After the bomb drops: A new look at radiation-induced multiple organ dysfunction syndrome (MODS)

PubMed Central

Williams, Jacqueline P.; McBride, William H.

2012-01-01

Purpose There is increasing concern that, since the Cold War era, there has been little progress regarding the availability of medical countermeasures in the event of either a radiological or nuclear incident. Fortunately, since much is known about the acute consequences that are likely to be experienced by an exposed population, the probability of survival from the immediate hematological crises after total body irradiation (TBI) has improved in recent years. Therefore focus has begun to shift towards later down-stream effects, seen in such organs as the gastrointestinal tract (GI), skin, and lung. However, the mechanisms underlying therapy-related normal tissue late effects, resulting from localised irradiation, have remained somewhat elusive and even less is known about the development of the delayed syndrome seen in the context of whole body exposures, when it is likely that systemic perturbations may alter tissue microenvironments and homeostasis. Conclusions The sequence of organ failures observed after near-lethal TBI doses are similar in many ways to that of multiple organ dysfunction syndrome (MODS), leading to multiple organ failure (MOF). In this review, we compare the mechanistic pathways that underlie both MODS and delayed normal tissue effects since these may impact on strategies to identify radiation countermeasures. PMID:21417595

Cardiovascular and systemic effects of gastric dilatation and volvulus in dogs.

PubMed

Sharp, Claire R; Rozanski, Elizabeth A

2014-09-01

Gastric dilatation and volvulus (GDV) is a common emergency condition in large and giant breed dogs that is associated with high morbidity and mortality. Dogs with GDV classically fulfill the criteria for the systemic inflammatory response syndrome (SIRS) and can go on to develop multiple organ dysfunction syndrome (MODS). Previously reported organ dysfunctions in dogs with GDV include cardiovascular, respiratory, gastrointestinal, coagulation and renal dysfunction. Cardiovascular manifestations of GDV include shock, cardiac arrhythmias and myocardial dysfunction. Respiratory dysfunction is also multifactorial, with contributory factors including decreased respiratory excursion due to gastric dilatation, decreased pulmonary perfusion and aspiration pneumonia. Gastrointestinal dysfunction includes gastric necrosis and post-operative gastrointestinal upset such as regurgitation, vomiting, and ileus. Coagulation dysfunction is another common feature of MODS in dogs with GDV. Disseminated intravascular coagulation can occur, putting them at risk of complications associated with thrombosis in the early hypercoagulable state and hemorrhage in the subsequent hypocoagulable state. Acute kidney injury, acid-base and electrolyte disturbances are also reported in dogs with GDV. Understanding the potential for systemic effects of GDV allows the clinician to monitor patients astutely and detect such complications early, facilitating early intervention to maximize the chance of successful management. Copyright © 2014 Elsevier Inc. All rights reserved.

Correlation of the expression of YY1 and Fas cell surface death receptor with apoptosis of peripheral blood mononuclear cells, and the development of multiple organ dysfunction in children with sepsis.

PubMed

Reséndiz-Martínez, Judith; Asbun-Bojalil, Juan; Huerta-Yepez, Sara; Vega, Mario

2017-05-01

Multiple organ dysfunction (MOD) is a lethal complication in children with sepsis. Apoptosis of several cell types is involved in this process, and it is associated with increased Fas cell surface death receptor (Fas) expression. As YY1 transcription factor (YY1) negatively regulates the expression of Fas in cancer models, and is associated with the clinical outcome, it may be important in MOD. The present study aimed to determine the association between the expression of Fas, YY1 and apoptosis in children with sepsis, and its association with MOD, these factors were analyzed in 30 pediatric patients that had been diagnosed with sepsis. Peripheral blood mononuclear cells were purified from patients, and YY1 and Fas protein expression was assessed by immunocytochemistry. Apoptosis was determined by terminal deoxynucleotidyl transferase dUTP nick‑end labeling. Sepsis was monitored using clinical parameters, pediatric logistic organ dysfunction (PELOD) score and the pediatric mortality index. The results demonstrated that Fas expression was directly correlated with apoptosis levels and the expression of YY1 was inversely correlated with apoptosis levels. Patients with high levels of apoptosis exhibited increased disease severity and poor clinical outcome. Notably, the findings of the present study demonstrated that there were higher survival rates in patients with high YY1 expression, compared with those with low YY1 expression. Additionally, patients with MOD exhibited lower proportions of apoptotic cells compared with sepsis patients without MOD. Furthermore, the PELOD score was positively correlated with Fas and inversely correlated with YY1 expression. Finally, high apoptosis and low YY1 expression were prognostic factors associated with poor survival rates. These data suggested that YY1 may be important for apoptosis induction via the regulation of Fas during sepsis. Therefore, Fas may be a potential therapeutic target to prevent MOD through regulation of YY1 expression. Furthermore, YY1 and Fas expression in PBMCs may be used to as prognostic markers.

