalline SnSe
Wu, Di; Wu, Lijun; He, Dongsheng; ...
2017-04-06
Single crystalline tin selenide (SnSe) recently emerged as a very promising thermoelectric material for waste heat harvesting and thermoelectric cooling, due to its record high figure of merit ZT in mediate temperature range. The most striking feature of SnSe lies in its extremely low lattice thermal conductivity as ascribed to the anisotropic and highly distorted Sn-Se bonds as well as the giant bond anharmonicity by previous studies, yet no theoretical models so far can give a quantitative explanation to such low a lattice thermal conductivity. Here, we presented direct observation of an astonishingly vast number of off-stoichiometric Sn vacancies andmore » Se interstitials, using sophisticated aberration corrected scanning transmission electron microscope; and credited the previously reported ultralow thermal conductivity of the SnSe single crystalline samples partly to their off-stoichiometric feature. In order to further validate the conclusion, we also synthesized stoichiometric SnSe single crystalline samples, and illustrated that the lattice thermal conductivity is deed much higher as compared with the off-stoichiometric single crystals. Finally, the scattering efficiency of individual point defect on heat-carrying phonons was then discussed in the state-of-art Debye-Callaway model.« less
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Photo-conductance of a single Quantum Dot
NASA Astrophysics Data System (ADS)
Zimmers, Alexandre; Wang, Hongyue; Lhuillier, Emmanuel; Yu, Qian; Dubertret, Benoit; Aubin, Herve; Ulysse, Christian; LPEM Collaboration
One promising strategy for the development of nanoscale resonant spin sensors is to measure the spin-dependent photo-current in Quantum Dots (QDots) containing spin-dependent recombination centers. To reach single spin sensitivity will require measurements of the photo-conductance of single QDots. We present here an experimental study of the conductance and photo-conductance of single HgSe QDots as function of drain and gate voltage. The evolution of the differential conductance dI/dV spectrum with the gate voltage demonstrates that single HgSe QDots are forming the junction. The amplitude of the gap measured in the differential conductance spectrum changes with the occupation level. A large inter-band gap, 0,85eV, is observed for the empty QDot, a smaller intra-band gap 0,25eV is observed for the doubly occupied QDot. These gap energies are consistent with the values extracted from the optical absorption spectrum. Upon illuminating the QDot junction, we show that the photo-conductive signal produced by this single QDot can be measured with a simple demodulation method. ANR Grant ''QUANTICON'' 10-0409-01 / DIM Nano-K / Chinese Scholarship Council.
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Burkhardt, Dwight A.; Bartoletti, Theodore M.; Thoreson, Wallace B.
2012-01-01
Receptive field organization of cone-driven bipolar cells was investigated by intracellular recording in the intact light-adapted retina of the tiger salamander (Ambystoma tigrinum). Centered spots and concentric annuli of optimum dimensions were used to selectively stimulate the receptive field center and surround with sinusoidal modulations of contrast at 3 Hz. At low contrasts, responses of both the center and surround of both ON and OFF bipolar cells were linear, showing high gain and thus contrast enhancement relative to cones. The contrast/response curves for the fundamental response, measured by a Fast Fourier Transform, reached half maximum amplitude quickly at 13% contrast followed by saturation at high contrasts. The variation of the normalized amplitude of the center and surround responses was remarkably similar, showing linear regression over the entire response range with very high correlations, r2 = 0.97 for both ON and OFF cells. The contrast/response curves of both center and surround for both ON and OFF cells were well fit (r2 = 0.98) by an equation for single-site binding. In about half the cells studied, the nonlinear waveforms of center and surround could be brought into coincidence by scaling and shifting the surround response in time. This implies that a nonlinearity, common to both center and surround, occurs after polarity inversion at the cone feedback synapse. Evidence from paired whole-cell recordings between single cones and OFF bipolar cells suggests that substantial nonlinearity is not due to transmission at the cone synapse but instead arises from intrinsic bipolar cell and network mechanisms. When sinusoidal contrast modulations were applied to the center and surround simultaneously, clear additivity was observed for small responses in both ON and OFF cells, whereas the interaction was strikingly nonadditive for large responses. The contribution of the surround was then greatly reduced, suggesting attenuation at the cone feedback
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Udy, Andrew A; Jarrett, Paul; Lassig-Smith, Melissa; Stuart, Janine; Starr, Therese; Dunlop, Rachel; Deans, Renae; Roberts, Jason A; Senthuran, Siva; Boots, Robert; Bisht, Kavita; Bulmer, Andrew C; Lipman, Jeffrey
2017-01-01
Augmented renal clearance (ARC) is being increasingly described in neurocritical care practice. The mechanisms driving this phenomenon are largely unknown. The aim of this project was therefore to explore changes in renal function, cardiac output (CO), and atrial natriuretic peptide (ANP) concentrations in patients with isolated traumatic brain injury (TBI). This prospective observational cohort study was conducted in a tertiary-level, university-affiliated intensive care unit (ICU). Patients with normal plasma creatinine concentrations (<120 μmol/L) at admission and no history of chronic kidney disease, admitted with isolated TBI, were eligible for enrollment. Continuous CO measures were obtained using arterial pulse waveform analysis. Eight-hour urinary creatinine clearances (CL CR ) were used to quantify renal function. ANP concentrations in plasma were measured on alternate days. Data were collected from study enrollment until ICU discharge, death, or day 15, which ever came first. Eleven patients, contributing 100 ICU days of physiological data, were enrolled into the study. Most participants were young men, requiring mechanical ventilation. Median ICU length of stay was 9.6 [7.8-13.0] days. Elevated CL CR measures (>150 mL/min) were frequent and appeared to parallel changes in CO. Plasma ANP concentrations were also significantly elevated over the study period (minimum value = 243 pg/mL). These data suggest that ARC is likely to complicate the care of TBI patients with normal plasma creatinine concentrations, and may be driven by associated cardiovascular changes and/or elevated plasma ANP concentrations. However, significant additional research is required to further understand these findings.
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NASA Astrophysics Data System (ADS)
Farah, Ashraf
2018-03-01
Global Positioning System (GPS) technology is ideally suited for inshore and offshore positioning because of its high accuracy and the short observation time required for a position fix. Precise point positioning (PPP) is a technique used for position computation with a high accuracy using a single GNSS receiver. It relies on highly accurate satellite position and clock data that can be acquired from different sources such as the International GNSS Service (IGS). PPP precision varies based on positioning technique (static or kinematic), observations type (single or dual frequency) and the duration of observations among other factors. PPP offers comparable accuracy to differential GPS with safe in cost and time. For many years, PPP users depended on GPS (American system) which considered the solely reliable system. GLONASS's contribution in PPP techniques was limited due to fail in maintaining full constellation. Yet, GLONASS limited observations could be integrated into GPS-based PPP to improve availability and precision. As GLONASS reached its full constellation early 2013, there is a wide interest in PPP systems based on GLONASS only and independent of GPS. This paper investigates the performance of kinematic PPP solution for the hydrographic applications in the Nile river (Aswan, Egypt) based on GPS, GLONASS and GPS/GLONASS constellations. The study investigates also the effect of using two different observation types; single-frequency and dual frequency observations from the tested constellations.
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Single-Molecule Three-Color FRET with Both Negligible Spectral Overlap and Long Observation Time
Hohng, Sungchul
2010-01-01
Full understanding of complex biological interactions frequently requires multi-color detection capability in doing single-molecule fluorescence resonance energy transfer (FRET) experiments. Existing single-molecule three-color FRET techniques, however, suffer from severe photobleaching of Alexa 488, or its alternative dyes, and have been limitedly used for kinetics studies. In this work, we developed a single-molecule three-color FRET technique based on the Cy3-Cy5-Cy7 dye trio, thus providing enhanced observation time and improved data quality. Because the absorption spectra of three fluorophores are well separated, real-time monitoring of three FRET efficiencies was possible by incorporating the alternating laser excitation (ALEX) technique both in confocal microscopy and in total-internal-reflection fluorescence (TIRF) microscopy. PMID:20808851
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Complications of Bilateral Neck Dissection in Thyroid Cancer From a Single High-Volume Center.
McMullen, Caitlin; Rocke, Daniel; Freeman, Jeremy
2017-04-01
The morbidity of bilateral lateral neck dissection (BLND) for thyroid cancers has not been described in detail. This study delineates the specific complications arising from BLND for thyroid cancers at a single high-volume center. To determine the morbidity associated with BLNDs for differentiated thyroid cancers at our institution. This was a retrospective review of medical records performed to identify patients having undergone BLNDs for thyroid cancers by a single surgeon at an academic, tertiary medical center in Toronto, Ontario, Canada, from 1988 to 2015. Patients who underwent BLND for papillary, follicular, or medullary thyroid cancers were identified through operative procedure codes and review of operative and pathology reports. The indication for this procedure was suspicious bilateral lateral compartment on imaging and clinical examination. Sixty-two patients who underwent BLND for thyroid cancers, with or without total thyroidectomy and central compartment dissection, were identified. The main outcome measures for this study were unanticipated medical or surgical complications during the operation or in the postoperative period. Secondary measures were oncologic outcomes, including regional structural or biochemical recurrence. Of the 62 patients, 24 were male (39%), and 38 (61%) were female. Their mean age was 46 years (range, 17-80 years). The overall risk of permanent hypoparathyroidism was 37%. There was 1 case of unanticipated permanent recurrent nerve paralysis and 1 case of temporary nerve paresis. Postoperative chyle fistula occurred in 6 cases (10%). There were 3 readmissions within 30 days of surgery, 1 pulmonary embolism, and 1 perioperative mortality. Fifty percent of patients had pN0 contralateral necks despite preoperative clinical suspicion. Four patients were found to have anaplastic thyroid cancers intraoperatively. Five patients (8%) developed nodal recurrence in the neck. Four patients died of their disease within available follow
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Huang, Xiaojun; Liu, Daihong
2011-01-01
The Institute of Hematology, Peking University, is the largest hematopoietic stem cell transplantation (HSCT) center in China. A total of 400 HSCTs performed in 2010 accounted for a quarter of all allogeneic HSCTs performed in China. The GIAC protocol, which uses HLA-mismatched/haploidentical blood or bone marrow transplantation without in vitro T-cell depletion, entails administration of granulocyte-colony stimulating factor (G-CSF) to all donors, intensified immunological suppression, and treatment with anti-human thymocyte immunoglobulin. The stem cell grafts are a combination of G-CSF-primed bone marrow cells and G-CSF-mobilized peripheral blood stem cells, which may be critical to the success of this protocol through the immune modulation of G-CSF. Using this protocol, more than 99% engraftment and complete donor chimerism were achieved in pediatric and adult patients with hematological malignancies. The incidence of graft-versus-host disease (GVHD) grades 3 and 4 was 13.4% and that of extensive chronic GVHD 22.6%. Comparable relapse rates were observed between patients who received unmanipulated haploidentical transplantation, and those who received HLA-identical or unrelated HSCT. Patients with confirmed minimal residual disease, (expression levels of Wilms' tumor suppressor gene 1 and flow cytometry) after HSCT received pre-emptive modified donor lymphocyte infusion to prevent relapse. Infection was the main cause of non-relapse death. Prospective studies are ongoing to investigate the mechanisms of immune reconstitution in order to refine the protocol. In 1964, a patient with severe aplastic anemia received a bone marrow infusion from her syngeneic, pregnant sister, and remained disease-free over a 40-year follow-up period. Following this success, there was a 20-year interruption in the transplantation program at our center. The hiatus ended in 1981 with the first allogeneic HSCT, which was used to treat a girl with acute lymphoblastic leukemia (ALL). In
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Pedroza, Claudia; Truong, Van Thi Thanh
2017-11-02
Analyses of multicenter studies often need to account for center clustering to ensure valid inference. For binary outcomes, it is particularly challenging to properly adjust for center when the number of centers or total sample size is small, or when there are few events per center. Our objective was to evaluate the performance of generalized estimating equation (GEE) log-binomial and Poisson models, generalized linear mixed models (GLMMs) assuming binomial and Poisson distributions, and a Bayesian binomial GLMM to account for center effect in these scenarios. We conducted a simulation study with few centers (≤30) and 50 or fewer subjects per center, using both a randomized controlled trial and an observational study design to estimate relative risk. We compared the GEE and GLMM models with a log-binomial model without adjustment for clustering in terms of bias, root mean square error (RMSE), and coverage. For the Bayesian GLMM, we used informative neutral priors that are skeptical of large treatment effects that are almost never observed in studies of medical interventions. All frequentist methods exhibited little bias, and the RMSE was very similar across the models. The binomial GLMM had poor convergence rates, ranging from 27% to 85%, but performed well otherwise. The results show that both GEE models need to use small sample corrections for robust SEs to achieve proper coverage of 95% CIs. The Bayesian GLMM had similar convergence rates but resulted in slightly more biased estimates for the smallest sample sizes. However, it had the smallest RMSE and good coverage across all scenarios. These results were very similar for both study designs. For the analyses of multicenter studies with a binary outcome and few centers, we recommend adjustment for center with either a GEE log-binomial or Poisson model with appropriate small sample corrections or a Bayesian binomial GLMM with informative priors.
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Overview of Submm Single Dish: From Observations to Useful Data
NASA Astrophysics Data System (ADS)
Stanke, Thomas
2018-03-01
Observing with single dish telescopes at submillimetre wavelengths adds a number of challenges. The Earth's atmosphere not only absorbs the sky signal with varying amounts as a function of frequency and weather conditions, but it also emits a signal that is many orders of magnitude brighter than the astronomical signal one is interested in. Additional challenges come in the calibration and removal of certain instrumental effects. I will give an overview of present and planned submillimetre telescopes, instrument types, and observing strategies.
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NASA Astrophysics Data System (ADS)
Ji, Peng; Hsu, Jen-Feng; Lewandowski, Charles W.; Dutt, M. V. Gurudev; D'Urso, Brian
2016-05-01
We report the observation of photoluminescence from nitrogen-vacancy (NV) centers in diamond nanocrystals levitated in a magneto-gravitational trap. The trap utilizes a combination of strong magnetic field gradients and gravity to confine diamagnetic particles in three dimensions. The well-characterized NV centers in trapped diamond nanocrystals provide an ideal built-in sensor to measure the trap magnetic field and the temperature of the trapped diamond nanocrystal. In the future, the NV center spin state could be coupled to the mechanical motion through magnetic field gradients, enabling in an ideal quantum interface between NV center spin and the mechanical motion. National Science Foundation, Grant No. 1540879.
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Lung Allocation Score: A Single-Center Simulation.
Rosso, L; Palleschi, A; Tosi, D; Mendogni, P; Righi, I; Carrinola, R; Montoli, M; Damarco, F; Rossetti, V; Morlacchi, L C; Nosotti, M
2016-03-01
The lung allocation score (LAS) was introduced in the United States in May 2005 with the main goal of reducing the waiting list mortality of patients with end-stage lung diseases, but also to enhance the lung transplant benefit and improve the management of urgent candidates. Several papers have reported that LAS resulted in a reduction of the waiting list mortality but no significant survival benefit was noted. We evaluate the usefulness of LAS as a predictor for lung transplantation outcome in 123 patients listed for lung transplantation in an Italian center. Primary endpoints were waiting list mortality and posttransplant mortality at 1 year; secondary endpoints included perioperative circulatory support, cardiopulmonary bypass, primary graft dysfunction, and long-term survival after transplantation. We observed the absence of correlation between LAS and waiting list mortality. The LAS did not affect the long-term survival in our population. High LAS was predictive of primary graft dysfunction of grade 3 in the first 72 hours after transplantation. Copyright © 2016 Elsevier Inc. All rights reserved.
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Group Time in Early Childhood Centers: An Exploratory Study.
ERIC Educational Resources Information Center
McAfee, Oralie
To investigate the current status of group time in early childhood centers, a small-scale exploratory study was designed and executed. Results of interviews with 35 teachers and observations in five classrooms serving children ages 2 1/2 through kindergarten revealed that all classrooms had at least one group time or circle time, usually in the…
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[Recent etiology and clinical features of acute viral hepatitis in a single center of Korea].
Kang, Hyung Min; Jeong, Sook Hyang; Kim, Jin Wook; Lee, Donhun; Choi, Chang Kyu; Park, Young Soo; Hwang, Jin Hyuk; Kim, Nayoung; Lee, Dong Ho
2007-12-01
The etiology of acute viral hepatitis in Korea has been dynamically changing during the recent years. The aim of this study was to investigate the recent etiology and the clinical features of acute viral hepatitis in a single center of Korea. We performed a retrospective analysis of a prospective cohort of 55 patients who were diagnosed with acute viral hepatitis A to E during the period from May 2005 to August 2006. In addition to the clinically acute manifestations, the confirmatory serological tests were performed for the diagnosis of acute hepatitis A, B, C and E. The proportion of patients with acute viral hepatitis A, B, C, E and others were 56.4% (n=31), 12.7% (n=7), 18.2% (n=10), 9.1% (n=5) and 3.6% (n=2), respectively. The mean age of the patients with acute hepatitis A, B, C and E were 29.1+/-4.38, 38.7+/-11.72, 45.3+/-17.62 and 32.4+/-6.58 years, respectively. There was no fatal case. All cases of acute hepatitis B and six out of ten cases of acute hepatitis C recovered spontaneously. Four out of the five patients with acute hepatitis E had no history of travel to endemic area. The most common etiology of acute viral hepatitis in Korea is hepatitis A virus, and hepatitis C and B virus were the next most common causes. The sporadic cases of acute hepatitis E were not rare, and coinfection of HAV and HEV was observed. A multicenter, prospective study is warranted in the future.
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Shi, Xiang'en; Zhou, Zhongqing; Wu, Bin; Zhang, Yongli; Qian, Hai; Sun, Yuming; Yang, Yang; Yu, Zaitao; Tang, Zhiwei; Lu, Shuaibin
2017-06-01
A retrospective review of the surgical outcome for patients with craniopharyngioma (CP) treated in a single neurosurgical center with surgical resection using visualization to ensure hypothalamic preservation. The study included 1054 patients. Before 2003, a pterional cranial approach was preferred for 78% of patients; after 2004, the unifrontal basal interhemispheric approach was performed in 79.1% of patients. Complete tumor resection was achieved in 89.6% of patients; vision improved in 47.1% of patients who had preoperative vision impairment. However, diabetes insipidus worsened in 70.4% of patients and new-onset diabetes insipidus occurred in 29.7% of the remaining patients. Pituitary stalk preservation occurred in 48.9% of cases. There were 89.6% of patients with total tumor removal; 13.3% of patients showed tumor recurrence within an average of 2.8 years. Of 69 follow-up patients with a subtotal or partial resection, 94.2% showed tumor recurrence within an average of 4.3 months. Of the total patients, 82.3% fully recovered. This study has shown that radical surgical resection of CP using microsurgical excision can be effective with a good patient outcome without more limitations on each individual tumor of distinct features despite the impact of recent endoscopic techniques on CP surgery. The surgical approach depends on a direct and wider visualization of CP located in the midline with preserving hypothalamic structures by identifying some hypothalamic landmark structures. After surgery, most patients can resume their normal activities even after aggressive tumor removal, although patients require postoperative hormonal replacement. Copyright © 2017 Elsevier Inc. All rights reserved.
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Wrapping of intracranial aneurysms: Single-center series and systematic review of the literature.
Perrini, Paolo; Montemurro, Nicola; Caniglia, Michele; Lazzarotti, Guido; Benedetto, Nicola
2015-01-01
Circumferential wrapping of the aneurysm wall with a variety of materials is a well-known therapeutic approach for the repair of unclippable intracranial aneurysms (IAs). Wrapping materials can stimulate foreign-body inflammatory reactions and parent artery narrowing with resultant ischemic stroke. In this study, a single-center retrospective review of the outcome with wrapping of IAs is presented beside an analysis of existing literature. For the institutional analysis, all patients who underwent wrapping of IAs in the last five years were analyzed. For the analysis of the literature, a MEDLINE search between 1990 and the present was performed for clinical series reporting wrapping of IAs. Specifically, the risk of rebleeding, cerebrovascular complications, and the incidence of granuloma formation were evaluated. Two hundred and ninety patients with IA were surgically treated in our department. Fifteen patients (5.2%) underwent wrapping of IA. Early parent artery narrowing occurred in one patient (6.7%) and was associated with ischemic stroke. Delayed cerebrovascular complications, including parent artery narrowing (one case), granuloma formation (one case), and fatal bleeding from an unruptured aneurysm, occurred in three patients (20%). For the review of the literature, 197 cases of wrapped aneurysms were collected. Bleeding after wrapping occurred in 16 (12%) of the patients with ruptured aneurysms. Acute ischemic complications were reported in 7 cases (3.5%) and granuloma formation was observed in 3 patients (1.5%). These data suggest that the microsurgical wrapping of IAs present a risk of ischemic complications and granuloma formation. Additionally, the rebleeding rate of ruptured aneurysms remains high, although still lower than the natural history of untreated ruptured aneurysms.
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von Mechow, Stefanie; Graefen, Markus; Haese, Alexander; Tennstedt, Pierre; Pehrke, Dirk; Friedersdorff, Frank; Beyer, Burkhard
2018-06-01
To compare the duration of sick leave in patients with localized prostate cancer after robot-assisted radical prostatectomy (RARP) and open retropubic RP (ORP) at a German high-volume prostate cancer center. The data of 1,415 patients treated with RP at Martini Klinik, Prostate Cancer Center between 2012 and 2016 were, retrospectively, analyzed. Information on employment status, monthly revenues and days of work missed due to sickness were assessed via online questionnaire. Additional data were retrieved from our institutional database. Medians and interquartile ranges (IQR) were reported for continuous data. Cox proportional hazard analysis was performed to compare both surgical techniques for return to work time after RP. Median time elapsed between surgery and return to work comprised 42 days in patients undergoing RARP (IQR: 21-70) and ORP (IQR: 28-84, P = 0.05). In Cox regression analysis, surgical approach showed no impact on return to work time (RARP vs. ORP hazard ratio = 1, 95% CI: 0.91-1.16, P = 0.69). Return to work time was significantly associated with employment status, physical workload and monthly income (all P<0.001). Limitation of this study is the nonrandomized design in a single-center. As the surgical approach did not show any influence on the number of days missed from work in patients undergoing RP, no superiority of either RARP or ORP could be identified for return to work time in a German cohort. Both surgical approaches are safe options usually allowing the patients to resume normal activities including work after an appropriate convalescence period. Copyright © 2018 Elsevier Inc. All rights reserved.
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NASA Astrophysics Data System (ADS)
Nelson, B. A.; Akcay, C.; Glasser, A. H.; Hansen, C. J.; Jarboe, T. R.; Marklin, G. J.; Milroy, R. D.; Morgan, K. D.; Norgaard, P. C.; Shumlak, U.; Sutherland, D. A.; Victor, B. S.; Sovinec, C. R.; O'Bryan, J. B.; Held, E. D.; Ji, J.-Y.; Lukin, V. S.
2014-10-01
The Plasma Science and Innovation Center (PSI-Center - http://www.psicenter.org) supports collaborating validation platform experiments with 3D extended MHD simulations using the NIMROD, HiFi, and PSI-TET codes. Collaborators include the Bellan Plasma Group (Caltech), CTH (Auburn U), HBT-EP (Columbia), HIT-SI (U Wash-UW), LTX (PPPL), MAST (Culham), Pegasus (U Wisc-Madison), SSX (Swarthmore College), TCSU (UW), and ZaP/ZaP-HD (UW). The PSI-Center is exploring application of validation metrics between experimental data and simulations results. Biorthogonal decomposition (BOD) is used to compare experiments with simulations. BOD separates data sets into spatial and temporal structures, giving greater weight to dominant structures. Several BOD metrics are being formulated with the goal of quantitive validation. Results from these simulation and validation studies, as well as an overview of the PSI-Center status will be presented.
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Observation of interlayer excitons in MoSe2 single crystals
NASA Astrophysics Data System (ADS)
Horng, Jason; Stroucken, Tineke; Zhang, Long; Paik, Eunice Y.; Deng, Hui; Koch, Stephan W.
2018-06-01
Interlayer excitons with direct optical transitions are observed coexisting with intralayer excitons in the same K valleys in bilayer, few-layer, and bulk MoSe2 single crystals by confocal reflection contrast spectroscopy. Quantitative analysis using the Dirac-Bloch equations provides unambiguous state assignment of all the measured resonances. The interlayer excitons in bilayer MoSe2 have a large binding energy of 153 meV and a narrow linewidth of 20 meV. Their spectral weight is comparable to the commonly studied higher-order intralayer excitons. At the same time, the interlayer excitons are characterized by distinct transition energies and permanent dipole moments, providing a promising high temperature and optically accessible platform for dipolar exciton physics.
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Hard X-ray observations of the region from the galactic center to Centaurus
NASA Technical Reports Server (NTRS)
Guo, D. D.; Webber, W. R.; Damle, S. V.
1974-01-01
A balloon flight from Parana, Argentina, was conducted to observe emissions from discrete or extended sources in the southern sky. The sources observed include GX 304-1, Nor X-2, GX 340+0, GX 354-5, a possibly composite source near the galactic center, and the nova-like source (2U1543-47) in the Lupus-Norma region which has been reported previously only in satellite observations. Data concerning the possibility of line emission near 0.5 MeV from different regions of the southern sky are also presented.
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Kute, Vivek B; Vanikar, Aruna V; Trivedi, Hargovind L; Shah, Pankaj R; Goplani, Kamal R; Gumber, Manoj R; Patel, Himanshu V; Godara, Suraj M; Modi, Pranjal R; Shah, Veena R
2011-06-01
Type 2 diabetes mellitus (DM) is the commonest cause of end-stage renal disease (ESRD) worldwide. Data scarcity on renal transplantation (RTx) outcome in diabetic nephropathy (DN) prompted us to review our experience. This retrospective single-center, 5-year study was undertaken to evaluate patient and graft survival and function, evaluated by serum creatinine (SCr), rejection episodes, and mortality in patients. One hundred type 2 DM-ESRD patients underwent RTx [80 living-related (LRD), 20 deceased donor (DD)] at our center following cardiac fitness of recipient. Post-transplant immunosuppression consisted of calcineurin inhibitor-based regimen. The mean donor age in the LRD group was 40.6 years and 52 years in the DD group. Male recipients constituted 95% in the LRD and 65% in the DD group. Over a mean follow-up of 2.47 years, 1- and 5-year patient/graft survival in LRDRTx was 85.1%/95.9% and 82.6%/95.9%, respectively, and mean SCr (in mg/dl) at 1 and 5 years was 1.38 and 1.58 mg/dl, respectively, with 20% of cases developing acute rejection (AR) episodes. Fifteen percent of patients died, mainly due to infections, and 1.3% died of coronary artery disease (CAD). In DDRTx, over a mean follow-up of 3.17 years, 1- and 4-year patient/graft survival was 72%/89.7% and 54%/89.7%, respectively; mean SCr at 1 and 4 years was 1.40 and 1.75 mg/dl, respectively, with 20% of cases developing AR episodes. Totally, 30% of patients were lost, mainly due to infections, and 10% of patients died from cerebrovascular events. In our center, in patients with RTx for type 2 DM diabetic nephropathy, the 4- and 5-year patient and graft survival rates and graft function can be considered acceptable. The results are better in LRDRTx than in DDRTx patients.
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A single-stage optical load-balanced switch for data centers.
Huang, Qirui; Yeo, Yong-Kee; Zhou, Luying
2012-10-22
Load balancing is an attractive technique to achieve maximum throughput and optimal resource utilization in large-scale switching systems. However current electronic load-balanced switches suffer from severe problems in implementation cost, power consumption and scaling. To overcome these problems, in this paper we propose a single-stage optical load-balanced switch architecture based on an arrayed waveguide grating router (AWGR) in conjunction with fast tunable lasers. By reuse of the fast tunable lasers, the switch achieves both functions of load balancing and switching through the AWGR. With this architecture, proof-of-concept experiments have been conducted to investigate the feasibility of the optical load-balanced switch and to examine its physical performance. Compared to three-stage load-balanced switches, the reported switch needs only half of optical devices such as tunable lasers and AWGRs, which can provide a cost-effective solution for future data centers.
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Microscopic observations during longitudinal compression loading of single pulp fibers
Irving B. Sachs
1986-01-01
Paperboard components (linerboard adn corrugating medium) fail in edgewise compression because of failure of single fibers, as well as fiber-to-fiber bonds. While fiber-to-fiber-bond failure has been studied extensively, little is known about the longitudinal compression failure of a single fiber. In this study, surface alterations on single loblolly pine kraft pulp...
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NASA Astrophysics Data System (ADS)
Jiang, Feng-Jian; Ye, Jian-Feng; Jiao, Zheng; Jiang, Jun; Ma, Kun; Yan, Xin-Hu; Lv, Hai-Jiang
2018-05-01
We perform a proof-of-principle experiment that uses a single negatively charged nitrogen–vacancy (NV) color center with a nearest neighbor 13C nuclear spin in diamond to detect the strength and direction (including both polar and azimuth angles) of a static vector magnetic field by optical detection magnetic resonance (ODMR) technique. With the known hyperfine coupling tensor between an NV center and a nearest neighbor 13C nuclear spin, we show that the information of static vector magnetic field could be extracted by observing the pulsed continuous wave (CW) spectrum. Project supported by the National Natural Science Foundation of China (Grant Nos. 11305074, 11135002, and 11275083), the Key Program of the Education Department Outstanding Youth Foundation of Anhui Province, China (Grant No. gxyqZD2017080), and the Education Department Natural Science Foundation of Anhui Province, China (Grant No. KJHS2015B09).
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EPR study of the effect of ionizing radiation on chromium centers in Mg2SiO4: Cr,Li laser crystals
NASA Astrophysics Data System (ADS)
Akhmetzyanov, D. A.; Dudnikova, V. B.; Zharikov, E. V.; Zhiteitsev, E. R.; Konovalov, A. A.; Tarasov, V. F.
2013-09-01
Forsterite single crystals doped with chromium and lithium and exposed to ionizing radiation have been studied using multifrequency electron paramagnetic resonance (EPR) spectroscopy. It has been found that ionizing irradiation up to a dose of 108 rad does not lead to a significant change in the concentration of single chromium impurity centers. At the same time, γ-ray irradiation of the crystal leads to a decrease in the concentration of active laser centers, which form an associate of trivalent chromium and monovalent lithium in the crystallographic positions M2 and M1, respectively, and to the formation of new centers of divalent chromium. The structure and magnetic properties of the new centers have been discussed.
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Wu, Jun; Cheng, Yifei; Zhang, Leping
2015-12-01
This retrospective single-center study assessed the incidence and clinical features of immune manifestations of refractory cytopenia of childhood (RCC) and childhood aplastic anemia (AA). We evaluated 72 children with RCC and 123 with AA between February 2008 and March 2013. RCC was associated with autoimmune disease in 4 children, including 1 case each with autoimmune hemolytic anemia, rheumatoid arthritis, systemic lupus erythematosus, and anaphylactoid purpura. No children with AA were diagnosed with autoimmune diseases. Immune abnormalities were common in both RCC and AA; the most significant reductions were in the relative numbers of CD3-CD56+ subsets found in RCC. Despite the many similar immunologic abnormalities in AA and RCC, the rate of autoimmune disease was significantly lower in childhood AA than RCC (p=0.008, χ2=6.976). The relative numbers of natural killer cells were significantly lower in RCC patients than AA patients. By month 6, there was no significant difference in autoimmune manifestations between RCC and AA in relation to the response to immunosuppressive therapy (p=0.907, χ2=0.014). The large overlap of analogous immunologic abnormalities indicates that RCC and childhood AA may share the same pathogenesis. Copyright © 2015 Elsevier Ltd. All rights reserved.
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A Study of Time Spent Working at Learning Centers. Technical Report #17.
ERIC Educational Resources Information Center
Omori, Sharon; And Others
This study examined the proportion of time children in the Kamehameha Early Education Program schools spend at actual school work in learning centers. Systematic time-sampled observations using multiple observers were conducted in December-January and again in March-April. The subjects, 12 children (6 kindergarteners and 6 first graders) were…
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Lyn, Rodney; Maalouf, Joyce; Evers, Sarah; Davis, Justin; Griffin, Monica
2013-05-23
The child care environment has emerged as an ideal setting in which to implement policies that promote healthy body weight of children. The purpose of this study was to assess the effect of a wellness policy and training program on the physical activity and nutrition environment in 24 child care centers in Georgia. We used the Environment and Policy Assessment and Observation instrument to identify changes to foods served, staff behaviors, and physical activity opportunities. Observations were performed over 1 day, beginning with breakfast and concluding when the program ended for the day. Observations were conducted from February 2010 through April 2011 for a total of 2 observations in each center. Changes to nutrition and physical activity in centers were assessed on the basis of changes in scores related to the physical activity and nutrition environment documented in the observations. Paired t test analyses were performed to determine significance of changes. Significant improvements to total nutrition (P < .001) and physical activity scores (P < .001) were observed. Results indicate that centers significantly improved the physical activity environments of centers by enhancing active play (P = .02), the sedentary environment (P = .005), the portable environment (P = .002), staff behavior (P = .004), and physical activity training and education (P < .001). Significant improvements were found for the nutrition environment (P < .001), and nutrition training and education (P < .001). Findings from this study suggest that implementing wellness policies and training caregivers in best practices for physical activity and nutrition can promote healthy weight for young children in child care settings.
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de Castro Rodrigues Ferreira, Flávio; Cristelli, Marina Pontello; Paula, Mayara Ivani; Proença, Henrique; Felipe, Claudia Rosso; Tedesco-Silva, Helio; Medina-Pestana, José Osmar
2017-08-01
To identify specific causes of graft failure in a large sample of kidney transplant patients from a middle-income, developing country. Retrospective cohort study analyzing all consecutive single kidney transplants (KTs) performed at a single center in Brazil between January 1st 1998 and December 31st 2013. The database closing date was December 31st 2014. Out of 10,400 KTs, there were 1191 (11.45%) deaths with a functioning graft, 40 cases (0.38%) of primary non-function (PNF) and 1417 cases (13.62%) of graft loss excluding death and PNF as the cause. Infectious complications (404 cases, 34% of all deaths) were the major cause of death. Most deaths due to infection occurred within the first year after transplantation (157 deaths, 38.86%). Immunologic mechanisms, comprising acute rejection and immune-mediated interstitial fibrosis/tubular atrophy (IF/TA), were responsible for 52% of all cases of graft failure not involving recipient death. Half of the losses by acute rejection occurred late after transplantation. Contrary to what is observed in developed countries, infectious complications are the main challenge with kidney transplantation in Brazil. Non-adherence to treatment also appears to contribute significantly to long-term kidney graft loss. Strategies for improvement should focus on better compliance and a greater safety profile of immunosuppressive treatment.
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Akturk, Eser S.; Yap, Glenn P. A.; Theopold, Klaus H.
2015-10-16
A chromium(I) dinitrogen complex reacts rapidly with O 2 to form the mononuclear dioxo complex [Tp tBu,MeCr V(O) 2] (Tp tBu,Me=hydrotris(3- tert-butyl-5-methylpyrazolyl)borate), whereas the analogous reaction with sulfur stops at the persulfido complex [Tp tBu,MeCr III(S 2)]. The transformation of the putative peroxo intermediate [Tp tBu,MeCr III(O 2)] (S= 3/ 2) into [Tp tBu,MeCr V(O) 2] (S= 1/ 2) is spin-forbidden. The minimum-energy crossing point for the two potential energy surfaces has been identified. Finally, although the dinuclear complex [(Tp tBu,MeCr) 2(μ-O) 2] exists, mechanistic experiments suggest that O 2 activation occurs on a single metal center, by an oxidativemore » addition on the quartet surface followed by crossover to the doublet surface.« less
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Variability in Antithrombotic Therapy Regimens Peri-TAVR: A Single Academic Center Experience.
Rossi, Jeffrey E; Noll, Andrew; Bergmark, Brian; McCabe, James M; Nemer, David; Okada, David R; Vasudevan, Anant; Davidson, Michael; Welt, Frederick; Eisenhauer, Andrew; Shah, Pinak; Giugliano, Robert
2015-12-01
The aim of this study was to describe peri-procedural antithrombotic use in patients undergoing transcatheter aortic valve replacement (TAVR) at a single academic medical center. Retrospective collection of antiplatelet and anticoagulant use during the index hospitalization for all patients undergoing TAVR at our institution from April 2009 through March 2014. Of a total of 255 patients undergoing the procedure, 132 (51%) had an indication for anticoagulation pre-TAVR and 92 (70% of those with an indication) were on treatment. On discharge, 106 patients (44% of total surviving to discharge, 73% of those surviving with an indication for anticoagulation) were treated with oral anticoagulation. Of these patients, 89 (84%) were discharged on aspirin and an oral anticoagulant without clopidogrel. Only 122 (51% of total patients) were discharged on the regimen of aspirin and clopidogrel alone. Peri-procedural antithrombotic regimens vary greatly following TAVR. More than half of patients have an indication for anticoagulation following the procedure. Most patients at our institution who require anticoagulation are discharged on aspirin and an oral anticoagulant, though the optimal regimen requires further investigation.
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Febrile neutropenia in children with acute lymphoblastic leukemia: single center experience
Özdemir, Nihal; Tüysüz, Gülen; Çelik, Nigar; Yantri, Leman; Erginöz, Ethem; Apak, Hilmi; Özkan, Alp; Yıldız, İnci; Celkan, Tiraje
2016-01-01
Aim: An important life-threatening complication of intensive chemotherapy administered in children with leukemia is febrile neutropenia. The objective of this study was to evaluate the clinical features and consequences of febrile neutropenia attacks in children who were treated for acute lymphoblastic leukemia. Material and Methods: Nighty-six children who received chemotherapy for acute lymphoblastic leukemia in our center between January 1995 and December 2010 were included in the study. The data related to demographic characteristics, treatment features, relapse and febrile neutropenia incidences, risk factors, culture results and prognosis were retrospectively evaluated from the patients’ files. Results: A total of two hundred-ninety nine febrile neutropenia attacks observed in the patients during initial treatment and relapse treatment were evaluated. When the incidence of febrile neutropenia was evaluated by years, it was observed that the patients treated after year 2000 had statistically significantly more febrile neutopenia attacks compared to the patients treated before year 2000. When the incidences of febrile neutropenia during initial treatment and during relapse treatment were compared, it was observed that more febrile neutropenia attacks occured during relapse treatment. Fifty-nine percent of all febrile neutropenia attacks were fever of unknown origin. Eighty microorganisms grew in cultures during febrile neutropenia throughout treatment in 75 patients; 86% were bacterial infections (50% gram positive and 50% gram negative), 8% were viral infections and 6% were fungal infections. Coagulase negative staphylococcus (n=17) was the most frequent gram positive pathogen; E. Coli (n=17) was the most commonly grown gram negative pathogen. Conclusions: In this study, it was found that an increase in the incidence of febrile neutropenia occured in years. Increments in treatment intensities increase the incidence of febrile neutropenia while improving
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Sokolov, Denis A; Morozov, Yurii V; McDonald, Matthew P; Vietmeyer, Felix; Hodak, Jose H; Kuno, Masaru
2014-06-11
Laser reduction of graphene oxide (GO) offers unique opportunities for the rapid, nonchemical production of graphene. By tuning relevant reduction parameters, the band gap and conductivity of reduced GO can be precisely controlled. In situ monitoring of single layer GO reduction is therefore essential. In this report, we show the direct observation of laser-induced, single layer GO reduction through correlated changes to its absorption and emission. Absorption/emission movies illustrate the initial stages of single layer GO reduction, its transition to reduced-GO (rGO) as well as its subsequent decomposition upon prolonged laser illumination. These studies reveal GO's photoreduction life cycle and through it native GO/rGO absorption coefficients, their intrasheet distributions as well as their spatial heterogeneities. Extracted absorption coefficients for unreduced GO are α405 nm ≈ 6.5 ± 1.1 × 10(4) cm(-1), α520 nm ≈ 2.1 ± 0.4 × 10(4) cm(-1), and α640 nm ≈ 1.1 ± 0.3 × 10(4) cm(-1) while corresponding rGO α-values are α405 nm ≈ 21.6 ± 0.6 × 10(4) cm(-1), α520 nm ≈ 16.9 ± 0.4 × 10(4) cm(-1), and α640 nm ≈ 14.5 ± 0.4 × 10(4) cm(-1). More importantly, the correlated absorption/emission imaging provides us with unprecedented insight into GO's underlying photoreduction mechanism, given our ability to spatially resolve its kinetics and to connect local rate constants to activation energies. On a broader level, the developed absorption imaging is general and can be applied toward investigating the optical properties of other two-dimensional materials, especially those that are nonemissive and are invisible to current single molecule optical techniques.
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Helmers, Ann-Kristin; Lübbing, Isabel; Birkenfeld, Falk; Witt, Karsten; Synowitz, Michael; Mehdorn, Hubertus Maximilian; Falk, Daniela
2018-05-01
Nonrechargeable deep brain stimulation impulse generators (IGs) with low or empty battery status require surgical IG exchange several years after initial implantation. The aim of this study was to investigate complication rates after IG exchange surgery and identify risk factors. We retrospectively analyzed complications following IG exchange surgery from 2008 to 2015 in our department. Medical records of all patients who underwent IG exchange surgery were systematically reviewed. The shortest follow-up time was 19 months. From 2008 to 2015, 438 IGs were exchanged in 319 patients. Overall complication rate was 8.90%. Infection developed in 12 patients (2.74%). Six patients (1.37%) experienced local wound erosions. Hardware malfunctions were present in 11 patients (2.51%), and local hemorrhage was observed in 3 cases (0.68%). Repeated fixation of the IG was required in 2 patients (0.46%). Traction of the connecting cables necessitated surgical revision in 2 patients (0.46%). In 2 cases (0.46%), the IG was placed abdominally or exchanged for a smaller device owing to patient discomfort resulting from the initial positioning. One 80-year-old patient (0.23%) had severely worsening heart failure and died 4 days after IG exchange surgery. IG exchange surgery, although often considered a minor surgery, was associated with a complication rate of approximately 9% in our center. Patients and physicians should understand the complication rates associated with IG exchange surgery because this information might facilitate selection of a rechargeable IG. Copyright © 2018 Elsevier Inc. All rights reserved.