Correlation of the expression of YY1 and Fas cell surface death receptor with apoptosis of peripheral blood mononuclear cells, and the development of multiple organ dysfunction in children with sepsis

PubMed Central

Reséndiz-Martínez, Judith; Asbun-Bojalil, Juan; Huerta-Yepez, Sara; Vega, Mario

2017-01-01

Multiple organ dysfunction (MOD) is a lethal complication in children with sepsis. Apoptosis of several cell types is involved in this process, and it is associated with increased Fas cell surface death receptor (Fas) expression. As YY1 transcription factor (YY1) negatively regulates the expression of Fas in cancer models, and is associated with the clinical outcome, it may be important in MOD. The present study aimed to determine the association between the expression of Fas, YY1 and apoptosis in children with sepsis, and its association with MOD, these factors were analyzed in 30 pediatric patients that had been diagnosed with sepsis. Peripheral blood mononuclear cells were purified from patients, and YY1 and Fas protein expression was assessed by immunocytochemistry. Apoptosis was determined by terminal deoxynucleotidyl transferase dUTP nick-end labeling. Sepsis was monitored using clinical parameters, pediatric logistic organ dysfunction (PELOD) score and the pediatric mortality index. The results demonstrated that Fas expression was directly correlated with apoptosis levels and the expression of YY1 was inversely correlated with apoptosis levels. Patients with high levels of apoptosis exhibited increased disease severity and poor clinical outcome. Notably, the findings of the present study demonstrated that there were higher survival rates in patients with high YY1 expression, compared with those with low YY1 expression. Additionally, patients with MOD exhibited lower proportions of apoptotic cells compared with sepsis patients without MOD. Furthermore, the PELOD score was positively correlated with Fas and inversely correlated with YY1 expression. Finally, high apoptosis and low YY1 expression were prognostic factors associated with poor survival rates. These data suggested that YY1 may be important for apoptosis induction via the regulation of Fas during sepsis. Therefore, Fas may be a potential therapeutic target to prevent MOD through regulation of YY1 expression. Furthermore, YY1 and Fas expression in PBMCs may be used to as prognostic markers. PMID:28447715

Effects of insulin combined with ethyl pyruvate on inflammatory response and oxidative stress in multiple-organ dysfunction syndrome rats with severe burns.

PubMed

Wang, Zhanke; Chen, Rongjian; Zhu, Zhongzhen; Zhang, Xiaoyun; Wang, Shiliang

2016-11-01

Inflammation response and oxidative stress promote the occurrence and development of multiple-organ dysfunction syndrome (MODS). Eighty MODS rats with third-degree burns were divided randomly into 4 groups: insulin, ethyl pyruvate (EP), insulin combined with EP, and control. Blood levels of glucose, alanine aminotransferase (ALT), creatine (CRE), creatine kinase (CK), tumor necrosis factor α (TNF-α), high-mobility group box 1 (HMGB-1), malondialdehyde (MDA), and total antioxidant capacity (TAC) before as well as 1, 3, 5, and 7 days after burns were measured. Blood levels of ALT, CRE, CK, TNF-α, HMGB-1, and MDA in INS, EP, and INS+EP groups at different time points were significantly lower, and TAC was significantly higher than that in the control group (C) (P<.01). These parameters in the INS+EP group were significantly lower, and TAC was significantly higher than that in INS and EP groups (P<.01). Blood levels of TNF-α, HMGB-1, and TAC in the INS group at different time points after burns were significantly lower, and MDA was significantly higher than that in the EP group (P<.01). Insulin combined with EP can effectively reduce the inflammatory response, oxidative stress, and main organ dysfunctions in MODS rats after severe burns. The therapeutic effect of insulin combined with EP is superior to single-agent treatment. The insulin anti-inflammatory effect is better than that of pyruvic acid ethyl ester, and the ethyl pyruvate antioxidation effect is better than that of insulin. The insulin can treat inflammation, whereas EP can reduce oxidative stress in MODS rats. Copyright © 2016 Elsevier Inc. All rights reserved.

MBL-2 polymorphisms (codon 54 and Y-221X) and low MBL levels are associated with susceptibility to multi organ dysfunction in P. falciparum malaria in Odisha, India.

PubMed

Das, Bidyut K; Panda, Aditya K

2015-01-01

Mannose binding lectin, a plasma protein protects host from virus, bacteria, and parasites. Deficiency in MBL levels has been associated with susceptibility to various infectious diseases including P. falciparum malaria. Common MBL polymorphisms in promoter and coding regions are associated with decrease in plasma MBL levels or production of deformed MBL, respectively. In the present study, we hypothesized that MBL2 variants and plasma MBL levels could be associated with different clinical phenotypes of severe P. falciparum malaria. A hospital based study was conducted in eastern Odisha, India which is endemic to P. falciparum malaria. Common MBL-2 polymorphisms (codon 54, H-550L, and Y-221X) were typed in 336 cases of severe malaria (SM) [94 cerebral malaria (CM), 120 multi-organ dysfunction (MOD), 122 non-cerebral severe malaria (NCSM)] and 131 un-complicated malaria patients (UM). Plasma MBL levels were quantified by ELISA. Severe malaria patients displayed lower plasma levels of MBL compared to uncomplicated falciparum malaria. Furthermore, on categorization of severe malaria patients into various subtypes, plasma MBL levels were very low in MOD patients compared to other categories. Higher frequency of AB genotype and allele B was observed in MOD compared to UM (AB genotype: P = 0.006; B allele: P = 0.008). In addition, prevalence of YX genotype of MBL Y-221X polymorphism was also statistically more frequent in MOD case than UM (P = 0.009). The observations of the present study reveal that MBL-2 polymorphisms (codon 54 and Y-221X) and lower plasma MBL levels are associated with increased susceptibility to multi organ dysfunctions in P. falciparum malaria.

Toxic Shock Syndrome: An Unusual Organism.

PubMed

Young, Katie; Luni, Faraz Khan; Yoon, Youngsook

2016-07-01

Streptococcal toxic shock syndrome is a rapidly fatal disease causing hypotension with multi organ dysfunction (MODS) early in the course of infection, which by definition is caused by Group A streptococcus (GAS). We describe a case of Toxic Shock like Syndrome (TSLS) in which the causative organism was not a GAS. A 71-year-old woman with hepatitis C and primary biliary cirrhosis had sudden onset of slurred speech and left arm and facial numbness. She had bilateral erythematous macular rash present on the flanks and legs. She was started on empiric antibiotics but her condition rapidly deteriorated 6 hours after admission. During this time, the development of multiple large reddish-pink areas of ecchymosis with bullae on her lower extremities, flanks, and groin were noted. She also developed multiorgan dysfunction (MODS) with renal dysfunction, coagulopathy and liver involvement. Patient expired before surgery could be performed and the time from presentation to the time of death was 16 hours. The blood and bullae fluid cultures grew Streptococcus dysgalactiae equisimilis. Streptococcus dysgalactiae equisimilis is a rare cause of TSLS which typically affects elderly or immunocompromised patients and only a few cases have been described in the literature. Our patient met criteria for TSLS which caused rapid shock and MODS. We review the literature of the cases describing the clinical characteristics of TSLS cause by non-GAS. Group G Streptococci is a rare but lethal cause of streptococcal toxic shock syndrome. Copyright © 2016 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

Streptococcal Toxic Shock syndrome.

PubMed

Krishna, Vidya; Sankaranarayan, Shuba; Sivaraman, Rajakumar Padur; Prabaharan, Krithika

2014-09-01

Streptococcal Toxic Shock syndrome (STSS) is a serious complication caused by exotoxins of Group A Streptococcus (GAS). It presents with fulminant shock and rash, is rapidly progressive with Multi-Organ Dysfunction Syndrome (MODS) and requires aggressive therapy with fluids, antibiotics and source control.

Use of a novel hemoadsorption device for cytokine removal as adjuvant therapy in a patient with septic shock with multi-organ dysfunction: A case study.

PubMed

Basu, Reshma; Pathak, Sunjay; Goyal, Jyoti; Chaudhry, Rajeev; Goel, Rati B; Barwal, Anil

2014-12-01

CytoSorb(®) (CytoSorbents Corporation, USA) is a novel sorbent hemoadsorption device for cytokine removal. The aim of this study was to examine the clinical use of CytoSorb(®) in the management of patient with septic shock. We used this device as an adjuvant to stabilize a young patient with multi-organ failure and severe sepsis with septic shock. A 36-year-old female patient was hospitalized with the complaints of malaise, general body ache, and breathing difficulty and had a medical history of diabetes mellitus type II, hypertension, obstructive sleep apnea, hypothyroidism and morbid obesity. She was diagnosed to have septic shock with multi-organ dysfunction (MODS) and a low perfusion state. CytoSorb(®) hemoadsorption column was used as an attempt at blood purification. Acute physiology and chronic health evaluation score, MODS score, and sequential organ failure assessment score were measured before and after the device application. CytoSorb application as an adjuvant therapy could be considered in septic shock.