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Dynamic fracture behavior of single and contacting Poly(methyl methacrylate) particles
Parab, Niranjan D.; Guo, Zherui; Hudspeth, Matthew C.; ...
2017-09-19
Fracture behaviors of single, two, and multiple contacting spherical Poly (methyl methacrylate) (PMMA) particles were recorded using high speed synchrotron X-ray phase contrast imaging. A miniaturized Kolsky bar setup was used to apply dynamic compressive loading on the PMMA particles. In both single and two particle experiments, cracking initiated near the center of the particles and propagated towards the contacts. The crack bifurcated near the contact points for single particle experiments, thus forming conical fragments. The crack bifurcation and subsequent conical fragment formation was observed only at the particle-particle contact for two particle experiments. The particles were observed to fracturemore » in hemispherical fragments normal to the contact plane in the multiparticle experiments. The observed failure mechanisms strongly suggest that the maximum tensile stress near the center of the particle is the critical parameter governing fracture of the particles. Moreover, the compressive stress under the contact areas led to the bifurcation and subsequent conical fragment formation.« less
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Dynamic fracture behavior of single and contacting Poly(methyl methacrylate) particles
DOE Office of Scientific and Technical Information (OSTI.GOV)
Parab, Niranjan D.; Guo, Zherui; Hudspeth, Matthew C.
Fracture behaviors of single, two, and multiple contacting spherical Poly (methyl methacrylate) (PMMA) particles were recorded using high speed synchrotron X-ray phase contrast imaging. A miniaturized Kolsky bar setup was used to apply dynamic compressive loading on the PMMA particles. In both single and two particle experiments, cracking initiated near the center of the particles and propagated towards the contacts. The crack bifurcated near the contact points for single particle experiments, thus forming conical fragments. The crack bifurcation and subsequent conical fragment formation was observed only at the particle-particle contact for two particle experiments. The particles were observed to fracturemore » in hemispherical fragments normal to the contact plane in the multiparticle experiments. The observed failure mechanisms strongly suggest that the maximum tensile stress near the center of the particle is the critical parameter governing fracture of the particles. Moreover, the compressive stress under the contact areas led to the bifurcation and subsequent conical fragment formation.« less
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Starling, Amaal J; Tepper, Stewart J; Marmura, Michael J; Shamim, Ejaz A; Robbins, Matthew S; Hindiyeh, Nada; Charles, Andrew C; Goadsby, Peter J; Lipton, Richard B; Silberstein, Stephen D; Gelfand, Amy A; Chiacchierini, Richard P; Dodick, David W
2018-05-01
Objective To evaluate the efficacy and tolerability of single pulse transcranial magnetic stimulation (sTMS) for the preventive treatment of migraine. Background sTMS was originally developed for the acute treatment of migraine with aura. Open label experience has suggested a preventive benefit. The objective of this trial was to evaluate the efficacy and tolerability of sTMS for migraine prevention. Methods The eNeura SpringTMS Post-Market Observational U.S. Study of Migraine (ESPOUSE) Study was a multicenter, prospective, open label, observational study. From December 2014 to March 2016, patients with migraine (n = 263) were consented to complete a 1-month baseline headache diary followed by 3 months of treatment. The treatment protocol consisted of preventive (four pulses twice daily) and acute (three pulses repeated up to three times for each attack) treatment. Patients reported daily headache status, medication use, and device use with a monthly headache diary. The primary endpoint, mean reduction of headache days compared to baseline, was measured over the 28-day period during weeks 9 to 12. The primary endpoint was compared to a statistically-derived placebo estimate (performance goal). Secondary endpoints included: 50% responder rate, acute headache medication consumption, HIT-6, and mean reduction in total headache days from baseline of any intensity. Results Of a total of 263 consented subjects, 229 completed a baseline diary, and 220 were found to be eligible based on the number of headache days. The device was assigned to 217 subjects (Safety Data Set) and 132 were included in the intention to treat Full Analysis Set. For the primary endpoint, there was a -2.75 ± 0.40 mean reduction of headache days from baseline (9.06 days) compared to the performance goal (-0.63 days) ( p < 0.0001). The 50% responder rate of 46% (95% CI 37%, 56%) was also significantly higher ( p < 0.0001) than the performance goal (20%). There was a reduction of -2
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Very-high energy observations of the galactic center region by VERITAS in 2010-2012
DOE Office of Scientific and Technical Information (OSTI.GOV)
Archer, A.; Beilicke, M.; Buckley, J. H.
2014-08-01
The Galactic center is an interesting region for high-energy (0.1-100 GeV) and very-high-energy (E > 100 GeV) γ-ray observations. Potential sources of GeV/TeV γ-ray emission have been suggested, e.g., the accretion of matter onto the supermassive black hole, cosmic rays from a nearby supernova remnant (e.g., Sgr A East), particle acceleration in a plerion, or the annihilation of dark matter particles. The Galactic center has been detected by EGRET and by Fermi/LAT in the MeV/GeV energy band. At TeV energies, the Galactic center was detected with moderate significance by the CANGAROO and Whipple 10 m telescopes and with high significancemore » by H.E.S.S., MAGIC, and VERITAS. We present the results from three years of VERITAS observations conducted at large zenith angles resulting in a detection of the Galactic center on the level of 18 standard deviations at energies above ∼2.5 TeV. The energy spectrum is derived and is found to be compatible with hadronic, leptonic, and hybrid emission models discussed in the literature. Future, more detailed measurements of the high-energy cutoff and better constraints on the high-energy flux variability will help to refine and/or disentangle the individual models.« less
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NASA Astrophysics Data System (ADS)
Yang, W. M.; Wang, Miao
2013-10-01
Single domain YBCO superconductors with different additions of Bi2O3 have been fabricated by top seeded infiltration and growth process (TSIG). The effect of Bi2O3 additions on the growth morphology, microstructure and levitation force of the YBCO bulk superconductor has been investigated. The results indicate that single domain YBCO superconductors can be fabricated with the additions of Bi2O3 less than 2 wt%; Bi2O3 can be reacted with Y2BaCuO5 and liquid phase and finally form Y2Ba4CuBiOx(YBi2411) nanoscale particles; the size of the YBi2411 particles is about 100 nm, which can act as effective flux pinning centers. It is also found that the levitation force of single domain YBCO bulks is increasing from 13 N to 34 N and decreasing to 11 N with the increasing of Bi2O3 addition from 0.1 wt% to 0.7 wt% and 2 wt%. This result is helpful for us to improve the physical properties of REBCO bulk superconductors.
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Cell biochemistry studied by single-molecule imaging.
Mashanov, G I; Nenasheva, T A; Peckham, M; Molloy, J E
2006-11-01
Over the last decade, there have been remarkable developments in live-cell imaging. We can now readily observe individual protein molecules within living cells and this should contribute to a systems level understanding of biological pathways. Direct observation of single fluorophores enables several types of molecular information to be gathered. Temporal and spatial trajectories enable diffusion constants and binding kinetics to be deduced, while analyses of fluorescence lifetime, intensity, polarization or spectra give chemical and conformational information about molecules in their cellular context. By recording the spatial trajectories of pairs of interacting molecules, formation of larger molecular complexes can be studied. In the future, multicolour and multiparameter imaging of single molecules in live cells will be a powerful analytical tool for systems biology. Here, we discuss measurements of single-molecule mobility and residency at the plasma membrane of live cells. Analysis of diffusional paths at the plasma membrane gives information about its physical properties and measurement of temporal trajectories enables rates of binding and dissociation to be derived. Meanwhile, close scrutiny of individual fluorophore trajectories enables ideas about molecular dimerization and oligomerization related to function to be tested directly.
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An Evaluation of the Observer Effect on Treatment Integrity in a Day Treatment Center for Children
ERIC Educational Resources Information Center
Howard, Monica R.; Burke, Raymond V.; Allen, Keith D.
2013-01-01
Treatment integrity is an important concern in treatment centers but is often overlooked. Performance feedback is a well-established approach to improving treatment integrity, but is underused and undervalued. One way to increase its value to treatment centers may be to expose unrealized benefits on the observer who collects the performance…
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NASA Astrophysics Data System (ADS)
Lagomarsino, Stefano; Sciortino, Silvio; Gelli, Nicla; Flatae, Assegid M.; Gorelli, Federico; Santoro, Mario; Chiari, Massimo; Czelusniac, Caroline; Massi, Mirko; Taccetti, Francesco; Agio, Mario; Giuntini, Lorenzo
2018-05-01
The line for the pulsed beam of the 3 MeV Tandetron accelerator at LABEC (Florence) has been upgraded for ion implantation experiments aiming at the fabrication of single-photon emitters in a solid-state matrix. A system based on Al attenuators has been calibrated in order to extend the energy range of the implanted ions from MeV down to the tens of keV. A new motorized XY stage has been installed in the implantation chamber for achieving ultra-fine control on the position of each implanted ion, allowing to reach the scale imposed by lateral straggling. A set-up for the activation of the implanted ions has been developed, based on an annealing furnace operating under controlled high-vacuum conditions. The first experiments have been performed with silicon ions implanted in diamond and the luminescent signal of the silicon-vacancy (SiV) center, peaked at 738 nm, has been observed for a wide range of implantation fluences (108 ÷ 1015 cm-2) and implantation depths (from a few nm to 2.4 μm). Studies on the efficiency of the annealing process have been performed and the activation yield has been measured to range from 1% to 3%. The implantation and annealing facility has thus been tuned for the production of SiV centers in diamond, but is in principle suitable for other ion species and solid-state matrices.
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NASA Technical Reports Server (NTRS)
Hepler, A. K.; Zeck, H.; Walker, W. H.; Polack, A.
1982-01-01
Control requirements of Controlled Configured Design Approach vehicles with far-aft center of gravity locations are studied. The baseline system investigated is a fully reusable vertical takeoff/horizontal landing single stage-to-orbit vehicle with mission requirements similar to that of the space shuttle vehicle. Evaluations were made to determine dynamic stability boundaries, time responses, trim control, operational center-of-gravity limits, and flight control subsystem design requirements. Study tasks included a baseline vehicle analysis, an aft center of gravity study, a payload size study, and a technology assessment.
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Wu, Lian-Ming; Chen, Jie; Hu, Jiani; Gu, Hai-Yan; Xu, Jian-Rong; Hua, Jia
2014-02-01
Breast cancer is the most common cancer in women worldwide. However, it remains a difficult diagnosis problem to differentiate between benign and malignant breast lesions, especially in small early breast lesions. To assess the diagnostic value of diffusion-weighted imaging (DWI) combined with T2-weighted imaging (T2WI) for small breast cancer characterization. Fifty-eight patients (65 lesions) with a lesion <2 cm in diameter underwent 3.0 Tesla breast magnetic resonance imaging (MRI) including DWI and histological analysis. Three observers with varying experience levels reviewed MRI. The probability of breast cancer in each lesion on MR images was recorded with a 5-point scale. Areas under the receiver-operating characteristic curve (AUCs) were compared by using the Z test; sensitivity and specificity were determined with the Z test after adjusting for data clustering. AUC of T2WI and DWI (Observer 1, 0.95; Observer 2, 0.91; Observer 3, 0.83) was greater than that of T2WI (Observer 1, 0.80; Observer 2, 0.74; Observer 3, 0.70) for all observers (P < 0.0001 in all comparisons). Sensitivity of T2WI and DWI (Observer 1, 90%; Observer 2, 93%; and Observer 3, 86%) was greater than that of T2WI alone (Observer 1, 76%; Observer 2, 83%; Observer 3, 79%) for all observers (P < 0.0001 in all comparisons). Specificity of T2WI and DWI was greater than that of T2WI alone for observer 1 (89% vs. 72%, P < 0.01) and observer 2 (94% vs. 78%, P < 0.001). DWI combined with T2WI can improve the diagnostic performance of MRI in small breast cancer characterization. It should be considered selectively in the preoperative evaluation of patients with small lesions of the breast.
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Volvulus without malposition--a single-center experience.
Kargl, Simon; Wagner, Oliver; Pumberger, Wolfgang
2015-01-01
This is a single-center case series about the rare condition of volvulus without malposition and/or malrotation (VWM) in preterm babies. We focus on diagnostic difficulties, and our results should help to distinguish VWM as a distinct entity different from classical volvulus and segmental volvulus. Medical chart review of infants with VWM from 2003-2012 was used. A total of 15 patients were identified. All of them had volvulus in the absence of intestinal malposition or other associated intestinal pathologies. All patients were born prematurely. Emergency laparotomy was necessary in all 15 patients. Two groups were identified. Group 1 includes four patients with typical signs of meconium obstruction of prematurity (MOP). Small bowel resection was only necessary in one of these four patients, all survived without residual intestinal lesions. Group 2 consists of 11 patients without signs of MOP-small bowel resection and temporary enterostomy were necessary in all these children. Four patients presented with pneumatosis intestinalis on the abdominal plain film, suggesting necrotizing enterocolitis. Although two infants died, the survivors showed complete recovery. VWM is a distinct disease of prematurity. When associated with MOP, VWM has a favorable outcome of treatment. In contrast, VWM occurring in the absence of signs of meconium obstruction requires small bowel resection. VWM primarily affects the top of the midgut (ileum). Because of absent malposition, presentation of VWM may be uncharacteristic. Pneumatosis intestinalis in advanced VWM may lead to diagnostic difficulties and a delay in treatment. Copyright © 2015 Elsevier Inc. All rights reserved.
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Schult, Janette; von Stülpnagel, Rul; Steffens, Melanie C.
2014-01-01
What are the memory-related consequences of learning actions (such as “apply the patch”) by enactment during study, as compared to action observation? Theories converge in postulating that enactment encoding increases item-specific processing, but not the processing of relational information. Typically, in the laboratory enactment encoding is studied for lists of unrelated single actions in which one action execution has no overarching purpose or relation with other actions. In contrast, real-life actions are usually carried out with the intention to achieve such a purpose. When actions are embedded in action sequences, relational information provides efficient retrieval cues. We contrasted memory for single actions with memory for action sequences in three experiments. We found more reliance on relational processing for action-sequences than single actions. To what degree can this relational information be used after enactment versus after the observation of an actor? We found indicators of superior relational processing after observation than enactment in ordered pair recall (Experiment 1A) and in emerging subjective organization of repeated recall protocols (recall runs 2–3, Experiment 2). An indicator of superior item-specific processing after enactment compared to observation was recognition (Experiment 1B, Experiment 2). Similar net recall suggests that observation can be as good a learning strategy as enactment. We discuss possible reasons why these findings only partly converge with previous research and theorizing. PMID:24927279
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Li, Fuzhong; Harmer, Peter
2014-05-26
Falls are the leading cause of injury death in older adults and present a significant public health problem and a major burden to healthcare. Although there is sufficient evidence from randomized controlled trials to indicate that exercise can prevent falls in older people, few effective, evidence-based fall prevention programs exist in community practice. Thus, there is a pressing need to translate and disseminate evidence-based exercise programs to community providers that serve older adults at increased risk of falling. The current study addresses this public health need by disseminating the evidence-based Tai Ji Quan: Moving for Better Balance (TJQMBB) program through community senior centers. The study uses a single-group design in which the TJQMBB program is being delivered to community-dwelling older adults through collaboration with senior centers in selected counties in Oregon, USA, for 48 weeks, followed by a 24-week post-intervention follow-up. Study process and outcome measures will be evaluated in accordance with the components of the RE-AIM framework that focus on Reach, Effectiveness, Adoption, Implementation and Maintenance. This study will determine whether the evidence-based TJQMBB fall prevention program can be disseminated through a broad spectrum of community-based senior centers that often cater to low-income, underserved community-dwelling older adults at risk of falling. If shown to be both practically implementable and sustainable, the TJQMBB program will provide an effective, potentially low-cost, easy-to-implement intervention that could be used by public health practitioners and community-based organizations to address the problem of falls among older adults. ClinicalTrials.gov Identifier: NCT01854931.
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Nawaz, Z; Mushtaq, F; Mousa, D; Rehman, E; Sulaiman, M; Aslam, N; Khawaja, N
2013-11-01
Glomerular diseases continue to be the leading cause of end-stage renal disease (ESRD) globally. Hence, it is important to recognize the pattern of glomerular diseases in different geographical areas in order to understand the patho-biology, incidence and progression of the disorder. Published studies from different centers in Saudi Arabia have reported contradicting results. In this retrospective study, we report our experience at the Armed Forces Hospital, Riyadh, Saudi Arabia. A total of 348 native renal biopsies performed at our center on patients with proteinuria >1 g, hematuria and/or renal impairment during a period of 5 years (between January 2005 and December 2009) were studied by a histopathologist using light microscopy, immunofluorescence and electron microscopy, and were categorized. Results showed that primary glomerular disease accounted for 55.1% of all renal biopsies. The most common histological lesion was focal and segmental glomerulosclerosis (FSGS) (27.6%), followed by minimal change disease (MCD) (17.7%) and membrano-proliferative glomerulonephritis (MPGN) (13.0%). Secondary glomerular disease accounted for 37.9% of the glomerular diseases, with lupus nephritis (LN) being the most common lesion (54.5%), followed by hypertensive nephrosclerosis (22%), post-infectious glomerulonephritis (7.5%), diabetic nephropathy (DN) (6.8%) and vasculitides (4.5%). Four percent of all biopsies turned out to be ESRD while biopsy was inadequate in 2.8% of the cases. In conclusion, our study showed that FSGS was the most common primary GN encountered, while LN was the most common secondary GN. We encountered 14 cases of crescentic glomerulonephritis. Also, the prevalence of MPGN, MCD, IgA nephropathy and membranous GN was many folds higher in males when compared with the Western data. We believe that it is mandatory to maintain a Saudi Arabian Renal Biopsy Registry to understand better the pattern of glomerular disease in the Saudi population and to follow any
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Probing the Extreme Environment of the Galactic Center with Observations from SOFIA/FORCAST
NASA Astrophysics Data System (ADS)
Lau, Ryan M.; Herter, Terry L.; Morris, Mark; Adams, Joseph D; Becklin, Eric E.
2014-06-01
In this thesis we present a study of the inner 40 pc of the Galactic center addressing the dense, dusty torus around Sgr A*, dust production around massive stars, and massive star formation. Observations of warm dust emission from the Galactic center were performed using the Faint Object Infrared Camera for the SOFIA Telescope (FORCAST). A dense, molecular torus referred to as the Circumnuclear Disk (CND) orbits Sgr A* with an inner radius of ~1.4 pc and extending to ~7 pc. The inner edge of the CND, which we refer to as the Circumnuclear Ring (CNR), exhibits features of a classic HII region and appears consistent with the prevailing paradigm in which the dust is heated by the Central cluster of hot, young stars. We do not detect any star formation occurring in the CNR; however, we reveal the presence of density “clumps” along the inner edge of the CNR. These clumps are not dense enough to be stable against tidal shear from Sgr A* and will be sheared out before completing a full orbit 10^5 yrs). Three Luminous Blue Variables (LBVs) are located in and near the Quintuplet Cluster 40 pc in projection from Sgr A*: qF362, the Pistol star, G0.120-0.048 (LBV3). FORCAST observation reveal the asymmetric, compressed shell of hot dust surrounding the Pistol Star and provide the first detection of the thermal emission from the symmetric, hot dust envelope surrounding LBV3. However, no detection of hot dust associated with qF362 is made. We argue that the Pistol star and LBV3 are identical “twins” that exhibit contrasting nebulae due to the external influence of their different environments. G-0.02-0.07, a complex consisting of three compact HII regions and one ultracompact HII region, is located at the edge of a molecular cloud 6 pc in projection to the east of Sgr A* and contains the most recent episode of star formation in the Galactic center. We probe the dust morphology, energetics, and composition of the regions to study the star forming conditions of a molecular
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Rojas-Campos, Enrique; Alcántar-Medina, Mario; Cortés-Sanabria, Laura; Martínez-Ramírez, Héctor R; Camarena, José L; Chávez, Salvador; Flores, Antonio; Nieves, Juan J; Monteón, Francisco; Gómez-Navarro, Benjamin; Cueto-Manzano, Alfonso M
2007-01-01
In Mexico, CAPD survival has been analyzed in few studies from the center of the country. However, there are concerns that such results may not represent what occurs in other province centers of our country, particularly in our geographical area. To evaluate the patient and technique survival on CAPD of a single center of the west of Mexico, and compare them with other reported series. Retrospective cohort study. Tertiary care, teaching hospital located in Guadalajara, Jalisco. Patients from our CAPD program (1999-2002) were retrospectively studied. Interventions. Clinical and biochemical variables at the start of dialysis and at the end of the follow-up were recorded and considered in the analysis of risk factors. Endpoints were patient (alive, dead or lost to follow-up) and technique status at the end of the study (June 2002). 49 patients were included. Mean patient survival (+/- SE) was 3.32 +/- 0.22 years (CI 95%: 2.9-3.8 years). Patients in the present study were younger (39 +/- 17yrs), had larger body surface area (1.72 +/- 0.22 m2), lower hematocrit (25.4 +/- 5.2%), albumin (2.6 +/- 0.6g/dL), and cholesterol (173 +/- 44 mg/dL), and higher urea (300 +/- 93 mg/dL) and creatinine (14.9 +/- 5.6 mg/ dL) than those in other Mexican series. In univariate analysis, the following variables were associated (p < 0.05) to mortality: pre-dialysis age and creatinine clearance, and serum albumin and cholesterol at the end of follow-up. In multivariate analysis, only pre-dialysis creatinine clearance (RR 0.66, p = 0.03) and age (RR 1.08, p = 0.005) significantly predicted mortality. Mean technique survival was 2.83 +/- 0.24 years (CI 95%: 2.4-3.3). Pre-dialysis age (p < 0.05), peritonitis rate (p < 0.05), and serum phosphorus at the end of follow-up (p < 0.05) were associated with technique failure in univariate analysis, while in multivariate analysis, only pre-dialysis age (RR 1.07, p = 0.001) and peritonitis rate (RR 481, p < 0.0001) were technique failure predictors
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Kim, Tae-Suk; Jeong, Seung Hee; Kim, Jung-Bum; Lee, Min-Soo; Kim, Jae-Min; Yim, Hyeon-Woo
2011-01-01
Objective The Clinical Research Center for Depression (CRESCEND) study is a 9-year observational collaborative prospective cohort study for the clinical outcomes in participants with depressive disorders in Korea. In this study, we examined the baseline characteristics of the depressive participants as the hospital-based cohort. Methods Participants were assessed using various instruments including the Clinical Global Impression scale, 17-item Hamilton Depression Rating Scale (HDRS-17), Hamilton Anxiety Rating Scale, Brief Psychiatric Rating Scale, Social and Occupational Functioning Assessment Scale, Beck Depression Inventory-Second Edition, Scale for Suicide Ideation, and World Health Organization Quality of Life assessment instruments-abbreviated version. Also, personal histories of medical and psychiatric illnesses and the range of socio-epidemiologic and clinical data were collected from each participant. Results One thousand one hundred eighty three participants were recruited from 18 hospitals. The mean age of the participants was 47.9±15.9 year-old, 74.4% were female, 82.9% had been diagnosed of major depressive disorder, 40.9% were experiencing their first depressive episode, and 21.4% had a past history of suicide attempts. The majority (85.3%) of the participants were moderately to severely ill. The average HDRS-17 was 19.8±6.1. Significant gender differences at baseline were shown in age, education, marriage, employment, religion, and first depressive episode. Conclusion The baseline findings in the CRESCEND study showed some different characteristics of depression in Korea, suggesting a possibility of ethnic and cultural factors in depression. PMID:21519530
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SOFIA/FORCAST Observations of the Arched Filamentary Region in the Galactic Center
NASA Astrophysics Data System (ADS)
Hankins, Matthew; Lau, Ryan M.; Morris, Mark; Herter, Terry L.
2016-06-01
Abstract: We present 19.7, 25.2, 31.5, and 37.1 μm maps of the Thermal Arched Filament region in the Galactic Center taken with the Faint Object Infrared Camera for the SOFIA Telescope (FORCAST) with an angular resolution of 3.2-3.8". We calculate the integrated infrared luminosity of the Arched Filaments and show that they are consistent with being heated by the nearby Arches cluster. Additionally, using our observations, we infer dust temperatures (75 - 90 K) across the Arched Filaments which are remarkably consistent over large spatial scales (˜ 25 pc). We discuss the possible geometric effects needed to recreate this temperature structure. Additionally, we compare the observed morphology of the Arches in the FORCAST maps with the Paschen-α emission in the region to study what fraction of the infrared emission may be coming from dust in the HII region versus the PDR beneath it. Finally, we use Spitzer/IRAC 8 μm data to look for spatial variations in PAH abundance in the rich UV environment of the young (~2-4 Myr) and massive Arches cluster.
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ERIC Educational Resources Information Center
Middlesex County Vocational and Technical High Schools, New Brunswick, NJ.
The Teenage Parent Center of the Single Parent Assistance, Counseling and Education Project was developed to support, guide, and direct adolescent mothers, pregnant teenagers, and teens at risk of becoming parents through successful completion of a high school diploma or school year in a vocational setting in Middlesex County, New Jersey. The…
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Kabbani, Mohamed S; Ismail, Sameh R; Fatima, Anis; Shafi, Rehana; Idris, Julinar A; Mehmood, Akhter; Singh, Reetam K; Elbarabry, Mahmoud; Hijazi, Omar; Hussein, Mohamed A
2016-01-01
Nosocomial urinary tract infection (UTI) increases hospitalization, cost and morbidity. In this cohort study, we aimed to determine the incidence, risk factors, etiology and outcomes of UTIs in post-operative cardiac children. To this end, we studied all post-operative patients admitted to the Pediatric Cardiac Intensive Care Unit (PCICU) in 2012, and we divided the patients into two groups: the UTI (UTI group) and the non-UTI (control group). We compared both groups for multiple peri-operative risk factors. We included 413 children in this study. Of these, 29 (7%) had UTIs after cardiac surgery (UTI group), and 384 (93%) were free from UTIs (control group). All UTI cases were catheter-associated UTIs (CAUTIs). A total of 1578 urinary catheter days were assessed in this study, with a CAUTI density rate of 18 per 1000 catheter days. Multivariate logistic regression analysis demonstrated the following risk factors for CAUTI development: duration of urinary catheter placement (p<0.001), presence of congenital abnormalities of kidney and urinary tract (CAKUT) (p<0.0041) and the presence of certain syndromes (Down, William, and Noonan) (p<0.02). Gram-negative bacteria accounted for 63% of the CAUTI. The main causes of CAUTI were Klebsiella (27%), Candida (24%) and Escherichia coli (21%). Resistant organisms caused 34% of CAUTI. Two patients (7%) died in the UTI group compared with the one patient (0.3%) who died in the control group (p<0.05). Based on these findings, we concluded that an increased duration of the urinary catheter, the presence of CAKUT, and the presence of syndromes comprised the main risk factors for CAUTI. Gram-negative organisms were the main causes for CAUTI, and one-third of them found to be resistant in this single-center study. Copyright © 2016 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.
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Bourgoin, Pierre; Merouani, Aicha; Phan, Véronique; Litalien, Catherine; Lallier, Michel; Alvarez, Fernando; Jouvet, Philippe
2014-05-01
Supportive care as a bridge to transplant or recovery remains challenging in children suffering from acute liver failure (ALF). We report our experience in children using the Molecular Absorbent Recirculating System (MARS(®)). Retrospective data from children receiving therapy using MARS(®) from October 2009 to October 2012 were included in this single-center retrospective study. Patient characteristics, clinical presentation and complications of ALF, clinical and biological data before and after each MARS(®) session, technical modalities and adverse events were recorded. A total of six children underwent 17 MARS(®) sessions during the study period. Two adolescents were treated with the adult filter MARSFLUX(®) and four infants were treated with the MiniMARS(®) filter. The mean PEdiatric Logistic Dysfunction (PELOD) score at admission was 19 (range 11-33). All patients were mechanically ventilated, and four had acute kidney injury. The neurological course improved in one case, judged as stable in two cases and worsened in one case; data were unavailable in two cases. Mean serum ammonia levels decreased significantly following treatment with MARS(®) from an initial 89 ± 29 to 58 ± 35 mcmol/L (p = 0.02). No other significant biological improvement was observed. Hemodynamic status improved/remained unchanged in the adolescent group, but in the infants four of the seven sessions were poorly tolerated and two sessions were aborted. Three patients died, two were successfully transplanted and one recovered without transplantation. In our experience, treatment with MARS(®) is associated with encouraging results in adolescents, but it needs modification for very sick infants to improve tolerance.
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Instrumentation for single-dish observations with The Greenland Telescope
NASA Astrophysics Data System (ADS)
Grimes, Paul K.; Asada, K.; Blundell, R.; Burgos, R.; Chang, H.-H.; Chen, M. T.; Goldie, D.; Groppi, C.; Han, C. C.; Ho, P. T. P.; Huang, Y. D.; Inoue, M.; Kubo, D.; Koch, P.; Leech, J.; de Lera Acedo, E.; Martin-Cocher, P.; Nishioka, H.; Nakamura, M.; Matsushita, S.; Paine, S. N.; Patel, N.; Raffin, P.; Snow, W.; Sridharan, T. K.; Srinivasan, R.; Thomas, C. N.; Tong, E.; Wang, M.-J.; Wheeler, C.; Withington, S.; Yassin, G.; Zeng, L.-Z.
2014-07-01
The Greenland Telescope project will deploy and operate a 12m sub-millimeter telescope at the highest point of the Greenland i e sheet. The Greenland Telescope project is a joint venture between the Smithsonian As- trophysical Observatory (SAO) and the Academia Sinica Institute of Astronomy and Astrophysics (ASIAA). In this paper we discuss the concepts, specifications, and science goals of the instruments being developed for single-dish observations with the Greenland Telescope, and the coupling optics required to couple both them and the mm-VLBI receivers to antenna. The project will outfit the ALMA North America prototype antenna for Arctic operations and deploy it to Summit Station,1 a NSF operated Arctic station at 3,100m above MSL on the Greenland I e Sheet. This site is exceptionally dry, and promises to be an excellent site for sub-millimeter astronomical observations. The main science goal of the Greenland Telescope is to carry out millimeter VLBI observations alongside other telescopes in Europe and the Americas, with the aim of resolving the event horizon of the super-massive black hole at the enter of M87. The Greenland Telescope will also be outfitted for single-dish observations from the millimeter-wave to Tera-hertz bands. In this paper we will discuss the proposed instruments that are currently in development for the Greenland Telescope - 350 GHz and 650 GHz heterodyne array receivers; 1.4 THz HEB array receivers and a W-band bolometric spectrometer. SAO is leading the development of two heterodyne array instruments for the Greenland Telescope, a 48- pixel, 325-375 GHz SIS array receiver, and a 4 pixel, 1.4 THz HEB array receiver. A key science goal for these instruments is the mapping of ortho and para H2D+ in old protostellar ores, as well as general mapping of CO and other transitions in molecular louds. An 8-pixel prototype module for the 350 GHz array is currently being built for laboratory and operational testing on the Greenland Telescope
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Alanazi, Menyfah Q.; Al-Jeriasy, Majed I.; Al-Assiri, Mohammed H.; Afesh, Lara Y.; Alhammad, Fahad; Salam, Mahmoud
2015-01-01
Abstract Admission rate and length of stay (LOS) are two hospital performance indicators that affect the quality of care, patients’ satisfaction, bed turnover, and health cost expenditures. The aim of the study was to identify factors associated with higher admission rates and extended average LOS among acutely poisoned children at a single poison center, central Saudi Arabia. This is a cross-sectional, poison and medical chart review between 2009 and 2011. Exposures were child characteristics, that is, gender, age, body mass index (BMI), health history, and Canadian 5-level triage scale. Poison incident characteristics were, that is, type, exposure route, amount, form, home remedy, and arrival time to center. Admission status and LOS were obtained from records. Chronic poisoning, plant allergies, and venomous bites were excluded. Bivariate and regression analyses were applied. Significance at P < 0.05. Of the 315 eligible cases, (72%) were toddlers with equal gender distribution, (58%) had normal BMI, and (77%) were previously healthy. Poison substances were pharmaceutical drugs (63%) versus chemical products (37%). Main exposure route was oral (98%). Home remedy was observed in (21.9%), which were fluids, solutes, and/or gag-induced vomiting. Almost (52%) arrived to center >1 h. Triage levels: non-urgent cases (58%), less urgent (11%), urgent (18%), emergency (12%), resuscitative (1%). Admission rate was (20.6%) whereas av. LOS was 13 ± 22 h. After adjusting and controlling for confounders, older children (adj.OR = 1.19) and more critical triage levels (adj.OR = 1.35) were significantly associated with higher admission rates compared to younger children and less critical triage levels (adj.P = 0.006) and (adj.P = 0.042) respectively. Home remedy prior arrival was significantly associated with higher av. LOS (Beta = 9.48, t = 2.99), compared to those who directly visited the center, adj.P = 0.003. Hospital administrators
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Addressing underutilization of consumer health information resource centers: a formative study.
Kennedy, May G; Kiken, Laura; Shipman, Jean P
2008-01-01
Four consumer health information centers in Richmond, Virginia, provide one-on-one assistance in accessing health information. Because they may not be fully utilized at present, an exploratory marketing study of factors affecting usage of the centers was conducted. Observers counted center passers-by and tracked their paths. Also, brief intercept interviews were conducted with people who had just used a center, people nearby who could have used one but did not, and people on the street. Finally, in-depth individual interviews were conducted with key informants. There was a high degree of satisfaction with the centers among users. Nonusers universally endorsed the center concept. However, most passers-by did not even glance at the centers, and intercept interviewees suggested better signage and promoting the resource centers through various media channels. Key informants added suggestions about interpersonal strategies (e.g., physician referrals) for center usage promotion but cautioned that a large increase in traffic could not be accommodated without increasing staff size or shifting from a model of individualized service. Triangulating findings from multiple data collection methods can provide useful guidance for efforts to promote center utilization. At minimum, steps should be taken to make the largest centers more noticeable. Because center utilization is not only associated with consumer satisfaction with hospitals, but may also foster health literacy, both hospital-based and community-based usage promotion strategies may be warranted. All such promotional strategies should be audience-tested before they are adopted.
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Evon, Donna M; Golin, Carol E; Stewart, Paul; Fried, Michael W; Alston, Shani; Reeve, Bryce; Lok, Anna S; Sterling, Richard K; Lim, Joseph K; Reau, Nancy; Sarkar, Souvik; Nelson, David R; Reddy, K R; Di Bisceglie, Adrian M
2017-06-01
New highly efficacious direct-acting antiviral (DAA) therapies are available to treat chronic hepatitis C viral (HCV) infection. Real-world, patient-centered data on harms and benefits associated with these therapies are needed. PROP UP is a multi-center prospective observational study that plans to enroll 1600 patients starting treatment with recently-approved DAA regimens. Informed by extensive input from a HCV patient engagement group who prioritized outcomes most important to them, patient-reported outcomes will be characterized using surveys at five time points: Baseline (T1), treatment week 4 (T2), end of treatment (T3), 12weeks post-treatment (T4), 12months post-treatment (T5). (1) Changes in side effects, functioning, pre-existing conditions, and out-of-pocket costs during therapy (T1 vs T2/T3); (2) Medication adherence in relation to a history of mental health/substance abuse, treatment regimens, pill burden, reasons for missed doses, and cure rates; (3) Short term impact of cure on functioning and amelioration of symptoms (T1 vs T4); (4) Long-term treatment harms or benefits of cure on symptoms, side effects, pre-existing conditions, and functioning (T1 vs T5). Similarities between regimens will be examined where comparisons are appropriate and meaningful. PROP UP complements previous clinical trials by focusing on patient-reported outcomes in a representative sample of patients treated in clinical practice, by collaborating with a patient engagement group, by characterizing the experiences of vulnerable subgroups, and by investigating long-term harms and benefits of treatments. PROP UP is designed to provide novel and detailed information to support informed decision-making for patients and providers contemplating HCV treatment (PCORI CER-1408-20,660; NCT02601820). Copyright © 2017 Elsevier Inc. All rights reserved.
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Evon, Donna M.; Golin, Carol E.; Stewart, Paul; Fried, Michael W.; Alston, Shani; Reeve, Bryce; Lok, Anna S.; Sterling, Richard K.; Lim, Joseph K.; Reau, Nancy; Sarkar, Souvik; Nelson, David R.; Reddy, K. Rajender; Di Bisceglie, Adrian M.
2017-01-01
Background New highly efficacious direct-acting antiviral (DAA) therapies are available to treat chronic hepatitis C viral (HCV) infection. Real-world, patient-centered data on harms and benefits associated with these therapies are needed. Methods PROP UP is a multi-center prospective observational study that plans to enroll 1,600 patients starting treatment with recently-approved DAA regimens. Informed by extensive input from a HCV patient engagement group who prioritized outcomes most important to them, patient-reported outcomes will be characterized using surveys at five time points: Baseline (T1), treatment week 4 (T2), end of treatment (T3), 12 weeks post-treatment (T4), 12 months post-treatment (T5). Outcomes (1) Changes in side effects, functioning, pre-existing conditions, and out-of-pocket costs during therapy (T1 vs T2/T3); (2) Medication adherence in relation to a history of mental health/substance abuse, treatment regimens, pill burden, reasons for missed doses, and cure rates; (3) Short term impact of cure on functioning and amelioration of symptoms (T1 vs T4); (4) Long-term treatment harms or benefits of cure on symptoms, side effects, pre-existing conditions, and functioning (T1 vs T5). Similarities between regimens will be examined where comparisons are appropriate and meaningful. Conclusion PROP UP complements previous clinical trials by focusing on patient-reported outcomes in a representative sample of patients treated in clinical practice, by collaborating with a patient engagement group, by characterizing the experiences of vulnerable subgroups, and by investigating long-term harms and benefits of treatments. PROP UP is designed to provide novel and detailed information to support informed decision-making for patients and providers contemplating HCV treatment (PCORI CER-1408-20660; NCT02601820). PMID:28342989
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Pyridostigmine in the treatment of postural orthostatic tachycardia: a single-center experience.
Kanjwal, Khalil; Karabin, Beverly; Sheikh, Mujeeb; Elmer, Lawrence; Kanjwal, Yousuf; Saeed, Bilal; Grubb, Blair P
2011-06-01
The long-term efficacy of pyridostigmine, a reversible acetyl cholinesterase inhibitor, in the treatment of postural orthostatic tachycardia syndrome (POTS) patients remains unclear. We report our retrospective, single-center, long-term experience regarding the efficacy and adverse effect profile of pyridostigmine in the treatment of POTS patients. This retrospective study included an extensive review of electronic charts and data collection in regards to patient demographics, orthostatic parameters, side-effect profile, subjective response to therapy, as well as laboratory studies recorded at each follow-up visit to our institution's Syncope and Autonomic Disorders Center. The response to pyridostigmine therapy was considered successful if patient had both symptom relief in addition to an objective response in orthostatic hemodynamic parameters (heart rate [HR] and blood pressure). Three hundred patients with POTS were screened for evaluation in this study. Of these 300, 203 patients with POTS who received pyridostigmine therapy were reviewed. Of these 203 patients, 168 were able to tolerate the medication after careful dose titration. The mean follow-up duration in this group of patients was 12 ± 3 (9-15) months. Pyridostigmine improved symptoms of orthostatic intolerance in 88 of 203 (43%) of total patients or 88 of 172 (51%) who were able to tolerate the drug. The symptoms that improved the most included fatigue (55%), palpitations (60%), presyncope (60%), and syncope (48%). Symptom reduction correlated with a statistically significant improvement in upright HR and diastolic blood pressure after treatment with pyridostigmine as compared to their baseline hemodynamic parameters (standing HR 94 ± 19 vs 82 ± 16, P < 0.003, standing diastolic blood pressure 71 ± 11 vs 74 ± 12, P < 0.02). Gastrointestinal problems were the most common adverse effects (n = 39, 19%) reported. The overall efficacy of pyridostigmine in our study was seen in 42% of total patients or
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Uncovering the single top: observation of electroweak top quark production
DOE Office of Scientific and Technical Information (OSTI.GOV)
Benitez, Jorge Armando
2009-01-01
The top quark is generally produced in quark and anti-quark pairs. However, the Standard Model also predicts the production of only one top quark which is mediated by the electroweak interaction, known as 'Single Top'. Single Top quark production is important because it provides a unique and direct way to measure the CKM matrix element V tb, and can be used to explore physics possibilities beyond the Standard Model predictions. This dissertation presents the results of the observation of Single Top using 2.3 fb -1 of Data collected with the D0 detector at the Fermilab Tevatron collider. The analysis includes the Single Top muon+jets and electron+jets final states and employs Boosted Decision Tress as a method to separate the signal from the background. The resulting Single Top cross section measurement is: (1) σ(pmore » $$\\bar{p}$$→ tb + X, tqb + X) = 3.74 -0.74 +0.95 pb, where the errors include both statistical and systematic uncertainties. The probability to measure a cross section at this value or higher in the absence of signal is p = 1.9 x 10 -6. This corresponds to a standard deviation Gaussian equivalence of 4.6. When combining this result with two other analysis methods, the resulting cross section measurement is: (2) σ(p$$\\bar{p}$$ → tb + X, tqb + X) = 3.94 ± 0.88 pb, and the corresponding measurement significance is 5.0 standard deviations.« less
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de Carvalho, Guilherme Moreira; Sponchiado Junior, Emílio Carlos; Garrido, Angela Delfina Bittencourt; Lia, Raphael Carlos Comelli; Garcia, Lucas da Fonseca Roberti; Marques, André Augusto Franco
2015-12-01
The aim of this study was to evaluate the apical transportation, the centering ability, and the cleaning effectiveness of a reciprocating single-file system associated to different glide path techniques. The mesial root canals of 52 mandibular molars were randomly distributed into 4 groups (n = 13) according to the different glide path techniques used before biomechanical preparation with Reciproc System (RS): KF/RS (sizes 10 and 15 K-files), NGP/RS (no glide path, only reciprocating system), PF/RS (sizes 13, 16, and 19 PathFile instruments), and NP (no preparation). Cone-beam computed tomography analysis was performed before and after instrumentation for apical third images acquisition. Apical transportation and its direction were evaluated by using the formula D = (X1 - X2) - (Y1 - Y2), and the centering ability was analyzed by the formula CC = (X1 - X2/Y1 - Y2 or Y1 - Y2/X1 - X2). The samples were submitted to histologic processing and analyzed under a digital microscope for debris quantification. The values were statistically analyzed (Kruskal-Wallis, the Dunn multiple comparisons test, P < .05). All groups had similar apical transportation values, with no significant difference among them (P > .05). Groups had a tendency toward transportation in the mesial direction. No technique had perfect centering ability (=1.0), with no significant difference among them. KF/RS had larger amount of debris, with statistically significant difference in comparison with NGP/RS (P > .05). The different glide path techniques promoted minimal apical transportation, and the reciprocating single-file system tested remained relatively centralized within the root canal. Also, the different techniques interfered in the cleaning effectiveness of the reciprocating system. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.