Use of a novel hemoadsorption device for cytokine removal as adjuvant therapy in a patient with septic shock with multi-organ dysfunction: A case study

PubMed Central

Basu, Reshma; Pathak, Sunjay; Goyal, Jyoti; Chaudhry, Rajeev; Goel, Rati B.; Barwal, Anil

2014-01-01

CytoSorb® (CytoSorbents Corporation, USA) is a novel sorbent hemoadsorption device for cytokine removal. The aim of this study was to examine the clinical use of CytoSorb® in the management of patient with septic shock. We used this device as an adjuvant to stabilize a young patient with multi-organ failure and severe sepsis with septic shock. A 36-year-old female patient was hospitalized with the complaints of malaise, general body ache, and breathing difficulty and had a medical history of diabetes mellitus type II, hypertension, obstructive sleep apnea, hypothyroidism and morbid obesity. She was diagnosed to have septic shock with multi-organ dysfunction (MODS) and a low perfusion state. CytoSorb® hemoadsorption column was used as an attempt at blood purification. Acute physiology and chronic health evaluation score, MODS score, and sequential organ failure assessment score were measured before and after the device application. CytoSorb application as an adjuvant therapy could be considered in septic shock. PMID:25538418

Kynurenine–3–monooxygenase inhibition prevents multiple organ failure in rodent models of acute pancreatitis

PubMed Central

Mole, Damian J; Webster, Scott P; Uings, Iain; Zheng, Xiaozhong; Binnie, Margaret; Wilson, Kris; Hutchinson, Jonathan P; Mirguet, Olivier; Walker, Ann; Beaufils, Benjamin; Ancellin, Nicolas; Trottet, Lionel; Bénéton, Véronique; Mowat, Christopher G; Wilkinson, Martin; Rowland, Paul; Haslam, Carl; McBride, Andrew; Homer, Natalie ZM; Baily, James E; Sharp, Matthew GF; Garden, O James; Hughes, Jeremy; Howie, Sarah EM; Holmes, Duncan S; Liddle, John; Iredale, John P

2015-01-01

Acute pancreatitis (AP) is a common and devastating inflammatory condition of the pancreas that is considered to be a paradigm of sterile inflammation leading to systemic multiple organ dysfunction syndrome (MODS) and death1,2 Acute mortality from AP-MODS exceeds 20%3 and for those who survive the initial episode, their lifespan is typically shorter than the general population4. There are no specific therapies available that protect individuals against AP-MODS. Here, we show that kynurenine-3-monooxygenase (KMO), a key enzyme of tryptophan metabolism5, is central to the pathogenesis of AP-MODS. We created a mouse strain deficient for Kmo with a robust biochemical phenotype that protected against extrapancreatic tissue injury to lung, kidney and liver in experimental AP-MODS. A medicinal chemistry strategy based on modifications of the kynurenine substrate led to the discovery of GSK180 as a potent and specific inhibitor of KMO. The binding mode of the inhibitor in the active site was confirmed by X-ray co-crystallography at 3.2 Å resolution. Treatment with GSK180 resulted in rapid changes in levels of kynurenine pathway metabolites in vivo and afforded therapeutic protection against AP-MODS in a rat model of AP. Our findings establish KMO inhibition as a novel therapeutic strategy in the treatment of AP-MODS and open up a new area for drug discovery in critical illness. PMID:26752518

Heart rate as an independent risk factor in patients with multiple organ dysfunction: a prospective, observational study.

PubMed

Hoke, Robert S; Müller-Werdan, Ursula; Lautenschläger, Christine; Werdan, Karl; Ebelt, Henning

2012-02-01

To study the association between baseline heart rate and outcome in patients with multiple organ dysfunction (MODS) as well as the course of heart rate over the first 4 days during MODS. Prospective observational study in 89 patients with MODS, defined as an APACHE-II score ≥20. Baseline heart rate (HR(0)) was determined over a 60-minute period at the time of MODS diagnosis. 28-day all-cause mortality was the primary endpoint of the study, a fall of the APACHE-II score by 4 points or more from day 0 to day 4 constituted the secondary endpoint. Hazard ratios for heart rate of 90 beats per minute (bpm) or greater relative to less than 90 bpm were calculated using Cox proportional hazards model and adjusted for confounding variables. Median baseline heart rate was 83 bpm in survivors and 92 bpm in non-survivors (p = 0.048). 28-day mortality was 32 and 61% in patients with HR(0) < 90 bpm and HR(0) ≥ 90 bpm, respectively. The adjusted hazard ratio for 28-day mortality was 2.30 (95% confidence interval 1.21-4.36, p = 0.001) for HR(0) ≥ 90 bpm relative to HR(0) < 90 bpm. No correlation was found between baseline heart rate and the secondary endpoint. From day 0 to day 4, heart rate remained elevated in all patients, as well as in survivors and non-survivors. A heart rate ≥90 bpm at the time of MODS diagnosis is an independent risk factor for increased 28-day mortality. As in patients with cardiovascular conditions such as coronary heart disease or chronic heart failure, heart rate might constitute a target for heart rate-lowering therapy in the narrow initial treatment window of MODS.

Predictive comparisons of procalcitonin (PCT) level, arterial ketone body ratio (AKBR), APACHE III score and multiple organ dysfunction score (MODS) in systemic inflammatory response syndrome (SIRS).