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Li, Jiapeng; Huang, Xiaojun; Wang, Qian; Jing, Shan; Jiang, Hao; Wei, Zhongna; Zang, Yannan; Liu, Yang; Zhao, Libo; Fang, Yi; Feng, Wanyu
2015-10-01
Histamine dihydrochloride (HDC) injection has been approved in Europe for the treatment of adults with acute myeloid leukemia, used in combination therapy with the T-cell-derived cytokine interleukin-2. Despite years of clinical applications of HDC in Europe, no data are available on its tolerability and pharmacokinetic properties in Chinese patients. The objective of this study was to determine the safety profile and pharmacokinetic properties of HDC in Chinese healthy volunteers (HVs). In this Phase I, single-center, open-label, randomized study, 20 Chinese HVs were randomized to receive a single dose of 0.5 or 1.0 mg HDC via a 10-minute subcutaneous injection. Whole-blood and urine samples were collected at designated time points after dosing. Plasma and urine concentrations of histamine and metabolite N-methyl histamine were measured using a validated HPLC-MS/MS method. Pharmacokinetic parameters were estimated through noncompartmental procedures based on concentration-time data. Adverse events and evaluation of clinical laboratory tests were used to assess the safety profile. The pharmacokinetic profile for a single-dose of 1.0 mg HDC in Chinese HVs was compared with that in Western HVs. No severe adverse events occurred in this study, and the severity of all adverse events was grade I according to the Common Terminology Criteria for Adverse Events, version 4.0. For the pharmacokinetic parameters of histamine at the 0.5-mg and 1.0-mg dose levels, t½ was 0.50 and 1.02 hours; Tmax was 0.15 and 0.14 hours; mean Cmax was 26.59 and 71.01 nmol/L; AUC0-t was 8.35 and 20.43 nmol/h/L; AUC0-∞ was 9.61 and 22.69 nmol/h/L; accumulated amount excreted in urine within 24 hours was 125.93 and 145.52 nmol; and maximum urine excretion rates were 21.85 and 38.94 nmol/h, respectively. For N-methyl histamine at the 0.5-mg and 1.0-mg dose levels, t½ was 0.58 and 0.66 hours; Tmax was 0.28 and 0.26 hours; mean Cmax was 17.01 and 23.54 nmol/L; AUC0-t was 7.72 and 17.08 nmol
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X-ray Observations of Binary and Single Wolf-Rayet Stars with XMM-Newton and Chandra
NASA Technical Reports Server (NTRS)
Skinner, Stephen; Gudel, Manuel; Schmutz, Werner; Zhekov, Svetozar
2006-01-01
We present an overview of recent X-ray observations of Wolf-Rayet (WR) stars with XMM-Newton and Chandra. These observations are aimed at determining the differences in X-ray properties between massive WR + OB binary systems and putatively single WR stars. A new XMM spectrum of the nearby WN8 + OB binary WR 147 shows hard absorbed X-ray emission (including the Fe Ka line complex), characteristic of colliding wind shock sources. In contrast, sensitive observations of four of the closest known single WC (carbon-rich) WR stars have yielded only nondetections. These results tentatively suggest that single WC stars are X-ray quiet. The presence of a companion may thus be an essential factor in elevating the X-ray emission of WC + OB stars to detectable levels.
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Biancone, Livia; Zuzzi, Sara; Ranieri, Micaela; Petruzziello, Carmelina; Calabrese, Emma; Onali, Sara; Ascolani, Marta; Zorzi, Francesca; Condino, Giovanna; Iacobelli, Simona; Pallone, Francesco
2012-06-01
The combined role of immunomodulators (IMM) and clinical characteristics of Inflammatory Bowel Disease (IBD) in determining the cancer risk is undefined. The aim was to assess whether clinical characteristics of IBD are independent risk factors for cancer, when considering thiopurines and anti-TNFs use. In a single-center cohort study, clinical characteristics of IBD patients with IBD duration ≥1 year and ≥2 visits from 2000 to 2009 were considered. Tests for crude rates and survival analysis methods were used to assess differences of incidence of cancer between groups. The methods were adjusted for the time interval between diagnosis and immunomodulatory treatments. IBD population included 1222 patients :615 Crohn's disease (CD), 607 ulcerative colitis (UC). Cancer was diagnosed in 51 patients (34 CD,17 UC), with an incidence rate of 4.3/1000 pt/year. The incidence rate of cancer was comparable between CD and UC (4.6/1000 pt/year vs 2.9/1000 pt/year ;p=n.s.). Cancer most frequently involved the breast, the GI tract, the skin. Lymphoma was diagnosed in CD (1HL, 1NHL,0 HSTCL). Risk factors for cancer included older age at diagnosis of IBD (CD: HR 1.25;95%CI 1.08-1.45; UC:HR 1.33;95%CI 1.15-1.55 for an increase by 5 years; p=0.0023; p=0.0002), fistulizing pattern in CD (HR 2.55; 95%CI 1.11-5.86,p=0.0275), pancolitis in UC (HR 2.79;95%CI 1.05-7.40 p=0.0396 vs distal). IMM and anti-TNFs did not increase the cancer risk in CD, neither IMM in UC (anti-TNFs risk in UC not feasible as no cases observed). Fistulizing pattern in CD, pancolitis in UC and older age at diagnosis of IBD are independent risk factors for cancer. Copyright © 2011 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.
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Selective upper airway stimulation for obstructive sleep apnea: a single center clinical experience.
Heiser, Clemens; Knopf, Andreas; Bas, Murat; Gahleitner, Constanze; Hofauer, Benedikt
2017-03-01
Selective upper airway stimulation (UAS) is a novel therapy for patients with obstructive sleep apnea (OSA). The aim of this study was to analyze the application and outcome of UAS in patients with moderate to severe OSA in the clinical routine of a tertiary referral center. The design of this study is single-center, prospective clinical trial. Thirty-one patients who received a UAS device (Inspire Medical Systems) were included. Treatment outcome was evaluated at 2, 3, 6, and 12 months after surgery. Data collection included demographics, body mass index (BMI), apnea hypopnea index (AHI), oxygen saturation and desaturation index (ODI), Epworth Sleepiness Score (ESS), adverse events, and adherence to therapy. Sher criteria were used to evaluate treatment response. The mean age was 59.6 years with thirty patients being male. Mean BMI was 28.8 kg/m 2 . The mean pre-implantation AHI of 32.9/h could be reduced to 7.1/h after 12 months (p < 0.001). The mean pre-implantation ODI of 30.7/h could be reduced to 9.9/h after 12 months (p = 0.004). The mean pre-implantation ESS of 12.6 could be reduced to 5.9 after 12 months (p = 0.006). Serious adverse events did not occur. Therapy adherence was a usage of 6.6 h/night after 12 months. OSA severity and subjective daytime sleepiness were improved in patients with moderate to severe OSA after receiving UAS therapy. Patients maintained high adherence to therapy use after 12 months. It is encouraging that UAS has been shown to be successfully implemented in the routine clinical management of OSA outside of a clinical trial setting.
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Alimoghaddam, Kamran; Jalali, Arash; Aliabadi, Leyla Sharifi; Ghaffari, Fatemeh; Maheri, Roghieh; Eini, Ezzat; Mashhadireza, Maryam; Mousavi, Seied Asadollah; Bahar, Babak; Jahani, Mohammad; Ghavamzadeh, Ardeshir
2014-01-01
Esophageal and gastric cancers are among the most common cancers in Iran. Usually survival of these cases is poor despite of treatment. Here we studied outcome of these cases in our center to have an estimation of general prognosis of patients. In this retrospective study, we reviewed the data of patient's files before treatment, including cancer stage at diagnosis, types of treatments and outcomes. We studied 368 patients treated between 1995 and 2011. The study included 368 patients (248 [67.4%] males and 120 [32.6%] females) with a median age of 58 (range: 23 - 94). Sixty nine patients (18.8%) had esophageal cancer with a median age of 58.5 years (range: 33 - 84), and 47.8% (33/69) of whom were male. Sixty five (17.7%) were reported to have gastro-esophageal junction (GEJ) with a median age of 62.0 (range: 32 - 94), among them 72.3% (47/65) of whom were male and finally Two hundred thirty four (63.6%) had gastric cancer with a median age of 57.0 (range: 23 - 82), which 71.8% (168/234) of whom were male. The Median follow-up was 10 months. The majority of patients were diagnosed at an advanced stage of disease. Stage III or IV was observed in 65.0% (39/60) of patients with esophageal cancer, 75.0% (33/44) with GEJ cancer and 65.4% (121/185) with gastric cancer. In this study, 58% of patients with esophageal cancer, 50.8% with GEJ and gastric cancers had unresectable disease or metastases at presentation. One-year EFS was 51.8% (95% CI: 39.8 - 67.3%), 32.8% (95% CI: 22.1 - 48.7%), and 56.7% (95% CI: 50.1 - 64.3%) in patients with esophageal, GEJ and gastric cancers, respectively (p = 0.002). The 1-year OS was 54.5% (95% CI: 42.6 - 69.8%), 39.5% (95 CI: 28.1 - 55.5%), and 68.2% (95% CI: 61.8 - 75.3%), respectively (p < 0.001). Cancers of the upper gastrointestinal (GI) tract contribute to the high mortality and morbidity rates because they are more likely to be diagnosed at late or advanced stages of disease. Cancer of the GEJ has a poor prognosis compared to
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Analysis of flow in an observation well intersecting a single fracture
Lapcevic, P.A.; Novakowski, K.S.; Paillet, Frederick L.
1993-01-01
A semi-analytical model is developed to determine transmissivity and storativity from the interpretation of transient flow in an observation well due to pumping in a source well where the two wells are connected by a single fracture. Flow rate can be determined using a heat-pulse flowmeter located above the intersection of the fracture in the observation well. The results of a field experiment were interpreted using the new model and compared with drawdown data from the same test. Good agreement between the transmissivity estimates was observed whereas estimates of storativity were found to be better determined from the analysis of flow rate. ?? 1993.
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Observing the Super-Massive Black Hole of the Galactic center with Simbol-X .
NASA Astrophysics Data System (ADS)
Goldwurm, A.
The Center of our Galaxy is one of the prime objective of the Simbol-X mission. This region of several square degrees around the dynamical center of the galaxy hosts a large variety of high energy sources and violent phenomena that involve different non-thermal processes contributing to the hard X-ray emission from the region. Here we present in detail the case for the observation of Sgr A*, the super-massive black hole of the galactic nucleus, with Simbol-X, stressing on the presently open questions and on the crucial measurements that will be performed in the hard X-ray domain with this formation-flying hard X-ray focussing telescope expected to flight in the next decade.
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Large-Scale periodic solar velocities: An observational study
NASA Technical Reports Server (NTRS)
Dittmer, P. H.
1977-01-01
Observations of large-scale solar velocities were made using the mean field telescope and Babcock magnetograph of the Stanford Solar Observatory. Observations were made in the magnetically insensitive ion line at 5124 A, with light from the center (limb) of the disk right (left) circularly polarized, so that the magnetograph measures the difference in wavelength between center and limb. Computer calculations are made of the wavelength difference produced by global pulsations for spherical harmonics up to second order and of the signal produced by displacing the solar image relative to polarizing optics or diffraction grating.
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Perspectives: When the Centers Do Not Hold
ERIC Educational Resources Information Center
Rosen, Lawrence
2010-01-01
During the last twenty years or so, the number of endowed centers at many universities has increased enormously--to as many as fifty or more at a single institution. There are centers for every region (or sub-region) of the world and every ethnic/religious group (or sub-group) known to history. There are centers for the study of illness and…
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Lushaj, Entela B; Schreiner, Athanasia; Jonuzi, Besa; Badami, Abbasali; DeOliveira, Nilto; Lozonschi, Lucian
2016-05-17
We retrospectively assessed the outcomes after coronary revascularization at a single Veterans Affairs Medical Center when a strategy of assigning higher risk patients to off-pump coronary artery bypass grafting (CABG) was employed. Over a 5 year period all consecutive patients that underwent CABG at our VA Medical Center were assigned to a surgeon who either performs the CABG exclusively off-pump or to one who performed the CABG on-pump. The higher risk patients were assigned preferentially for off-pump revascularization. VASQIP (VA Hospitals Surgical Quality Improvement Program) data between 10/2007 and 12/2012 were retrospectively reviewed at our VA Medical Center and the short term outcomes were assessed. A total of 252 consecutive patients underwent off-pump CABG (n = 170) and on-pump CABG (n = 82). There were significantly more patients with low LVEF (<45 %; p = 0.008) and cerebrovascular disease in the off-pump group (p = 0.024). The number of patients smoking at the time of surgery was significantly higher in the off-pump group (p = 0.002) as well. The 30-day composite morbidity and mortality was 6 % for all CABG patients and significantly lower with off-pump vs. on-pump CABG (3.5 % vs. 11 %; p = 0.019). There were no conversions from off-pump to on-pump surgery. A selective strategy to direct higher risk patients towards an off-pump revascularization yielded favorable outcomes in an unselected veteran population treated at a single VA Medical Center over a 5 year period.
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Formation mechanism of fivefold deformation twins in a face-centered cubic alloy.
Zhang, Zhenyu; Huang, Siling; Chen, Leilei; Zhu, Zhanwei; Guo, Dongming
2017-03-28
The formation mechanism considers fivefold deformation twins originating from the grain boundaries in a nanocrystalline material, resulting in that fivefold deformation twins derived from a single crystal have not been reported by molecular dynamics simulations. In this study, fivefold deformation twins are observed in a single crystal of face-centered cubic (fcc) alloy. A new formation mechanism is proposed for fivefold deformation twins in a single crystal. A partial dislocation is emitted from the incoherent twin boundaries (ITBs) with high energy, generating a stacking fault along {111} plane, and resulting in the nucleating and growing of a twin by the successive emission of partials. A node is fixed at the intersecting center of the four different slip {111} planes. With increasing stress under the indentation, ITBs come into being close to the node, leading to the emission of a partial from the node. This generates a stacking fault along a {111} plane, nucleating and growing a twin by the continuous emission of the partials. This process repeats until the formation of fivefold deformation twins.
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Formation mechanism of fivefold deformation twins in a face-centered cubic alloy
NASA Astrophysics Data System (ADS)
Zhang, Zhenyu; Huang, Siling; Chen, Leilei; Zhu, Zhanwei; Guo, Dongming
2017-03-01
The formation mechanism considers fivefold deformation twins originating from the grain boundaries in a nanocrystalline material, resulting in that fivefold deformation twins derived from a single crystal have not been reported by molecular dynamics simulations. In this study, fivefold deformation twins are observed in a single crystal of face-centered cubic (fcc) alloy. A new formation mechanism is proposed for fivefold deformation twins in a single crystal. A partial dislocation is emitted from the incoherent twin boundaries (ITBs) with high energy, generating a stacking fault along {111} plane, and resulting in the nucleating and growing of a twin by the successive emission of partials. A node is fixed at the intersecting center of the four different slip {111} planes. With increasing stress under the indentation, ITBs come into being close to the node, leading to the emission of a partial from the node. This generates a stacking fault along a {111} plane, nucleating and growing a twin by the continuous emission of the partials. This process repeats until the formation of fivefold deformation twins.
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Fiaccadori, Enrico; Sabatino, Alice; Schito, Franco; Angella, Francesca; Malagoli, Martina; Tucci, Marco; Cupisti, Adamasco; Capitanini, Alessandro; Regolisti, Giuseppe
2014-01-01
In patients on chronic dialysis a sedentary lifestyle is a strong, yet potentially modifiable, predictor of mortality. The present single-center pilot study evaluated social, psychological and clinical barriers that may hinder physical activity in this population. We explored the association between barriers to physical activity and sedentarism in adult patients at a chronic dialysis facility in Parma, Italy. We used different questionnaries exploring participation in physical activity, physical functioning, patient attitudes and preferences, and barriers to physical activity perceived by either patients or dialysis doctors and nurses. We enrolled 104 patients, (67 males, 65%), mean age 69 years (79% of patients older than 60 years); median dialysis vintage 60 months (range 8-440); mean Charlson score 5.55, ADL (Activities of Daily Living) score 5.5. Ninety-two participants (88.5%) reported at least one barrier to physical activity. At multivariable analysis, after adjusting for age and sex, feeling to have too many medical problems (OR 2.99, 95% CI 1.27 to 7.07; P=0.012), chest pain (OR 10.78, 95% CI 1.28 to 90.28; P=0.029) and sadness (OR 2.59, 95% CI 1.10 to 6.09; P=0.030) were independently associated with physical inactivity. Lack of time for exercise counseling and the firm belief about low compliance/interest by the patients toward exercise were the most frequent barriers reported by doctors and nurses. We identified a number of patient-related and health personnel-related barriers to physical activity in patients on chronic dialysis. Solutions for these barriers should be addressed in future studies aimed at increasing the level of physical activity in this population. © 2014 S. Karger AG, Basel.
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Sadot, Dan; Dorman, G; Gorshtein, Albert; Sonkin, Eduard; Vidal, Or
2015-01-26
112Gbit/sec DSP-based single channel transmission of PAM4 at 56Gbaud over 15GHz of effective analog bandwidth is experimentally demonstrated. The DSP enables use of mature 25G optoelectronics for 2-10km datacenter intra-connections, and 8Tbit/sec over 80km interconnections between data centers.
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Photoluminescence Study of Plasma-Induced Damage of GaInN Single Quantum Well
NASA Astrophysics Data System (ADS)
Izumi, Shouichiro; Minami, Masaki; Kamada, Michiru; Tatsumi, Tetsuya; Yamaguchi, Atsushi A.; Ishikawa, Kenji; Hori, Masaru; Tomiya, Shigetaka
2013-08-01
Plasma-induced damage (PID) due to Cl2/SiCl4/Ar plasma etching of the GaN capping layer (CAP)/GaInN single quantum well (SQW)/GaN structure was investigated by conventional photoluminescence (PL), transmission electron microscopy (TEM), and time-resolved and temperature-dependent photoluminescence (TRPL). SQW PL intensity remained constant initially, although plasma etching of the CAP layer proceeded, but when the etching thickness reached a certain amount (˜60 nm above the SQW), PL intensity started to decrease sharply. On the other hand, TEM observations show that the physical damage (structural damage) was limited to the topmost surface region. These findings can be explained by the results of TRPL studies, which revealed that there exist two different causes of PID. One is an increase in the number of nonradiative recombination centers, which mainly affects the PL intensity. The other is an increase in the quantum level fluctuation owing mainly to physical damage.
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Role of surgical treatment in breast cancer liver metastases: a single center experience.
Bacalbasa, Nicolae; Dima, Simona Olimpia; Purtan-Purnichescu, Raluca; Herlea, Vlad; Popescu, Irinel
2014-10-01
The aim of the present study was to review a single hepatobiliary center experience, the benefit of hepatic metastasectomy in breast cancer liver metastases (BCLM) patients and to identify predictors of survival. Fifty-two female patients underwent surgery for BCLM between 2002 and 2013. Only patients with liver resections (n=43) were included in the analysis. The median survival of the 43 patients with liver resection was 32.2 months. The factors significantly associated with overall post-hepatectomy survival were estrogen/progesteron receptor (ER/PR) status (p=0.002), node involvement of the primary tumor (p=0.049), size (p=0.005) and number (p=0.006) of the metastatic lesions. The 1-, 3- and 5-year survival rates after curative liver resection were 93.02%, 74.42%, 58.14%, respectively. BCLM resection is a safe procedure and offers survival benefit, especially in patients with reduced liver metastatic burden (solitary metastases, diameter of the metastases <5 cm) and positive ER/PR status. Copyright© 2014 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.
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Observation of entanglement between a quantum dot spin and a single photon.
Gao, W B; Fallahi, P; Togan, E; Miguel-Sanchez, J; Imamoglu, A
2012-11-15
Entanglement has a central role in fundamental tests of quantum mechanics as well as in the burgeoning field of quantum information processing. Particularly in the context of quantum networks and communication, a main challenge is the efficient generation of entanglement between stationary (spin) and propagating (photon) quantum bits. Here we report the observation of quantum entanglement between a semiconductor quantum dot spin and the colour of a propagating optical photon. The demonstration of entanglement relies on the use of fast, single-photon detection, which allows us to project the photon into a superposition of red and blue frequency components. Our results extend the previous demonstrations of single-spin/single-photon entanglement in trapped ions, neutral atoms and nitrogen-vacancy centres to the domain of artificial atoms in semiconductor nanostructures that allow for on-chip integration of electronic and photonic elements. As a result of its fast optical transitions and favourable selection rules, the scheme we implement could in principle generate nearly deterministic entangled spin-photon pairs at a rate determined ultimately by the high spontaneous emission rate. Our observation constitutes a first step towards implementation of a quantum network with nodes consisting of semiconductor spin quantum bits.
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Addressing underutilization of consumer health information resource centers: a formative study*
Kennedy, May G.; Kiken, Laura; Shipman, Jean P.
2008-01-01
Problem: Four consumer health information centers in Richmond, Virginia, provide one-on-one assistance in accessing health information. Because they may not be fully utilized at present, an exploratory marketing study of factors affecting usage of the centers was conducted. Method: Observers counted center passers-by and tracked their paths. Also, brief intercept interviews were conducted with people who had just used a center, people nearby who could have used one but did not, and people on the street. Finally, in-depth individual interviews were conducted with key informants. Results: There was a high degree of satisfaction with the centers among users. Nonusers universally endorsed the center concept. However, most passers-by did not even glance at the centers, and intercept interviewees suggested better signage and promoting the resource centers through various media channels. Key informants added suggestions about interpersonal strategies (e.g., physician referrals) for center usage promotion but cautioned that a large increase in traffic could not be accommodated without increasing staff size or shifting from a model of individualized service. Conclusions: Triangulating findings from multiple data collection methods can provide useful guidance for efforts to promote center utilization. At minimum, steps should be taken to make the largest centers more noticeable. Because center utilization is not only associated with consumer satisfaction with hospitals, but may also foster health literacy, both hospital-based and community-based usage promotion strategies may be warranted. All such promotional strategies should be audience-tested before they are adopted. PMID:18219380
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Real-time single-molecule observations of proteins at the solid-liquid interface
NASA Astrophysics Data System (ADS)
Langdon, Blake Brianna
Non-specific protein adsorption to solid surfaces is pervasive and observed across a broad spectrum of applications including biomaterials, separations, pharmaceuticals, and biosensing. Despite great interest in and considerable literature dedicated to the phenomena, a mechanistic understanding of this complex phenomena is lacking and remains controversial, partially due to the limits of ensemble-averaging techniques used to study it. Single-molecule tracking (SMT) methods allow us to study distinct protein dynamics (e.g. adsorption, desorption, diffusion, and intermolecular associations) on a molecule-by-molecule basis revealing the protein population and spatial heterogeneity inherent in protein interfacial behavior. By employing single-molecule total internal reflection fluorescence microscopy (SM-TIRFM), we have developed SMT methods to directly observe protein interfacial dynamics at the solid-liquid interface to build a better mechanistic understanding of protein adsorption. First, we examined the effects of surface chemistry (e.g. hydrophobicity, hydrogen-bonding capacity), temperature, and electrostatics on isolated protein desorption and interfacial diffusion for fibrinogen (Fg) and bovine serum albumin (BSA). Next, we directly and indirectly probed the effects of protein-protein interactions on interfacial desorption, diffusion, aggregation, and surface spatial heterogeneity on model and polymeric thin films. These studies provided many useful insights into interfacial protein dynamics including the following observations. First, protein adsorption was reversible, with the majority of proteins desorbing from all surface chemistries within seconds. Isolated protein-surface interactions were relatively weak on both hydrophobic and hydrophilic surfaces (apparent desorption activation energies of only a few kBT). However, proteins could dynamically and reversibly associate at the interface, and these interfacial associations led to proteins remaining on the
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Liver transplantation utilizing old donor organs: a German single-center experience.
Rauchfuss, F; Voigt, R; Dittmar, Y; Heise, M; Settmacher, U
2010-01-01
Due to the current profound lack of suitable donor organs, transplant centers are increasingly forced to accept so-called marginal organs. One criterion for marginal donors is the donor age >65 years. We have presented herein the impact of higher donor age on graft and patient survival. Since 2004, 230 liver transplantations have been performed at our center, including 54 donor organs (23.5%) from individuals >65 years of age. We performed a retrospective analysis of recipient and graft survivals. The overall 1-year mortality was 22.2% (12/54) among recipients of organs from older donors versus 19.5% among recipients whose donors were <65 years. When donor organs were grouped according to age, the 1-year mortality in patients receiving organs from donors aged 65-69 years was 30% (6/20); 70-74 years, 29.4% (5/17); and donors >75 years, 5.9% (1/17). There was no significant correlation between mortality rate and the number of additional criteria of a marginal donor organ. The current lack of donor organs forces transplant centers to accept organs from older individuals; increasingly older patients are being recruited for the donor pool. Our results showed that older organs may be transplanted with acceptable outcomes. This observation was consistent with data from the current literature. It should be emphasized, however, that caution is advised when considering the acceptance of older organs for patients with hepatitis C-related cirrhosis.
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NASA Astrophysics Data System (ADS)
Kim, Moonyong; Chen, Daniel; Abbott, Malcolm; Nampalli, Nitin; Wenham, Stuart; Stefani, Bruno; Hallam, Brett
2018-04-01
We explore the influence of interstitial iron (Fei) on lifetime spectroscopy of boron-oxygen (B-O) related degradation in p-type Czochralski silicon. Theoretical and experimental evidence presented in this study indicate that iron-boron pair (Fe-B) related reactions could have influenced several key experimental results used to derive theories on the fundamental properties of the B-O defect. Firstly, the presence of Fei can account for higher apparent capture cross-section ratios (k) of approximately 100 observed in previous studies during early stages of B-O related degradation. Secondly, the association of Fe-B pairs can explain the initial stage of a two-stage recovery of carrier lifetime with dark annealing after partial degradation. Thirdly, Fei can result in high apparent k values after the permanent deactivation of B-O defects. Subsequently, we show that a single k value can describe the recombination properties associated with B-O defects throughout degradation, that the recovery during dark annealing occurs with a single-stage, and both the fast- and slow-stage B-O related degradation can be permanently deactivated during illuminated annealing. Accounting for the recombination activity of Fei provides further evidence that the B-O defect is a single defect, rather than two separate defects normally attributed to fast-forming recombination centers and slow-forming recombination centers. Implications of this finding for the nature of the B-O defect are also discussed.
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Sekine, Ryojun; Aoki, Hiroyuki; Ito, Shinzaburo
2009-05-21
The localization and orientation of the symmetric diblock copolymer chain in a quasi-two-dimensional microphase-separated structure were studied by scanning near-field optical microscopy (SNOM). In the monolayer of poly(isobutyl methacrylate)-block-poly(octadecyl methacrylate) (PiBMA-b-PODMA), the individual PiBMA subchains were directly observed by SNOM, and the center of mass (CM) and orientational angle relative to the phase interface were examined at the single chain level. It was found that the position of the CM and the orientation of the PiBMA subchain in the lamellar structure were dependent on the curvature of the PiBMA/PODMA interface. As the interface was bent toward the objective chain, the block chain preferred the CM position closer to the domain center, and the conformation was strongly oriented perpendicularly to the domain interface. With increase of the curvature, the steric hindrance among the block chain increases, resulting in the stretched conformation.
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Laparoscopic treatment for esophageal achalasia: experience at a single center.
Agrusa, A; Romano, G; Bonventre, S; Salamone, G; Cocorullo, G; Gulotta, G
2013-01-01
Achalasia is a not frequent esophageal disorder characterized by the absence of esophageal peristalsis and incomplete relaxation of the lower esophageal sphincter (LES). Its cause is unknown. The aim of treatment is to improve the symptoms. We report the results of the treatment of this condition achieved in one center. We conducted a retrospective study of patients with esophageal achalasia. In the period 2010-2012 we observed 64 patients, of whom 19 were referred for medical treatment. Three of the remaining patients underwent botulinum toxin injection, 17 underwent multiple endoscopic dilation procedures and 25 underwent laparoscopic surgery. There were no complications in the group undergoing endoscopic therapy, but symptom remission was only temporary. Patients undergoing surgery showed a significant improvement in symptoms and no recurrence throughout the follow-up period, that is still ongoing (3 years). There were no major complications in any case and no morbidity or mortality. Surgical treatment of esophageal achalasia with laparoscopic Heller myotomy and Dor fundoplication gives the best and longest-lasting results in suitably selected patients. The extension of the myotomy and reduction in LES pressure are the most important parameters to achieve a good result.
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Strongly Cavity-Enhanced Spontaneous Emission from Silicon-Vacancy Centers in Diamond
Zhang, Jingyuan Linda; Sun, Shuo; Burek, Michael J.; ...
2018-01-29
Quantum emitters are an integral component for a broad range of quantum technologies, including quantum communication, quantum repeaters, and linear optical quantum computation. Solid-state color centers are promising candidates for scalable quantum optics due to their long coherence time and small inhomogeneous broadening. However, once excited, color centers often decay through phonon-assisted processes, limiting the efficiency of single-photon generation and photon-mediated entanglement generation. Herein, we demonstrate strong enhancement of spontaneous emission rate of a single silicon-vacancy center in diamond embedded within a monolithic optical cavity, reaching a regime in which the excited-state lifetime is dominated by spontaneous emission into themore » cavity mode. We observe 10-fold lifetime reduction and 42-fold enhancement in emission intensity when the cavity is tuned into resonance with the optical transition of a single silicon-vacancy center, corresponding to 90% of the excited-state energy decay occurring through spontaneous emission into the cavity mode. Here, we also demonstrate the largest coupling strength ( g/2π = 4.9 ± 0.3 GHz) and cooperativity ( C = 1.4) to date for color-center-based cavity quantum electrodynamics systems, bringing the system closer to the strong coupling regime.« less
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Strongly Cavity-Enhanced Spontaneous Emission from Silicon-Vacancy Centers in Diamond
DOE Office of Scientific and Technical Information (OSTI.GOV)
Zhang, Jingyuan Linda; Sun, Shuo; Burek, Michael J.
Quantum emitters are an integral component for a broad range of quantum technologies, including quantum communication, quantum repeaters, and linear optical quantum computation. Solid-state color centers are promising candidates for scalable quantum optics due to their long coherence time and small inhomogeneous broadening. However, once excited, color centers often decay through phonon-assisted processes, limiting the efficiency of single-photon generation and photon-mediated entanglement generation. Herein, we demonstrate strong enhancement of spontaneous emission rate of a single silicon-vacancy center in diamond embedded within a monolithic optical cavity, reaching a regime in which the excited-state lifetime is dominated by spontaneous emission into themore » cavity mode. We observe 10-fold lifetime reduction and 42-fold enhancement in emission intensity when the cavity is tuned into resonance with the optical transition of a single silicon-vacancy center, corresponding to 90% of the excited-state energy decay occurring through spontaneous emission into the cavity mode. Here, we also demonstrate the largest coupling strength ( g/2π = 4.9 ± 0.3 GHz) and cooperativity ( C = 1.4) to date for color-center-based cavity quantum electrodynamics systems, bringing the system closer to the strong coupling regime.« less
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Park, Tae Hyun; Lee, Dae-Yeol
2016-01-01
We examined the clinical and laboratory characteristics of children newly diagnosed with diabetes mellitus (DM) in a single-center study. We retrospectively reviewed the data of 155 children with DM between January 2000 and December 2013. Of 155 diabetic children, 87 (56.1%) were diagnosed with type 1 DM (T1DM) and 68 (43.9%) with type 2 DM (T2DM). Mean ages at diagnosis were 8.95±3.89 years (T1DM) and 13.76±2.23 years (T2DM), respectively (p<0.001). There were significant differences in HbA1c, C-peptide, and glutamic acid decarboxylase antibody levels between the T1DM and T2DM groups. Annual numbers of children with DM have increased, and since 2011 the number of children with T2DM has surpassed the number with T1DM. The most common clinical symptom in T1DM was polyuria, and 26.4% of children with T1DM presented initially with diabetic ketoacidosis. In contrast, 60.3% of T2DM children showed glucosuria in a school urine screening, and only 19.1% presented with polydipsia. The rate of positivity for at least more than one islet autoantibody was 77.1% in T1DM and 26.3% in T2DM. Serum C-peptide levels in T2DM were increased up to 12 months after onset and remained >3.59 ng/mL for 36 months. However, serum C-peptide levels in T1DM were slightly increased up to 6 months after onset and gradually decreased to 0.32 ng/mL for 36 months. The prevalence of children with DM has increased over the last 14 years, and the proportion of T2DM patients has rapidly increased since 2009. Because childhood DM is associated with several metabolic and cardiovascular complications, children should be screened for early detection of DM, especially asymptomatic T2DM in children and adolescents. PMID:26866002
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Ghafur, Abdul; Devarajan, Vidyalakshmi; Raja, T; Easow, Jose; Raja, M A; Sreenivas, Sankar; Ramakrishnan, Balasubramaniam; Raman, S G; Devaprasad, Dedeepiya; Venkatachalam, Balaji; Nimmagadda, Ramesh
2017-12-01
Superiority of colistin-carbapenem combination therapy (CCCT) over colistin monotherapy (CMT) against carbapenem-resistant Gram-negative bacterial (CRGNB) infections is not conclusively proven. The aim of the current study was to analyze the effectiveness of both strategies against CRGNB nonbacteremic infections. This was a retrospective observational cohort study. Case record analysis of patients who had CRGNB nonbacteremic infections identified over a period of 4 years (January 2012-December 2015) was done by medical record review at a tertiary care center in India. P < 0.05 was considered as significant. Multivariate analysis was performed using Cox regression. Out of 153 patients (pneumonia 115, urinary tract infection 17, complicated skin and soft-tissue infection 18, intra-abdominal infection 1, and meningitis 2), 92 patients received CCCT and 61 received CMT. Univariate analysis revealed higher Acute Physiology and Chronic Health Evaluation II (APACHE II) score, pneumonia as the diagnosis, and Klebsiella as the causative organism to be the risk factors for higher 28-day mortality ( P = 0.036, 0.006, 0.016, respectively). Combination therapy had no significant impact on mortality (odds ratio [OR] = 0.91, 95% confidence interval [CI] = 0.327-2.535, P = 0.857). Multivariate analysis revealed that higher APACHE II score and infection due to Klebsiella were found to be independent risk factors for higher mortality (OR = 3.16 and 4.9, 95% CI = 1.34-7.4 and 2.19-11.2, P = 0.008 and 0.0001, respectively). In our retrospective single-center series of CRGNB nonbacteremic infections, CCCT was not superior to CMT. Multicenter large observational studies or prospective randomized clinical trials are the need of the hour.
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Dislocation Multiplication by Single Cross Slip for FCC at Submicron Scales
NASA Astrophysics Data System (ADS)
Cui, Yi-Nan; Liu, Zhan-Li; Zhuang, Zhuo
2013-04-01
The operation mechanism of single cross slip multiplication (SCSM) is investigated by studying the response of one dislocation loop expanding in face-centered-cubic (FCC) single crystal using three-dimensional discrete dislocation dynamic (3D-DDD) simulation. The results show that SCSM can trigger highly correlated dislocation generation in a short time, which may shed some light on understanding the large strain burst observed experimentally. Furthermore, we find that there is a critical stress and material size for the operation of SCSM, which agrees with that required to trigger large strain burst in the compression tests of FCC micropillars.
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The Chandra Source Catalog 2.0: the Galactic center region
NASA Astrophysics Data System (ADS)
Civano, Francesca Maria; Allen, Christopher E.; Anderson, Craig S.; Budynkiewicz, Jamie A.; Burke, Douglas; Chen, Judy C.; D'Abrusco, Raffaele; Doe, Stephen M.; Evans, Ian N.; Evans, Janet D.; Fabbiano, Giuseppina; Gibbs, Danny G., II; Glotfelty, Kenny J.; Graessle, Dale E.; Grier, John D.; Hain, Roger; Hall, Diane M.; Harbo, Peter N.; Houck, John C.; Lauer, Jennifer L.; Laurino, Omar; Lee, Nicholas P.; Martínez-Galarza, Juan Rafael; McCollough, Michael L.; McDowell, Jonathan C.; Miller, Joseph; McLaughlin, Warren; Morgan, Douglas L.; Mossman, Amy E.; Nguyen, Dan T.; Nichols, Joy S.; Nowak, Michael A.; Paxson, Charles; Plummer, David A.; Primini, Francis Anthony; Rots, Arnold H.; Siemiginowska, Aneta; Sundheim, Beth A.; Tibbetts, Michael; Van Stone, David W.; Zografou, Panagoula
2018-01-01
The second release of the Chandra Source Catalog (CSC 2.0) comprises all the 10,382 ACIS and HRC-I imaging observations taken by Chandra and released publicly through the end of 2014. Among these, 534 single observations surrounding the Galactic center are included, covering a total area of ~19deg2 and a total exposure time of ~9 Ms.The single 534 observations were merged into 379 stacks (overlapping observations with aim-points within 60") to increase the flux limit for source detection purposes.Thanks to the combination of the point source detection algorithm with the maximum likelihood technique used to asses the source significance, ~21,000 detections are listed in the CSC 2.0 for this field only, 80% of which are unique sources. The central region of this field around the SgrA* location has the deepest exposure of 2.2 Ms and the highest source density with ~5000 sources. In this poster, we present details about this region including source distribution and density, coverage, exposure.This work has been supported by NASA under contract NAS 8-03060 to the Smithsonian Astrophysical Observatory for operation of the ChandraX-ray Center.
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Pedraza, Dixis Figueroa; de Menezes, Tarciana Nobre
2016-01-01
Abstract Objective: To obtain an overview of available information on the anthropometric assessment of Brazilian children attending daycare centers. Data source: A literature search was carried out in the PubMed, LILACS and SciELO databases of studies published from 1990 to 2013 in Portuguese and English languages. The following search strategy was used: (nutritional status OR anthropometrics OR malnutrition OR overweight) AND daycare centers, as well as the equivalent terms in Portuguese. In the case of MEDLINE search, the descriptor Brazil was also used. Data synthesis: It was verified that the 33 studies included in the review were comparable from a methodological point of view. The studies, in general, were characterized by their restrictive nature, geographical concentration and dispersion of results in relation to time. Considering the studies published from 2010 onwards, low prevalence of acute malnutrition and significant rates of stunting and overweight were observed. Conclusions: Despite the limitations, considering the most recent studies that used the WHO growth curves (2006), it is suggested that the anthropometric profile of Brazilian children attending daycare centers is characterized by a nutritional transition process, with significant prevalence of overweight and short stature. We emphasize the need to develop a multicenter survey that will more accurately define the current anthropometric nutritional status of Brazilian children attending daycare centers. PMID:26553574
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Multiple-photon excitation of nitrogen vacancy centers in diamond
NASA Astrophysics Data System (ADS)
Ji, Peng; Balili, R.; Beaumariage, J.; Mukherjee, S.; Snoke, D.; Dutt, M. V. Gurudev
2018-04-01
We report the observation of multiphoton photoluminescence excitation (PLE) below the resonant energies of nitrogen vacancy (NV) centers in diamond. The quadratic and cubic dependence of the integrated fluorescence intensity as a function of excitation power indicates a two-photon excitation pathway for the NV- charge state and a three-photon process involved for the neutral NV0 charge state, respectively. Comparing the total multiphoton energy with its single-photon equivalent, the PLE spectra follows the absorption spectrum of single photon excitation. We also observed that the efficiency of photoluminescence for different charge states, as well as the decay time constant, was dependent on the excitation wavelength and power.
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Surgical treatment of rib fracture nonunion: A single center experience.
de Jong, M B; Houwert, R M; van Heerde, S; de Steenwinkel, M; Hietbrink, F; Leenen, L P H
2018-03-01
In contrast to the emerging evidence on the operative treatment of flail chest, there is a paucity of literature on the surgical treatment of rib fracture nonunion. The purpose of this study was to describe our standardized approach and report the outcome (e.g. patient satisfaction, pain and complications) after surgical treatment of a rib fracture nonunion. A single centre retrospective cohort study was performed at a level 1 trauma centre. Symptomatic rib nonunion was defined as a severe persistent localized pain associated with the nonunion of one or more rib fractures on a chest CT scan at least 3 months after the initial trauma. Patients after initial operative treatment of rib fractures were excluded. Nineteen patients (11 men, 8 women), with symptomatic nonunions were included. Fourteen patients were referred from other hospitals and 8 patients received treatment from a pain medicine specialist. The mean follow-up was 36 months. No in-hospital complications were observed. In 2 patients, new fractures adjacent to the implant, without new trauma were observed. Furthermore 3 patients requested implant removal with a persistent nonunion in one patient. There was a mean follow-up of 36 months, the majority of patients (n = 13) were satisfied with the results of their surgical treatment and all patients experienced a reduction in the number of complaints. Persisting pain was a common complaint. Three patients reporting severe pain used opioid analgesics on a daily or weekly basis. Only 1 patient needed ongoing treatment by a pain medicine specialist. Surgical fixation of symptomatic rib nonunion is a safe and feasible procedure, with a low perioperative complication rate, and might be beneficial in selected symptomatic patients in the future. In our study, although the majority of patients were satisfied and the pain level subjectively decreases, complaints of persistent pain were common. Copyright © 2018 Elsevier Ltd. All rights reserved.