PubMed

Lee, Young-Joo; Park, Chan-Hee; Yun, Jang-Woon; Lee, Young-Suk

2004-02-29

Procalcitonin (PCT) is a newly introduced marker of systemic inflammation and bacterial infection. A marked increase in circulating PCT level in critically ill patients has been related with the severity of illness and poor survival. The goal of this study was to compare the prognostic power of PCT and three other parameters, the arterial ketone body ratio (AKBR), the acute physiology, age, chronic health evaluation (APACHE) III score and the multiple organ dysfunction score (MODS), in the differentiation between survivors and nonsurvivors of systemic inflammatory response syndrome (SIRS). The study was performed in 95 patients over 16 years of age who met the criteria of SIRS. PCT and AKBR were assayed in arterial blood samples. The APACHE III score and MODS were recorded after the first 24 hours of surgical ICU (SICU) admission and then daily for two weeks or until either discharge or death. The patients were divided into two groups, survivors (n=71) and nonsurvivors (n=24), in accordance with the ICU outcome. They were also divided into three groups according to the trend of PCT level: declining, increasing or no change. Significant differences between survivors and nonsurvivors were found in APACHE III score and MODS throughout the study period, but in PCT value only up to the 7th day and in AKBR only up to the 3rd day. PCT values of the three groups were not significantly different on the first day between survivors and nonsurvivors. Receiver operating characteristic (ROC) curves for prediction of mortality by PCT, AKBR, APACHE III score and MODS were 0.690, 0.320, 0.915 and 0.913, respectively, on the admission day. In conclusion, PCT could have some use as a mortality predictor in SIRS patients but was less reliable than APACHE III score or MODS.

Scrub Typhus - A Major Cause of Pediatric Intensive Care Admission and Multiple Organ Dysfunction Syndrome: A Single-Center Experience from India.

PubMed

Giri, Prabahs Prasun; Roy, Joydeb; Saha, Agnisekhar

2018-02-01

Scrub typhus has been globally recognized as an emerging infectious disease contributing significantly to pyrexia of unknown origin (PUO) and a potential cause of multiorgan dysfunction syndrome (MODS). We studied the incidence of scrub typhus as a cause of pediatric intensive care unit (PICU) admission and MODS in our hospital and its clinical and laboratory characteristics to measure the incidence of MODS caused by scrub typhus. This study was done in a pediatric teaching hospital in Kolkata, India. Records of patients admitted with PUO from March 2012 to December 2015 were reviewed. Rathi-Goodman-Aghai scoring system was used to identify potential ST patients and confirmed by serological testing. Clinical characteristics, laboratory findings, and treatment response were noted of those needing PICU admissions. Ninety-seven cases of scrub typhus have been identified during that period. PICU admission was needed in 30 of them (31%) which contributed 8.43% of total PICU admissions. Among these 30 patients, 16 (53%) developed MODS which contributed 18.29% of total MODS admitted in PICU. Septic shock was the most common manifestation in as many as 18 (60%) patients followed by encephalopathy in 13 (43%). Patients were treated with either doxycycline alone or in combination with azithromycin. Mean time to complete defervescence was 32 h after first dose of doxycycline. The outcome was excellent without a single mortality. Scrub typhus is an important cause of MODS in this part of the world, especially in fevers associated with features as identified and not responding to conventional antibiotics.

Kynurenine-3-monooxygenase inhibition prevents multiple organ failure in rodent models of acute pancreatitis.

PubMed

Mole, Damian J; Webster, Scott P; Uings, Iain; Zheng, Xiaozhong; Binnie, Margaret; Wilson, Kris; Hutchinson, Jonathan P; Mirguet, Olivier; Walker, Ann; Beaufils, Benjamin; Ancellin, Nicolas; Trottet, Lionel; Bénéton, Véronique; Mowat, Christopher G; Wilkinson, Martin; Rowland, Paul; Haslam, Carl; McBride, Andrew; Homer, Natalie Z M; Baily, James E; Sharp, Matthew G F; Garden, O James; Hughes, Jeremy; Howie, Sarah E M; Holmes, Duncan S; Liddle, John; Iredale, John P

2016-02-01

Acute pancreatitis (AP) is a common and devastating inflammatory condition of the pancreas that is considered to be a paradigm of sterile inflammation leading to systemic multiple organ dysfunction syndrome (MODS) and death. Acute mortality from AP-MODS exceeds 20% (ref. 3), and the lifespans of those who survive the initial episode are typically shorter than those of the general population. There are no specific therapies available to protect individuals from AP-MODS. Here we show that kynurenine-3-monooxygenase (KMO), a key enzyme of tryptophan metabolism, is central to the pathogenesis of AP-MODS. We created a mouse strain that is deficient for Kmo (encoding KMO) and that has a robust biochemical phenotype that protects against extrapancreatic tissue injury to the lung, kidney and liver in experimental AP-MODS. A medicinal chemistry strategy based on modifications of the kynurenine substrate led to the discovery of the oxazolidinone GSK180 as a potent and specific inhibitor of KMO. The binding mode of the inhibitor in the active site was confirmed by X-ray co-crystallography at 3.2 Å resolution. Treatment with GSK180 resulted in rapid changes in the levels of kynurenine pathway metabolites in vivo, and it afforded therapeutic protection against MODS in a rat model of AP. Our findings establish KMO inhibition as a novel therapeutic strategy in the treatment of AP-MODS, and they open up a new area for drug discovery in critical illness.