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Grochowiecki, T; Jakimowicz, T; Grabowska-Derlatka, L; Szmidt, J
2014-10-01
The high rate of complication after pancreas transplantation not only had an impact on recipient quality of life and survival but also had significant financial implications. Thus, monitoring transplant center performance was crucial to indentifying changes in clinical practice that result in quality deterioration. To evaluate retrospectively the quality of the single, small pancreatic transplant program and to establish prospective monitoring of the center using risk-adjusted cumulative sum (CUSUM). From 1988 to 2014, 119 simultaneous pancreas and the kidney transplantations (SPKTx) were performed. The program was divided into 3 eras, based on surgical technique and immunosuppression. Analyses of the 15 fatal outcomes due to complication from pancreatic graft were performed. The risk model was developed using multivariable logistic regression analysis based on retrospective data of 112 SPKTx recipients. The risk-adjusted 1-sided CUSUM chart was plotted for retrospective and prospective events. The upper control limit was set to 2. There were 2 main causes of death: multiorgan failure (73.3%; 11/15) and septic hemorrhage (26.7%; 4/15). Quality analysis using the CUSUM chart revealed that the process was not homogeneous; however, no significant signal of program deterioration was obtained and the performance of the whole program was within the settled control limit. For a single pancreatic transplant center. The risk-adjusted CUSUM chart was a useful tool for quality program assessment. It could support decision making during traditional surgical morbidity and mortality conferences. For small transplant centers, increasing the sensitivity of the CUSUM method by lowering the upper control limit should be considered. However, an individual assessment approach of the for particular centers is recommended.
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Kataoka, Yuki; Ikegaki, Shunkichi; Saito, Emiko; Matsumoto, Hirotaka; Kaku, Sawako; Shimada, Masatoshi; Hirabayashi, Masataka
2017-01-01
In this study, we aimed to examine the clinical value of the pleural effusion (PE) biomarkers, soluble mesothelin-related peptide (SMRP), cytokeratin 19 fragment (CYFRA 21–1) and carcinoembryonic antigen (CEA), and the utility of combining chest computed tomography (CT) findings with these biomarkers, in diagnosing malignant pleural mesothelioma (MPM). We conducted a retrospective cohort study in a single center. Consecutive patients with undiagnosed pleural effusions who underwent PE analysis between September 2014 and August 2016 were reviewed. This study included 240 patients (32 with MPM and 208 non-MPM). SMRP and the CYFRA 21-1/CEA ratio had a sensitivity and specificity for diagnosing MPM of 56.3% and 86.5%, and 87.5% and 74.0%, respectively. Using receiver operating characteristics (ROC) curve analysis of the ability of these markers to distinguish MPM from all other PE causes, the area under the ROC curve (AUC) for SMRP and the CYFRA 21-1/CEA ratio was 0.804 and 0.874, respectively. The sensitivity and specificity of SMRP combined with the CYFRA 21-1/CEA ratio were 93.8% and 64.9%, respectively. The sensitivity of the combination of SMRP, the CYFRA 21-1/CEA ratio, and the presence of Leung’s criteria (a chest CT finding that is suggestive of malignant pleural disease) was 93.8%. In conclusion, the combined PE biomarkers had a high sensitivity for diagnosing MPM, although the addition of chest CT findings did not improve the sensitivity of SMRP combined with the CYFRA 21-1/CEA ratio. Combination of these biomarkers helped to rule out MPM effectively among patients at high risk of suffering MPM and would be valuable especially for old frail patients who have difficulty in undergoing invasive procedures such as thoracoscopy. PMID:28968445
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Otoshi, Takehiro; Kataoka, Yuki; Ikegaki, Shunkichi; Saito, Emiko; Matsumoto, Hirotaka; Kaku, Sawako; Shimada, Masatoshi; Hirabayashi, Masataka
2017-01-01
In this study, we aimed to examine the clinical value of the pleural effusion (PE) biomarkers, soluble mesothelin-related peptide (SMRP), cytokeratin 19 fragment (CYFRA 21-1) and carcinoembryonic antigen (CEA), and the utility of combining chest computed tomography (CT) findings with these biomarkers, in diagnosing malignant pleural mesothelioma (MPM). We conducted a retrospective cohort study in a single center. Consecutive patients with undiagnosed pleural effusions who underwent PE analysis between September 2014 and August 2016 were reviewed. This study included 240 patients (32 with MPM and 208 non-MPM). SMRP and the CYFRA 21-1/CEA ratio had a sensitivity and specificity for diagnosing MPM of 56.3% and 86.5%, and 87.5% and 74.0%, respectively. Using receiver operating characteristics (ROC) curve analysis of the ability of these markers to distinguish MPM from all other PE causes, the area under the ROC curve (AUC) for SMRP and the CYFRA 21-1/CEA ratio was 0.804 and 0.874, respectively. The sensitivity and specificity of SMRP combined with the CYFRA 21-1/CEA ratio were 93.8% and 64.9%, respectively. The sensitivity of the combination of SMRP, the CYFRA 21-1/CEA ratio, and the presence of Leung's criteria (a chest CT finding that is suggestive of malignant pleural disease) was 93.8%. In conclusion, the combined PE biomarkers had a high sensitivity for diagnosing MPM, although the addition of chest CT findings did not improve the sensitivity of SMRP combined with the CYFRA 21-1/CEA ratio. Combination of these biomarkers helped to rule out MPM effectively among patients at high risk of suffering MPM and would be valuable especially for old frail patients who have difficulty in undergoing invasive procedures such as thoracoscopy.
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Al Balushi, Ahmed A.; Zehtabi-Oskuie, Ana; Gordon, Reuven
2013-01-01
We experimentally demonstrate protein binding at the single particle level. A double nanohole (DNH) optical trap was used to hold onto a 20 nm biotin-coated polystyrene (PS) particle which subsequently is bound to streptavidin. Biotin-streptavidin binding has been detected by an increase in the optical transmission through the DNH. Similar optical transmission behavior was not observed when streptavidin binding sites where blocked by mixing streptavidin with excess biotin. Furthermore, interaction of non-functionalized PS particles with streptavidin did not induce a change in the optical transmission through the DNH. These results are promising as the DNH trap can make an excellent single molecule resolution sensor which would enable studying biomolecular interactions and dynamics at a single particle/molecule level. PMID:24049672
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Shi, Jun; Chang, Hong; Zhang, Li; Shao, Yinqi; Nie, Neng; Zhang, Jing; Huang, Jinbo; Zhang, Li; Tang, Xudong; Quan, Richeng; Zheng, Chunmei; Xiao, Haiyan; Hu, Dengming; Hu, Lingyan; Liu, Feng; Zhou, Yongming; Zheng, Yizhou; Zhang, Fengkui
2016-01-01
To explore the efficacy and safety of deferasirox in aplastic anemia (AA)patients with iron overload. A single arm, multi- center, prospective, open- label study was conducted to evaluate absolute change in serum ferritin (SF)from baseline to 12 months of deferasirox administration, initially at a dose of 20 mg·kg(-1)·d(-1), and the safety in 64 AA patients with iron overload. All patients started their deferasirox treatment with a daily dose of 20 mg · kg(-1) ·d(-1). The mean actual dose was (18.6±3.60) mg · kg(-1)·d(-1). The median SF decreased from 4 924 (2 718- 6 765)μg/L at baseline (n=64) to 3 036 (1 474- 5 551)μg/L at 12 months (n=23) with the percentage change from baseline as 38%. A median SF decrease of 651 (126-2 125)μg/L was observed at the end of study in 23 patients who completed 12 months' treatment, the median SF level decreased by 1 167(580-4 806)μg/L [5 271(3 420-8 278)μg/L at baseline; 3 036(1 474-5 551)μg/L after 12 months' treatment; the percentage change from baseline as 42% ] after 12 months of deferasirox treatment. The most common adverse events (AEs) were increased serum creatinine levels (40.98%), gastrointestinal discomfort (40.98%), elevated liver transaminase (ALT: 21.31%; AST: 13.11%)and proteinuria (24.59%). The increased serum creatinine levels were reversible and non-progressive. Of 38 patients with concomitant cyclosporine use, 12(31.8%)patients had two consecutive values >ULN, 10(26.3%)patients had two consecutive values >1.33 baseline values, but only 1(2.6%)patient's serum creatinine increased more than 1.33 baseline values and exceeded ULN. For both AST and ALT, no patients experienced two post- baseline values >5 ×ULN or >10 × ULN during the whole study. In AA patients with low baseline PLT count (less than 50 × 10(9)/L), there was no decrease for median PLT level during 12 months' treatment period. AA patients with iron overload could achieve satisfactory efficacy of iron chelation by deferasirox treatment
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Beyond Gaussians: a study of single spot modeling for scanning proton dose calculation
Li, Yupeng; Zhu, Ronald X.; Sahoo, Narayan; Anand, Aman; Zhang, Xiaodong
2013-01-01
Active spot scanning proton therapy is becoming increasingly adopted by proton therapy centers worldwide. Unlike passive-scattering proton therapy, active spot scanning proton therapy, especially intensity-modulated proton therapy, requires proper modeling of each scanning spot to ensure accurate computation of the total dose distribution contributed from a large number of spots. During commissioning of the spot scanning gantry at the Proton Therapy Center in Houston, it was observed that the long-range scattering protons in a medium may have been inadequately modeled for high-energy beams by a commercial treatment planning system, which could lead to incorrect prediction of field-size effects on dose output. In the present study, we developed a pencil-beam algorithm for scanning-proton dose calculation by focusing on properly modeling individual scanning spots. All modeling parameters required by the pencil-beam algorithm can be generated based solely on a few sets of measured data. We demonstrated that low-dose halos in single-spot profiles in the medium could be adequately modeled with the addition of a modified Cauchy-Lorentz distribution function to a double-Gaussian function. The field-size effects were accurately computed at all depths and field sizes for all energies, and good dose accuracy was also achieved for patient dose verification. The implementation of the proposed pencil beam algorithm also enabled us to study the importance of different modeling components and parameters at various beam energies. The results of this study may be helpful in improving dose calculation accuracy and simplifying beam commissioning and treatment planning processes for spot scanning proton therapy. PMID:22297324
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Real-space and real-time observation of a plasmon-induced chemical reaction of a single molecule.
Kazuma, Emiko; Jung, Jaehoon; Ueba, Hiromu; Trenary, Michael; Kim, Yousoo
2018-05-04
Plasmon-induced chemical reactions of molecules adsorbed on metal nanostructures are attracting increased attention for photocatalytic reactions. However, the mechanism remains controversial because of the difficulty of direct observation of the chemical reactions in the plasmonic field, which is strongly localized near the metal surface. We used a scanning tunneling microscope (STM) to achieve real-space and real-time observation of a plasmon-induced chemical reaction at the single-molecule level. A single dimethyl disulfide molecule on silver and copper surfaces was dissociated by the optically excited plasmon at the STM junction. The STM study combined with theoretical calculations shows that this plasmon-induced chemical reaction occurred by a direct intramolecular excitation mechanism. Copyright © 2018 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.
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Yamada, Shozo; Fukuhara, Noriaki; Horiguchi, Kentaro; Yamaguchi-Okada, Mitsuo; Nishioka, Hiroshi; Takeshita, Akira; Takeuchi, Yasuhiro; Ito, Junko; Inoshita, Naoko
2014-12-01
The aim of this study was to analyze clinicopathological characteristics and treatment outcomes in a large single-center clinical series of cases of thyrotropin (TSH)-secreting pituitary adenomas. The authors retrospectively reviewed clinical, pathological, and treatment characteristics of 90 consecutive cases of TSH-secreting pituitary adenomas treated with transsphenoidal surgery between December 1991 and May 2013. The patient group included 47 females and 43 males (median age 42 years, range 11-74 years). Sixteen tumors (18%) were microadenomas and 74 (82%) were macroadenomas. Microadenomas were significantly more frequent in the more recent half of our case series (12 of 45 cases) (p = 0.0274). Cavernous sinus invasion was confirmed in 21 patients (23%). In 67 cases (74%), the tumors were firm elastic or hard in consistency. Acromegaly and hyperprolactinemia were observed, respectively, in 14 (16%) and 11 (12%) of the 90 cases. Euthyroidism was achieved in 40 (83%) of 48 patients and tumor shrinkage was found in 24 (55%) of 44 patients following preoperative somatostatin analog treatment. Conventional transsphenoidal surgery, extended transsphenoidal surgery, and a simultaneous combined supra- and infrasellar approach were performed in 85, 2, and 3 patients, respectively. Total removal with endocrinological remission was achieved in 76 (84%) of 90 patients, including all 16 (100%) patients with microadenomas, 60 (81%) of the 74 with macroadenomas, and 8 (38%) of the 21 with cavernous sinus invasion. None of these 76 patients experienced tumor recurrence during a median follow-up period of 2.8 years. Stratifying by Knosp grade, total removal with endocrinological remission was achieved in 34 of 36 patients with Knosp Grade 0 tumors, all 24 of those with Grade 1 tumors, 12 of the 14 with Grade 2 tumors, 6 of the 8 with Grade 3 tumors, and none of the 8 with Grade 4 tumors. Cavernous sinus invasion and tumor size were significant independent predictors of surgical
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NASA Astrophysics Data System (ADS)
Osipov, V. Yu.; Shames, A. I.; Efimov, N. N.; Shakhov, F. M.; Kidalov, S. V.; Minin, V. V.; Vul', A. Ya.
2018-04-01
The electron paramagnetic resonance (EPR) spectra of triplet centers in detonation nanodiamonds (DNDs) and diamond single crystals of submicrometer size, synthesized from those DNDs at high pressures and temperatures, are studied. In the EPR spectra of DNDs, signals from negatively charged nitrogen- vacancy centers (NV)/sup(-) with a g factor of g 1 = 4.24 and multivacancies with g 2 = 4.00 are observed. The signals from (NV)/sup(-) centers disappear in the spectra of diamond single crystals, and a quintet signal with g = 4.00 is detected at the position of the signal from multivacancies. Analysis of the shape and position of the quintet' lines showed that this ESR signal is due to the pairs of nitrogen substitution centers in diamond, separated from each other by distances not exceeding 0.7 nm, between which a strong exchange interaction takes place. A comparison of the experimental data and the simulation results allows determining the spin-Hamiltonian parameters of the exchange-coupled pairs of paramagnetic impurity nitrogen atoms.
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de Tommaso, Marina; Sciruicchio, Vittorio; Delussi, Marianna; Vecchio, Eleonora; Goffredo, Marvita; Simeone, Michele; Barbaro, Maria Grazia Foschino
2017-12-01
Central sensitization is an important epiphenomenon of the adult migraine, clinically expressed by allodynia, pericranial tenderness and comorbidity for fibromyalgia in a relevant number of patients. This study aimed to evaluate the frequency and the clinical characteristics of allodynia, pericranial tenderness, and comorbidity for Juvenile Fibromialgia (JFM) in a cohort of migraine children selected in a tertiary headache center. This was an observational cross-sectional study on 8-15 years old migraine patients. Allodynia was assessed by a questionnaire. Pericranial tenderness and comorbidity for JFM as well as their possible association with poor quality of life and migraine related disability, and with other clinical symptoms as anxiety, depression, sleep disorders and pain catastrophizing, were also evaluated. One hundred and fifty one patients were selected, including chronic migraine (n°47), migraine without aura (n° 92) and migraine with aura (n° 12) sufferers. Allodynia was reported in the 96,6% and pericranial tenderness was observed in the 68.8% of patients. Pericranial tenderness was more severe in patients with more frequent migraine and shorter sleep duration. Allodynia seemed associated with anxiety, pain catastrophizing and high disability scores. Comorbidity for JFM was present in the 0.03% ofpatients. These children presented with a severe depression and a significant reduction of quality of life as compared to the other patients. This study outlined a relevant presence of symptoms of central sensitization among children with migraine. Severe allodynia and comorbidity for JFM seemed to cause a general decline of quality of life, which would suggest the opportunity of a routine assessment of these clinical features.
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NASA Astrophysics Data System (ADS)
Li, Wei-bing; Li, Kang; Fan, Kan-qi; Zhang, Da-xing; Wang, Wei-dong
2018-04-01
Atomistic simulations are capable of providing insights into physical mechanisms responsible for mechanical properties of the transition metal of Tantalum (Ta). By using molecular dynamics (MD) method, temperature and pressure dependences of the elastic properties of Ta single crystals are investigated through <100> tensile loading. First of all, a comparative study between two types of embedded-atom method (EAM) potentials is made in term of the elastic properties of Ta single crystals. The results show that Ravelo-EAM (Physical Review B, 2013, 88: 134101) potential behaves well at different hydrostatic pressures. Then, the MD simulation results based on the Ravelo-EAM potential show that Ta will experience a body-centered-cubic (BCC) to face-centered-cubic (FCC) phase transition before fracture under <100> tensile loading at 1 K temperature, and model size and strain rate have no obvious effects on tensile behaviors of Ta. Next, from the simulation results at the system temperature from 1 to 1500 K, it can be derived that the elastic modulus of E 100 linearly decrease with the increasing temperature, while the yielding stress decrease with conforming a quadratic polynomial formula. Finally, the pressure dependence of the elastic properties is performed from 0 to 140 GPa and the observations show that the elastic modulus increases with the increasing pressure overall.
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Salomon, Say; Frankel, Hilary; Chuang, Elizabeth; Eti, Serife; Selwyn, Peter
2018-05-01
Left ventricular assist devices (LVADs) are increasingly used to improve quality of life for end-stage heart failure patients. The Joint Commission now requires preimplantation palliative care assessment; however, many palliative care teams have little experience providing this service. To describe the integration of palliative services at one Center of Excellence for Heart and Vascular Care. This is a retrospective chart review of all patients receiving LVADs at a single urban academic medical center from January 2015 to September 2016. Palliative care needs and services provided are described. Two case presentations illustrate the collaboration between the cardiothoracic and palliative care teams. Fifty one patients were included. Of those, 28 received a palliative care consultation during this roll-out period. The rate of consultation rose from 35% to 71% as workflows improved with institutional commitment. Symptom assessment, psychosocial assessment, and advance care planning (ACP) were always performed (n = 28; 100%). More than half of the patients were evaluated for dyspnea (n = 20; 71%), fatigue (n = 18; 64%), and pain (n = 16; 57%). Consults centered around ACP, and very few patients (n = 7; 25%) required palliative care follow-up. Palliative consultation did not delay LVAD placement. Although palliative care consultants provided initial evaluation and management of multiple symptoms, there was not a large ongoing need. Integration of palliative services into the care of patients receiving LVADs can be incorporated into the workflow of the cardiothoracic and palliative care teams, resulting in improved ACP for all patients receiving LVADs and better care coordination for patients at the end of life. Copyright © 2018 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
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Clinical spectrum of hypopituitarism in India: A single center experience
Gundgurthi, Abhay; Garg, M. K.; Bhardwaj, Reena; Brar, Karninder S.; Kharb, Sandeep; Pandit, Aditi
2012-01-01
Objectives: There is paucity of information regarding clinical profile of hypopituitarism from India. We report the clinical profile of hypopituitarism from a tertiary center in North India. Materials and Methods: This study was carried out in patients attending our endocrine center between January 2010 and December 2011. All new patients were studied prospectively and those registered before January 2010 retrospectively. Relevant clinical, hormonal, and imaging data were collected. Dynamic testing for pituitary functions was carried out as necessary. Hormonal deficiencies were defined as per prevailing recommendations. Results: This study included 113 subjects. The mean age was 38.6 ± 17.8 years (range, 4 – 76 years). There were 78 (69%) males and 35 females (31%). There were 22 subjects aged ≤18 years (childhood and adolescence) and 91 adults (>18 years). Visual disturbances were the most common presenting complaint (33%), though headache was the most common symptom (81%). Fifteen percent presented with pituitary apoplexy. Tumors comprised of 84% of cases. Hypogonadism (97%) was the most common abnormality seen followed by hypothyroidism (83.2%), hypoadrenalism (79.6%), growth hormone deficiency (88.1% of the 42 patients tested), and diabetes insipidus (13.3%). Panhypopituitarism was seen in 104 (92%) patients. There were no cases of hypopituitarism secondary to traumatic brain injury, subarachnoid hemorrhage, central nervous system infections, or cranial irradiation to extrasellar tumors. Conclusion: The most common cause of hypopituitarism at tertiary care center is pituitary tumors and the commonest presenting complaint is visual symptoms. Panhypopituitarism is present in 92% cases. PMID:23087868
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Center determination for trailed sources in astronomical observation images
NASA Astrophysics Data System (ADS)
Du, Jun Ju; Hu, Shao Ming; Chen, Xu; Guo, Di Fu
2014-11-01
Images with trailed sources can be obtained when observing near-Earth objects, such as small astroids, space debris, major planets and their satellites, no matter the telescopes track on sidereal speed or the speed of target. The low centering accuracy of these trailed sources is one of the most important sources of the astrometric uncertainty, but how to determine the central positions of the trailed sources accurately remains a significant challenge to image processing techniques, especially in the study of faint or fast moving objects. According to the conditions of one-meter telescope at Weihai Observatory of Shandong University, moment and point-spread-function (PSF) fitting were chosen to develop the image processing pipeline for space debris. The principles and the implementations of both two methods are introduced in this paper. And some simulated images containing trailed sources are analyzed with each technique. The results show that two methods are comparable to obtain the accurate central positions of trailed sources when the signal to noise (SNR) is high. But moment tends to fail for the objects with low SNR. Compared with moment, PSF fitting seems to be more robust and versatile. However, PSF fitting is quite time-consuming. Therefore, if there are enough bright stars in the field, or the high astronometric accuracy is not necessary, moment is competent. Otherwise, the combination of moment and PSF fitting is recommended.
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ERIC Educational Resources Information Center
McAfee, Dianne Talmadge
Elementary school instructional media centers (IMC's) were studied to determine the presence or absence of six conditions identified as promoting positive self-concept: cooperation, independence, success, positive atmosphere, challenge, and a feeling of value or acceptance. Following a review by a panel of experts of a preliminary observation…
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Confidence Region of Least Squares Solution for Single-Arc Observations
NASA Astrophysics Data System (ADS)
Principe, G.; Armellin, R.; Lewis, H.
2016-09-01
The total number of active satellites, rocket bodies, and debris larger than 10 cm is currently about 20,000. Considering all resident space objects larger than 1 cm this rises to an estimated minimum of 500,000 objects. Latest generation sensor networks will be able to detect small-size objects, producing millions of observations per day. Due to observability constraints it is likely that long gaps between observations will occur for small objects. This requires to determine the space object (SO) orbit and to accurately describe the associated uncertainty when observations are acquired on a single arc. The aim of this work is to revisit the classical least squares method taking advantage of the high order Taylor expansions enabled by differential algebra. In particular, the high order expansion of the residuals with respect to the state is used to implement an arbitrary order least squares solver, avoiding the typical approximations of differential correction methods. In addition, the same expansions are used to accurately characterize the confidence region of the solution, going beyond the classical Gaussian distributions. The properties and performances of the proposed method are discussed using optical observations of objects in LEO, HEO, and GEO.
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"Lies, damned lies ..." and observational studies in comparative effectiveness research.
Albert, Richard K
2013-06-01
A new federal initiative has allocated $1.1 billion to comparative effectiveness research, and many have emphasized the importance of including observational studies in this effort. The rationale for using observational studies to assess comparative effectiveness is based on concerns that randomized controlled trials (RCTs) are not "real world" because they enroll homogeneous patient populations, measure study outcomes that are not important to patients, use protocols that are overly complex, are conducted in specialized centers, and use study treatments that are not consistent with usual care, and that RCTs are not always feasible because of a lack of equipoise, the need to assess delayed endpoints, and concerns that they take years to complete and are expensive. This essay questions the validity of each of these proposed limitations, summarizes concerns raised about the accuracy of results generated by observational studies, provides some examples of discrepancies between results of observational studies and RCTs that pertain to pulmonary and critical care, and suggests that using observational studies for comparative effectiveness research may increase rather than decrease the cost of health care and may harm patients.
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Tanaka, Masaki; Matsumoto, Ippei; Shinzeki, Makoto; Asari, Sadaki; Goto, Tadahiro; Yamashita, Hironori; Ishida, Jun; Ajiki, Tetsuo; Fukumoto, Takumi; Ku, Yonson
2014-08-20
The study aim was to determine the short- and long-term results of surgical drainage procedure for chronic pancreatitis at a single center in Japan. The records of 28 consecutive patients were retrospectively reviewed. All patients underwent surgery at Kobe University Hospital between June 1999 and April 2013. Long-term follow-up was performed in all patients for a median period of 77 months. The 26 men (93%) and 2 women (7%) had a mean age of 47 years. The etiology of pancreatitis was chronic alcohol abuse in 24 patients (86%). The major indication for surgery was persistent symptoms (97%). Modified Frey's procedure in 21 patients, lateral pancreaticojejunostomy (LPJ) in 6 patients, LPJ and distal pancreatectomy in one patient, were performed. There was no postoperative mortality. Postoperative morbidity occurred in 6 patients (21%). The percentage of pain-free patients after surgery was 97%, and further acute exacerbation was prevented in 97%. Two patients (6%) required subsequent surgery for infectious pancreatic cyst and intraabdominal abscess. Of the patients that completed follow-up, 13 (46%) had diabetes mellitus, including 5 patients (19%) with new-onset diabetes, and 6 patients (19%) developed pancreatic exocrine insufficiency. Modified Frey's procedure is safe, feasible, and effective to manage chronic pancreatitis. The technique prevents further exacerbations and maintains appropriate pancreatic endocrine and exocrine function.
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Bouldouyre, Marie-Anne; De Verdière, Nathalie Colin; Pavie, Juliette; De Castro, Nathalie; Ponscarme, Diane; Hamane, Samia; Rachline, Anne; Ferret, Samuel; Molina, Jean-Michel
2012-01-01
The number of international trips undertaken by French citizens is rising and we wished to assess the appropriateness of advices given to travelers in a vaccine and travel medicine center in France. We conducted a 3-month prospective study in one center in Paris where prescriptions and advice to travelers are given by trained physicians in travel medicine who have access to a computerized decision support system (Edisan). A questionnaire was used to record trip characteristics, patients' demographics, and prescriptions. Main outcome measure was the adequacy of prescriptions for malaria prophylaxis, yellow fever, and hepatitis A vaccines to French guidelines. A total of 730 subjects were enrolled in this study, with a median age of 28 years. Travel destinations were sub-Saharan Africa (58%), Asia (21%), and South America (18%). Among the 608 patients (83%) traveling to malaria-endemic areas, malaria prophylaxis was in accordance with guidelines in 578/608 patients (95.1%, 95% CI: 93-96.5), and doxycycline was the regimen of choice (48%). Inappropriate malaria prophylaxis was given to eight patients, one of whom developed plasmodium falciparum malaria. All 413 patients (100%, 95% CI: 99-100) traveling to yellow fever-endemic areas who needed vaccination were correctly vaccinated. However, three patients received yellow fever vaccination without indication. Also, 442 of 454 patients (97.4%, 95% CI: 95.4-98.5) eligible to receive hepatitis A vaccination were immunized. Appropriate advice for malaria prophylaxis, yellow fever, and hepatitis A vaccinations was provided in a travel medicine and vaccine center where trained physicians used a computerized decision support system. Even in this setting, however, errors can occur and professional practices should be regularly assessed to improve health care. © 2012 International Society of Travel Medicine.
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Xiao, X.; Liang, J. H.; Chen, B. L.
2015-07-28
Face-centered-cubic cobalt films are epitaxially grown on insulating LaAlO{sub 3}(001) substrates by molecular beam epitaxy. Transport measurements are conducted in different current directions relative to the crystal axes. We find that the temperature dependent anisotropic magnetoresistance ratio strongly depends on the current direction. However, the anomalous Hall effect shows isotropic behavior independent of the current direction. Our results demonstrate the interplay between the current direction and the crystalline lattice in single-crystalline ferromagnetic films. A phenomenological analysis is presented to interpret the experimental data.
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Schwab, Kristin; Saggar, Rajeev; Duffy, Erin; Elashoff, David; Tseng, Chi-Hong; Weigt, Sam; Charan, Deepshikha; Abtin, Fereidoun; Johannes, Jimmy; Derhovanessian, Ariss; Conklin, Jeffrey; Ghassemi, Kevin; Khanna, Dinesh; Siddiqui, Osama; Ardehali, Abbas; Hunter, Curtis; Kwon, Murray; Biniwale, Reshma; Lo, Michelle; Volkmann, Elizabeth; Torres Barba, David; Belperio, John A.; Mahrer, Thomas; Furst, Daniel E.; Kafaja, Suzanne; Clements, Philip; Shino, Michael; Gregson, Aric; Kubak, Bernard; Lynch, Joseph P.; Ross, David
2016-01-01
Rationale: Consideration of lung transplantation in patients with systemic sclerosis (SSc) remains guarded, often due to the concern for esophageal dysfunction and the associated potential for allograft injury and suboptimal post–lung transplantation outcomes. Objectives: The purpose of this study was to systematically report our single-center experience regarding lung transplantation in the setting of SSc, with a particular focus on esophageal dysfunction. Methods: We retrospectively reviewed all lung transplants at our center from January 1, 2000 through August 31, 2012 (n = 562), comparing the SSc group (n = 35) to the following lung transplant diagnostic subsets: all non-SSc (n = 527), non-SSc diffuse fibrotic lung disease (n = 264), and a non-SSc matched group (n = 109). We evaluated post–lung transplant outcomes, including survival, primary graft dysfunction, acute rejection, bronchiolitis obliterans syndrome, and microbiology of respiratory isolates. In addition, we defined severe esophageal dysfunction using esophageal manometry and esophageal morphometry criteria on the basis of chest computed tomography images. For patients with SSc referred for lung transplant but subsequently denied (n = 36), we queried the reason(s) for denial with respect to the concern for esophageal dysfunction. Measurements and Main Results: The 1-, 3-, and 5-year post–lung transplant survival for SSc was 94, 77, and 70%, respectively, and similar to the other groups. The remaining post–lung transplant outcomes evaluated were also similar between SSc and the other groups. Approximately 60% of the SSc group had severe esophageal dysfunction. Pre–lung transplant chest computed tomography imaging demonstrated significantly abnormal esophageal morphometry for SSc when compared with the matched group. Importantly, esophageal dysfunction was the sole reason for lung transplant denial in a single case. Conclusions: Relative to other lung transplant
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Yahara, I; Furukawa, H; Sato, K; Nishimura, K; Harihara, A; Yabuuchi, K; Miyauchi, H; Kii, Y; Muraoka, Y; Kitamura, T; Kato, I
2001-05-01
A single oral dose toxicity study of Cefmatilen hydrochloride hydrate (S-1090) and a single intravenous dose toxicity study of its sodium salt (S-1090-Na) were conducted in rats. One dose level of 2000 mg potency/kg was set in both studies. Single oral dose toxicity study of S-1090 No deaths occurred. Diarrhea occurred on the dosing day and slightly soft feces lasted until 6 days after administration. These changes were considered to result from changes of intestinal flora induced by the antibiotic activity of S-1090. Reddish-brown feces (due to chelated products of S-1090 or its decomposition products with Fe3+ in the diet) were also observed until the next day after administration. Body weights increased favorably, and no S-1090-related pathological changes were observed. The oral lethal dose of S-1090 was estimated to be more than 2000 mg potency/kg. Single intravenous dose toxicity study of S-1090-Na No deaths occurred. The rats showed characteristic clinical signs such as hypoactivity, abnormal gait and hypopnea immediately after dosing, and some rats showed prone position or paleness of eyeballs and ear auricles in due course. These signs disappeared by 4 hr after administration. Slightly soft feces and reddish-brown feces were observed much the same as in the orally-treated rats. Body weights increased favorably. In the pathological examinations, slight cecal enlargement and increased basophilia, dilatation and calcification of the renal tubules in the kidney were observed. The intravenous lethal dose of S-1090-Na was estimated to be more than 2000 mg potency/kg.
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Peschel, G; Moleda, L; Baier, L; Selgrad, M; Schmid, S; Scherer, M N; Müller, M; Weigand, K
2018-06-01
Patients after liver transplantation (LT) with hepatitis C virus (HCV) infection often suffer from renal or hepatic impairment. Treating patients after LT with direct-acting antivirals (DAA) might result in decreasing renal function due to interaction of DAA and immunosuppressive therapy. In this single-center study we analyzed clinical parameters of 18 HCV-infected patients treated with DAA therapy after LT. The primary end points were change of renal function (glomerular filtration rate) and sustained virologic response 12 weeks after therapy (SVR12). For secondary end points, we investigated the influence of DAA therapy on transaminases, bilirubin, international normalized ratio, noninvasive fibrosis measurement, and Model for End-Stage Liver Disease (MELD) score. Five out of 18 patients treated with DAA suffered from renal impairment stage 2, and 7 patients of renal impairment stage 3. Renal function at SVR12 was not influenced by preexisting renal impairment (P > .5), type of immunosuppressant (P > .5), or type of DAA regimen (P > .5). All patients reached SVR12. The levels of transaminases and bilirubin declined rapidly, as expected. Ten out of 18 patients already suffered from cirrhosis or liver fibrosis >F3 according to noninvasive measurement before initiation of treatment. Single-point acoustic radiation force impulse imaging improved in 9 patients (P = .012). In 7 patients, MELD score improved owing to the decrease of bilirubin levels. In 6 patients it worsened. DAA therapy in LT patients was effective and safe in this single-center real-life cohort. Renal function was not influenced by the administered drug combinations, even in patients with preexisting renal impairment. Copyright © 2018. Published by Elsevier Inc.
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Koulaouzidis, Anastasios; Yung, Diana E.; Nemeth, Artur; Sjöberg, Klas; Giannakou, Andry; Qureshi, Raheel; Bartzis, Leonidas; McNeill, Morna; Johansson, Gabriele Wurm; Lucendo, Alfredo J.; Fineron, Paul; Trimble, Ken C.; Saeed, Athar; Plevris, John N.; Toth, Ervin
2017-01-01
Background Collagenous colitis (CC) is by definition a histological diagnosis. However, colonoscopy often reveals characteristic endoscopic findings. The aim of this study was to evaluate the frequency and type of endoscopic findings in patients diagnosed with CC in 4 participating centers. Methods This was a retrospective study; the databases of 2 university hospitals in Edinburgh (Scotland) and Malmö (Sweden), and 2 district general hospitals in Tomelloso (Spain) and Gateshead (England) were interrogated for patients diagnosed with CC between May 2008 and August 2013. Endoscopy reports and images were retrieved and reviewed; data on lesions, sedation, bowel preparation and endoscopist experience were abstracted. Categorical data are reported as mean±SD. Fischer’s exact, chi-square and t (unpaired) tests were used to compare datasets. A two-tailed P-value of <0.05 was considered statistically significant. Results 607 patients (149 male, mean age 66.9±12.25 years) were diagnosed with CC. A total of 108/607 (17.8%) patients had one or more suggestive endoscopy findings: i.e., mucosal erythema/edema, 91/607 (15%); linear colonic mucosal defects, 12/607 (2%); or mucosal scarring, 5/607 (0.82%). For colonic mucosa erythema, there was no difference in the odds of finding erythema with the use of different bowel preparation methods (P=0.997). For colonic mucosal defects there was some evidence (P=0.005) that patients colonoscoped by experienced endoscopists had 87% less odds of developing such defects. Moreover, there was evidence that analgesia reduced the odds of developing mucosal defects by 84%. Conclusion A significant minority of patients with CC have endoscopic findings in colonoscopy. The description of such findings appears to be related to the endoscopist’s experience. PMID:28469361
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Single crystal and optical ceramic multicomponent garnet scintillators: A comparative study
NASA Astrophysics Data System (ADS)
Wu, Yuntao; Luo, Zhaohua; Jiang, Haochuan; Meng, Fang; Koschan, Merry; Melcher, Charles L.
2015-04-01
Multicomponent garnet materials can be made in optical ceramic as well as single crystal form due to their cubic crystal structure. In this work, high-quality Gd3Ga3Al2O12:0.2 at% Ce (GGAG:Ce) single crystal and (Gd,Lu)3Ga3Al2O12:1 at% Ce (GLuGAG:Ce) optical ceramics were fabricated by the Czochralski method and a combination of hot isostatic pressing (HIPing) and annealing treatment, respectively. Under optical and X-ray excitation, the GLuGAG:Ce optical ceramic exhibits a broad Ce3+ transition emission centered at 550 nm, while the emission peak of the GGAG:Ce single crystal is centered at 540 nm. A self-absorption effect in GLuGAG:Ce optical ceramic results in this red-shift of the Ce3+ emission peak compared to that in the GGAG:Ce single crystal. The light yield under 662 keV γ-ray excitation was 45,000±2500 photons/MeV and 48,200±2410 photons/MeV for the GGAG:Ce single crystal and GLuGAG:Ce optical ceramic, respectively. An energy resolution of 7.1% for 662 keV γ-rays was achieved in the GLuGAG:Ce optical ceramic with a Hamamatsu R6231 PMT, which is superior to the value of 7.6% for a GGAG:Ce single crystal. Scintillation decay time measurements under 137Cs irradiation show two exponential decay components of 58 ns (47%) and 504 ns (53%) for the GGAG:Ce single crystal, and 84 ns (76%) and 148 ns (24%) for the GLuGAG:Ce optical ceramic. The afterglow level after X-ray cutoff in the GLuGAG:Ce optical ceramic is at least one order of magnitude lower than in the GGAG:Ce single crystal.
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Zeeman Effect observations toward 36 GHz methanol masers in the Galactic Center
NASA Astrophysics Data System (ADS)
Potvin, Justin A.; Momjian, Emmanuel; Pratim Sarma, Anuj
2017-01-01
We present observations of 36 GHz Class I methanol masers taken with the Karl G. Jansky Very Large Array (VLA) in the B configuration with the aim of detecting the Zeeman Effect. We targeted several 36 GHz Class I methanol masers associated with supernova remnants (SNRs) toward the Galactic Center. Each source was observed in dual circular polarizations for three hours. The observed spectral profiles of the masers are complex, with several components blended in velocity. In only one case was the Stokes V maser profile prominent enough to reveal a 2-sigma hint of a magnetic field of zBlos = 14.56 +/- 5.60 Hz; we have chosen to express our results in terms of zBlos since the Zeeman splitting factor (z) for 36 GHz methanol masers has not been measured. There are several hints that these spectra would reveal significant magnetic fields if they could be spatially and spectrally resolved.
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Rahbar, Mohammad H.; Fox, Erin E.; del Junco, Deborah J.; Cotton, Bryan A.; Podbielski, Jeanette M.; Matijevic, Nena; Cohen, Mitchell J.; Schreiber, Martin A.; Zhang, Jiajie; Mirhaji, Parsa; Duran, Sarah; Reynolds, Robert J.; Benjamin-Garner, Ruby; Holcomb, John B.
2011-01-01
Aim Early death due to hemorrhage is a major consequence of traumatic injury. Transfusion practices differ among hospitals and it is unknown which transfusion practices improve survival. This report describes the experience of the PRospective Observational Multicenter Major Trauma Transfusion (PROMMTT) Study Data Coordination Center in designing and coordinating a study to examine transfusion practices at ten Level 1 trauma centers in the U.S. Methods PROMMTT was a multisite prospective observational study of severely injured transfused trauma patients. The clinical sites collected real-time information on the timing and amounts of blood product infusions as well as colloids and crystalloids, vital signs, initial diagnostic and clinical laboratory tests, life saving interventions and other clinical care data. Results Between July 2009 and October 2010, PROMMTT screened 12,561 trauma admissions and enrolled 1,245 patients who received one or more blood transfusions within 6 hours of ED admission. A total of 297 massive transfusions were observed over the course of the study at a combined rate of 5.0 massive transfusion patients/week. Conclusion PROMMTT is the first multisite study to collect real-time prospective data on trauma patients requiring transfusion. Support from the Department of Defense and collaborative expertise from the ten participating centers helped to demonstrate the feasibility of prospective trauma transfusion studies. The observational data collected from this study will be an invaluable resource for research in trauma surgery and it will guide the design and conduct of future randomized trials. PMID:22001613
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Prognostic factors of Bell's palsy: prospective patient collected observational study.
Fujiwara, Takashi; Hato, Naohito; Gyo, Kiyofumi; Yanagihara, Naoaki
2014-07-01
The purpose of this study was to evaluate various parameters potentially influencing poor prognosis in Bell's palsy and to assess the predictive value for Bell's palsy. A single-center prospective patient collected observation and validation study was conducted. To evaluate the correlation between patient characteristics and poor prognosis, we performed univariate and multivariate analyzes of age, gender, side of palsy, diabetes mellitus, hypertension, and facial grading score 1 week after onset. To evaluate the accuracy of the facial grading score, we prepared a receiver operating characteristic (ROC) curve and calculated the area under the ROC curve (AUROC). We also calculated sensitivity, specificity, positive/negative likelihood ratio, and positive/negative predictive value. We included Bell's palsy patients who attended Ehime University Hospital within 1 week after onset between 1977 and 2011. We excluded patients who were less than 15 years old and lost-to-follow-up within 6 months. The main outcome was defined as non-recovery at 6 months after onset. In total, 679 adults with Bell's palsy were included. The facial grading score at 1 week showed a correlation with non-recovery in the multivariate analysis, although age, gender, side of palsy, diabetes mellitus, and hypertension did not. The AUROC of the facial grading score was 0.793. The Y-system score at 1 week moderate accurately predicted non-recovery at 6 months in Bell's palsy.
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2002-05-29
of the Budget, • New York City Partnership and Chamber of Commerce , Washington, DC 20548 Report Documentation Page Report Date 29MAY2002 Report Type...700R Impact of Terrorist Attacks on the World Trade Center 10 Eight Studies (cont’d) ! New York City Partnership and Chamber of Commerce , Economic...Center 29 Observations Observations The New York City Partnership and Chamber of Commerce study generated the most comprehensive estimates—direct and
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Optimal joint measurements of complementary observables by a single trapped ion
NASA Astrophysics Data System (ADS)
Xiong, T. P.; Yan, L. L.; Ma, Z. H.; Zhou, F.; Chen, L.; Yang, W. L.; Feng, M.; Busch, P.
2017-06-01
The uncertainty relations, pioneered by Werner Heisenberg nearly 90 years ago, set a fundamental limitation on the joint measurability of complementary observables. This limitation has long been a subject of debate, which has been reignited recently due to new proposed forms of measurement uncertainty relations. The present work is associated with a new error trade-off relation for compatible observables approximating two incompatible observables, in keeping with the spirit of Heisenberg’s original ideas of 1927. We report the first direct test and confirmation of the tight bounds prescribed by such an error trade-off relation, based on an experimental realisation of optimal joint measurements of complementary observables using a single ultracold {}40{{{Ca}}}+ ion trapped in a harmonic potential. Our work provides a prototypical determination of ultimate joint measurement error bounds with potential applications in quantum information science for high-precision measurement and information security.
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Laparoscopic treatment for esophageal achalasia: experience at a single center
AGRUSA, A.; ROMANO, G.; BONVENTRE, S.; SALAMONE, G.; COCORULLO, G.; GULOTTA, G.
2013-01-01
Summary Background Achalasia is a not frequent esophageal disorder characterized by the absence of esophageal peristalsis and incomplete relaxation of the lower esophageal sphincter (LES). Its cause is unknown. The aim of treatment is to improve the symptoms. We report the results of the treatment of this condition achieved in one center. Patients and methods We conducted a retrospective study of patients with esophageal achalasia. In the period 2010–2012 we observed 64 patients, of whom 19 were referred for medical treatment. Three of the remaining patients underwent botulinum toxin injection, 17 underwent multiple endoscopic dilation procedures and 25 underwent laparoscopic surgery. Results There were no complications in the group undergoing endoscopic therapy, but symptom remission was only temporary. Patients undergoing surgery showed a significant improvement in symptoms and no recurrence throughout the follow-up period, that is still ongoing (3 years). There were no major complications in any case and no morbidity or mortality. Conclusions Surgical treatment of esophageal achalasia with laparoscopic Heller myotomy and Dor fundoplication gives the best and longest-lasting results in suitably selected patients. The extension of the myotomy and reduction in LES pressure are the most important parameters to achieve a good result. PMID:24091178
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2012-01-01
Background Patients with heightened platelet reactivity in response to antiplatelet agents are at an increased risk of recurrent ischemic events. However, there is a lack of diagnostic criteria for increased response to combined aspirin/clopidogrel therapy. The challenge is to identify patients at risk of bleeding. This study sought to characterize bleeding tendency in patients treated with aspirin and clopidogrel. Patients/methods In a single-center prospective study, 100 patients under long-term aspirin/clopidogrel treatment, the effect of therapy was assayed by template bleeding time (BT) and the inhibition of platelet aggregation (IPA) by light transmission aggregometry (LTA). Arachidonic acid (0.625 mmol/L) and adenosine diphosphate (ADP; 2, 4, and 8 μmol/L) were used as platelet agonists. Results Bleeding episodes (28 nuisance, 2 hematuria [1 severe], 1 severe proctorrhagia, 1 severe epistaxis) were significantly more frequent in patients with longer BT. Template BT ≥ 24 min was associated with bleeding episodes (28 of 32). Risk of bleeding increased 17.4% for each 1 min increase in BT. Correlation was found between BT and IPAmax in response to ADP 2 μmol/L but not to ADP 4 or 8 μmol/L. Conclusion In patients treated with dual aspirin/clopidogrel therapy, nuisance and internal bleeding were significantly associated with template BT and with IPAmax in response to ADP 2 μmol/L but not in response to ADP 4 μmol/L or 8 μmol/L. PMID:22236361
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NASA Astrophysics Data System (ADS)
Burnett, W.; Bouchard, R.; Hervey, R.; Crout, R.; Luke, R.
2008-12-01
As the Integrated Ocean Observing System (IOOS) Data Assembly Center (DAC), NOAA's National Data Buoy Center (NDBC) collects data from many ocean observing systems, quality controls the data, and distributes them nationally and internationally. The DAC capabilities provide instant interoperability of any ocean observatory with the national and international agencies responsible for critical forecasts and warnings and with the national media. This interoperability is an important milestone in an observing system's designation as an operational system. Data collection begins with NDBC's own observing systems - Meteorological and Oceanographic Buoys and Coastal Stations, the Tropical Atmosphere Ocean Array, and the NOAA tsunameter network. Leveraging the data management functions that support NDBC systems, the DAC can support data partners including ocean observations from IOOS Regional Observing Systems, the meteorological observations from the National Water Level Observing Network, meteorological and oceanographic observations from the National Estuarine Research Reserve System, Integrated Coral Observing Network, merchant ship observations from the Voluntary Observing Ship program, and ocean current measurements from oil and gas platforms in the Gulf of Mexico and from Coastal HF Radars. The DAC monitors and quality controls IOOS Partner data alerting the data provider to outages and quality discrepancies. After performing automated and manual quality control procedures, the DAC prepares the observations for distribution. The primary means of data distribution is in standard World Meteorological Organization alphanumeric coded messages distributed via the Global Telecommunications System, NOAAPort, and Family of Services. Observing systems provide their data via ftp to an NDBC server using a simple XML. The DAC also posts data in real-time to the NDBC webpages in columnar text format and data plots that maritime interests (e.g., surfing, fishing, boating) widely
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Binding and Translocation of Termination Factor Rho Studied at the Single-Molecule Level
Koslover, Daniel J.; Fazal, Furqan M.; Mooney, Rachel A.; Landick, Robert; Block, Steven M.
2012-01-01
Rho termination factor is an essential hexameric helicase responsible for terminating 20–50% of all mRNA synthesis in E. coli. We used single- molecule force spectroscopy to investigate Rho-RNA binding interactions at the Rho- utilization (rut) site of the ? tR1 terminator. Our results are consistent with Rho complexes adopting two states, one that binds 57 ±2 nucleotides of RNA across all six of the Rho primary binding sites, and another that binds 85 ±2 nucleotides at the six primary sites plus a single secondary site situated at the center of the hexamer. The single-molecule data serve to establish that Rho translocates 5′-to-3′ towards RNA polymerase (RNAP) by a tethered-tracking mechanism, looping out the intervening RNA between the rut site and RNAP. These findings lead to a general model for Rho binding and translocation, and establish a novel experimental approach that should facilitate additional single- molecule studies of RNA-binding proteins. PMID:22885804
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NASA Astrophysics Data System (ADS)
Haas, Sabrina; Heintze, Eric; Zapf, Sina; Gorshunov, Boris; Dressel, Martin; Bogani, Lapo
2014-05-01
The far-infrared optical transmission has been studied for two lanthanide-based single-chain magnets DyPhOPh and TbPhOPh in the frequency range between 3 and 80 cm-1. The spectra were acquired at temperatures between 2 and 80 K and magnetic fields up to 6 T. Based on their magnetic field dependence in DyPhOPh two of the observed absorption lines are identified as transitions inside the crystal field split Dy3+ ground multiplet 6H15/2, coupled to the neighboring spins. In TbPhOPh one transition was observed inside the crystal-field-split Tb3+ ground multiplet 7F6. The results allow a spectroscopic investigation of the role of single-ion anisotropy and exchange in Glauber dynamics.
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Struys, Michel M R F; Valk, Beatrijs I; Eleveld, Douglas J; Absalom, Anthony R; Meyer, Peter; Meier, Sascha; den Daas, Izaak; Chou, Thomas; van Amsterdam, Kai; Campagna, Jason A; Sweeney, Steven P
2017-07-01
Cyclopropyl-methoxycarbonylmetomidate (ABP-700) is a new "soft" etomidate analog. The primary objectives of this first-in-human study were to describe the safety and efficacy of ABP-700 and to determine its maximum tolerated dose. Secondary objectives were to characterize the pharmacokinetics of ABP-700 and its primary metabolite (cyclopropyl-methoxycarbonyl acid), to assess the clinical effects of ABP-700, and to investigate the dose-response and pharmacokinetic/pharmacodynamic relationships. Sixty subjects were divided into 10 cohorts and received an increasing, single bolus of either ABP-700 or placebo. Safety was assessed by clinical laboratory evaluations, infusion-site reactions, continuous monitoring of vital signs, physical examination, adverse event monitoring, and adrenocorticotropic hormone stimulation testing. Clinical effects were assessed with modified observer's assessment of alertness/sedation and Bispectral Index monitoring. Pharmacokinetic parameters were calculated. Stopping criteria were met at 1.00 mg/kg dose. No serious adverse events were reported. Adverse events were dose-dependent and comprised involuntary muscle movement, tachycardia, and ventilatory effects. Adrenocorticotropic hormone stimulation evoked a physiologic cortisol response in all subjects, no different from placebo. Pharmacokinetics were dose-proportional. A three-compartment pharmacokinetic model described the data well. A rapid onset of anesthesia/sedation after bolus administration and also a rapid recovery were observed. A quantitative concentration-effect relationship was described for the modified observer's assessment of alertness/sedation and Bispectral Index. This first-in-human study of ABP-700 shows that ABP-700 was safe and well tolerated after single-bolus injections up to 1.00 mg/kg. Bolus doses of 0.25 and 0.35 mg/kg were found to provide the most beneficial clinical effect versus side-effect profile.
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Single-molecule conductance studies of photo-active and photochromic molecules
NASA Astrophysics Data System (ADS)
Tam, E. S.; Parks, J. J.; Santiago-Berrios, M. B.; Zhong, Y.-W.; Abruna, H. D.; Ralph, D. C.
2010-03-01
We perform statistical measurements of single molecule conductance in repeatedly-formed metal-molecule-metal junctions at room temperature. Our results on diaminoalkanes are consistent with those reported by the Venkataraman group. We focus on photo-active and photochromic molecules, including a series of transition-metal complexes with different metal centers and endgroups. We compare the trend in conductance across the family of complexes with that expected from electrochemical measurements. We will also report initial results on the voltage dependence of single-molecule conductances and the effects of optical excitations.
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Development of a Method to Observe Preschoolers' Packed Lunches in Early Care and Education Centers.
Sweitzer, Sara J; Byrd-Williams, Courtney E; Ranjit, Nalini; Romo-Palafox, Maria Jose; Briley, Margaret E; Roberts-Gray, Cynthia R; Hoelscher, Deanna M
2015-08-01
As early childhood education (ECE) centers become a more common setting for nutrition interventions, a variety of data collection methods are required, based on the center foodservice. ECE centers that require parents to send in meals and/or snacks from home present a unique challenge for accurate nutrition estimation and data collection. We present an observational methodology for recording the contents and temperature of preschool-aged children's lunchboxes and data to support a 2-day vs a 3-day collection period. Lunchbox observers were trained in visual estimation of foods based on Child and Adult Care Food Program and MyPlate servings and household recommended measures. Trainees weighed and measured foods commonly found in preschool-aged children's lunchboxes and practiced recording accurate descriptions and food temperatures. Training included test assessments of whole-grain bread products, mixed dishes such as macaroni and cheese, and a variety of sandwich preparations. Validity of the estimation method was tested by comparing estimated to actual amounts for several distinct food types. Reliability was assessed by computing the intraclass correlation coefficient for each observer as well as an interrater reliability coefficient across observers. To compare 2- and 3-day observations, 2 of the 3 days of observations were randomly selected for each child and analyzed as a separate dataset. Linear model estimated mean and standard error of whole grains, fruits and vegetables, and amounts of energy, carbohydrates, protein, total fat, saturated fat, dietary fiber, thiamin, riboflavin, niacin, vitamins A and C, calcium, iron, sodium, and dietary fiber per lunch were compared across the 2- and 3-day observation datasets. The mean estimated amounts across 11 observers were statistically indistinguishable from the measured portion size for each of the 41 test foods, implying that the visual estimation measurement method was valid: intraobserver intraclass correlation
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Learning curve for intracranial angioplasty and stenting in single center.
Cai, Qiankun; Li, Yongkun; Xu, Gelin; Sun, Wen; Xiong, Yunyun; Sun, Wenshan; Bao, Yuanfei; Huang, Xianjun; Zhang, Yao; Zhou, Lulu; Zhu, Wusheng; Liu, Xinfeng
2014-01-01
To identify the specific caseload to overcome learning curve effect based on data from consecutive patients treated with Intracranial Angioplasty and Stenting (IAS) in our center. The Stenting and Aggressive Medical Management for Preventing Recurrent Stroke and Intracranial Stenosis trial was prematurely terminated owing to the high rate of periprocedural complications in the endovascular arm. To date, there are no data available for determining the essential caseload sufficient to overcome the learning effect and perform IAS with an acceptable level of complications. Between March 2004 and May 2012, 188 consecutive patients with 194 lesions who underwent IAS were analyzed retrospectively. The outcome variables used to assess the learning curve were periprocedural complications (included transient ischemic attack, ischemic stroke, vessel rupture, cerebral hyperperfusion syndrome, and vessel perforation). Multivariable logistic regression analysis was employed to illustrate the existence of learning curve effect on IAS. A risk-adjusted cumulative sum chart was performed to identify the specific caseload to overcome learning curve effect. The overall rate of 30-days periprocedural complications was 12.4% (24/194). After adjusting for case-mix, multivariate logistic regression analysis showed that operator experience was an independent predictor for periprocedural complications. The learning curve of IAS to overcome complications in a risk-adjusted manner was 21 cases. Operator's level of experience significantly affected the outcome of IAS. Moreover, we observed that the amount of experience sufficient for performing IAS in our center was 21 cases. Copyright © 2013 Wiley Periodicals, Inc.
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Arias, Miguel A; Pachón, Marta; Akerström, Finn; Puchol, Alberto; Martín-Sierra, Cristina; Rodríguez-Padial, Luis
2017-12-05
The subcutaneous implantable cardioverter-defibrillator (S-ICD) has emerged as an alternative to the transvenous defibrillator. The incidence of complications is similar, with inappropriate shocks (IS) being more frequent than those occurring with contemporary programming of transvenous defibrillators. Several improvements have been implemented after the S-ICD was approved for use in Europe in 2009. This study reports the results of S-ICD use in a single center, whose experience began late, at the end of 2013. Prospective observational study including consecutive patients with defibrillator indication and no indication for either permanent pacing or cardiac resynchronization who underwent S-ICD implantation. Implant data and long-term follow-up were analyzed. An S-ICD was implanted in 50 patients who were deemed suitable after electrocardiographic screening. The mean age was 46.9±15 (range, 15-78) years and 72% were male. Thirty eight percent had left ventricular ejection fraction ≤ 35%. The most frequent heart disease was ischemic heart disease (34%), followed by hypertrophic cardiomyopathy (18%). The intermuscular technique was used, with 3 incisions in 10% and 2 incisions in the remaining 90%. Ventricular fibrillation was induced in 49 patients, with 100% effectiveness in their conversion. After a mean follow-up of 18.1 (range, 2.3-44.8) months, there were no late complications requiring surgical revision, the rate of IS was 0%, and 1 patient (2%) experienced appropriate shocks. Improvements in technology, implant technique and device programming, along with appropriate patient selection, have led to outstanding acute and long-term results, especially regarding the absence of both IS and complications requiring surgical revision. Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.
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Selective Transformation of CO2 to CO at a Single Nickel Center.
Yoo, Changho; Kim, Yeong-Eun; Lee, Yunho
2018-05-15
Carbon dioxide conversion mediated by transition metal complexes continues to attract much attention because of its future potential utilization as a nontoxic and inexpensive C1 source for the chemical industry. Given the presence of nickel in natural systems that allow for extremely efficient catalysis, albeit in an Fe cluster arrangement, studies that focus on selective CO 2 conversion with synthetic nickel species are currently of considerable interest in our group. In this Account, the selective conversion of CO 2 to carbon monoxide occurring at a single nickel center is discussed. The chemistry is based on a series of related nickel pincer complexes with attention to the uniqueness of the coordination geometry, which is crucial in allowing for particular reactivity toward CO 2 . Our research is inspired by the efficient enzymatic CO 2 catalysis occurring at the active site of carbon monoxide dehydrogenase. Since the binding and reactivity toward CO 2 are controlled in part by the geometry of a L 3 Ni scaffold, we have explored the chemistry of low-valent nickel supported by PP Me P and PNP ligands, in which a pseudotetrahedral or square-planar geometry is accommodated. Two isolated nickel-CO 2 adducts, (PP Me P)Ni(η 2 -CO 2 -κ C) (2) and {Na(12-C-4) 2 }{(PNP)Ni(η 1 -CO 2 -κ C)} (7), clearly demonstrate that the geometry of the nickel ion is crucial in the binding of CO 2 and its level of activation. In the case of a square-planar nickel center supported by a PNP ligand, a series of bimetallic metallacarboxylate Ni-μ-CO 2 -κ C, O-M species (M = H, Na, Ni, Fe) were synthesized, and their structural features and reactivity were studied. Protonation cleaves the C-O bond, resulting in the formation of a nickel(II) monocarbonyl complex. By sequential reduction, the corresponding mono- and zero-valent Ni-CO species were produced. The reactivities of three nickel carbonyl species toward various iodoalkanes and CO 2 were explored to address whether their
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Kim, Kwan-Ii; Jo, Junyoung
2018-01-01
Male factor subfertility has increasingly been considered the cause of infertility in couples. Many men with male infertility have sperm problems such as oligozoospermia, asthenozoospermia, or teratozoospermia. Because abnormal semen parameters are idiopathic to some extent, no standard therapy has been established to date. Herbal medicine has been reported to have beneficial properties in the treatment of subfertility, especially in improving semen quality both in vivo and in human studies. Therefore, we intend to investigate the effectiveness and safety of treatment using Korean medicine (KM) for infertile male patients with poor semen quality.This will be a single-center, prospective, case-only observational pilot study. About 20 male patients with infertility who visit Conmaul Hospital of Korean Medicine will be recruited. We will follow the standard treatment protocol, which has shown good results in the treatment of male infertility. The protocol is composed mainly of a 10-week herbal decoction treatment; acupuncture and/or pharmacopuncture are added when needed. Semen samples, quality of life, and the scrotal temperatures of infertile men will be observed before and after the 10-week treatment with KM.The study has received ethical approval from the Public Institutional Review Board (approval number: P01-201708-21-008). The findings will be disseminated to appropriate audiences via peer-reviewed publication and conference presentations. Korean Clinical Trial Registry (CRIS), Republic of Korea: KCT0002611.
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A review of colour center and nanostructure creation in LiF under heavy ion irradiation
NASA Astrophysics Data System (ADS)
Schwartz, K.; Maniks, J.; Manika, I.
2015-09-01
A study of radiation damage in LiF crystals under irradiation with MeV-GeV energy ions, from 12C to 238U, at temperatures varying from 8 to 300 K, depending on the ion energy, energy loss and irradiation temperature, is presented. For light ions (12C, 14N) at low fluences, it is mainly color centers that are created. Increasing the fluence leads to the overlapping of tracks and the creation of more complex color centers, defect aggregates and dislocations. For ions with an energy loss above a threshold value (dE/dx = 10 keV nm-1) the tracks exhibit a central core damage region with a radius of 1-2 nm, surrounded by an extended halo which mainly contains single color centers. In this case, ion-induced nanostructuring is observed. Novel effects of radiation damage creation under ion irradiation at 8 K are observed. The role of energy loss and irradiation temperature in damage creation is discussed.
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Phonon self-energy corrections to non-zero wavevector phonon modes in single-layer graphene
NASA Astrophysics Data System (ADS)
Araujo, Paulo; Mafra, Daniela; Sato, Kentaro; Saito, Richiiro; Kong, Jing; Dresselhaus, Mildred
2012-02-01
Phonon self-energy corrections have mostly been studied theoretically and experimentally for phonon modes with zone-center (q = 0) wave-vectors. Here, gate-modulated Raman scattering is used to study phonons of a single layer of graphene (1LG) in the frequency range from 2350 to 2750 cm-1, which shows the G* and the G'-band features originating from a double-resonant Raman process with q 0. The observed phonon renormalization effects are different from what is observed for the zone-center q = 0 case. To explain our experimental findings, we explored the phonon self-energy for the phonons with non-zero wave-vectors (q 0) in 1LG in which the frequencies and decay widths are expected to behave oppositely to the behavior observed in the corresponding zone-center q = 0 processes. Within this framework, we resolve the identification of the phonon modes contributing to the G* Raman feature at 2450 cm-1 to include the iTO+LA combination modes with q 0 and the 2iTO overtone modes with q = 0, showing both to be associated with wave-vectors near the high symmetry point K in the Brillouin zone.
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Earth Observations to Assess Impact of Hurricane Katrina on John C. Stennis Space Center
NASA Technical Reports Server (NTRS)
Graham, William D.; Ross, Kenton W.
2007-01-01
The peril from hurricanes to Space Operations Centers is real and is forecast to continue; Katrina, Rita, and Wilma of 2005 and Charley, Frances, Ivan, and Jeanne of 2004 are sufficient motivation for NASA to develop a multi-Center plan for preparedness and response. As was demonstrated at SSC (Stennis Space Center) in response to Hurricane Katrina, NASA Centers are efficiently activated as local command centers, playing host to Federal and State agencies and first responders to coordinate and provide evacuation, relocation, response, and recovery activities. Remote sensing decision support provides critical insight for managing NASA infrastructure and for assisting Center decision makers. Managers require geospatial information to manage the federal city. Immediately following Katrina, SSC s power and network connections were disabled, hardware was inoperative, technical staff was displaced and/or out of contact, and graphical decision support tools were non-existent or less than fully effective. Despite this circumstance, SSC EOC (Emergency Operations Center) implemented response operations to assess damage and to activate recovery plans. To assist Center Managers, the NASA ASP (Applied Sciences Program) made its archive of high-resolution data over the site available. In the weeks and months after the immediate crisis, NASA supplemented this data with high-resolution, post-Katrina imagery over SSC and much of the affected coastal areas. Much of the high-resolution imagery was made available through the Department of Defense Clear View contract and was distributed through U.S. Geological Survey Center for Earth Resources Observation and Science "Hurricane Katrina Disaster Response" Web site. By integrating multiple image data types with other information sources, ASP applied an all-source solutions approach to develop decision support tools that enabled managers to respond to critical issues, such as expedient access to infrastructure and deployment of resources
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NASA Technical Reports Server (NTRS)
Lapenta, C. C.
1992-01-01
The functionality of the Distributed Active Archive Centers (DAACs) which are significant elements of the Earth Observing System Data and Information System (EOSDIS) is discussed. Each DAAC encompasses the information management system, the data archival and distribution system, and the product generation system. The EOSDIS DAACs are expected to improve the access to earth science data set needed for global change research.
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Kim, Jong Seung; Oh, Jong Seok; Kwon, Sam Hyun
2016-06-01
Sinonasal organized hematoma is a rare, benign disease that can be locally aggressive and may be mistaken for malignancy. Because of its rarity, the clinical characteristics are not well known. The aim of this study is to investigate the distinguishing features of organized hematoma with an emphasis on incidence change. In this retrospective study, we reviewed the records of 23 patients with organized hematoma confirmed histopathologically among 5,378 patients who underwent endoscopic sinus surgery performed by a single surgeon from January 1995 to December 2014 at a tertiary care center. Clinical symptoms, endoscopic photography, computed tomography, and operative findings were reviewed. We also reviewed the relevant literature. Age, sex, site, origin subsite and histopathology were investigated. A statistical review was performed using R 3.1.2 to examine incidence change. The most common complaint was frequent epistaxis and nasal obstruction (52.1%). Of the 23 patients, eight were women and 15 were men with an age range of 18 to 75 years. (mean 38.9 years). Nine of these hematomas occurred on the right side and 14 on the left side. The predominant occurrence site was the antrum (65%), followed by the septum (17.3%), inferior turbinate (8%), and ethmoid sinus (8%). The incidence steadily increased over 20 years. Investigation of the clinical characteristics and incidence change of organized hematoma can provide useful information. Through analysis of the 23 cases in our study, the age distribution was found to be bimodal and the incidence of organizing hematoma was observed to steadily increase. Clinicians should be aware of these characteristics to avoid misdiagnoses of malignant tumors.
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Rahbar, Mohammad H; Fox, Erin E; del Junco, Deborah J; Cotton, Bryan A; Podbielski, Jeanette M; Matijevic, Nena; Cohen, Mitchell J; Schreiber, Martin A; Zhang, Jiajie; Mirhaji, Parsa; Duran, Sarah J; Reynolds, Robert J; Benjamin-Garner, Ruby; Holcomb, John B
2012-04-01
Early death due to hemorrhage is a major consequence of traumatic injury. Transfusion practices differ among hospitals and it is unknown which transfusion practices improve survival. This report describes the experience of the PRospective Observational Multicenter Major Trauma Transfusion (PROMMTT) Study Data Coordination Center in designing and coordinating a study to examine transfusion practices at ten Level 1 trauma centers in the US. PROMMTT was a multisite prospective observational study of severely injured transfused trauma patients. The clinical sites collected real-time information on the timing and amounts of blood product infusions as well as colloids and crystalloids, vital signs, initial diagnostic and clinical laboratory tests, life saving interventions and other clinical care data. Between July 2009 and October 2010, PROMMTT screened 12,561 trauma admissions and enrolled 1245 patients who received one or more blood transfusions within 6h of Emergency Department (ED) admission. A total of 297 massive transfusions were observed over the course of the study at a combined rate of 5.0 massive transfusion patients/week. PROMMTT is the first multisite study to collect real-time prospective data on trauma patients requiring transfusion. Support from the Department of Defense and collaborative expertise from the ten participating centers helped to demonstrate the feasibility of prospective trauma transfusion studies. The observational data collected from this study will be an invaluable resource for research in trauma surgery and it will guide the design and conduct of future randomized trials. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
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Direct observation of resonance scattering patterns in single silicon nanoparticles
NASA Astrophysics Data System (ADS)
Valuckas, Vytautas; Paniagua-Domínguez, Ramón; Fu, Yuan Hsing; Luk'yanchuk, Boris; Kuznetsov, Arseniy I.
2017-02-01
We present the first direct observation of the scattering patterns of electric and magnetic dipole resonances excited in a single silicon nanosphere. Almost perfectly spherical silicon nanoparticles were fabricated and deposited on a 30 nm-thick silicon nitride membrane in an attempt to minimize particle—substrate interaction. Measurements were carried out at visible wavelengths by means of the Fourier microscopy in a dark-field illumination setup. The obtained back-focal plane images clearly reveal the characteristic scattering patterns associated with each resonance and are found to be in a good agreement with the simulated results.
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Li, Wei-Bing; Li, Kang; Fan, Kang-Qi; Zhang, Da-Xing; Wang, Wei-Dong
2018-04-24
Atomistic simulations are capable of providing insights into physical mechanisms responsible for mechanical properties of the transition metal of Tantalum (Ta). By using molecular dynamics (MD) method, temperature and pressure dependences of the elastic properties of Ta single crystals are investigated through <100> tensile loading. First of all, a comparative study between two types of embedded-atom method (EAM) potentials is made in term of the elastic properties of Ta single crystals. The results show that Ravelo-EAM (Physical Review B, 2013, 88: 134101) potential behaves well at different hydrostatic pressures. Then, the MD simulation results based on the Ravelo-EAM potential show that Ta will experience a body-centered-cubic (BCC) to face-centered-cubic (FCC) phase transition before fracture under <100> tensile loading at 1 K temperature, and model size and strain rate have no obvious effects on tensile behaviors of Ta. Next, from the simulation results at the system temperature from 1 to 1500 K, it can be derived that the elastic modulus of E 100 linearly decrease with the increasing temperature, while the yielding stress decrease with conforming a quadratic polynomial formula. Finally, the pressure dependence of the elastic properties is performed from 0 to 140 GPa and the observations show that the elastic modulus increases with the increasing pressure overall.
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Hayes, Justin F; Turner, Orlando D; McCarty, Todd P; Manning, Malia; Hoesley, Craig J; Pappas, Peter G
2017-01-01
Abstract Background Antimicrobial stewardship has traditionally focused on the optimal use of antibacterial agents. Much less attention is focused on the optimal use of antifungal therapy (AFT). The high mortality and emergence of resistance in invasive infections due to Candida presents a critical opportunity for AFT stewardship. The T2Candida (T2C) panel is a rapid diagnostic test using magnetic resonance to detect 5 different species of Candida in whole blood. T2C has a sensitivity of 91%, specificity of 99%, negative predictive value of 99%, and generates results in <6 hours. Methods We conducted a retrospective analysis of candidemia cases at the UAB Medical Center in 2015–16. T2C testing was introduced in January 2016. We compared outcomes among patients prior to and following the implementation of routine T2C testing. The focus of the study was to gather data on AFT, time to initiation of therapy(TTT), and overall use of echinocandin patterns during the study period utilizing days of therapy (DOT) /1000 pt days as a parameter. Results In 2015 and 2016, 100 patients and 138 patients with candidemia, respectively, were included in the analysis. In 2016, there were 354 T2C valid results; 36 (10.2%) were positive and 318 (89.8%) were negative. The TTT for all candidemic patients in 2015 was 2.02 days vs 1.15 days for candidemic patients in 2016, including all who were blood culture(BC)+ and/or T2C+ (P < 0.0001). For patients with candidemia in 2016, TTT in the T2C+ group vs those in whom only BC+ was 0.09 days and 1.69 days, respectively (P < 0.00001). Comparing results for 2015 and 2016, we observed echinocandin (ECH) usage of 15.1 and 17.8 DOT/1000 pt days, respectively. Conclusion We observed a significant decrease in the TTT for candidemic patients since introduction of the T2C. These results suggest that rapid identification of candidemia may be an important tool for AFT stewardship. We hypothesize that other factors, such as the updated IDSA
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Checkpoint Kinase 2 (CHEK2) Mutation in Renal Cell Carcinoma: A Single-Center Experience
Huszno, Joanna; Kołosza, Zofia
2018-01-01
Renal cell carcinoma (RCC) occurs in sporadic and heritable forms. Genetic mutations have been identified as risk factors in 1–2% of RCC. The aim of this study was to evaluate I157T and CHEK2*1100delC mutations of checkpoint kinase 2 (CHEK2) gene in RCC. Medical records of 40 clear cell RCC patients who had genetic tests and consultation at the Genetic Outpatient Clinic, Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Poland, were reviewed retrospectively. Mutation profile was assessed by ASA-PCR and RFLP-PCR techniques. Only three female patients had CHEK2 mutation (I157T). No CHEK2*1100delC was observed in any of the patients. These tumors were N0, and two were Grade 3. One showed capsular infiltration. No blood vessel infiltration or metastases was observed. Overall, RCC from patients with CHEK2 mutation did not display any special characteristics when compared with those without the mutation. While no association between CHEK2 mutation and RCC could be established, all three patients with CHEK2 mutation developed second neoplasms many years after first diagnosis. Further studies, especially regarding CHEK2 mutation as a predictive factor for second neoplasm in RCC patients, are warranted. PMID:29682443
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Checkpoint Kinase 2 (CHEK2) Mutation in Renal Cell Carcinoma: A Single-Center Experience.
Huszno, Joanna; Kołosza, Zofia
2018-01-01
Renal cell carcinoma (RCC) occurs in sporadic and heritable forms. Genetic mutations have been identified as risk factors in 1-2% of RCC. The aim of this study was to evaluate I157T and CHEK2*1100delC mutations of checkpoint kinase 2 (CHEK2) gene in RCC. Medical records of 40 clear cell RCC patients who had genetic tests and consultation at the Genetic Outpatient Clinic, Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Poland, were reviewed retrospectively. Mutation profile was assessed by ASA-PCR and RFLP-PCR techniques. Only three female patients had CHEK2 mutation (I157T). No CHEK2*1100delC was observed in any of the patients. These tumors were N0, and two were Grade 3. One showed capsular infiltration. No blood vessel infiltration or metastases was observed. Overall, RCC from patients with CHEK2 mutation did not display any special characteristics when compared with those without the mutation. While no association between CHEK2 mutation and RCC could be established, all three patients with CHEK2 mutation developed second neoplasms many years after first diagnosis. Further studies, especially regarding CHEK2 mutation as a predictive factor for second neoplasm in RCC patients, are warranted.
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A Multi-center Milestone Study of Clinical Vertebral CT Segmentation
Yao, Jianhua; Burns, Joseph E.; Forsberg, Daniel; Seitel, Alexander; Rasoulian, Abtin; Abolmaesumi, Purang; Hammernik, Kerstin; Urschler, Martin; Ibragimov, Bulat; Korez, Robert; Vrtovec, Tomaž; Castro-Mateos, Isaac; Pozo, Jose M.; Frangi, Alejandro F.; Summers, Ronald M.; Li, Shuo
2017-01-01
A multiple center milestone study of clinical vertebra segmentation is presented in this paper. Vertebra segmentation is a fundamental step for spinal image analysis and intervention. The first half of the study was conducted in the spine segmentation challenge in 2014 International Conference on Medical Image Computing and Computer Assisted Intervention (MICCAI) Workshop on Computational Spine Imaging (CSI 2014). The objective was to evaluate the performance of several state-of-the-art vertebra segmentation algorithms on computed tomography (CT) scans using ten training and five testing dataset, all healthy cases; the second half of the study was conducted after the challenge, where additional 5 abnormal cases are used for testing to evaluate the performance under abnormal cases. Dice coefficients and absolute surface distances were used as evaluation metrics. Segmentation of each vertebra as a single geometric unit, as well as separate segmentation of vertebra substructures, was evaluated. Five teams participated in the comparative study. The top performers in the study achieved Dice coefficient of 0.93 in the upper thoracic, 0.95 in the lower thoracic and 0.96 in the lumbar spine for healthy cases, and 0.88 in the upper thoracic, 0.89 in the lower thoracic and 0.92 in the lumbar spine for osteoporotic and fractured cases. The strengths and weaknesses of each method as well as future suggestion for improvement are discussed. This is the first multi-center comparative study for vertebra segmentation methods, which will provide an up-to-date performance milestone for the fast growing spinal image analysis and intervention. PMID:26878138
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Closed-Form 3-D Localization for Single Source in Uniform Circular Array with a Center Sensor
NASA Astrophysics Data System (ADS)
Bae, Eun-Hyon; Lee, Kyun-Kyung
A novel closed-form algorithm is presented for estimating the 3-D location (azimuth angle, elevation angle, and range) of a single source in a uniform circular array (UCA) with a center sensor. Based on the centrosymmetry of the UCA and noncircularity of the source, the proposed algorithm decouples and estimates the 2-D direction of arrival (DOA), i.e. azimuth and elevation angles, and then estimates the range of the source. Notwithstanding a low computational complexity, the proposed algorithm provides an estimation performance close to that of the benchmark estimator 3-D MUSIC.
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ERIC Educational Resources Information Center
Rondeau, Ann E.
2010-01-01
This dissertation touches on a series of events leading to an aspect of United States public policy dealing with weapons of mass destruction (WMD). After exploring the literature that describes the understanding of public policy, this paper uses the case study method to understand why and how a single research center and a particular set of…
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Senel, Saliha; Karacan, Candemir; Erkek, Nilgun; Gol, Nese
2010-01-01
To assess the prevalence of urinary tract pathogens and their resistance patterns against antimicrobial agents in a single center. In children <16 years of age admitted for urinary tract infection (UTI) to the Dr. Sami Ulus Teaching and Training Hospital from January 2004 to December 2008, positive urine cultures were reviewed. A total of 3,485 positive urine cultures were identified, of which 2,379 (68%) were from females and 106 (32%) from males. Their mean age was 63.5 +/- 40.7 months. Escherichia coli was the most common causative agent both in total and among different age groups. Ampicillin had the highest resistance rate from all the pathogens isolated (63.8%), followed by piperacillin (51.8%) and trimethoprim-sulfamethoxazole (TMP-SMX; 48.6%). Cephalotin also had a high resistance rate (32.7%). The least resistance was for imipenem, amikacin, netilmicin and ciprofloxacin (0.13, 1.7, 2.4 and 7.5%, respectively). None of the Klebsiella and Pseudomonas isolates were resistant to imipenem. None of the Staphylococcus aureus isolates were resistant to teicoplanin and vancomycin. Vancomycin-resistant Enterococcus spp. were isolated from two cultures. E. coli was the most common causative agent of UTI in children. Ampicillin, TMP-SMX or cephalothin and piperacillin had the highest resistance rates against urinary tract pathogens in our center. Copyright 2010 S. Karger AG, Basel.
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Sudden Unexplained Cardiac Arrest in Apparently Healthy Children: A Single Center Experience
Alapati, Srilatha; Strobel, Nathaniel; Hashmi, Sharukh; Bricker, John T.; Gupta-Malhotra, Monesha
2012-01-01
Objective To determine the causes of sudden cardiac arrest (SCA) in apparently healthy children in a single center in the era of primary prevention (screening questionnaire, SQ) and secondary prevention (automated external defibrillator, AED and automated implantable cardioverter defibrillator, AICD). Study Design Any child (0–18 year’s age) without prior known disease except for attention deficit disorder who underwent out-of-the hospital cardiopulmonary resuscitation was included in the study as SCA. Using retrospective chart review we evaluated the efficacy of the SQ, electrocardiogram (EKG), chest roentgenogram (CXR) and an echocardiogram. Results We found 44 out of 6,656 children admitted to intensive care with SCA; an AED was used in 39%, AICD placed in 18% and survival to hospital discharge was 50%. The etiology for SCA was identified in 57% of the cases, mostly in those above one year of age and among these the majority of had a cardiac etiology (50%) while 7% had rupture of an arteriovenous malformation. Stimulant medication use was seen in 11% of the SCA. In the best case scenario of hypothesized primary prevention, a prior SQ, CXR, EKG and echocardiogram may have detected 18%, 9%, 23% and 16% of at-risk cases respectively and 32% may have been detected with EKG and SQ together. Based on a historical control cohort, a positive EKG was significantly higher in children with SCA (p = 0.014). Conclusion An EKG along with a screening SQ may be more effective in identifying children who are potentially at-risk for SCA than a SQ alone. PMID:23052663
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Overnight switching from oxcarbazepine to eslicarbazepine acetate: an observational study.
Schmid, E; Kuchukhidze, G; Kirschner, M; Leitinger, M; Höfler, J; Rohracher, A; Kalss, G; Wendling, A-S; Steinhoff, B J; Trinka, E
2017-04-01
There are clinical situations where it might be appropriate to switch patients from immediate-release oxcarbazepine (OXC) to eslicarbazepine acetate (ESL). We investigated the effects of transitioning patients overnight from OXC to ESL. A retrospective, single-center study was conducted in which patients with drug-resistant focal epilepsy on a stable dose of immediate-release OXC for at least 4 weeks were switched overnight to ESL. Patients were switched because they experienced persistent seizures with OXC but were unable to tolerate increased OXC dosing due to adverse events. Tolerability was assessed using the Adverse Events Profile (AEP), quality of life was assessed using the Quality of Life in Epilepsy Inventory 10 (QOLIE-10), and alertness was assessed as reaction time using a subtest of the Test Battery for Attention Performance version 2.3. Assessments were performed immediately prior to and 5 days after switching from OXC to ESL (days 0 and 5, respectively). The analysis included 21 patients (12 women, 9 men; mean age 36 years). After switching from OXC to ESL, there were significant improvements in mean scores for AEP (P<.001), QOLIE-10 (P=.001), and alertness (P<.05). Adverse Events Profile total scores improved for 21/21 (100.0%) patients, QOLIE-10 total scores improved for 17/21 (81.0%) patients, and alertness scores improved for 16/21 (76.2%) patients. In this short-term, single-center study, an overnight switch from twice-daily OXC to once-daily ESL in patients with drug-resistant focal epilepsies resulted in improvements in side effects, quality of life, and alertness. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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Raman study of supported molybdenum disulfide single layers
NASA Astrophysics Data System (ADS)
Durrer, William; Manciu, Felicia; Afanasiev, Pavel; Berhault, Gilles; Chianelli, Russell
2008-10-01
Owing to the increasing demand for clean transportation fuels, highly dispersed single layer transition metal sulfides such as MoS2-based catalysts play an important role in catalytic processes for upgrading and removing sulfur from heavy petroleum feed. In its crystalline bulk form, MoS2 is chemically rather inactive due to a strong tendency to form highly stacked layers, but, when dispersed as single-layer nanoclusters on a support, the MoS2 becomes catalytically active in the hydrogenolysis of sulphur and nitrogen from organic compounds (hydrotreating catalysis). In the present studies alumina-supported MoS2 samples were analyzed by confocal Raman spectroscopy. Evidence of peaks at 152 cm-1, 234 cm-1, and 336 cm-1, normally not seen in the Raman spectrum of the standard bulk crystal, confirms the formation of single layers of MoS2. Furthermore, the presence of the 383 cm-1 Raman line suggests the trigonal prismatic coordination of the formed MoS2 single layers. Depending on the sample preparation method, a restacking of MoS2 layers is also observed, mainly for ex-thiomolybdate samples sulfided at 550 C.
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Mudie, Kurt L; Gupta, Amitabh; Green, Simon; Hobara, Hiroaki; Clothier, Peter J
2017-02-01
This study assessed the agreement between K vert calculated from 4 different methods of estimating vertical displacement of the center of mass (COM) during single-leg hopping. Healthy participants (N = 38) completed a 10-s single-leg hopping effort on a force plate, with 3D motion of the lower limb, pelvis, and trunk captured. Derived variables were calculated for a total of 753 hop cycles using 4 methods, including: double integration of the vertical ground reaction force, law of falling bodies, a marker cluster on the sacrum, and a segmental analysis method. Bland-Altman plots demonstrated that K vert calculated using segmental analysis and double integration methods have a relatively small bias (0.93 kN⋅m -1 ) and 95% limits of agreement (-1.89 to 3.75 kN⋅m -1 ). In contrast, a greater bias was revealed between sacral marker cluster and segmental analysis (-2.32 kN⋅m -1 ), sacral marker cluster and double integration (-3.25 kN⋅m -1 ), and the law of falling bodies compared with all methods (17.26-20.52 kN⋅m -1 ). These findings suggest the segmental analysis and double integration methods can be used interchangeably for the calculation of K vert during single-leg hopping. The authors propose the segmental analysis method to be considered the gold standard for the calculation of K vert during single-leg, on-the-spot hopping.
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MacMillan Pier Transportation Center Feasibility Study.