Pathophysiology of the gut and the microbiome in the host response

PubMed Central

Lyons, John D.; Coopersmith, Craig M.

2016-01-01

Objective To describe and summarize the data supporting the “gut” as the motor driving critical illness and multiple organ dysfunction syndrome (MODS) presented at the Eunice Kennedy Shriver National Institute of Child Health and Human Development MODS Workshop (March 26–27, 2015). Data Sources Summary of workshop keynote presentation. Study Selection Not applicable. Data Extraction Presented by an expert in the field, the data assessing the role of gastrointestinal dysfunction driving critical illness were described with a focus on identifying knowledge gaps and research priorities. Data Synthesis Summary of presentation and discussion supported and supplemented by relevant literature. Conclusions The understanding of gut dysfunction in critical illness has evolved greatly over time, and the gut is now often considered as the “motor” of critical illness. The association of the gut with critical illness is supported by both animal models and clinical studies. Initially, the association between gut dysfunction and critical illness focused primarily on bacterial translocation into the bloodstream. However, that work has evolved to include other gut-derived products causing distant injury via other routes (e.g. lymphatics). Additionally, alterations in the gut epithelium may be associated with critical illness and influence outcomes. Gut epithelial apoptosis, intestinal hyperpermeability and perturbations in the intestinal mucus layer have all been associated with critical illness. Finally, there is growing evidence that the intestinal microbiome plays a crucial role in mediating pathology in critical illness. Further research is needed to better understand the role of each of these mechanisms and their contribution to MODS in children. PMID:28248833

Angiogenic factors and their soluble receptors predict organ dysfunction and mortality in post-cardiac arrest syndrome.

PubMed

Wada, Takeshi; Jesmin, Subrina; Gando, Satoshi; Yanagida, Yuichiro; Mizugaki, Asumi; Sultana, Sayeeda N; Zaedi, Sohel; Yokota, Hiroyuki

2012-09-29

Post-cardiac arrest syndrome (PCAS) often leads to multiple organ dysfunction syndrome (MODS) with a poor prognosis. Endothelial and leukocyte activation after whole-body ischemia/reperfusion following resuscitation from cardiac arrest is a critical step in endothelial injury and related organ damage. Angiogenic factors, including vascular endothelial growth factor (VEGF) and angiopoietin (Ang), and their receptors play crucial roles in endothelial growth, survival signals, pathological angiogenesis and microvascular permeability. The aim of this study was to confirm the efficacy of angiogenic factors and their soluble receptors in predicting organ dysfunction and mortality in patients with PCAS. A total of 52 resuscitated patients were divided into two subgroups: 23 survivors and 29 non-survivors. The serum levels of VEGF, soluble VEGF receptor (sVEGFR)1, sVEGFR2, Ang1, Ang2 and soluble Tie2 (sTie2) were measured at the time of admission (Day 1) and on Day 3 and Day 5. The ratio of Ang2 to Ang1 (Ang2/Ang1) was also calculated. This study compared the levels of angiogenic factors and their soluble receptors between survivors and non-survivors, and evaluated the predictive value of these factors for organ dysfunction and 28-day mortality. The non-survivors demonstrated more severe degrees of organ dysfunction and a higher prevalence of MODS. Non-survivors showed significant increases in the Ang2 levels and the Ang2/Ang1 ratios compared to survivors. A stepwise logistic regression analysis demonstrated that the Ang2 levels or the Ang2/Ang1 ratios on Day 1 independently predicted the 28-day mortality. The receiver operating characteristic curves of the Ang2 levels, and the Ang2/Ang1 ratios on Day 1 were good predictors of 28-day mortality. The Ang2 levels also independently predicted increases in the Sequential Organ Failure Assessment (SOFA) scores. We observed a marked imbalance between Ang1 and Ang2 in favor of Ang2 in PCAS patients, and the effect was more prominent in non-survivors. Angiogenic factors and their soluble receptors, particularly Ang2 and Ang2/Ang1, are considered to be valuable predictive biomarkers in the development of organ dysfunction and poor outcomes in PCAS patients.

Defibrotide sodium for the treatment of hepatic veno-occlusive disease/sinusoidal obstruction syndrome.