DOT National Transportation Integrated Search
2006-06-01
The MacMillan Pier Transportation Center Feasibility Study examines two potential sites (landside and waterside) for a transportation center that provides a range of tourist and traveler information. It would serve as a gateway for Provincetown and t...
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Vacancy-impurity centers in diamond: prospects for synthesis and applications
NASA Astrophysics Data System (ADS)
Ekimov, E. A.; Kondrin, M. V.
2017-06-01
The bright luminescence of impurity-vacancy complexes, combined with high chemical and radiation resistance, makes diamond an attractive platform for the production of single-photon emitters and luminescent biomarkers for applications in nanoelectronics and medicine. Two representatives of this kind of defects in diamond, silicon-vacancy (SiV) and germanium-vacancy (GeV) centers, are discussed in this review; their similarities and differences are demonstrated in terms of the more thoroughly studied nitrogen-vacancy (NV) complexes. The recent discovery of GeV luminescent centers opens a unique opportunity for the controlled synthesis of single-photon emitters in nanodiamonds. We demonstrate prospects for the high-pressure high-temperature (HPHT) technique to create single-photon emitters, not only as an auxiliary to chemical vapor deposition (CVD) and ion-implantation methods but also as a primary synthesis tool for producing color centers in nanodiamonds. Besides practical applications, comparative studies of these two complexes, which belong to the same structural class of defects, have a fundamental importance for deeper understanding of shelving levels, the electronic structure, and optical properties of these centers. In conclusion, we discuss several open problems regarding the structure, charge state, and practical application of these centers, which still require a solution.
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Cumulative recruitment experience in two large single-center randomized, controlled clinical trials.
Galbreath, Autumn Dawn; Smith, Brad; Wood, Pamela; Forkner, Emma; Peters, Jay I
2008-05-01
Trial recruitment is challenging for researchers, who frequently overestimate the pool of qualified, willing participants. Little has been written about recruitment and the comparative success of recruitment strategies. We describe one center's experience with recruitment in two regional single-center clinical trials with a combined total of 1971 participants. The heart failure trial was conducted between 1999 and 2003. The asthma trial was performed between 2003 and 2006. Trial databases were queried for referral source of each individual. Data were analyzed for effectiveness of referral source using three measures: percentage of enrollment due to that source, subject commitment to the trial (retention rate), and economics (cost per enrollee). 47.8% of CHF enrollees came from computer-generated lists or from healthcare provider referrals. Average marketing cost for enrollees and completers was $29.20 and $41.96 respectively. The most economical marketing strategy was self-referral in response to flyers. Most asthma participants (53.5%) were referred from healthcare providers, mailings to lists from local healthcare institutions, or self-referred in response to flyers. Average marketing cost for enrollees and completers was $20.44 and $38.10 respectively. The most economical marketing strategy was patient mailings. Retention rates were not markedly different among referral sources in either trial. In order to be considered effective, a recruitment strategy must demonstrate a balance between response to recruitment, retention rates, and economics. Despite the differences between these two clinical trials, the most effective recruitment strategies in both trials were mailings to locally-generated, targeted lists, and referrals from healthcare providers.
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Polymer relaxation and stretching dynamics in semi-dilute DNA solutions: a single molecule study
NASA Astrophysics Data System (ADS)
Hsiao, Kai-Wen; Brockman, Christopher; Schroeder, Charles
2015-03-01
In this work, we study polymer relaxation and stretching dynamics in semi-dilute DNA solutions using single molecule techniques. Using this approach, we uncover a unique scaling relation for longest polymer relaxation time that falls in the crossover regime described by semi-flexible polymer solutions, which is distinct from truly flexible polymer chains. In addition, we performed a series of step-strain experiments on single polymers in semi-dilute solutions in planar extensional flow using an automated microfluidic trap. In this way, we are able to precisely control the flow strength and the amount of strain applied to single polymer chains, thereby enabling direct observation of the full stretching and relaxation process in semi-dilute solutions during transient start-up and flow cessation. Interestingly, we observe polymer individualism in the conformation of single chains in semi-dilute solutions, which to our knowledge has not yet been observed. In addition, we observe the relaxation data can be explained by a multi-exponential decay process after flow cessation in semi-dilute solutions. Overall, our work reports key advance in non-dilute polymer systems from a molecular perspective via direct observation of dynamics in strong flows. DOW fellowship.
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Patients' attitudes toward the attire of male physicians: a single-center study in Saudi Arabia.
Batais, Mohammad Ali
2014-01-01
The doctor-patient relationship has been influenced by the appearance of physicians, and there is an association between a physician's physical appearance and the patients' initial perceptions of physician competence. This study aims to explore patients' preferences toward the attire of a male physician, and to examine if a physician's choice of uniform influences the degree of trust, confidence, and follow-up care among respondents. A cross-sectional survey conducted among patients of the Alwazarat family medicine center in Riyadh, Saudi Arabia. A self-administered questionnaire was completed by 300 patients (50% were male and 83.6% had received a secondary education; the mean age was 33.4 [10.1] years) in the Alwazarat family medicine center in Riyadh. The questionnaire was also customized for the local setting with the inclusion of photos of a male doctor in Saudi Arabian national costume, and 3 other dress styles (Western dress with white coat, scrubs with white coat, and scrubs only). Overall, across all questions regarding physician dress style preferences, participants significantly preferred Western dress (39.9%, P < .001), followed by Saudi national dress (26.3%), a scrub suit with a white coat (22.3%), and scrubs only (11.5%). Respondents reported that they were more likely to follow medical advice and would return for follow-up care if a physician wore Western dress. They were significantly more willing to share their social, sexual, and psychological problems with a physician wearing Saudi national dress (P < .001). The importance of a physician's appearance was ranked significantly higher by older patients (P=.002). Respondents were more likely to favor a physician wearing Western attire with a white coat. However, Saudi national dress, followed by Western dress, is the preferred attire when physicians are dealing with social, sexual, and psychological problems.
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Observing conformations of single FoF1-ATP synthases in a fast anti-Brownian electrokinetic trap
NASA Astrophysics Data System (ADS)
Su, Bertram; Düser, Monika G.; Zarrabi, Nawid; Heitkamp, Thomas; Starke, Ilka; Börsch, Michael
2015-03-01
To monitor conformational changes of individual membrane transporters in liposomes in real time, we attach two fluorophores to selected domains of a protein. Sequential distance changes between the dyes are recorded and analyzed by Förster resonance energy transfer (FRET). Using freely diffusing membrane proteins reconstituted in liposomes, observation times are limited by Brownian motion through the confocal detection volume. A. E. Cohen and W. E. Moerner have invented and built microfluidic devices to actively counteract Brownian motion of single nanoparticles in electrokinetic traps (ABELtrap). Here we present a version of an ABELtrap with a laser focus pattern generated by electro-optical beam deflectors and controlled by a programmable FPGA. This ABELtrap could hold single fluorescent nanobeads for more than 100 seconds, increasing the observation times of a single particle more than 1000-fold. Conformational changes of single FRET-labeled membrane enzymes FoF1-ATP synthase can be detected in the ABELtrap.
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Late onset rheumatoid arthritis an observational study.
Rexhepi, Sylejman; Rexhepi, Mjellma; Sahatçiu-Meka, Vjollca; Rexhepi, Blerta; Bahtiri, Elton; Mahmutaj, Vigan
Rheumatoid arthritis (RA) may have an onset at older age. The onset of the disease at the age of 60 and over is called late-onset rheumatoid arthritis (LORA). The aim of this study was to analyze the clinical, laboratory, radiological, and treatment characteristics of patients with LORA compared to those with early-onset RA (EaORA), provided that all the patients had an approximately equal duration of the disease. This is an observational single-center study, which involved 120 patients with an established diagnosis of RA, of which 60 patients had LORA, and 60 patients EaORA. The disease activity, measured by the Disease Activity Score 28 (DAS28-ESR), was significantly higher in the LORA group compared to the EaORA group (p<0.05). Significantly more patients with LORA had involvement of the shoulders (LORA vs. EaORA, 30% vs. 15%; p <0.05) and knees (LORA vs. EaORA, 46.7% vs. 16.7%; p <0.05). Radiological erosive changes were significantly more frequent in the LORA group in comparison with EaORA (p <0.05). There was no difference between the groups regarding rheumatoid factor (RF) positivity (p>0.05), while the number of patients positive for anti-citrullinated protein antibody (ACPA) was signifi cantly greater in the EaORA group (p<0.05). The values of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were significantly higher in the LORA than in the EaORA group. Hemoglobin levels were lower in the LORA group (11.96±1.64 g/dL) than in the EaORA group (12.18±1.56 g/dL). The most used disease-modifying antirheumatic drugs (DMARDs) were methotrexate and sulfasalazine, while biological drugs were not used. In conclusion, based on the results of our study, LORA has some features that distinguish it from EaORA, such as higher disease activity, more frequent involvement of large joints, and more pronounced structural damage. This should be taken in account in clinical practice, especially regarding treatment choices.
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Patient-centered recruitment and retention for a randomized controlled study.
Chhatre, Sumedha; Jefferson, Ashlie; Cook, Ratna; Meeker, Caitlin R; Kim, Ji Hyun; Hartz, Kayla Marie; Wong, Yu-Ning; Caruso, Adele; Newman, Diane K; Morales, Knashawn H; Jayadevappa, Ravishankar
2018-03-27
Recruitment and retention strategies for patient-centered outcomes research are evolving and research on the subject is limited. In this work, we present a conceptual model of patient-centered recruitment and retention, and describe the recruitment and retention activities and related challenges in a patient-centered comparative effectiveness trial. This is a multicenter, longitudinal randomized controlled trial in localized prostate cancer patients. We recruited 743 participants from three sites over 15 months period (January 2014 to March 2015), and followed them for 24 months. At site 1, of the 773 eligible participants, 551 (72%) were enrolled. At site 2, 34 participants were eligible and 23 (68%) enrolled. Of the 434 eligible participants at site 3, 169 (39%) enrolled. We observed that strategies related to the concepts of trust (e.g., physician involvement, ensuring protection of information), communication (e.g., brochures and pamphlets in physicians' offices, continued contact during regular clinic visits and calling/emailing assessment), attitude (e.g., emphasizing the altruistic value of research, positive attitude of providers and research staff), and expectations (e.g., full disclosure of study requirements and time commitment, update letters) facilitated successful patient recruitment and retention. A stakeholders' advisory board provided important input for the recruitment and retention activities. Active engagement, reminders at the offices, and personalized update letters helped retention during follow-up. Usefulness of telephone recruitment was site specific and, at one site, the time requirement for telephone recruitment was a challenge. We have presented multilevel strategies for successful recruitment and retention in a clinical trial using a patient-centered approach. Our strategies were flexible to accommodate site-level requirements. These strategies as well as the challenges can aid recruitment and retention efforts of future large
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Parvin, C A
1993-03-01
The error detection characteristics of quality-control (QC) rules that use control observations within a single analytical run are investigated. Unlike the evaluation of QC rules that span multiple analytical runs, most of the fundamental results regarding the performance of QC rules applied within a single analytical run can be obtained from statistical theory, without the need for simulation studies. The case of two control observations per run is investigated for ease of graphical display, but the conclusions can be extended to more than two control observations per run. Results are summarized in a graphical format that offers many interesting insights into the relations among the various QC rules. The graphs provide heuristic support to the theoretical conclusions that no QC rule is best under all error conditions, but the multirule that combines the mean rule and a within-run standard deviation rule offers an attractive compromise.
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Zhang, Junli; Zhu, Shimeng; Li, Hongli; Zhu, Liu; Hu, Yang; Xia, Weixing; Zhang, Xixiang; Peng, Yong; Fu, Jiecai
2018-05-31
Discovering how the magnetization reversal process is governed by the magnetic anisotropy in magnetic nanomaterials is essential and significant to understand the magnetic behaviour of micro-magnetics and to facilitate the design of magnetic nanostructures for diverse technological applications. In this study, we present a direct observation of a dynamical magnetization reversal process in single NiFe2O4 nanowire, thus clearly revealing the domination of shape anisotropy on its magnetic behaviour. Individual nanoparticles on the NiFe2O4 nanowire appear as single domain states in the remanence state, which is maintained until the magnetic field reaches 200 Oe. The magnetization reversal mechanism of the nanowire is observed to be a curling rotation mode. These observations are further verified by micromagnetic computational simulations. Our findings show that the modulation of shape anisotropy is an efficient way to tune the magnetic behaviours of cubic spinel nano-ferrites.
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Influence of processing conditions on point defects and luminescence centers in ZnO
NASA Astrophysics Data System (ADS)
Zhong, J.; Kitai, A. H.; Mascher, P.
1993-12-01
Positron lifetime spectroscopy and cathodoluminescence were employed to study luminescence centers in ZnO. The samples were high-purity polycrystalline ceramics sintered at temperatures ranging from 800 to 1400 C for 2 to 40 h. Scanning electron microscopy shows that as annealing temperatures and/or times increase, the average grain size increases and can reach 30 micron for samples sintered at 1200 C. At the same time, the positron bulk lifetime approaches theoretically estimated single-crystal values, while the integrated luminescence intensity increase significantly. A further increase of the sintering temperature beyond 1200 C results in a decrease in the luminescence intensity, in good agreement with the only weak luminescence observed in single-crystalline material. The positron lifetime spectra clearly show the existence of the dominant vacancy-type defect, most likely a complex involving V(sub Zn), or the divacancy, V(sub Zn)V(sub O), independent of sample thermal history. The concentration of this center steadily decreases with increasing sintering temperatures. It is concluded that the yellow luminescence centers are related to charged zinc vacancies trapped in the grain boundary regions. We propose that the observed broadness of the spectra likely originates from the modification of the electronic configuration of the luminescence centers due to their complex environment. A direct connection between the positron and the luminescence results could not be established; instead, they appear to reflect two relatively independent aspects of the samples. It could be shown, however, that positron annihilation measurements can be used effectively to monitor the evolution of the microstructure of the samples, in good agreement with scanning electron micrographs.
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Characterization of single grain by observing magnetic ejection and rotation in microgravity
NASA Astrophysics Data System (ADS)
Uyeda, Chiaki
A simple and nondestructive method to perform material identification on a single particle is desired in various fields of material science that is concerned with nano-sized particles. We propose a method of identification based on magnetization data, which is obtained from field-induced translation and rotation in microgravity [1]. Material identification is possible from magnetization data because an intrinsic value of susceptibility and anisotropy is assigned to every material according to a data book that compiles the published values [2]. Preliminary ob-servation on free translational motion due to repulsive field-gradient force was reported for mm-sized crystal of corundum [1] and other oxides. Rotational oscillation was observed for various diamagnetic single-crystals in homogeneous field [2]. In order to examine the capability of the above-mentioned material characterization, translation and rotation motion was observed for sub-millimeter-sized quartz, calcite and forsterite in microgravity condition (MGLAB, Japan, duration: 4.5s). It is expected from motional equations that the 2 motions are independent to mass of particles, In a given field distribution, acceleration of translation is expected to be uniquely determined from intrinsic susceptibility of sample. The above properties are exam-ined in the present work by varying experimental parameters. It is noted that observation of the above two motions in microgravity serve as a useful method to detect magnetization of single small particles, be cause the system is free of both sample holder and mass measure-ment. It is expected that magnetization can be measured on a isolated small sample down to nano-level, in condition that motion of the sample is observable. For both susceptibility and anisotropy, range of observed values using microgravity cover the range of compiled published values [2]. Hence material identification is possible for solid material in general. Diamagnetic magnetization and its
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Fujiwara, Takashi; Nishida, Naoya; Nota, Jumpei; Kitani, Takashi; Aoishi, Kunihide; Takahashi, Hirotaka; Sugahara, Takuya; Hato, Naohito
2016-12-01
Chlorophyll c2 extracted from Sargassum horneri improved allergic symptoms in an animal model of allergic rhinitis. In the present study, we explored the efficacy of chlorophyll c2 in patients with seasonal allergic rhinitis. This was a single-center, randomized, double-blind placebo-controlled trial. Sixty-six patients aged 20-43 years, each with a 2-year history of seasonal allergic rhinitis, were randomly assigned to receive either a single daily dose (0.7 mg) of chlorophyll c2 or placebo for 12 weeks. The use of medications including H1-antihistamines and topical nasal steroids was recorded by rescue medication scores (RMSs) noted after 4, 8, and 12 weeks of treatment. Disease-specific quality of life was measured using the Japan Rhinitis Quality of Life Questionnaire (JRQLQ) both before and after 4, 8, and 12 weeks of treatment. The RMS at 8 weeks was significantly better in the chlorophyll c2 than the placebo group (mean RMS difference = -3.09; 95 % confidence interval = -5.96 to -0.22); the mean RMS at 4 weeks was only slightly better in the chlorophyll c2 group. The JRQLQ scores did not differ significantly between the two groups. Chlorophyll c2 would have a potential to be an alternative treatment for allergic rhinitis.
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NASA Astrophysics Data System (ADS)
Temi, Pasquale; Amblard, Alexandre; Gitti, Myriam; Brighenti, Fabrizio; Gaspari, Massimo; Mathews, William G.; David, Laurence
2018-05-01
We present new ALMA CO(2–1) observations of two well-studied group-centered elliptical galaxies: NGC 4636 and NGC 5846. In addition, we include a revised analysis of Cycle 0 ALMA observations of the central galaxy in the NGC 5044 group. We find evidence that molecular gas is a common presence in bright group-centered galaxies (BGG). CO line widths are broader than Galactic molecular clouds, and using the reference Milky Way X CO, the total molecular mass ranges from 2.6 × 105 M ⊙ in NGC 4636 to 6.1 × 107 M ⊙ in NGC 5044. Complementary observations using the ALMA Compact Array do not exhibit any detection of a CO diffuse component at the sensitivity level achieved by current exposures. The origin of the detected molecular features is still uncertain, but these ALMA observations suggest that they are the end product of the hot gas cooling process and not the result of merger events. Some of the molecular clouds are associated with dust features as revealed by HST dust extinction maps, suggesting that these clouds formed from dust-enhanced cooling. The global nonlinear condensation may be triggered via the chaotic turbulent field or buoyant uplift. The large virial parameter of the molecular structures and correlation with the warm ({10}3{--}{10}5 {{K}})/hot (≥106) phase velocity dispersion provide evidence that they are unbound giant molecular associations drifting in the turbulent field, consistent with numerical predictions of the chaotic cold accretion process. Alternatively, the observed large CO line widths may be generated by molecular gas flowing out from cloud surfaces due to heating by the local hot gas atmosphere.
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NASA Astrophysics Data System (ADS)
Wulf, Dallas; Eckart, Mega E.; Galeazzi, Massimiliano; Jaeckel, Felix; Kelley, Richard L.; Kilbourne, Caroline A.; McCammon, Dan; Morgan, Kelsey M.; Porter, Frederick S.; Szymkowiak, Andrew E.
2018-01-01
High spectral resolution observations in the soft x-rays are necessary for understanding and modelling the hot component of the interstellar medium and its contribution to the Soft X-ray Background (SXRB). This extended source emission cannot be resolved with most wavelength dispersive spectrometers, making energy dispersive microcalorimeters the ideal choice for these observations. We present here the analysis of the most recent sounding rocket flight of the University of Wisconsin-Madison/Goddard Space Flight Center X-ray Quantum Calorimeter (XQC), a large area silicon thermistor microcalorimeter. This 111 second observation integrates a nearly 1 steradian field of view in the direction of the galactic anti-center (l, b = 165°, -5°) and features ~5 eV spectral resolution below 1 keV. Direct comparison will also be made to the previous, high-latitude observations.
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Success of single-balloon enteroscopy in patients with surgically altered anatomy.
Kurzynske, Frank C; Romagnuolo, Joseph; Brock, Andrew S
2015-08-01
Single-balloon enteroscopy (SBE) was introduced in 2007 to diagnose and treat small-bowel disorders. No study to date has evaluated SBE in patients with surgically altered anatomy outside of ERCP. To evaluate the efficacy, yield, and safety of SBE in patients with surgically altered anatomy. Retrospective study. Tertiary-care academic medical center. All patients with altered surgical anatomy who underwent SBE at the Medical University of South Carolina from July 2007 to September 2013. SBE. Diagnostic yield, therapeutic yield, technical success, and adverse events. A total of 48 patients met inclusion criteria. Mean age was 56 years (77% female). Eleven patients underwent single-balloon PEG placement, 8 single-balloon ERCP, 22 non-PEG/non-ERCP anterograde SBE, and 7 retrograde SBE. Previous surgeries included Roux-en-Y gastric bypass (n=26), small-intestine resection (n=6), colon resection (n=5), Whipple procedure (n=4), choledochojejunostomy (n=3), hepaticojejunostomy (n=1), Billroth I (n=1), Billroth II (n=1), and Puestow procedure (n=1). Procedural indications were PEG tube placement (n=11), choledocholithiasis (n=2), biliary stricture (n=2), obstructive jaundice (n=1), cholangitis (n=1), ampullary mass (n=1), sphincter of Oddi dysfunction (n=1), anemia and/or bleeding (n=15), abdominal pain (n=9), radiologic evidence of obstruction (n=3), and Peutz-Jeghers syndrome (n=2). The technical success rate was 73% in single-balloon PEG placement, 88% in single-balloon ERCP, 82% in other anterograde SBEs, and 86% in retrograde SBEs. No intraprocedural or postprocedural adverse events were observed. Single center, retrospective study. SBE is safe and effective in patients with surgically altered anatomy. Copyright © 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.
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Optical characterization of single-crystal diamond grown by DC arc plasma jet CVD
NASA Astrophysics Data System (ADS)
Hei, Li-fu; Zhao, Yun; Wei, Jun-jun; Liu, Jin-long; Li, Cheng-ming; Lü, Fan-xiu
2017-12-01
Optical centers of single-crystal diamond grown by DC arc plasma jet chemical vapor deposition (CVD) were examined using a low-temperature photoluminescence (PL) technique. The results show that most of the nitrogen-vacancy (NV) complexes are present as NV- centers, although some H2 and H3 centers and B-aggregates are also present in the single-crystal diamond because of nitrogen aggregation resulting from high N2 incorporation and the high mobility of vacancies under growth temperatures of 950-1000°C. Furthermore, emissions of radiation-induced defects were also detected at 389, 467.5, 550, and 588.6 nm in the PL spectra. The reason for the formation of these radiation-induced defects is not clear. Although a Ni-based alloy was used during the diamond growth, Ni-related emissions were not detected in the PL spectra. In addition, the silicon-vacancy (Si-V)-related emission line at 737 nm, which has been observed in the spectra of many previously reported microwave plasma chemical vapor deposition (MPCVD) synthetic diamonds, was absent in the PL spectra of the single-crystal diamond prepared in this work. The high density of NV- centers, along with the absence of Ni-related defects and Si-V centers, makes the single-crystal diamond grown by DC arc plasma jet CVD a promising material for applications in quantum computing.
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NASA Astrophysics Data System (ADS)
Wielgosz, P. A.
In this year, the system of active geodetic GPS permanent stations is going to be estab- lished in Poland. This system should provide GPS observations for a wide spectrum of users, especially it will be a great opportunity for surveyors. Many of surveyors still use cheaper, single frequency receivers. This paper focuses on processing of single frequency GPS observations only. During processing of such observations the iono- sphere plays an important role, so we concentrated on the influence of the ionosphere on the positional coordinates. Twenty consecutive days of GPS data from 2001 year were processed to analyze the accuracy of a derived three-dimensional relative vec- tor position between GPS stations. Observations from two Polish EPN/IGS stations: BOGO and JOZE were used. In addition to, a new test station - IGIK was created. In this paper, the results of single frequency GPS observations processing in near real- time are presented. Baselines of 15, 27 and 42 kilometers and sessions of 1, 2, 3, 4, and 6 hours long were processed. While processing we used CODE (Centre for Orbit De- termination in Europe, Bern, Switzerland) predicted products: orbits and ionosphere info. These products are available in real-time and enable near real-time processing. Software Bernese v. 4.2 for Linux and BPE (Bernese Processing Engine) mode were used. These results are shown with a reference to dual frequency weekly solution (the best solution). Obtained GPS positional time and GPS baseline length dependency accuracy is presented for single frequency GPS observations.
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NASA Astrophysics Data System (ADS)
Topaz, On; Luxenberg, Michael; Schumacher, Audrey
1994-07-01
Clinical experience with the mid IR holmium:YAG laser in a single medical center (St. Paul Ramsey Medical Center, University of Minnesota Medical School, St. Paul, MN) includes 112 patients who underwent holmium laser coronary angioplasty. Utilizing a unique lasing technique; `pulse and retreat,' we applied this laser to thrombotic and nonthrombotic lesions in patients presenting with unstable angina, stable angina, and acute myocardial infarction. A very high clinical success and very low complication rates were achieved. Holmium:YAG laser is effective and safe therapy for patients with symptomatic coronary artery disease. Unlike excimer lasers, the clinical success, efficacy and safety of holmium laser angioplasty is not compromised when thrombus is present.
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The Management of Superior Mesenteric Artery Aneurysm: Experience with 16 Cases in a Single Center.
Zilun, Li; Henghui, Yin; Yang, Zhao; Mian, Wang; Guangqi, Chang; Shenming, Wang
2017-07-01
Superior mesenteric artery aneurysm (SMAA) represents a rare but potentially fatal condition. This study aimed to present the individual management protocol of SMAA in our center and to discuss a potential preliminary treatment algorithm. SMAA patients treated in our center between January 2007 and December 2014 were retrospectively reviewed on January 2015. Sixteen patients with SMAA were identified, including 1 female and 15 males, with a mean age of 48.9 ± 12.9 years. Three patients (3/16, 18.8%) were treated by multiple overlapping bare stents and one (1/16, 6.3%) initially by a single bare stent. Two cases (2/16, 12.5%) were treated by a covered stent implantation, but one of those suffered from SMAA rupture 7 days later, whereas the other had inner-stent thrombosis one month after discharge and died from multiple organ-dysfunction syndrome. Nine patients (9/16, 56.2%) received conservative therapy, one of who received multiple overlapping bare stents implantations for persistent abdominal pain. One patient underwent open surgery. There were 2 major complications, with no death during hospitalization and 1 death during follow-up. SMAA treatment needs to be individually prescribed, based on clinical manifestation, anatomy, and etiology. Multiple overlapping bare stents are safe and effective in selective patients with SMAA, and covered stents should be used with caution to avoid covering proximal branches; open surgery should be reserved for patients with suspected intestinal necrosis. Copyright © 2017 Elsevier Inc. All rights reserved.
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Falls, Roman; Seman, Michael; Braat, Sabine; Sortino, Joshua; Allen, Jason D; Neil, Christopher J
2017-08-08
Acute heart failure (AHF) is a frequent reason for hospitalization worldwide and effective treatment options are limited. It is known that AHF is a condition characterized by impaired vasorelaxation, together with reduced nitric oxide (NO) bioavailability, an endogenous vasodilatory compound. Supplementation of inorganic sodium nitrate (NaNO 3 ) is an indirect dietary source of NO, through bioconversion. It is proposed that oral sodium nitrate will favorably affect levels of circulating NO precursors (nitrate and nitrite) in AHF patients, resulting in reduced systemic vascular resistance, without significant hypotension. We propose a single center, randomized, double-blind, placebo-controlled pilot trial, evaluating the feasibility of sodium nitrate as a treatment for AHF. The primary hypothesis that sodium nitrate treatment will result in increased systemic levels of nitric oxide pre-cursors (nitrate and nitrite) in plasma, in parallel with improved vasorelaxation, as assessed by non-invasively derived systemic vascular resistance index. Additional surrogate measures relevant to the known pathophysiology of AHF will be obtained in order to assess clinical effect on dyspnea and renal function. The results of this study will provide evidence of the feasibility of this novel approach and will be of interest to the heart failure community. This trial may inform a larger study.
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Medical Waste Management in Community Health Centers.
Tabrizi, Jafar Sadegh; Rezapour, Ramin; Saadati, Mohammad; Seifi, Samira; Amini, Behnam; Varmazyar, Farahnaz
2018-02-01
Non-standard management of medical waste leads to irreparable side effects. This issue is of double importance in health care centers in a city which are the most extensive system for providing Primary Health Care (PHC) across Iran cities. This study investigated the medical waste management standards observation in Tabriz community health care centers, northwestern Iran. In this triangulated cross-sectional study (qualitative-quantitative), data collecting tool was a valid checklist of waste management process developed based on Iranian medical waste management standards. The data were collected in 2015 through process observation and interviews with the health center's staff. The average rate of waste management standards observance in Tabriz community health centers, Tabriz, Iran was 29.8%. This case was 22.8% in dimension of management and training, 27.3% in separating and collecting, 31.2% in transport and temporary storage, and 42.9% in sterilization and disposal. Lack of principal separation of wastes, inappropriate collecting and disposal cycle of waste and disregarding safety tips (fertilizer device performance monitoring, microbial cultures and so on) were among the observed defects in health care centers supported by quantitative data. Medical waste management was not in a desirable situation in Tabriz community health centers. The expansion of community health centers in different regions and non-observance of standards could predispose to incidence the risks resulted from medical wastes. So it is necessary to adopt appropriate policies to promote waste management situation.
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Learner-Centered Principles in Teacher-Centered Practices?
ERIC Educational Resources Information Center
Schuh, K.L.
2004-01-01
In the study reported here, I compare Learner-Centered Battery (a questionnaire of students' perceptions of the classroom) results and the observation and interview data gathered in one sixth-grade classroom noting first a discrepancy between the descriptions of the classroom that stems from each. I review this discrepancy, highlighting a need for…
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Fernando, Disala; Siederer, Sarah; Singh, Sunita; Schneider, Ian; Gupta, Ashutosh; Powell, Marcy; Richards, Duncan; McIntosh, Michelle P; Lambert, Peter; Fowles, Susan
2017-08-01
The utility of intramuscular (IM) oxytocin for the prevention of postpartum hemorrhage in resource-poor settings is limited by the requirement for temperature-controlled storage and skilled staff to administer the injection. We evaluated the safety, tolerability and pharmacokinetics (PK) of a heat-stable, inhaled (IH) oxytocin formulation. This phase 1, randomized, single-center, single-blind, dose-escalation, fixed-sequence study (NCT02542813) was conducted in healthy, premenopausal, non-pregnant, non-lactating women aged 18-45years. Subjects initially received IM oxytocin 10 international units (IU) on day 1, IH placebo on day 2, and IH oxytocin 50μg on day 3. Subjects were then randomized 4:1 using validated GSK internal software to IH placebo or ascending doses of IH oxytocin (200, 400, 600μg). PK was assessed by comparing systemic exposure (maximum observed plasma concentration, area under the concentration-time curve, and plasma concentrations at 10 and 30min post dose) for IH versus IM oxytocin. Adverse events (AEs), spirometry, laboratory tests, vital signs, electrocardiograms, physical examinations, and cardiac telemetry were assessed. Subjects were recruited between September 14, 2015 and October 12, 2015. Of the 16 subjects randomized following initial dosing, 15 (IH placebo n=3; IH oxytocin n=12) completed the study. IH (all doses) and IM oxytocin PK profiles were comparable in shape. However, systemic exposure with IH oxytocin 400μg most closely matched IM oxytocin 10IU. Systemic exposure was approximately dose proportional for IH oxytocin. No serious AEs were reported. No clinically significant findings were observed for any safety parameters. These data suggest that similar oxytocin systemic exposure can be achieved with IM and IH administration routes, and no safety concerns were identified with either route. The inhalation route may offer the opportunity to increase access to oxytocin for women giving birth in resource-poor settings. Copyright
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An automated single ion hit at JAERI heavy ion microbeam to observe individual radiation damage
NASA Astrophysics Data System (ADS)
Kamiya, Tomihiro; Sakai, Takuro; Naitoh, Yutaka; Hamano, Tsuyoshi; Hirao, Toshio
1999-10-01
Microbeam scanning and a single ion hit technique have been combined to establish an automated beam positioning and single ion hit system at the JAERI Takasaki heavy ion microbeam system. Single ion irradiation on preset points of a sample in various patterns can be performed automatically in a short period. The reliability of the system was demonstrated using CR-39 nuclear track detectors. Single ion hit patterns were achieved with a positioning accuracy of 2 μm or less. In measurement of single event transient current using this system, the reduction of the pulse height by accumulation of radiation damages was observed by single ion injection to the same local areas. This technique showed a possibility to get some quantitative information about the lateral displacement of an individual radiation effect in silicon PIN photodiodes. This paper will give details of the irradiation system and present results from several experiments.
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A single-center retrospective study of pediatric hepatoblastoma
Zhang, Yi; Zhang, Weiling; Tang, Suoqin; Chen, Liping; Yi, You; Zhang, Pinwei; Liu, Aiping; Zhi, Tian; Huang, Dongsheng
2016-01-01
Hepatoblastoma is a malignant liver tumor generally diagnosed in infants and children <3 years old. The current retrospective study aimed to investigate the associations of tumor stage, pathological type, metastasis and chemotherapy with clinical outcomes. In the current study, a total of 102 patients with hepatoblastoma were enrolled between September 2006 and June 2014. Clinical records and follow-up information for each of patient were obtained to conduct a Kaplan-Meier survival analysis and log-rank test. The median age of the subjects was 1.5 years, and 98 patients had stage III or IV hepatoblastoma. Complete or partial remittance occurred in 72 subjects, and 91 underwent surgical operation. The survival rate differed significantly among patients with different tumor stages (P=0.015, χ2=8.359). The mortality rate of stage IV subjects with intrahepatic metastasis was significantly higher than that of those without (P=0.004). Among the 45 subjects with relapsed hepatoblastoma, the mortality rate was higher in the subjects that abandoned chemotherapy than in patients who continued regular chemotherapy. In total, 27 of 45 subjects with relapsed hepatoblastoma succumbed to the disease; 20 of them abandoned chemotherapy treatment; and the remaining 7 patients underwent regular chemotherapy and succumbed to the disease by the end of follow-up. The present study indicates that the increased mortality rate was associated with postoperative residual-induced intrahepatic metastasis and relapsed hepatoblastoma; and that regular chemotherapy is necessary for patient to achieve complete or partial remission following surgical operation. PMID:27895749
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[TRENDS OF PERMANENT PACEMAKER IMPLANTATION IN A SINGLE CENTER OVER A 20-YEAR PERIOD].
Antonelli, Dante; Ilan, Limor Bushar; Freedberg, Nahum A; Feldman, Alexander; Turgeman, Yoav
2015-05-01
To review the changes in permanent pacemaker implantation indications, pacing modes and patients' demographics over a 20-year period. We retrospectively retrieved data on patients who underwent first implantation of the pacemaker between 1-1-1991 and 31-12-2010. One thousand and nine (1,009) patients underwent a first pacemaker implantation during that period; 535 were men (53%), their mean age was 74.6±19.5 years; the highest rate of implanted pacemaker was in patients ranging in age from 70-79 years, however there was an increasing number of patients aged over 80 years. The median survival time after initial pacemaker implantation was 8 years. Syncope was the most common symptom (62.5%) and atrioventricular block was the most common electrocardiographic indication (56.4%) leading to pacemaker implantation. There was increased utilization of dual chamber and rate responsive pacemakers over the years. There was no difference regarding mode selection between genders. Pacemaker implantation rates have increased over a 20-year period. Dual chamber replaced most of the single ventricular chamber pacemaker and rate responsive pacemakers became the norm. The data of a small volume center are similar to those reported in pacemaker surveys of high volume pacemaker implantation centers. They confirm adherence to the published guidelines for pacing.
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Hypertensive crisis in children: an experience in a single tertiary care center in Korea.
Lee, Geum Hwa; Lee, I Re; Park, Se Jin; Kim, Ji Hong; Oh, Ji Young; Shin, Jae Il
2015-01-01
Hypertensive crisis is a medical emergency that can cause acute damage to multiple end-organs. However, relatively little is known on the etiology, treatment, and outcomes of hypertensive crisis in Korean children. The aim of this study was to determine the etiologies and efficacy of drugs for hypertensive crisis in children during the past 5 years at a single center in Korea. We analyzed data from 51 children with hypertensive crisis during the period between January 1, 2010 and April 1, 2014. The patients were divided into two groups: those diagnosed with a hypertensive emergency (hypertension with organ injury, n = 31) and those diagnosed with a hypertensive urgency (hypertension without organ injury, n = 20). Baseline etiologies and risk factors were compared between the two groups. In addition, systolic and diastolic blood pressures were evaluated at 1, 2, 4, and 5 hours after the administration of intravenous antihypertensive drugs. Kidney injury and cancer were the common causes in patients with hypertensive crisis. Cardiovascular complications (cardiac hypertrophy) (p = 0.002), central nervous system complications (p = 0.004), and retinopathy (p = 0.034) were more frequently observed in children with hypertensive emergency than those with hypertensive urgency. However, the proportion of renal complications was similar in both groups. Hydralazine was most commonly used in both groups to control acute increasing blood pressure at first. However, it was often ineffective for controlling abrupt elevated blood pressure. Therefore, intravenous antihypertensive drugs were changed from hydralazine to nicardipine, labetalol, or nitroprusside to control the high blood pressure in 45.1 % of the patients. Particularly, in patients with hypertensive crisis, there was no significant difference in reduction of systolic and diastolic blood pressure and in improvement of clinical outcomes between nicardipine and labetalol administration. Close blood
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A Naturalistic Observational Study of Informal Segregation: Seating Patterns in Lectures
ERIC Educational Resources Information Center
Koen, Jennifer; Durrheim, Kevin
2010-01-01
In spite of the removal of legislated racial segregation, a number of observational studies in South Africa and elsewhere have shown that "informal," nonlegislated segregation persists in spaces of everyday interaction. Most of these have been case studies of segregation at single sites. The authors seek to quantify segregation in a…
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Thompson, Keith A; Morrissey, Ryan P; Phan, Anita; Schwarz, Ernst R
2012-08-01
To determine the effects of the US economy on heart failure hospitalization rates. The recession was associated with worsening unemployment, loss of private insurance and prescription medication benefits, medication nonadherence, and ultimately increased rates of hospitalization for heart failure. We compared hospitalization rates at a large, single, academic medical center from July 1, 2006 to February 28, 2007, a time of economic stability, and July 1, 2008 to February 28, 2009, a time of economic recession in the United States. Significantly fewer patients had private medical insurance during the economic recession than during the control period (36.5% vs 46%; P = 0.04). Despite this, there were no differences in the heart failure hospitalization or readmission rates, length of hospitalization, need for admission to an intensive care unit, in-hospital mortality, or use of guideline-recommended heart failure medications between the 2 study periods. We conclude that despite significant effects on medical insurance coverage, rates of heart failure hospitalization at our institution were not significantly affected by the recession. Additional large-scale population-based research is needed to better understand the effects of fluctuations in the US economy on heart failure hospitalization rates. © 2012 Wiley Periodicals, Inc.
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Color-Center Production and Formation in Electron-Irradiated Magnesium Aluminate Spinel and Ceria
Costantini, Jean-Marc; Lelong, Gerald; Guillaumet, Maxime; ...
2016-06-20
Single crystals of magnesium aluminate spinel (MgAl2O4) with (100) or (110) orientations and cerium dioxide or ceria (CeO2) were irradiated by 1.0-MeV and 2.5-MeV electrons in a high fluence range. Point-defect production was studied by off-line UV-visible optical spectroscopy after irradiation. For spinel, regardless of both crystal orientation and electron energy, two characteristic broad bands centered at photon energies of 5.4 eV and 4.9 eV were assigned to F and F+ centers (neutral and singly-ionized oxygen vacancies), respectively, on the basis of available literature data. No clear differences in colour-centre formation were observed for the two crystal orientations. Using calculationsmore » of displacement cross sections by elastic collisions, these results are consistent with a very large threshold displacement energy (200 eV) for oxygen atoms at RT. A third very broad band centered at 3.7 eV might be attributed either to an oxygen hole center (V-type center) or an F2 dimer center (oxygen di-vacancy). The onset of recovery of these color centers took place at 200°C with almost full bleaching at 600°C. Activation energies (~0.3-0.4 eV) for defect recovery were deduced from the isochronal annealing data by using a first-order kinetics analysis. For ceria, a sub band-gap absorption feature peaked at ~3.1 eV was recorded for 2.5-MeV electron irradiation only. Assuming a ballistic process, we suggest that the latter defect might result from cerium atom displacement on the basis of computed cross sections.« less
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Cocci, Andrea; Russo, Giorgio Ivan; Salonia, Andrea; Cito, Gianmartin; Regis, Federica; Polloni, Gaia; Giubilei, Gianluca; Cacciamani, Giovanni; Capece, Marco; Falcone, Marco; Greco, Isabella; Timpano, Massimiliano; Minervini, Andrea; Gacci, Mauro; Cai, Tommaso; Garaffa, Giulio; Giammusso, Bruno; Arcaniolo, Davide; Mirone, Vincenzo; Mondaini, Nicola
2018-05-01
Collagenase Clostridium histolyticum (CCH; Xiapex) injections represent the only licensed medical treatment for Peyronie's disease (PD). To evaluate the efficacy and safety of CCH injections in men with stable PD, using a modified treatment protocol and to assess partners' bother improvement in a large cohort of White-European sexually active heterosexual men treated in a single tertiary-referral center. All the 135 patients enrolled underwent a thorough assessment, which included history taking, physical examination, and pharmacologically induced artificial erection test (intra-cavernous injection) to assess the degree of penile curvature (PC) at baseline and after the completion of the treatment. Patients with calcified plaque and/or ventral curvature were excluded. All patients underwent a modified treatment protocol, which consisted of 3 intra-lesional injections of 0.9 mg of CCH performed at 4-week intervals at the point of maximum curvature. After each injection, patients were instructed to follow a strict routine involving daily penile stretching in the intervals between injections. International Index of Erectile Function (IIEF)-15, Global Assessment of PD, PD questionnaires (PDQ), and Female Sexual Function Index (FSFI) questionnaire were performed at baseline and at the end of treatment. Overall, 135 patients completed the study protocol. Before treatment, 18 (13.33%) partners showed a degree of sexual dysfunction. Baseline median IIEF-15, FSFI, and PDQ scores were, respectively, 59.0, 35.0, and 23.0. Overall, both IIEF-total and all domains significantly improved after treatment (all P < .01). A PC mean change of 19.07 (P = .00) was measured. At the univariate linear regression analysis, IIEF-15, IIEF-erectile function, IIEF-sexual desire, and IIEF-intercourse satisfaction were positively associated with FSFI (all P ≤ .03); conversely, PDQ-penile pain, PDQ-symptom bother, and post-treament penile curvature (P ≤ .04) were associated with a decreased
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Xue, Yu; Jiang, Li; Wan, Wei-Guo; Chen, Yu-Ming; Zhang, Jiong; Zhang, Zhen-Chun
2016-02-05
Rheumatic diseases involve multiple organs that are affected by immunological mechanisms. Treatment with corticosteroids and immunosuppressive agents may also increase the frequency of infection. Cytomegalovirus (CMV) is a widespread herpes virus and a well-recognized pathogen, which causes an opportunistic and potentially fatal infection in immunocompromised patients. This retrospective study aimed to investigate the clinical and laboratory characteristics of CMV pneumonia in patients with rheumatic diseases after immunosuppressive therapy in a single center in Shanghai, China. Eight hundred and thirty-four patients with rheumatic diseases who had undergone CMV-DNA viral load tests were included, and the medical records of 142 patients who were positive for CMV-DNA in plasma samples were evaluated. GraphPad Prism version 5.013 (San Diego, CA, USA) was used to conduct statistical analysis. The correlation between CMV-DNA viral loads and lymphocyte counts was assessed using the Spearman rank correlation coefficient test. Significance between qualitative data was analyzed using Pearson's Chi-squared test. The cut-off thresholds for CMV-DNA viral load and lymphocyte count were determined by receiver operating characteristic (ROC) curve analysis. One hundred and forty-two patients had positive CMV viral load tests. Of these 142 patients, 73 patients with CMV pneumonia were regarded as symptomatic, and the other 69 were asymptomatic. The symptomatic group received higher doses of prednisolone (PSL) and more frequently immunosuppressants than the asymptomatic group (P < 0.01). The symptomatic group had lower lymphocyte counts, especially CD4+ T-cells, than the asymptomatic group (P < 0.01). By ROC curve analysis, when CD4+ T-cell count was <0.39 × 109/L, patients with rheumatic diseases were at high risk for symptomatic CMV infection. The CMV-DNA load was significantly higher in the symptomatic patients than that in asymptomatic patients (P < 0.01; threshold viral loads
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A single center analysis of factors influencing study start-up timeline in clinical trials.
Krafcik, Brianna M; Doros, Gheorghe; Malikova, Marina A
2017-11-01
Efficient start-up phase in clinical trials is crucial to execution. The goal was to determine factors contributing to delays. The start-up milestones were assessed for 38 studies and analyzed. Total start-up time was shorter for following studies: device trials, no outsourcing, fewer ancillary services used and in interventional versus observational designs. The use of a centralized Institutional Review Board (IRB) versus a local IRB reduced time to approval. Studies that never enrolled took longer on average to finalize their budget/contract, and obtain IRB than ones that did enroll. Different features of clinical trials can affect timeline of start-up process. An understanding of the impact of each feature allows for optimization.
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Applying a structured innovation process to interventional radiology: a single-center experience.
Sista, Akhilesh K; Hwang, Gloria L; Hovsepian, David M; Sze, Daniel Y; Kuo, William T; Kothary, Nishita; Louie, John D; Yamada, Kei; Hong, Richard; Dhanani, Riaz; Brinton, Todd J; Krummel, Thomas M; Makower, Joshua; Yock, Paul G; Hofmann, Lawrence V
2012-04-01
To determine the feasibility and efficacy of applying an established innovation process to an active academic interventional radiology (IR) practice. The Stanford Biodesign Medical Technology Innovation Process was used as the innovation template. Over a 4-month period, seven IR faculty and four IR fellow physicians recorded observations. These observations were converted into need statements. One particular need relating to gastrostomy tubes was diligently screened and was the subject of a single formal brainstorming session. Investigators collected 82 observations, 34 by faculty and 48 by fellows. The categories that generated the most observations were enteral feeding (n = 9, 11%), biopsy (n = 8, 10%), chest tubes (n = 6, 7%), chemoembolization and radioembolization (n = 6, 7%), and biliary interventions (n = 5, 6%). The output from the screening on the gastrostomy tube need was a specification sheet that served as a guidance document for the subsequent brainstorming session. The brainstorming session produced 10 concepts under three separate categories. This formalized innovation process generated numerous observations and ultimately 10 concepts to potentially to solve a significant clinical need, suggesting that a structured process can help guide an IR practice interested in medical innovation. Copyright © 2012 SIR. Published by Elsevier Inc. All rights reserved.
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Feng, Wei; Wang, Zhigang; Zhang, Wenke
2017-02-28
Understanding the relationship between polymer chain conformation as well as the chain composition within the single crystal and the mechanical properties of the corresponding single polymer chain will facilitate the rational design of high performance polymer materials. Here three model systems of polymer single crystals, namely poly(ethylene oxide) (PEO), polyethylene (PE), and nylon-66 (PA66) have been chosen to study the effects of chain conformation, helical (PEO) versus planar zigzag conformation (PE, PA66), and chain composition (PE versus PA66) on the mechanical properties of a single polymer chain. To do that, steered molecular dynamics simulations were performed on those polymer single crystals by pulling individual polymer chains out of the crystals. Our results show that the patterns of force-extension curve as well as the chain moving mode are closely related to the conformation of the polymer chain in the single crystal. In addition, hydrogen bonds can enhance greatly the force required to stretch the polymer chain out of the single crystal. The dynamic breaking and reformation of multivalent hydrogen bonds have been observed for the first time in PA66 at the single molecule level.
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A single residue controls electron transfer gating in photosynthetic reaction centers
NASA Astrophysics Data System (ADS)
Shlyk, Oksana; Samish, Ilan; Matěnová, Martina; Dulebo, Alexander; Poláková, Helena; Kaftan, David; Scherz, Avigdor
2017-03-01
Interquinone QA- → QB electron-transfer (ET) in isolated photosystem II reaction centers (PSII-RC) is protein-gated. The temperature-dependent gating frequency “k” is described by the Eyring equation till levelling off at T ≥ 240 °K. Although central to photosynthesis, the gating mechanism has not been resolved and due to experimental limitations, could not be explored in vivo. Here we mimic the temperature dependency of “k” by enlarging VD1-208, the volume of a single residue at the crossing point of the D1 and D2 PSII-RC subunits in Synechocystis 6803 whole cells. By controlling the interactions of the D1/D2 subunits, VD1-208 (or 1/T) determines the frequency of attaining an ET-active conformation. Decelerated ET, impaired photosynthesis, D1 repair rate and overall cell physiology upon increasing VD1-208 to above 130 Å3, rationalize the >99% conservation of small residues at D1-208 and its homologous motif in non-oxygenic bacteria. The experimental means and resolved mechanism are relevant for numerous transmembrane protein-gated reactions.
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Analysis of sepsis in allogeneic bone marrow transplant recipients: a single-center study.
Mitsui, Hideki; Karasuno, Takahiro; Santo, Taisuke; Fukushima, Kentaro; Matsunaga, Hitomi; Nakamura, Hiroyuki; Hiraoka, Akira
2003-09-01
We reviewed the records of 235 consecutive recipients of allogeneic bone marrow transplantation (allo-BMT) at our center between February 1983 and October 2000. Sepsis occurred in 25 patients (10.6%) at a median of 10 days (range, 1-280 days) after BMT. Five of the 25 patients (20%) died of sepsis. Pathogens isolated from blood culture were gram-positive cocci in 19 patients, gram-negative rods in 7, fungi in 2, and others in 1 patient. Two pathogens were detected concomitantly in 4 patients. Univariate analysis revealed that risk factors for sepsis were selective gut decontamination using lomefloxacin hydrochloride and nystatin, an unrelated donor, HLA mismatched BMT, and stomatitis. Multivariate logistic regression analysis revealed that an unrelated donor was the only significant independent risk factor, with a relative risk of 5.432. In 12 of 25 patients with sepsis, the pathogens of sepsis were sensitive to antibiotics used for gut decontamination. Selective gut decontamination significantly increased the incidence of sepsis, especially that with gram-positive cocci, but not the mortality rate of sepsis, compared with total gut decontamination using vancomycin. We also found a significant relationship between pathogens isolated from blood culture and those isolated from surveillance cultures of stool, urine, and gargled water in the period before sepsis occurred. The present study revealed an independent risk factor for sepsis (unrelated donor), the feasibility of selective gut decontamination, and the importance of surveillance culture.
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[Study on single-walled carbon nanotube thin film photoelectric device].
Xie, Wen-bin; Zhu, Yong; Gong, Tian-cheng; Chen, Yu-lin; Zhang, Jie
2015-01-01
The single-walled carbon nanotube film photoelectric device was invented, and it can generate net photocurrent under bias voltage when it is illuminated by the laser. The influences of bias voltage, laser power and illuminating position on the net photocurrent were investigated. The experimental results showed that when the center of the film was illuminated, the photocurrent increased with the applied bias, but tended to saturate as the laser power increased. As the voltage and the laser power reached 0. 2 V and 22. 7 mW respectively, the photocurrent reached 0. 24 µA. When the voltage was removed, the photocurrent varied with the laser illuminating position on the film and its value was distributed symmetrically about the center of the device. The photocurrent reached maximum and almost zero respectively when the laser illuminated on two ends and the center of the film. Analysis proposes that the net photocurrent can be generated due to internal photoelectric effect when the device is under voltage and the laser illuminates on the center of the film. It can be also generated due to photo-thermoelectric effect when the device is under no voltage and the laser illuminates on the film, and the relation between the net photocurrent and the illuminating position was derived according to the nature of thermoelectric power of single-walled carbon nanotubes with the established temperature model, which coincides with experimental result. Two effects are the reasons for the generation and variety of the net photocurrent and they superimpose to form the result of the net photocurrent when the device is under general conditions of voltage and laser illuminating position. The device has potential applications in the areas of photovoltaic device and optical sensor for its characteristic.
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Observational Study of Human Electrical Muscle Incapacitation and Cardiac Effects
2016-05-01
the American College of Cardiology Foundation. Circulation. 2010 Mar 2; 121(8):1047-1060. 12. U.S. Department of Health and Human Services, Food and...AFRL-RH-FS-TR-2016-0010 Observational Study of Human Electrical Muscle Incapacitation and Cardiac Effects John A. Gibbons Brian B. Lupfer Alan...Ashworth Human Effectiveness Directorate Bioeffects Division Andrew J. Mojica KBRwyle Inc. Mark E. Peele USARMY MEDCOM Brooke Army Medical Center
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Deformation induced microtwins and stacking faults in aluminum single crystal.
Han, W Z; Cheng, G M; Li, S X; Wu, S D; Zhang, Z F
2008-09-12
Microtwins and stacking faults in plastically deformed aluminum single crystal were successfully observed by high-resolution transmission electron microscope. The occurrence of these microtwins and stacking faults is directly related to the specially designed crystallographic orientation, because they were not observed in pure aluminum single crystal or polycrystal before. Based on the new finding above, we propose a universal dislocation-based model to judge the preference or not for the nucleation of deformation twins and stacking faults in various face-centered-cubic metals in terms of the critical stress for dislocation glide or twinning by considering the intrinsic factors, such as stacking fault energy, crystallographic orientation, and grain size. The new finding of deformation induced microtwins and stacking faults in aluminum single crystal and the proposed model should be of interest to a broad community.
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NASA Technical Reports Server (NTRS)
An, Deokkeun; Ramirez, Solange V.; Sellgren, Kris; Arendt, Richard G.; Boogert, A. C. Adwin; Robitaille, Thomas P.; Schultheis, Mathias; Cotera, Angela S.; Smith, Howard A.; Stolovy, Susan R.
2011-01-01
We present results from our spectroscopic study, using the Infrared Spectrograph (IRS) onboard the Spitzer Space Telescope, designed to identify massive young stellar objects (YSOs) in the Galactic Center (GC). Our sample of 107 YSO candidates was selected based on IRAC colors from the high spatial resolution, high sensitivity Spitzer/IRAC images in the Central Molecular Zone (CMZ), which spans the central approximately 300 pc region of the Milky Way Galaxy. We obtained IRS spectra over 5 micron to 35 micron using both high- and low-resolution IRS modules. We spectroscopically identify massive YSOs by the presence of a 15.4 micron shoulder on the absorption profile of 15 micron CO2 ice, suggestive of CO2 ice mixed with CH30H ice on grains. This 15.4 micron shoulder is clearly observed in 16 sources and possibly observed in an additional 19 sources. We show that 9 massive YSOs also reveal molecular gas-phase absorption from C02, C2H2, and/or HCN, which traces warm and dense gas in YSOs. Our results provide the first spectroscopic census of the massive YSO population in the GC. We fit YSO models to the observed spectral energy distributions and find YSO masses of 8 - 23 solar Mass, which generally agree with the masses derived from observed radio continuum emission. We find that about 50% of photometrically identified YSOs are confirmed with our spectroscopic study. This implies a preliminary star formation rate of approximately 0.07 solar mass/yr at the GC.
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Multidisciplinary Approach to Esophageal Achalasia: A Single Center Experience.
Schlottmann, Francisco; Andolfi, Ciro; Kavitt, Robert T; Konda, Vani J A; Patti, Marco G
2017-04-01
The treatment of achalasia is palliative. Pneumatic dilatation (PD) or laparoscopic Heller myotomy (LHM) just eliminates the outflow obstruction allowing easier emptying of the esophagus. The aim of this study was to evaluate the results of a multidisciplinary approach to esophageal achalasia. A consecutive series of patients with achalasia treated by a multidisciplinary esophageal team consisting of radiologists, gastroenterologists, and surgeons in a quaternary care center between May 2008 and April 2015 were analyzed. A total of 147 patients with achalasia underwent LHM and partial fundoplication. Sixty-two patients (42%) had been treated preoperatively with PD and/or botulinum toxin (BT). The preoperative Eckardt score (ES) was 6.4 ± 2. At a median follow-up of 22 months, 128 patients (87%) did well and required no further treatment (ES 0.1). The remaining 19 patients (13%) had recurrence of symptoms and required further treatment: 12 were treated with PD and improved (ES 0.7); 4 were treated with PD and BT and improved (ES 1.3); 3 failed PD. These 3 patients had been treated with multiple sessions of PD and BT before the myotomy. Overall, 144 patients (98%) did well with laparoscopic (87%) or laparoscopic and endoscopic treatment (11%). The results of this study show that (a) LHM is an effective treatment modality, (b) PD improved symptoms in the majority of patients with recurrent dysphagia after myotomy and (c) multiple preoperative endoscopic treatments seem to affect outcomes of LHM. Patients with achalasia should be treated in a quaternary care center by a multidisciplinary team.
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Azimi, Parisa; Shahzadi, Sohrab; Bitaraf, Mohammad Ali; Azar, Maziar; Alikhani, Mazdak; Zali, Alireza; Sadeghi, Sohrab; Montazeri, Ali
2017-01-01
Background: This study was aimed to explore data on brain metastases in cancer patients attending the Iranian Gamma Knife Center. Meterials and Methods: This was a retrospective study. In all 5216 case records of patients who referred to the Iranian Gamma Knife Center for treatment of brain tumors during year 2003-2011 were reviewed. Data were explored to identify patients who developed brain metastases due to cancer and assessed the information as applied to cancer patients including survival analysis. Results: Two hundred and twenty patients were identified as having brain metastases due to cancer. The mean age of patients was 54.0 (standard deviation [SD] =12.7) years. Patients were followed for an average of 7 months after treatment with gamma-knife. The median survival time for different the Graded Prognostic Assessment (GPA) was: GPA: 0-1, 4.0 ± 0.4 months; GPA: 1.5-2.5, 6.0 ± 0.7 months; GPA: 3, 9.0 ± 0.9 months; and GPA: 3.5-4.0, 12.0 ± 1.8 months and the overall median survival was 7.0 (SD = 0.6) months. Conclusion: The findings suggest that many cancer patients in Iran might develop brain metastasis. Although, this is not a very high incidence compared with the existing statistics from other countries, there is an urgent need to explore the issue further. PMID:28761536
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Azimi, Parisa; Shahzadi, Sohrab; Bitaraf, Mohammad Ali; Azar, Maziar; Alikhani, Mazdak; Zali, Alireza; Sadeghi, Sohrab; Montazeri, Ali
2017-01-01
This study was aimed to explore data on brain metastases in cancer patients attending the Iranian Gamma Knife Center. This was a retrospective study. In all 5216 case records of patients who referred to the Iranian Gamma Knife Center for treatment of brain tumors during year 2003-2011 were reviewed. Data were explored to identify patients who developed brain metastases due to cancer and assessed the information as applied to cancer patients including survival analysis. Two hundred and twenty patients were identified as having brain metastases due to cancer. The mean age of patients was 54.0 (standard deviation [SD] =12.7) years. Patients were followed for an average of 7 months after treatment with gamma-knife. The median survival time for different the Graded Prognostic Assessment (GPA) was: GPA: 0-1, 4.0 ± 0.4 months; GPA: 1.5-2.5, 6.0 ± 0.7 months; GPA: 3, 9.0 ± 0.9 months; and GPA: 3.5-4.0, 12.0 ± 1.8 months and the overall median survival was 7.0 (SD = 0.6) months. The findings suggest that many cancer patients in Iran might develop brain metastasis. Although, this is not a very high incidence compared with the existing statistics from other countries, there is an urgent need to explore the issue further.
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NASA Technical Reports Server (NTRS)
Holmes, Thomas; Owe, Manfred; deJeu, Richard
2007-01-01
Two data sets of experimental field observations with a range of meteorological conditions are used to investigate the possibility of modeling near-surface soil temperature profiles in a bare soil. It is shown that commonly used heat flow methods that assume a constant ground heat flux can not be used to model the extreme variations in temperature that occur near the surface. This paper proposes a simple approach for modeling the surface soil temperature profiles from a single depth observation. This approach consists of two parts: 1) modeling an instantaneous ground flux profile based on net radiation and the ground heat flux at 5cm depth; 2) using this ground heat flux profile to extrapolate a single temperature observation to a continuous near surface temperature profile. The new model is validated with an independent data set from a different soil and under a range of meteorological conditions.
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Competition of the self-activated and Mn-related luminescence in ZnS single crystals
NASA Astrophysics Data System (ADS)
Bacherikov, Yu. Yu.; Vorona, I. P.; Markevich, I. V.; Korsunska, N. O.; Kurichka, R. V.
2018-06-01
The photoluminescence (PL) and photoluminescence excitation (PLE) spectra of ZnS single crystals thermally doped from ZnS/MnS mixture were studied at 300 and 77 K. PL spectra exhibit bands caused by Mn-related centers and centers of self-activated (SA) emission. Besides intrinsic maximum, a number of narrow peaks corresponded to Mn-related absorption are found in the PLE spectra of both SA and Mn-related emission. A redistribution of SA and Mn-related emission intensities is observed with temperature change. The mechanism of this phenomenon involving free hole trapping by MnZn and the possible position of a ground energy level of substitutional Mn are discussed.
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Patel, Manish V; Patel, Kalapi B; Gupta, Shivenarain; Michalsen, Andreas; Stapelfeldt, Elmar; Kessler, Christian S
2015-01-01
Hepatic cirrhosis is one of the leading causes of death worldwide, especially if complicated by ascites. This chronic condition can be related to the classical disease entity jalodara in Traditional Indian Medicine (Ayurveda). The present paper aims to evaluate the general potential of Ayurvedic therapy for overall clinical outcomes in hepatic cirrhosis complicated by ascites (HCcA). In form of a nonrandomized, uncontrolled, single group, open-label observational clinical study, 56 patients fulfilling standardized diagnostic criteria for HCcA were observed during their treatment at the P. D. Patel Ayurveda Hospital, Nadiad, India. Based on Ayurvedic tradition, a standardized treatment protocol was developed and implemented, consisting of oral administration of single and compound herbal preparations combined with purificatory measures as well as dietary and lifestyle regimens. The outcomes were assessed by measuring liver functions through specific clinical features and laboratory parameters and by evaluating the Child-Pugh prognostic grade score. After 6 weeks of treatment and a follow-up period of 18 weeks, the outcomes showed statistically significant and clinically relevant improvements. Further larger and randomized trials on effectiveness, safety, and quality of the Ayurvedic approach in the treatment of HCcA are warranted to support these preliminary findings.
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Tranexamic acid use during total hip arthroplasty: A single center retrospective analysis.
Stoicea, Nicoleta; Moran, Kenneth; Mahmoud, Abdel-Rasoul; Glassman, Andrew; Ellis, Thomas; Ryan, John; Granger, Jeffrey; Joseph, Nicholas; Salon, Nathan; Ackermann, Wiebke; Rogers, Barbara; Niermeyer, Weston; Bergese, Sergio D
2018-05-01
Tranexamic acid (TXA) is an antifibrinolytic agent that has shown promise in reducing blood loss during total hip arthroplasty (THA). Several studies have reported side effects of high-dose TXA administration, including myocardial infarction (MI), thromboembolic events, and seizures. These possible side effects have prevented the widespread adoption of TXA in the surgical community. We conducted a retrospective chart review of 564 primary and revision THAs performed at a single academic center. Surgical patients received either no TXA or 1 g IV TXA at the beginning of surgery followed by a second bolus just before the surgical wound closure, at the surgeon's discretion. We analyzed differences in hemoglobin (Hb), hematocrit (Hct), estimated blood loss (EBL), and adverse events in patients receiving TXA versus patients not receiving TXA up to 2 days following surgery. Significantly higher Hb and Hct values were found across all time points among patients undergoing primary posterior or revision THA who had received TXA. In addition, transfusion rates were significantly decreased in both primary posterior THAs and revision THAs when TXA was administered. Patients who received TXA experienced significantly fewer adverse events than those who did not for all surgery types. Administration of low-dose intravenous (IV) and intra-articular (IA) TXA does not appear to increase rates of adverse events and may be effective in minimizing blood loss, as reflected by Hb and Hct values following THA.
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Churilov, Leonid
2018-01-01
The hemodynamic effects of intravenous (IV) paracetamol in patients undergoing cardiac surgery are unknown. We performed a prospective single center placebo controlled randomized study with parallel group design in adult patients undergoing elective cardiac surgery. Participants received paracetamol (1 gram) IV or placebo (an equal volume of 0.9% saline) preoperatively followed by two postoperative doses 6 hours apart. The primary endpoint was the absolute change in systolic (SBP) 30 minutes after the preoperative infusion, analysed using an ANCOVA model. Secondary endpoints included absolute changes in mean arterial pressure (MAP) and diastolic blood pressure (DPB), and other key hemodynamic variables after each infusion. All other endpoints were analysed using random-effect generalized least squares regression modelling with individual patients treated as random effects. Fifty participants were randomly assigned to receive paracetamol (n = 25) or placebo (n = 25). Post preoperative infusion, paracetamol decreased SBP by a mean (SD) of 13 (18) mmHg, p = 0.02, compared to a mean (SD) of 1 (11) mmHg with saline. Paracetamol decreased MAP and DBP by a mean (SD) of 9 (12) mmHg and 8 (9) mmHg (p = 0.01 and 0.02), respectively, compared to a mean (SD) of 1 (8) mmHg and 0 (6) mmHg with placebo. Postoperatively, there were no significant differences in pressure or flow based hemodynamic parameters in both groups. This study provides high quality evidence that the administration of IV paracetamol in patients undergoing cardiac surgery causes a transient decrease in preoperative blood pressure when administered before surgery but no adverse hemodynamic effects when administered in the postoperative setting. PMID:29659631
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Chiam, Elizabeth; Bellomo, Rinaldo; Churilov, Leonid; Weinberg, Laurence
2018-01-01
The hemodynamic effects of intravenous (IV) paracetamol in patients undergoing cardiac surgery are unknown. We performed a prospective single center placebo controlled randomized study with parallel group design in adult patients undergoing elective cardiac surgery. Participants received paracetamol (1 gram) IV or placebo (an equal volume of 0.9% saline) preoperatively followed by two postoperative doses 6 hours apart. The primary endpoint was the absolute change in systolic (SBP) 30 minutes after the preoperative infusion, analysed using an ANCOVA model. Secondary endpoints included absolute changes in mean arterial pressure (MAP) and diastolic blood pressure (DPB), and other key hemodynamic variables after each infusion. All other endpoints were analysed using random-effect generalized least squares regression modelling with individual patients treated as random effects. Fifty participants were randomly assigned to receive paracetamol (n = 25) or placebo (n = 25). Post preoperative infusion, paracetamol decreased SBP by a mean (SD) of 13 (18) mmHg, p = 0.02, compared to a mean (SD) of 1 (11) mmHg with saline. Paracetamol decreased MAP and DBP by a mean (SD) of 9 (12) mmHg and 8 (9) mmHg (p = 0.01 and 0.02), respectively, compared to a mean (SD) of 1 (8) mmHg and 0 (6) mmHg with placebo. Postoperatively, there were no significant differences in pressure or flow based hemodynamic parameters in both groups. This study provides high quality evidence that the administration of IV paracetamol in patients undergoing cardiac surgery causes a transient decrease in preoperative blood pressure when administered before surgery but no adverse hemodynamic effects when administered in the postoperative setting.
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2012-01-01
Background Enzyme replacement therapy (ERT) in adults with Pompe disease, a progressive neuromuscular disorder, is of promising but variable efficacy. We investigated whether it alters the course of disease, and also identified potential prognostic factors. Methods Patients in this open-label single-center study were treated biweekly with 20 mg/kg alglucosidase alfa. Muscle strength, muscle function, and pulmonary function were assessed every 3–6 months and analyzed using repeated-measures ANOVA. Results Sixty-nine patients (median age 52.1 years) were followed for a median of 23 months. Muscle strength increased after start of ERT (manual muscle testing 1.4 percentage points per year (pp/y); hand-held dynamometry 4.0 pp/y; both p < 0.001). Forced vital capacity (FVC) remained stable when measured in upright, but declined in supine position (−1.1 pp/y; p = 0.03). Muscle function did not improve in all patients (quick motor function test 0.7 pp/y; p = 0.14), but increased significantly in wheelchair-independent patients and those with mild and moderate muscle weakness. Relative to the pre-treatment period (49 patients with 14 months pre-ERT and 22 months ERT median follow-up), ERT affected muscle strength positively (manual muscle testing +3.3 pp/y, p < 0.001 and hand-held dynamometry +7.9 pp/y, p < 0.001). Its effect on upright FVC was +1.8 pp/y (p = 0.08) and on supine FVC +0.8 (p = 0.38). Favorable prognostic factors were female gender for muscle strength, and younger age and better clinical status for supine FVC. Conclusions We conclude that ERT positively alters the natural course of Pompe disease in adult patients; muscle strength increased and upright FVC stabilized. Functional outcome is probably best when ERT intervention is timely. PMID:23013746
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Correlation of Site of Embryo Transfer with IVF Outcome: Analysis of 743 Cycles from a Single Center
Singh, Neeta; Lata, Kusum; Malhotra, Neena; Vanamail, P.
2017-01-01
Objective: To investigate the influence of site of embryo transfer (ET) on reproductive outcome. Materials and Methods: A retrospective analysis of 743 ultrasound-guided ET in fresh in vitro fertilization (IVF) cycles from a single center over a period of 4 years was conducted. The distance between the fundal endometrial surface and the air bubble was measured, and accordingly, patients were divided into four groups (≤10 mm; >10 and ≤15 mm; >15 and 20 mm; >20 and <25 mm). Setting: Tertiary Assisted Reproductive Technology (ART) center. Patient(s): All patients enrolled in the IVF program undergoing ET. Intervention(s): Controlled ovarian hyperstimulation (OS), IVF, and ET. Main Outcome Measure(s): Cleavage rate and clinical pregnancy rate. Result(s): Clinical pregnancy rate was significantly more in groups 2 and 3 compared to the other groups. Logistic regression analysis showed that one unit increase in embryos transfer will enhance the pregnancy outcome about 3.7 (adjusted odds ratio) times with 95% confidence limits 2.6 to 5.4. Similarly, pregnancy outcome will be 3.1 (95% confidence limits: 1.5–6.4) times higher for distance group >15 and <20 mm compared to less than 10-mm distance group. Ectopic pregnancy rates were similar in all the four groups. Conclusion: The present study demonstrates that site of ET has significant difference on reproductive outcome. PMID:28904498
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Single Meson Photoproduction at JLab Energies
NASA Astrophysics Data System (ADS)
Mathieu, Vincent; Joint Physics Analysis Center Team
2016-09-01
In this talk, I present the results from the Joint Physics Analysis Center about the photoproduction of a single meson (pseudoscalar or vector meson). We have developed the theoretical formalism to analysis forthcoming data at the, recently upgraded, JLab facility. We also present prediction for observables in the energy range of Eg = 5-11 GeV. Material (codes, notes, sim- ulations, etc) can be found online at the JPAC interactive website: http://www.indiana.edu/ jpac/index.html
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Fis protein induced λF-DNA bending observed by single-pair fluorescence resonance energy transfer
NASA Astrophysics Data System (ADS)
Chi-Cheng, Fu; Wunshain, Fann; Yuan Hanna, S.
2006-03-01
Fis, a site-specific DNA binding protein, regulates many biological processes including recombination, transcription, and replication in E.coli. Fis induced DNA bending plays an important role in regulating these functions and bending angle range from ˜50 to 95 dependent on the DNA sequence. For instance, the average bending angle of λF-DNA (26 bp, 8.8nm long, contained λF binding site on the center) measured by gel mobility shift assays was ˜ 94 . But the traditional method cannot provide information about the dynamics and the angle distribution. In this study, λF-DNA was labeled with donor (Alexa Fluor 546) and acceptor (Alexa Fluor 647) dyes on its two 5' ends and the donor-acceptor distances were measured using single-pair fluorescence resonance energy transfer (sp-FRET) with and without the present of Fis protein. Combing with structure information of Fis-DNA complex, the sp-FRET results are used to estimate the protein induced DNA bending angle distribution and dynamics.
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Biological Information Processing in Single Microtubules
2014-03-05
single Microtubule Google Mountain view campus, workshop on quantum biology 22 October 2010 3. Paul Davies Beyond Center at Arizona State University...Phoenix) Phoenix, workshop on quantum biology and cancer research, Experimental studies on single microtubule, 25-27 October 2010, Tempe, Arizona...State University, USA 4. Quantum aspects of microtubule: Direct experimental evidence for the existence of quantum states in microtubule, Towards a
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AFTER-SCHOOL STUDY CENTERS, VOLUNTEER WORK IN READING.
ERIC Educational Resources Information Center
JANOWITZ, GAYLE
A STUDY CENTER IN HYDE PARK, CHICAGO, WAS OPENED IN SEPTEMBER 1962. IT CONSISTED OF A DEPOSIT COLLECTION FROM THE PUBLIC LIBRARY, A STUDY ROOM EQUIPPED WITH REFERENCE MATERIAL, AND SPACE FOR INDIVIDUAL TUTORING. THE PURPOSE OF THE STUDY CENTER WAS TO HELP CHILDREN FEEL THAT SUCCESS IS POSSIBLE SO THAT THEY COULD BEGIN TO FEEL MORE SELF-CONFIDENT…
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Interruptions in a level one trauma center: a case study.
Brixey, Juliana J; Tang, Zhihua; Robinson, David J; Johnson, Craig W; Johnson, Todd R; Turley, James P; Patel, Vimla L; Zhang, Jiajie
2008-04-01
The emergency department has been characterized as interrupt-driven. Government agencies and patient safety organizations recognize that interruptions contribute to medical errors. The purpose of this study was to observe, record, and contextualize activities and interruptions experienced by physicians and Registered Nurses (RNs) working in a Level One Trauma Center. A case study that relied on an ethnographic study design using the shadowing method. A convenience sample of physicians and RNs, each with at least 6 months of experience in the Emergency Department (ED), were asked to participate. In these kinds of detailed qualitative investigations, it is quite common to have a small sample size. Ethical approval: Approval was obtained from institutional ethic committees prior to initiating the study. Community consent was obtained from the ED staff through in-service education. All observations were made in the trauma section of the ED of a tertiary teaching hospital. The hospital is situated in a major medical center in the Gulf Coast region of the United States of America (USA). Five attending ED physicians were observed for a total of 29h, 31min. Eight RNs were shadowed for a total of 40 h, 9min. Interruptions and activities were categorized using the Hybrid Method to Categorize Interruptions and Activities (HyMCIA). Registered Nurses received slightly more interruptions per hour than physicians. People, pagers, and telephones were identified as mediums through which interruptions were delivered. The physical environment was found to contribute to interruptions in workflow because of physical design and when supplies were not available. Physicians and RNs usually returned to the original, interrupted activity more often than leaving the activity unfinished. This research provides an enhanced understanding of interruptions in workflow in the ED, the identification of work constraints, and the need to develop interventions to manage interruptions. It is crucial
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NASA Astrophysics Data System (ADS)
Cremer, Johannes W.; Thaler, Klemens M.; Haisch, Christoph; Signorell, Ruth
2016-03-01
Photochemistry taking place in atmospheric aerosol droplets has a significant impact on the Earth's climate. Nanofocusing of electromagnetic radiation inside aerosols plays a crucial role in their absorption behaviour, since the radiation flux inside the droplet strongly affects the activation rate of photochemically active species. However, size-dependent nanofocusing effects in the photokinetics of small aerosols have escaped direct observation due to the inability to measure absorption signatures from single droplets. Here we show that photoacoustic measurements on optically trapped single nanodroplets provide a direct, broadly applicable method to measure absorption with attolitre sensitivity. We demonstrate for a model aerosol that the photolysis is accelerated by an order of magnitude in the sub-micron to micron size range, compared with larger droplets. The versatility of our technique promises broad applicability to absorption studies of aerosol particles, such as atmospheric aerosols where quantitative photokinetic data are critical for climate predictions.
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Cremer, Johannes W.; Thaler, Klemens M.; Haisch, Christoph; Signorell, Ruth
2016-01-01
Photochemistry taking place in atmospheric aerosol droplets has a significant impact on the Earth's climate. Nanofocusing of electromagnetic radiation inside aerosols plays a crucial role in their absorption behaviour, since the radiation flux inside the droplet strongly affects the activation rate of photochemically active species. However, size-dependent nanofocusing effects in the photokinetics of small aerosols have escaped direct observation due to the inability to measure absorption signatures from single droplets. Here we show that photoacoustic measurements on optically trapped single nanodroplets provide a direct, broadly applicable method to measure absorption with attolitre sensitivity. We demonstrate for a model aerosol that the photolysis is accelerated by an order of magnitude in the sub-micron to micron size range, compared with larger droplets. The versatility of our technique promises broad applicability to absorption studies of aerosol particles, such as atmospheric aerosols where quantitative photokinetic data are critical for climate predictions. PMID:26979973
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NASA Astrophysics Data System (ADS)
Kwok, Ngaiming; Shi, Haiyan; Peng, Yeping; Wu, Hongkun; Li, Ruowei; Liu, Shilong; Rahman, Md Arifur
2018-04-01
Restoring images captured under low-illuminations is an essential front-end process for most image based applications. The Center-Surround Retinex algorithm has been a popular approach employed to improve image brightness. However, this algorithm in its basic form, is known to produce color degradations. In order to mitigate this problem, here the Single-Scale Retinex algorithm is modifid as an edge extractor while illumination is recovered through a non-linear intensity mapping stage. The derived edges are then integrated with the mapped image to produce the enhanced output. Furthermore, in reducing color distortion, the process is conducted in the magnitude sorted domain instead of the conventional Red-Green-Blue (RGB) color channels. Experimental results had shown that improvements with regard to mean brightness, colorfulness, saturation, and information content can be obtained.
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Yamada, Shozo; Fukuhara, Noriaki; Yamaguchi-Okada, Mitsuo; Nishioka, Hiroshi; Takeshita, Akira; Takeuchi, Yasuhiro; Inoshita, Naoko; Ito, Junko
2018-03-30
OBJECTIVE The aim of this study was to analyze the outcomes of transsphenoidal surgery (TSS) in a single-center clinical series of pediatric craniopharyngioma patients treated with gross-total resection (GTR). METHODS The authors retrospectively reviewed the surgical outcomes for 65 consecutive patients with childhood craniopharyngiomas (28 girls and 37 boys, mean age 9.6 years) treated with TSS (45 primary and 20 repeat surgeries) between 1990 and 2015. Tumors were classified as subdiaphragmatic or supradiaphragmatic. Demographic and clinical characteristics, including extent of resection, complications, incidence of recurrence, pre- and postoperative visual disturbance, pituitary function, and incidence of diabetes insipidus (DI), as well as new-onset obesity, were analyzed and compared between the primary surgery and repeat surgery groups. RESULTS Of the 45 patients in the primary surgery group, 26 (58%) had subdiaphragmatic tumors and 19 had supradiaphragmatic tumors. Of the 20 patients in the repeat surgery group, 9 (45%) had subdiaphragmatic tumors and 11 had supradiaphragmatic tumors. The only statistically significant difference between the 2 surgical groups was in tumor size; tumors were larger (mean maximum diameter 30 mm) in the primary surgery group than in the repeat surgery group (25 mm) (p = 0.008). GTR was accomplished in 59 (91%) of the 65 cases; the GTR rate was higher in the primary surgery group than in the repeat surgery group (98% vs 75%, p = 0.009). Among the patients who underwent GTR, 12% experienced tumor recurrence, with a median follow-up of 7.8 years, and recurrence tended to occur less frequently in primary than in repeat surgery patients (7% vs 27%, p = 0.06). Of the 45 primary surgery patients, 80% had deteriorated pituitary function and 83% developed DI, whereas 100% of the repeat surgery patients developed these conditions. Among patients with preoperative visual disturbance, vision improved in 62% but worsened in 11%. Visual
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Thiering, Gergő; Londero, Elisa; Gali, Adam
2014-10-21
Fluorescent nanodiamonds constitute an outstanding alternative to semiconductor quantum dots and dye molecules for in vivo biomarker applications, where the fluorescence comes from optically active point defects acting as color centers in the nanodiamonds. For practical purposes, these color centers should be photostable as a function of the laser power or the surface termination of nanodiamonds. Furthermore, they should exhibit a sharp and nearly temperature-independent zero-phonon line. In this study, we show by hybrid density functional theory calculations that nickel doped nanodiamonds exhibit the desired properties, thus opening the avenue to practical applications. In particular, harnessing the strong quantum confinement effect in molecule-sized nanodiamonds is very promising for achieving multicolor imaging by single nickel-related defects.
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NASA Astrophysics Data System (ADS)
Thiering, Gergő; Londero, Elisa; Gali, Adam
2014-09-01
Fluorescent nanodiamonds constitute an outstanding alternative to semiconductor quantum dots and dye molecules for in vivo biomarker applications, where the fluorescence comes from optically active point defects acting as color centers in the nanodiamonds. For practical purposes, these color centers should be photostable as a function of the laser power or the surface termination of nanodiamonds. Furthermore, they should exhibit a sharp and nearly temperature-independent zero-phonon line. In this study, we show by hybrid density functional theory calculations that nickel doped nanodiamonds exhibit the desired properties, thus opening the avenue to practical applications. In particular, harnessing the strong quantum confinement effect in molecule-sized nanodiamonds is very promising for achieving multicolor imaging by single nickel-related defects.
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1992-12-30
34 Family Policy," December 30, 1988 o / (b) DoD Directive 4001.1, "Installation Management ,, September 4, 1986 (c) DoD 4165.63-M, "DoD Housing Management ... managing the competing demands of the military mission and the family . They shall provide the information and family services necessary to support single...effectiveness of Family Centers. The evaluation system shall include: (1) A management information report to allow Family Centers to reflect actual workloads
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Dowell, Joshua D., E-mail: Joshua.Dowell@osumc.edu; Wagner, Daniel, E-mail: Daniel.Wagner@osumc.edu; Elliott, Eric, E-mail: Eric.Elliott@osumc.edu
PurposeTo identify factors associated with advanced inferior vena cava filter (IVCF) retrieval to raise awareness on technical considerations, retrieval efficiency, and patient safety.Materials and MethodsA single-center retrospective review was performed of 203 consecutive retrievable IVC filters placed between 2007 and 2014. Attempted retrievals were classified as advanced if the routine “snare and sheath” technique was initially unsuccessful after multiple attempts, or an alternate endovascular maneuver or access site was utilized. Patient and filter characteristics were recorded.Results203 attempted retrievals were reviewed (48.7 % male, 51.2 % female, mean age 52.7 years, mean dwell time 109 days). Advanced retrievals were observed in 20 patients (9.8 %) (15more » females, 5 males). Fluoroscopy time (p ≤ 0.01, 34.3 ± 21.1 and 5.3 ± 4.5 min for advanced retrievals and routine retrievals respectively, same below), gender (p = 0.031), and retrieval tilt angle (p ≤ 0.01, 5.7 ± 5.10° vs. 11.9 ± 11.03°) were associated with advanced retrievals. Females were 3.16 times more likely to have an advanced retrieval performed than males with a significantly higher tilt angle in those with advanced retrieval. History of cancer (p = 0.502), dwell time (p = 0.916), retrieval caval diameter (p = 0.053), placement caval diameter (p = 0.365), filter type (p = 0.710), strut perforation (p = 0.506), placement tilt angle (p = 0.311), and age (p = 0.558) were not found significantly associated with advanced retrievals.ConclusionsWomen are at increased risk for advanced filter retrieval secondary to a significant change in filter tilt over time compared to men, independent of filter type or competing demographic or filter risks, likely placing them at increased risk for higher procedural fluoroscopy times.« less
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NASA Technical Reports Server (NTRS)
Wheeler, R. M.; Sager, J. C.; Prince, R. P.; Knott, W. M.; Mackowiak, C. L.; Stutte, G. W.; Yorio, N. C.; Ruffe, L. M.; Peterson, B. V.; Goins, G. D.