PubMed

Richardson, Paul G; Triplett, Brandon M; Ho, Vincent T; Chao, Nelson; Dignan, Fiona L; Maglio, Michelle; Mohty, Mohamad

2018-02-01

Hepatic veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS) is an unpredictable condition associated with endothelial-cell damage due to conditioning for hematopoietic stem-cell transplantation (HSCT) or chemotherapy without HSCT. Mortality in patients with VOD/SOS and multi-organ dysfunction (MOD) may be >80%. Areas covered: Defibrotide is the only approved drug for the treatment of severe hepatic VOD/SOS after HSCT in the European Union and hepatic VOD/SOS with renal or pulmonary dysfunction in the United States. Its efficacy in patients with VOD/SOS with MOD post-HSCT was demonstrated in a clinical-trial program that included a historically controlled treatment study, a phase 2 trial, and a large T-IND expanded-access program that also included patients without MOD and who received chemotherapy without HSCT. Expert commentary: Defibrotide appears to protect endothelial cells and restore the thrombolytic-fibrinolytic balance. It addresses a significant clinical need and has demonstrated favorable Day +100 survival and overall adverse-event rates that seem similar to control groups receiving supportive care alone. Currently, defibrotide is under investigation for the prevention of VOD/SOS in high-risk pediatric and adult patients.

Signatures of inflammation and impending multiple organ dysfunction in the hyperacute phase of trauma: A prospective cohort study

PubMed Central

Longhi, M. Paula; Hoti, Mimoza; Patel, Minal B.; O’Dwyer, Michael; Nourshargh, Sussan; Barnes, Michael R.; Brohi, Karim

2017-01-01

Background Severe trauma induces a widespread response of the immune system. This “genomic storm” can lead to poor outcomes, including Multiple Organ Dysfunction Syndrome (MODS). MODS carries a high mortality and morbidity rate and adversely affects long-term health outcomes. Contemporary management of MODS is entirely supportive, and no specific therapeutics have been shown to be effective in reducing incidence or severity. The pathogenesis of MODS remains unclear, and several models are proposed, such as excessive inflammation, a second-hit insult, or an imbalance between pro- and anti-inflammatory pathways. We postulated that the hyperacute window after trauma may hold the key to understanding how the genomic storm is initiated and may lead to a new understanding of the pathogenesis of MODS. Methods and findings We performed whole blood transcriptome and flow cytometry analyses on a total of 70 critically injured patients (Injury Severity Score [ISS] ≥ 25) at The Royal London Hospital in the hyperacute time period within 2 hours of injury. We compared transcriptome findings in 36 critically injured patients with those of 6 patients with minor injuries (ISS ≤ 4). We then performed flow cytometry analyses in 34 critically injured patients and compared findings with those of 9 healthy volunteers. Immediately after injury, only 1,239 gene transcripts (4%) were differentially expressed in critically injured patients. By 24 hours after injury, 6,294 transcripts (21%) were differentially expressed compared to the hyperacute window. Only 202 (16%) genes differentially expressed in the hyperacute window were still expressed in the same direction at 24 hours postinjury. Pathway analysis showed principally up-regulation of pattern recognition and innate inflammatory pathways, with down-regulation of adaptive responses. Immune deconvolution, flow cytometry, and modular analysis suggested a central role for neutrophils and Natural Killer (NK) cells, with underexpression of T- and B cell responses. In the transcriptome cohort, 20 critically injured patients later developed MODS. Compared with the 16 patients who did not develop MODS (NoMODS), maximal differential expression was seen within the hyperacute window. In MODS versus NoMODS, 363 genes were differentially expressed on admission, compared to only 33 at 24 hours postinjury. MODS transcripts differentially expressed in the hyperacute window showed enrichment among diseases and biological functions associated with cell survival and organismal death rather than inflammatory pathways. There was differential up-regulation of NK cell signalling pathways and markers in patients who would later develop MODS, with down-regulation of neutrophil deconvolution markers. This study is limited by its sample size, precluding more detailed analyses of drivers of the hyperacute response and different MODS phenotypes, and requires validation in other critically injured cohorts. Conclusions In this study, we showed how the hyperacute postinjury time window contained a focused, specific signature of the response to critical injury that led to widespread genomic activation. A transcriptomic signature for later development of MODS was present in this hyperacute window; it showed a strong signal for cell death and survival pathways and implicated NK cells and neutrophil populations in this differential response. PMID:28715416

Plasma biomarkers of SIRS and MODS associated with canine babesiosis.

PubMed

Kuleš, J; de Torre-Minguela, C; Barić Rafaj, R; Gotić, J; Nižić, P; Ceron, J J; Mrljak, V

2016-04-01

Canine babesiosis is a tick-borne disease caused by the haemoprotozoan parasites of the genus Babesia. Early detection of systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS) is of major importance in clinical practice for providing information about severity and outcomes of the disease and therapy. Plasma samples were taken at admission from five dogs with uncomplicated babesiosis caused by B. canis canis, five dogs with babesiosis and SIRS, five dogs with babesiosis and MODS, and five healthy dogs. After two-dimensional electrophoresis and capillary reversed - phase liquid chromatography coupled online with tandem mass spectrometry, 68 differentially expressed spots with level of significance P<0.05 were detected between groups. SIRS in babesiosis was characterised by increases in paraoxonase 1 and apoA-I, whereas MODS with decrease of complement inhibitors leading to prolonged complement activation and decrease of vitamin D binding protein due to haemolysis and activation of the coagulation cascade. Copyright © 2016 Elsevier Ltd. All rights reserved.