2003-01-01
The use of plants for bioregenerative life support for space missions was first studied by the US Air Force in the 1950s and 1960s. Extensive testing was also conducted from the 1960s through the 1980s by Russian researchers located at the Institute of Biophysics in Krasnoyarsk, Siberia, and the Institute for Biomedical Problems in Moscow. NASA initiated bioregenerative research in the 1960s (e.g., Hydrogenomonas) but this research did not include testing with plants until about 1980, with the start of the Controlled Ecological Life Support System (CELSS) Program. The NASA CELSS research was carried out at universities, private corporations, and NASA field centers, including Kennedy Space Center (KSC). The project at KSC began in 1985 and was called the CELSS Breadboard Project to indicate the capability for plugging in and testing various life support technologies; this name has since been dropped but bioregenerative testing at KSC has continued to the present under the NASA s Advanced Life Support (ALS) Program. A primary objective of the KSC testing was to conduct pre-integration tests with plants (crops) in a large, atmospherically closed test chamber called the Biomass Production Chamber (BPC). Test protocols for the BPC were based on observations and growing procedures developed by university investigators, as well as procedures developed in plant growth chamber studies at KSC. Growth chamber studies to support BPC testing focused on plant responses to different carbon dioxide (CO2) concentrations, different spectral qualities from various electric lamps, and nutrient film hydroponic culture techniques.
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Single visit nonsurgical endodontic therapy for periapical cysts: A clinical study.
Maity, Ipsita; Meena, N; Kumari, R Anitha
2014-04-01
The aim of this study was to assess the outcome of single sitting root canal treatment (RCT) of asymptomatic teeth with periapical cysts. Ten maxillary anterior teeth showing periapical lesion on the radiograph was further screened by ultrasound with color power Doppler (CPD) for confirmation of a cyst. The average dimension of the lesions ranged from 1.3 to 1.9 cm. Single sitting RCT was performed on all the selected teeth. Postoperative healing was monitored at regular interval of 3 months, 6 months, and 1 year by using subjective feedback, radiograph, and ultrasound with CPD study. Eight among the ten cases showed either signs of complete healing or healing in progress by the end of 6-12 months. It was observed that single sitting nonsurgical endodontic management of asymptomatic teeth with periapical cyst confirmed by ultrasound was successful in selected cases.
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Single-molecule studies of the neuronal SNARE fusion machinery.
Brunger, Axel T; Weninger, Keith; Bowen, Mark; Chu, Steven
2009-01-01
SNAREs are essential components of the machinery for Ca(2+)-triggered fusion of synaptic vesicles with the plasma membrane, resulting in neurotransmitter release into the synaptic cleft. Although much is known about their biophysical and structural properties and their interactions with accessory proteins such as the Ca(2+) sensor synaptotagmin, their precise role in membrane fusion remains an enigma. Ensemble studies of liposomes with reconstituted SNAREs have demonstrated that SNAREs and accessory proteins can trigger lipid mixing/fusion, but the inability to study individual fusion events has precluded molecular insights into the fusion process. Thus, this field is ripe for studies with single-molecule methodology. In this review, we discuss applications of single-molecule approaches to observe reconstituted SNAREs, their complexes, associated proteins, and their effect on biological membranes. Some of the findings are provocative, such as the possibility of parallel and antiparallel SNARE complexes or of vesicle docking with only syntaxin and synaptobrevin, but have been confirmed by other experiments.
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ERIC Educational Resources Information Center
Garrett, Tracey
2008-01-01
The major purpose of this case study was to document the classroom management beliefs and practices of three teachers reputed to implement student-centered instruction and to examine the relationship between their instructional and managerial approaches. More specifically, do teachers who use student-centered instruction also implement…
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Laundry pack exposures in children 0-5 years evaluated at a single pediatric institution.
Yin, Shan; Behrman, Alysha; Colvin, Jonathan
2015-05-01
Case reports and poison center series have highlighted increased safety concerns with laundry packs, especially when compared to traditional laundry detergents. The purpose of this study was to examine the clinical experience with laundry pack exposures at a single institution. A retrospective chart review was performed for exposures to laundry packs seen at a single tertiary care children's hospital medical center. Cases were identified by searching the poison center database for exposures to laundry products from March 2012 to October 2013 in children <5 years old. Medical records were reviewed for all identified cases. Data collected included demographics, treatments, laboratory and radiology data, disposition, and length of stay in the emergency department (ED). Forty cases were included. Thirty-two were ingestions and eight were ocular exposures. Nine children were admitted, two of which were admitted to a critical care unit. Seven other children were discharged after 1-night admissions; none received any treatments after initial ED treatment. Of these, four children were admitted for the possibility of central nervous system (CNS) depression, but none showed any progression. Twenty-nine children with ingestions were discharged directly from the ED. No children had progression of CNS symptoms. Children discharged from the ED were observed a mean of 189 min. Cases of laundry pack exposures seen at our institution were similar to cases described by US poison centers. No child had progression of CNS depression suggesting that prolonged observation is not necessary if the child does not have CNS depression at presentation. Copyright © 2015 Elsevier Inc. All rights reserved.
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Lee, Jun-Young; Kim, Jeong-Hyeon; Jeon, Deok-Jin; Han, Jaehyun; Yeo, Jong-Souk
2016-10-12
A phase change nanowire holds a promise for nonvolatile memory applications, but its transition mechanism has remained unclear due to the analytical difficulties at atomic resolution. Here we obtain a deeper understanding on the phase transition of a single crystalline Ge 2 Sb 2 Te 5 nanowire (GST NW) using atomic scale imaging, diffraction, and chemical analysis. Our cross-sectional analysis has shown that the as-grown hexagonal close-packed structure of the single crystal GST NW transforms to a metastable face-centered cubic structure due to the atomic migration to the pre-existing vacancy layers in the hcp structure going through iterative electrical switching. We call this crystal structure transformation "metastabilization", which is also confirmed by the increase of set-resistance during the switching operation. For the set to reset transition between crystalline and amorphous phases, high-resolution imaging indicates that the longitudinal center of the nanowire mainly undergoes phase transition. According to the atomic scale analysis of the GST NW after repeated electrical switching, partial crystallites are distributed around the core-centered amorphous region of the nanowire where atomic migration is mainly induced, thus potentially leading to low power electrical switching. These results provide a novel understanding of phase change nanowires, and can be applied to enhance the design of nanowire phase change memory devices for improved electrical performance.
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Goniotomy with a single-use dual blade: Short-term results.
Greenwood, Michael D; Seibold, Leonard K; Radcliffe, Nathan M; Dorairaj, Syril K; Aref, Ahmad A; Román, Jesús Jimenez; Lazcano-Gomez, Gabriel S; Darlington, Jason K; Abdullah, Suhail; Jasek, Mark C; Bahjri, Khaled A; Berdahl, John P
2017-09-01
To evaluate the intraocular pressure (IOP)-lowering efficacy and safety of a single-use dual blade (Kahook) in patients with mild to end-stage glaucoma. International multicenter ophthalmic care centers. Prospective interventional case series. Consecutive patients with glaucoma who had phacoemulsification plus goniotomy with the single-use dual blade were enrolled in this study. Each center collected deidentified clinical data, including preoperative and postoperative IOP, medication use, adverse events, and whether additional surgery was required during a 6-month follow-up. Of the 71 eyes included in this study, 70% had primary open-angle glaucoma. Other diagnoses included angle-closure, pigmentary, pseudoexfoliative, and normal-tension glaucoma. Sixty-five percent of eyes were classified as having mild to moderate glaucoma and 35%, severe glaucoma. The mean baseline IOP decreased from 17.4 mm Hg ± 5.2 (SD) to 12.8 ± 2.6 mm Hg 6 months postoperatively and the hypotensive medication use decreased from 1.6 ± 1.3 to 0.9 ± 1.0, respectively (P < .001 and P = .005, respectively). The most common observation was blood reflux during surgery (39.4%). Single-use dual blade goniotomy plus phacoemulsification resulted in a significant and sustained reduction in IOP and a decrease in glaucoma medications after 6 months of follow-up. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.
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Force-Manipulation Single-Molecule Spectroscopy Studies of Enzymatic Dynamics
NASA Astrophysics Data System (ADS)
Lu, H. Peter; He, Yufan; Lu, Maolin; Cao, Jin; Guo, Qing
2014-03-01
Subtle conformational changes play a crucial role in protein functions, especially in enzymatic reactions involving complex substrate-enzyme interactions and chemical reactions. We applied AFM-enhanced and magnetic tweezers-correlated single-molecule spectroscopy to study the mechanisms and dynamics of enzymatic reactions involved with kinase and lysozyme proteins. Enzymatic reaction turnovers and the associated structure changes of individual protein molecules were observed simultaneously in real-time by single-molecule FRET detections. Our single-molecule spectroscopy measurements of enzymatic conformational dynamics have revealed time bunching effect and intermittent coherence in conformational state change dynamics involving in enzymatic reaction cycles. The coherent conformational state dynamics suggests that the enzymatic catalysis involves a multi-step conformational motion along the coordinates of substrate-enzyme complex formation and product releasing. Our results support a multiple-conformational state model, being consistent with a complementary conformation selection and induced-fit enzymatic loop-gated conformational change mechanism in substrate-enzyme active complex formation.
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[Study of the work and of working in Family Health Care Support Center].
Lancman, Selma; Gonçalves, Rita Maria de Abreu; Cordone, Nicole Guimarães; Barros, Juliana de Oliveira
2013-10-01
To understand the organization of and the working conditions in family health care support centers, as well as subjective experiences related to work in two of these centers. This was a case study carried out during 2011 and 2012 in two family health care support centers in Sao Paulo, Southeastern Brazil. Data were collected and analyzed using two theoretical-methodological references from ergonomics and work psychodynamics influenced, respectively, by ergonomic work analysis, developed based on open observations of a variety of tasks and on interviews and in practice in work psychodynamics, carried out using think tanks about the work. The work of the Family Health Care Support Centers in question is constituted on the bases of complex, diversified actions to be shared among the various professionals and teams involved. Innovative technological tools, which are not often adopted by primary health care professionals, are used and the parameters and productivity measures do not encompass the specificity and the complexity of the work performed. These situations require constant organizational rearrangement, especially between the Family Health Care Support Centers and the Family Health Care Teams, causing difficulties in carrying out the work as well as in constituting the identity of the professionals studied. The study attempts to lend greater visibility to the work processes at the Family Health Care Support Centers in order to contribute to advances in public policy on primary healthcare. It is important to stress that introducing changes at work, which affect both its organization and work conditions, is above all a commitment, which to be effective, must be permanent and must involve the different levels of hierarchy.
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Marjanović, Slobodan; Stamatović, Dragana; Tukić, Ljiljana; Tarabar, Olivera; Elez, Marija; Madjaru, Lavinika; Balint, Bela; Tatomirović, Zeljka; Kuljić-Kapulica, Nada; Andjelković, Nebojsa
2011-05-01
In comparison to standard therapy autologous stem cell transplant (ASCT) with high doses mel-phalane has improved treatment of multiple myeloma (MM) patients. The aim of this study was to evaluate the results of treatment of MM patients in our center with ASCTconditioning with melphalane or combining busulphane, cyclophosphamide and melphalane. We performed 62 ASCT procedures in 47 patients from 1998 till 2008. Single ASCT were performed in 32 patients (68%), after 3-6 cycles of (26% patients. Median engraftment was on 12th day. In a 50-month follow-up period 64% patients were alive. The overall response rate (ORR), wich was reached in 38 (80%) patients, was better in the group of patients treated in the early phase of MM. Totally 25 (53%) patients were without progression in a 25-month follow-up period. Twenty patients met criteria for CR + VGPR (very good partial remission), that was 5 patients more than in the period before ASCT. Fourteen (30%) patients died and median time till death was 17 months. The ASCT perfomed in early phase of MM after V A D induction had a significant influence onthe treatment of MM patients. Reaching CR + VGPR before and after the ASCT is predictive factor for overall survival (OS) or prolongation of period till recidive appears, progression, therapy withdrowal or death.
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Devendra M. Amatya; Carl C. Trettin; R. Wayne Skaggs; T.J. Callahan; Ge Sun; J.E. Nettles; J.E. Parsons; M. Miwa
2005-01-01
The U.S. Department of Agriculture Forest Service Center for Forested Wetlands Research has conducted or cooperated in studies designed to improve understanding of fundamental hydrologic and biogeochemical processes that link aquatic and terrestrial ecosystems. Five of these studies are discussed here. The first is based on observations made on long-term experimental...
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Jategaonkar, Priyadarshan Anand; Yadav, Sudeep Pradeep
2014-01-01
Purpose. This prospective observational study compares an innovative approach of Single-Site Multi-Port Per-umbilical Laparoscopic Endo-surgery (SSMPPLE) cholecystectomy with the gold standard—Conventional Multi-port Laparoscopic Cholecystectomy (CMLC)—to assess the feasibility and efficacy of the former. Methods. In all, 646 patients were studied. SSMPPLE cholecystectomy utilized three ports inserted through three independent mini-incisions at the umbilicus. Only the day-to-day rigid laparoscopic instruments were used in all cases. The SSMPPLE cholecystectomy group had 320 patients and the CMLC group had 326 patients. The outcomes were statistically compared. Results. SSMPPLE cholecystectomy had average operative time of 43.8 min and blood loss of 9.4 mL. Their duration of hospitalization was 1.3 days (range, 1–5). Six patients (1.9%) of this group were converted to CMLC. Eleven patients had controlled gallbladder perforations at dissection. The Visual Analogue Scores for pain on postoperative days 0 and 7, the operative time, and the scar grades were significantly better for SSMPPLE than CMLC. However, umbilical sepsis and seroma outcomes were similar. We had no bile-duct injuries or port-site hernias in this study. Conclusion. SSMPPLE cholecystectomy approach complies with the principles of laparoscopic triangulation; it seems feasible and safe method of minimally invasive cholecystectomy. Overall, it has a potential to emerge as an economically viable alternative to single-port surgery. PMID:24876955
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The Savage Origins of Child-Centered Pedagogy, 1871-1913
ERIC Educational Resources Information Center
Fallace, Thomas
2015-01-01
Child-centered pedagogy is at the ideological core of progressive education. The simple idea that the child rather than the teacher or textbook should be the major focus of the classroom is, perhaps, the single most enduring educational idea of the era. In this historical study, the author argues that child-centered education emerged directly from…
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Stennis Space Center observes Disability Awareness Day
2009-10-15
Members of STARC, a non-profit organization in Slidell, La., that seeks to help people with disabilities lead meaningful, productive lives, pose with their appreciation awards during Disability Awareness Day at Stennis Space Center on Oct. 15. The group members received appreciation awards for their dedicated service to the rocket engine testing facility. Disability Awareness Day was hosted by the Stennis Diversity Council and included guest speakers from several area agencies.
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Stennis Space Center observes Disability Awareness Day
NASA Technical Reports Server (NTRS)
2009-01-01
Members of STARC, a non-profit organization in Slidell, La., that seeks to help people with disabilities lead meaningful, productive lives, pose with their appreciation awards during Disability Awareness Day at Stennis Space Center on Oct. 15. The group members received appreciation awards for their dedicated service to the rocket engine testing facility. Disability Awareness Day was hosted by the Stennis Diversity Council and included guest speakers from several area agencies.
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Seng, Elizabeth K.; Buse, Dawn C.; Klepper, Jaclyn E.; Mayson, Sarah Jo; Grinberg, Amy S.; Grosberg, Brian M.; Pavlovic, Jelena M.; Robbins, Matthew S.; Vollbracht, Sarah E.; Lipton, Richard B.
2016-01-01
Objective To evaluate relationships among modifiable psychological factors and chronic migraine and severe migraine-related disability in a clinic-based sample of persons with migraine. Background Evidence evaluating relationships between modifiable psychological factors and chronic migraine and severe migraine-related disability is lacking in people with migraine presenting for routine clinical care. Methods Adults with migraine completed surveys during routinely scheduled visits to a tertiary headache center. Participants completed surveys assessing chronic migraine (meeting criteria for migraine with ≥15 headache days in the past month), severe migraine disability (Migraine Disability Assessment Scale score ≥ 21), and modifiable psychological factors [depressive symptoms (Patient Health Questionnaire-9), anxious symptoms (Generalized Anxiety Disorder-7), Pain Catastrophizing Scale and Headache Specific Locus of Control]. Logistic regression evaluated relationships between modifiable psychological factors and chronic migraine and severe migraine disability. Results Among 90 eligible participants the mean age was 45.0 (SD = 12.4); 84.8% were women. One-third (36.0%) met study criteria for chronic migraine; half of participants (51.5%) reported severe migraine-related disability. Higher depressive symptoms (OR = 1.99, 95% CI = 1,11, 3.55) and chance HSLC (OR = 1.85, 95% CI = 1.13, 1.43) were associated with chronic migraine. Higher depressive symptoms (OR = 3.54, 95%CI = 1.49, 8.41), anxiety symptoms (OR = 3.65, 95% CI = 1.65, 8.06), and pain catastrophizing (OR = 1.95, 95% CI = 1.14, 3.35), were associated with severe migraine-related disability. Conclusions Psychiatric symptoms and pain catastrophizing were strongly associated with severe migraine-related disability. Depression and chance locus of control were associated with chronic migraine. This study supports the need for longitudinal observational studies to evaluate relationships among naturalistic
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Motivation to volunteer among senior center participants.
Pardasani, Manoj
2018-04-01
Senior centers in the United States play a vital role in the aging continuum of care as the focal points of a community-based system of services targeting independent older adults to promote their social integration and civically engagement. Although several studies have evaluated the diversity of senior center programs, demographic characteristics of participants, and benefits of participation, very few have explored motivations to volunteer among participants. Many senior centers rely on a cadre of participants who volunteer there to assist with programs and meal services. However, a systematic examination of volunteering interests and the rationale for volunteering among senior center participants has been missing from the literature. This mixed-methods study, conducted at a large suburban senior center, explores the interests and motivations of volunteerism among the participants. The study found that there was limited interest in volunteering among senior center participants. Those who were motivated to volunteer wanted to do so in order to stay connected with their community. There was strong interest in volunteering for single events or projects rather than a long-term commitment. Implications for senior centers are discussed.
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Observational/Numerical Study of the Upper Ocean Response to Hurricanes.
1987-12-01
current variance within 30-60 km of the storm center. The effect of the stress divergence and Eknan terms on the ocean current response rapidly...observed current variance within 30-60 km of the storm center. The effect of the stress divergence and Ekman terms on the ocean current response rapidly...110 2. M ode Splitting ....................................... IIl 3. M ixing Effects ....................................... 112 4
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Studies of Day Care Center Climate and Its Effect on Children's Social and Emotional Behavior.
ERIC Educational Resources Information Center
Ekholm, Bodil; Hedin, Anna
School climates at 12 day care centers in Sweden were compared to investigate effects of center climates on children's social and emotional behavior. Observations and interviews conducted at the day care centers revealed differences in center climates related to child-rearing patterns, patterns of interaction, the distribution of power, and in…
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Single-Molecule Spectroscopy and Imaging Studies of Protein Dynamics
NASA Astrophysics Data System (ADS)
Lu, H. Peter
2012-04-01
Enzymatic reactions and protein-protein interactions are traditionally studied at the ensemble level, despite significant static and dynamic inhomogeneities. Subtle conformational changes play a crucial role in protein functions, and these protein conformations are highly dynamic rather than being static. We applied AFM-enhanced single-molecule spectroscopy to study the mechanisms and dynamics of enzymatic reactions involved with kinase and lysozyme proteins. Enzymatic reaction turnovers and the associated structure changes of individual protein molecules were observed simultaneously in real-time by single-molecule FRET detections. Our single-molecule spectroscopy measurements of T4 lysozyme and HPPK enzymatic conformational dynamics have revealed time bunching effect and intermittent coherence in conformational state change dynamics involving in enzymatic reaction cycles. The coherent conformational state dynamics suggests that the enzymatic catalysis involves a multi-step conformational motion along the coordinates of substrate-enzyme complex formation and product releasing, presenting as an extreme dynamic behavior intrinsically related to the time bunching effect that we have reported previously. Our results of HPPK interaction with substrate support a multiple-conformational state model, being consistent with a complementary conformation selection and induced-fit enzymatic loop-gated conformational change mechanism in substrate-enzyme active complex formation. Our new approach is applicable to a wide range of single-molecule FRET measurements for protein conformational changes under enzymatic reactions.
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Handbook. Midwest Center for Off-Campus Studies.
ERIC Educational Resources Information Center
Midwest Center for Off-Campus Studies, Lincoln, IL.
The Midwest Center for Off-Campus Studies offers students the opportunity to learn in a holistic manner by inserting them into a new community, either domestic or foreign, so that they can not only see the physical characteristics of the site, but can experience learning. Although the Center is at present an association of five Illinois two-year…
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Haddad, Sizeph Edward; Shishani, Jan Mohammad; Qtaish, Izzeddin; Rawashdeh, Mohammad Abdelmajeed; Qtaishat, Belal Saleh
2017-01-01
Objective: Conventional percutaneous transluminal angioplasty (PTA) for long lesions in the below-the-knee (BTK) arteries in patients presenting with critical limb ischemia (CLI) has high restenosis rates at 1 year. Our goal is to evaluate whether paclitaxel drug-eluting balloons (DEB) have higher 1 year primary patency rates compared to conventional PTA. Methods: This is a single-center, prospective, randomized trial that was conducted from June 2013 to December 2015. The aim of the study was to compare 1 year primary patency rates of DEB and PTA in BTK arteries in CLI patients. Inclusion criteria were patients presenting with CLI (Rutherford class 4 or greater), stenosis or occlusion ≥30 mm of at least one tibial artery, and agreement to 12-month evaluation. Exclusion criteria were life expectancy <1 year, allergy to paclitaxel, and contraindication to combined antiplatelet treatment. Follow-up was performed by clinical assessment, ankle brachial pressure index, Doppler ultrasound imaging, and conventional angiogram if indicated. Primary end point was 1 year primary patency, and secondary end points were target lesion revascularization (TLR) and major amputation. Statistical analysis was performed using Fischer's exact test. Results: Ninety-three patients with 106 lesions in the BTK arteries were enrolled in this study. One year primary patency was achieved in 26 (65%) and seven (17%) in the DEB and PTA groups (P = 0.006), respectively. TLR was performed in nine lesions (23%) and 29 lesions (71%) in DEB and PTA groups (P = 0.009), respectively. Major amputations occurred in one limb (2%) and two limbs (4%) in DEB and PTA groups (P = 0.6), respectively. Conclusion: Paclitaxel DEB has significantly higher 1 year primary patency rate associated with significantly less TLR than conventional PTA, following endovascular recanalization of BTK arteries in patients presenting with CLI. PMID:28852581
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Center for the Study of Rhythmic Processes
1990-12-01
NO. ;hington, D.C. 20332-6448 161103F 13484 1A4 iE (incude Security Ca--sficarion) iter for the Study of Rhythmic Processes ER$ONAL A~~S Kopell TYPE 9F...Djock number) The Center for the Study of Rhythmic Processes began operation in the academic year 1986-1989 and was supported as a Center of Excellence... Processes Personnel, 1986-1990 1. Nancy Kopell, Department of Mathematics, Boston University, P.I. Steven Strogatz, Postdoctoral Fellow Stephane Laederich
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Study of living single cells in culture: automated recognition of cell behavior.
Bodin, P; Papin, S; Meyer, C; Travo, P
1988-07-01
An automated system capable of analyzing the behavior, in real time, of single living cells in culture, in a noninvasive and nondestructive way, has been developed. A large number of cell positions in single culture dishes were recorded using a computer controlled, robotized microscope. During subsequent observations, binary images obtained from video image analysis of the microscope visual field allowed the identification of the recorded cells. These cells could be revisited automatically every few minutes. Long-term studies of the behavior of cells make possible the analysis of cellular locomotary and mitotic activities as well as determination of cell shape (chosen from a defined library) for several hours or days in a fully automated way with observations spaced up to 30 minutes. Short-term studies of the behavior of cells permit the study, in a semiautomatic way, of acute effects of drugs (5 to 15 minutes) on changes of surface area and length of cells.
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Mire, Chad E; Geisbert, Joan B; Versteeg, Krista M; Mamaeva, Natalia; Agans, Krystle N; Geisbert, Thomas W; Connor, John H
2015-10-01
The filoviruses, Marburg marburgvirus (MARV), Zaire ebolavirus (ZEBOV), and Sudan ebolavirus (SEBOV), cause severe and often fatal hemorrhagic fever in humans and nonhuman primates (NHPs). Monovalent recombinant vesicular stomatitis virus (rVSV)-based vaccine vectors, which encode a filovirus glycoprotein (GP) in place of the VSV glycoprotein, have shown 100% efficacy against homologous filovirus challenge in rodent and NHP studies. Here, we examined the utility of a single-vector, single-injection trivalent rVSV vector expressing MARV, ZEBOV, and SEBOV GPs to protect against MARV-, ZEBOV-, and SEBOV-induced disease in outbred Hartley guinea pigs where we observed protection from effects of all 3 filoviruses. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.
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Quantum logic readout and cooling of a single dark electron spin
NASA Astrophysics Data System (ADS)
Shi, Fazhan; Zhang, Qi; Naydenov, Boris; Jelezko, Fedor; Du, Jiangfeng; Reinhard, Friedemann; Wrachtrup, Jörg
2013-05-01
We study a single dark N2 electron spin defect in diamond, which is magnetically coupled to a nearby nitrogen-vacancy (NV) center. We perform pulsed electron spin resonance on this single spin by mapping its state to the NV center spin and optically reading out the latter. Moreover, we show that the NV center's spin polarization can be transferred to the electron spin by combined two decoupling control-NOT gates. These two results allow us to extend the NV center's two key properties—optical spin polarization and detection—to any electron spin in its vicinity. This enables dark electron spins to be used as local quantum registers and engineerable memories.
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Aysan, Erhan; Idiz, Ufuk Oguz; Akbulut, Huseyin; Elmas, Leyla
2016-05-01
The activity of the application of single-session ultrasonography (US)-guided percutaneous radio frequency ablation (RFA) in benign thyroid nodules was investigated in this prospective clinical study. RFA treatment was applied to 100 nodules in 100 patients (78 women, 22 men; average age 44.5 years old; age range 18-71) who had euthyroid condition, nodule size larger than 1 cm in the ultrasonography, proven to be benign by fine needle aspiration cytology. The nodules were separated into three groups according to the content: solid, cystic and mixed. In first 73 cases, the process performed under local anesthesia and the other 27 cases were performed under general anesthesia. RFA process was standardized to 70 W in all of the patients, and a moving shot technique was used. The results acquired in the third and sixth months of the controls were evaluated, and the volume of the nodules was screened. No differences between the thyroid function tests performed before and after RFA were detected (p > 0.05). The mean volume of the nodules before the process, in the third month after the process, and in the sixth month were 16.8, 4.8, and 2.6 ml, respectively (p < 0.001). The decrease in cystic nodules was greater than solid and mixed structures. Temporary hoarseness occurred in one case and skin edema was detected in a patient at the isthmus. RFA is an option for treatment, with minimal invasiveness and a low complication rate, and it is effective primarily in cases with benign nodules and nodular goiter. In cases with good compliance, the likelihood of success is greater. General anesthesia can be a good option for anxious cases to gather better results.
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Passive tracking scheme for a single stationary observer
NASA Astrophysics Data System (ADS)
Chan, Y. T.; Rea, Terry
2001-08-01
While there are many techniques for Bearings-Only Tracking (BOT) in the ocean environment, they do not apply directly to the land situation. Generally, for tactical reasons, the land observer platform is stationary; but, it has two sensors, visual and infrared, for measuring bearings and a laser range finder (LRF) for measuring range. There is a requirement to develop a new BOT data fusion scheme that fuses the two sets of bearing readings, and together with a single LRF measurement, produces a unique track. This paper first develops a parameterized solution for the target speeds, prior to the occurrence of the LRF measurement, when the problem is unobservable. At, and after, the LRF measurement, a BOT formulated as a least squares (LS) estimator then produces a unique LS estimate of the target states. Bearing readings from the other sensor serve as instrumental variables in a data fusion setting to eliminate the bias in the BOT estimator. The result is recursive, unbiased and decentralized data fusion scheme. Results from two simulation experiments have corroborated the theoretical development and show that the scheme is optimal.
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Freeman, Christine M; Crudgington, Sean; Stolberg, Valerie R; Brown, Jeanette P; Sonstein, Joanne; Alexis, Neil E; Doerschuk, Claire M; Basta, Patricia V; Carretta, Elizabeth E; Couper, David J; Hastie, Annette T; Kaner, Robert J; O'Neal, Wanda K; Paine, Robert; Rennard, Stephen I; Shimbo, Daichi; Woodruff, Prescott G; Zeidler, Michelle; Curtis, Jeffrey L
2015-01-27
Subpopulations and Intermediate Outcomes in COPD Study (SPIROMICS) is a multi-center longitudinal, observational study to identify novel phenotypes and biomarkers of chronic obstructive pulmonary disease (COPD). In a subset of 300 subjects enrolled at six clinical centers, we are performing flow cytometric analyses of leukocytes from induced sputum, bronchoalveolar lavage (BAL) and peripheral blood. To minimize several sources of variability, we use a "just-in-time" design that permits immediate staining without pre-fixation of samples, followed by centralized analysis on a single instrument. The Immunophenotyping Core prepares 12-color antibody panels, which are shipped to the six Clinical Centers shortly before study visits. Sputum induction occurs at least two weeks before a bronchoscopy visit, at which time peripheral blood and bronchoalveolar lavage are collected. Immunostaining is performed at each clinical site on the day that the samples are collected. Samples are fixed and express shipped to the Immunophenotyping Core for data acquisition on a single modified LSR II flow cytometer. Results are analyzed using FACS Diva and FloJo software and cross-checked by Core scientists who are blinded to subject data. Thus far, a total of 152 sputum samples and 117 samples of blood and BAL have been returned to the Immunophenotyping Core. Initial quality checks indicate useable data from 126 sputum samples (83%), 106 blood samples (91%) and 91 BAL samples (78%). In all three sample types, we are able to identify and characterize the activation state or subset of multiple leukocyte cell populations (including CD4+ and CD8+ T cells, B cells, monocytes, macrophages, neutrophils and eosinophils), thereby demonstrating the validity of the antibody panel. Our study design, which relies on bi-directional communication between clinical centers and the Core according to a pre-specified protocol, appears to reduce several sources of variability often seen in flow cytometric
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Blum, Suzanne A.
2016-05-24
The reactive behavior of individual molecules is seldom observed, because we usually measure the average properties of billions of molecules. What we miss is important: the catalytic activity of less than 1% of the molecules under observation can dominate the outcome of a chemical reaction seen at a macroscopic level. Currently available techniques to examine reaction mechanisms (such as nuclear magnetic resonance spectroscopy and mass spectrometry) study molecules as an averaged ensemble. These ensemble techniques are unable to detect minor components (under ~1%) in mixtures or determine which components in the mixture are responsible for reactivity and catalysis. In themore » field of mechanistic chemistry, there is a resulting heuristic device that if an intermediate is very reactive in catalysis, it often cannot be observed (termed “Halpern’s Rule” ). Ultimately, the development of single-molecule imaging technology could be a powerful tool to observe these “unobservable” intermediates and active catalysts. Single-molecule techniques have already transformed biology and the understanding of biochemical processes. The potential of single-molecule fluorescence microscopy to address diverse chemical questions, such as the chemical reactivity of organometallic or inorganic systems with discrete metal complexes, however, has not yet been realized. In this respect, its application to chemical systems lags significantly behind its application to biophysical systems. This transformative imaging technique has broad, multidisciplinary impact with the potential to change the way the chemistry community studies reaction mechanisms and reactivity distributions, especially in the core area of catalysis.« less
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Economics of data center optics
NASA Astrophysics Data System (ADS)
Huff, Lisa
2016-03-01
Traffic to and from data centers is now reaching Zettabytes/year. Even the smallest of businesses now rely on data centers for revenue generation. And, the largest data centers today are orders of magnitude larger than the supercomputing centers of a few years ago. Until quite recently, for most data center managers, optical data centers were nice to dream about, but not really essential. Today, the all-optical data center - perhaps even an all-single mode fiber (SMF) data center is something that even managers of medium-sized data centers should be considering. Economical transceivers are the key to increased adoption of data center optics. An analysis of current and near future data center optics economics will be discussed in this paper.
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Jia, Yong; Zhu, Lei-Yi; Xian, Yu-Xin; Sun, Xiao-Qing; Gao, Jian-Gang; Zhang, Xin-Hong; Hou, Si-Chuan; Zhang, Chang-Cun; Liu, Zhao-Xu
2017-08-29
Prostate cancer is known to have ethnic and regional differences. The study aimed to clinically evaluate the detection rate of prostate cancer on transrectal ultrasonography (TRUS)-guided prostate biopsy and analyze its characteristics among the northern Han Chinese population at a single center. Between October 2009 and September 2016, a total of 1027 Chinese men, who had undergone TRUS-guided prostate biopsy at Qingdao Municipal Hospital, were retrospectively analyzed. Prostate biopsies were performed in the case of an abnormally elevated serum PSA level, and/or abnormal digital rectal examination (DRE) findings, and/or suspicious prostatic imaging findings. Of the 1022 men enrolled in the analysis, 438 patients (42.8%) were diagnosed with prostate adenocarcinoma histologically. When serum PSA levels were divided into five subgroups (less than 4.0, 4.0 to 10.0, 10.0 to 20.0, 20.0 to 100.0, and ≥ 100.0 ng/ml), the detection rates of prostate cancer were 12.4, 15.9, 34.1, 66.2, and 93.8%, respectively. With serum PSA levels of 4.0 to 10.0 ng/ml, the cancer detection rates for a normal DRE and a suspect DRE finding were 13.5 and 58.2%, respectively. Accordingly, the cancer detection rates for a normal imaging and a suspect imaging finding were 13.5 and 58.2%, respectively. Besides, a large proportion of the patients were in the clinically advanced stage. The present study data reported a relatively higher prostate cancer detection rate of 42.8% and that the majority of the patients presented with clinically advanced prostate cancers within a local clinical urologic practice. An early detection and screening program for prostate cancer is of great need to reduce the burden from this disease among the northern Han Chinese population.
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The Role of Re-resection for Breast Cancer Liver Metastases-a Single Center Experience.
BacalbaȘa, Nicolae; Balescu, Irina; Dima, Simona; Popescu, Irinel
2015-12-01
The aim of the present study was to evaluate the effectiveness and safety of hepatic re-resection for breast cancer liver metastases. Between January 2004 and December 2014 seven patients were submitted to liver re-resection for breast cancer liver metastases at our Center. The main inclusion criteria were presence of isolated liver metastases and absence of systemic recurrent disease Results: The median age at the time of breast surgery was 51 years (range=39-69 years). The first liver resection was performed after a median period of 34.7 months and consisted of minor hepatectomies in six and major hepatectomy in one patient. The second liver resection was performed after a median interval of 22 months from the first liver resection and consisted of major resection in one case and minor resection in the other six cases. Postoperative complications occurred in a single case after the first liver surgery and in two cases after the second hepatic resection, all cases being successfully managed conservatively. Overall postoperative mortality was 0. The median overall survival after the second liver resection was 28 months. Re-resection for breast cancer liver metastases can be safely performed and may bring survival benefit. Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.
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Single visit nonsurgical endodontic therapy for periapical cysts: A clinical study
Maity, Ipsita; Meena, N.; Kumari, R. Anitha
2014-01-01
Aims: The aim of this study was to assess the outcome of single sitting root canal treatment (RCT) of asymptomatic teeth with periapical cysts. Materials and Methods: Ten maxillary anterior teeth showing periapical lesion on the radiograph was further screened by ultrasound with color power Doppler (CPD) for confirmation of a cyst. The average dimension of the lesions ranged from 1.3 to 1.9 cm. Single sitting RCT was performed on all the selected teeth. Postoperative healing was monitored at regular interval of 3 months, 6 months, and 1 year by using subjective feedback, radiograph, and ultrasound with CPD study. Results: Eight among the ten cases showed either signs of complete healing or healing in progress by the end of 6-12 months. Conclusions: It was observed that single sitting nonsurgical endodontic management of asymptomatic teeth with periapical cyst confirmed by ultrasound was successful in selected cases. PMID:24963246
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Theoretical study on the photocatalytic properties of graphene oxide with single Au atom adsorption
NASA Astrophysics Data System (ADS)
Ju, Lin; Dai, Ying; Wei, Wei; Li, Mengmeng; Jin, Cui; Huang, Baibiao
2018-03-01
The photocatalytic properties of graphene oxide (GO) with single Au atom adsorption are studied via the first-principles calculations based on the density functional theory. The present study addresses the origin of enhancement in photocatalytic efficiency of GO derived from single Au atom depositing. Compared with the clean one, the work function of the single Au atom adsorbed GO is lowered due to the charge transfer from Au to GO, indicating enhanced surface activity. The Au atom plays as an electron trapping center and a mediating role in charge transfer from photon excited GO to target species. The photogenerated electron-hole pairs can be separated effectively. For the GO configuration with atomic Au dispersion, there are some states introduced in the band gap, which are predominantly composed of Au 6s states. Through the in-gap state, the photo-generated electron transfer from the valence band of clean GO to the conductive band more easily. In addition, the reduction of the gap in the system is also presented in the current work, which indicates that the single Au atom adsorption improves light absorption for the GO based photocatalyst. These theoretical results are valuable for the future applications of GO materials as photocatalyst for water splitting.
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Kanekar, Neeta; Aruin, Alexander S
2015-04-01
Humans use anticipatory and compensatory postural strategies to maintain and restore balance when perturbed. Inefficient generation and utilization of anticipatory postural adjustments (APAs) is one of the reasons for postural instability. The aim of the study was to investigate the role of training in improvement of APAs and its effect on subsequent control of posture. Thirteen healthy young adults were exposed to predictable external perturbations before and after a single training session consisting of catches of a medicine ball thrown at the shoulder level. 3-D body kinematics, EMG activity of thirteen trunk and lower limb muscles, and ground reaction forces were recorded before and immediately after a single training session. Muscle onsets, EMG integrals, center of pressure (COP), and center of mass (COM) displacements were analyzed during the anticipatory and compensatory phases of postural control. The effect of a single training session was seen as significantly early muscle onsets and larger anticipatory COP displacements. As a result, significantly smaller peak COM displacements were observed after the perturbation indicating greater postural stability. The outcome of this study provides a background for examining the role of training in improvement of APAs and its effect on postural stability in individuals in need. Copyright © 2014 Elsevier Ltd. All rights reserved.
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The Minnesota Center for Twin and Family Research Genome-Wide Association Study
Miller, Michael B.; Basu, Saonli; Cunningham, Julie; Eskin, Eleazar; Malone, Steven M.; Oetting, William S.; Schork, Nicholas; Sul, Jae Hoon; Iacono, William G.; Mcgue, Matt
2012-01-01
As part of the Genes, Environment and Development Initiative (GEDI), the Minnesota Center for Twin and Family Research (MCTFR) undertook a genome-wide association study (GWAS), which we describe here. A total of 8405 research participants, clustered in 4-member families, have been successfully genotyped on 527,829 single nucleotide polymorphism (SNP) markers using Illumina’s Human660W-Quad array. Quality control screening of samples and markers as well as SNP imputation procedures are described. We also describe methods for ancestry control and how the familial clustering of the MCTFR sample can be accounted for in the analysis using a Rapid Feasible Generalized Least Squares algorithm. The rich longitudinal MCTFR assessments provide numerous opportunities for collaboration. PMID:23363460
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Ma, Jianying; Hou, Lei; Qian, Juying; Ge, Lei; Zhang, Feng; Chang, Shufu; Xu, Rende; Qin, Qing; Ge, Junbo
2017-10-01
The monorail Guidezilla guide extension catheter was designed to provide additional backup and facilitate device delivery in percutaneous coronary intervention (PCI) for complex coronary anatomy such as chronic total occlusion (CTO), extreme vessel tortuosity, diseased bypass grafts, and anomalous coronary arteries, among others.The present retrospective, single-center study included 188 consecutive patients who underwent PCI using the Guidezilla catheter from March 2015 to August 2016. Study outcomes were rates of target lesion crossing success, procedural success, and complications.The Guidezilla catheter was used most commonly in PCI of CTOs (45%) and heavy proximal calcification (37%), followed by tortuosity (10%), previously deployed proximal stents (4%), and coronary artery anomaly (4%). The right coronary artery (48%) was most commonly intervened followed by the left ascending (35%) and left circumflex (17%) arteries. Rates of target lesion crossing success and procedural success were both 99%, with one device-related periprocedural complication, namely proximal vessel dissection secondary to deep insertion which was successfully treated with stent implantation. Ninety percent of PCI were performed and completed successfully by radial access.In a single center with experienced operators, the use of the Guidezilla guide extension catheter in PCI of complex coronary anatomy performed mostly via radial artery access appeared safe and efficacious, and greatly facilitated device delivery.
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Ma, Jianying; Hou, Lei; Qian, Juying; Ge, Lei; Zhang, Feng; Chang, Shufu; Xu, Rende; Qin, Qing; Ge, Junbo
2017-01-01
Abstract The monorail GuidezillaTM guide extension catheter was designed to provide additional backup and facilitate device delivery in percutaneous coronary intervention (PCI) for complex coronary anatomy such as chronic total occlusion (CTO), extreme vessel tortuosity, diseased bypass grafts, and anomalous coronary arteries, among others. The present retrospective, single-center study included 188 consecutive patients who underwent PCI using the Guidezilla catheter from March 2015 to August 2016. Study outcomes were rates of target lesion crossing success, procedural success, and complications. The Guidezilla catheter was used most commonly in PCI of CTOs (45%) and heavy proximal calcification (37%), followed by tortuosity (10%), previously deployed proximal stents (4%), and coronary artery anomaly (4%). The right coronary artery (48%) was most commonly intervened followed by the left ascending (35%) and left circumflex (17%) arteries. Rates of target lesion crossing success and procedural success were both 99%, with one device-related periprocedural complication, namely proximal vessel dissection secondary to deep insertion which was successfully treated with stent implantation. Ninety percent of PCI were performed and completed successfully by radial access. In a single center with experienced operators, the use of the Guidezilla guide extension catheter in PCI of complex coronary anatomy performed mostly via radial artery access appeared safe and efficacious, and greatly facilitated device delivery. PMID:28984768