Recent Advances in the Molecular Mechanisms Underlying Pyroptosis in Sepsis

PubMed Central

2018-01-01

Sepsis is recognized as a life-threatening organ dysfunctional disease that is caused by dysregulated host responses to infection. Up to now, sepsis still remains a dominant cause of multiple organ dysfunction syndrome (MODS) and death among severe condition patients. Pyroptosis, originally named after the Greek words “pyro” and “ptosis” in 2001, has been defined as a specific programmed cell death characterized by release of inflammatory cytokines. During sepsis, pyroptosis is required for defense against bacterial infection because appropriate pyroptosis can minimize tissue damage. Even so, pyroptosis when overactivated can result in septic shock, MODS, or increased risk of secondary infection. Proteolytic cleavage of gasdermin D (GSDMD) by caspase-1, caspase-4, caspase-5, and caspase-11 is an essential step for the execution of pyroptosis in activated innate immune cells and endothelial cells stimulated by cytosolic lipopolysaccharide (LPS). Cleaved GSDMD also triggers NACHT, LRR, and PYD domain-containing protein (NLRP) 3-mediated activation of caspase-1 via an intrinsic pathway, while the precise mechanism underlying GSDMD-induced NLRP 3 activation remains unclear. Hence, this study provides an overview of the recent advances in the molecular mechanisms underlying pyroptosis in sepsis. PMID:29706799

Recent Advances in the Molecular Mechanisms Underlying Pyroptosis in Sepsis.

PubMed

Gao, Yu-Lei; Zhai, Jian-Hua; Chai, Yan-Fen

2018-01-01

Sepsis is recognized as a life-threatening organ dysfunctional disease that is caused by dysregulated host responses to infection. Up to now, sepsis still remains a dominant cause of multiple organ dysfunction syndrome (MODS) and death among severe condition patients. Pyroptosis, originally named after the Greek words " pyro " and " ptosis " in 2001, has been defined as a specific programmed cell death characterized by release of inflammatory cytokines. During sepsis, pyroptosis is required for defense against bacterial infection because appropriate pyroptosis can minimize tissue damage. Even so, pyroptosis when overactivated can result in septic shock, MODS, or increased risk of secondary infection. Proteolytic cleavage of gasdermin D (GSDMD) by caspase-1, caspase-4, caspase-5, and caspase-11 is an essential step for the execution of pyroptosis in activated innate immune cells and endothelial cells stimulated by cytosolic lipopolysaccharide (LPS). Cleaved GSDMD also triggers NACHT, LRR, and PYD domain-containing protein (NLRP) 3-mediated activation of caspase-1 via an intrinsic pathway, while the precise mechanism underlying GSDMD-induced NLRP 3 activation remains unclear. Hence, this study provides an overview of the recent advances in the molecular mechanisms underlying pyroptosis in sepsis.

Soluble tumor necrosis factor receptor p55 predicts cytokinemia and systemic inflammatory response after cardiopulmonary bypass.

PubMed

el-Barbary, Mahmoud; Khabar, Khalid S A

2002-08-01

To examine the behavior of soluble tumor necrosis factor (TNF) receptors in circulation before and after cardiopulmonary bypass and the relationship to the development of cytokinemia and acute complications comprising systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS). The predictive value of soluble TNF receptor is assessed herein. Prospective study comparing prebypass and postbypass levels in patients with and without complications indicative of SIRS and MODS. Cardiac surgical intensive care unit in a tertiary care hospital. A total of 20 pediatric patients who underwent cardiopulmonary bypass during open heart surgery. Blood samples were collected from catheters before and 2 hrs and 24 hrs after the onset of bypass. We measured plasma levels of soluble TNF receptors by using enzyme-linked immunosorbent assay in 20 patients before and after cardiopulmonary bypass. Clinical data, including duration of bypass and tests or signs indicative of SIRS/MODS, were collected. Soluble TNF receptor I (p55 sR), significantly increased (2241 +/- 312 pg/mL) at 2 hrs after bypass (p <.0005) and remained elevated (2826 +/- 695 pg/mL) at 1 day after bypass (p <.005) when compared with prebypass levels (725 +/- 130 pg/mL). Patients with the acute complications of SIRS/MODS had a higher ratio of postbypass to prebypass p55 sR levels (5.0-fold, p <.001) when compared with patients with no SIRS/MODS (1.75-fold). Remarkably, before surgery, levels of TNF p55 sR predict both cytokinemia (r =.67 to.73, p <.05) and SIRS/MODS (p <.01). The prebypass levels of TNF p55 sR were consistently higher (range, 1000-1400 pg/mL) in patients who subsequently developed SIRS/MODS than the levels (range, 400-570 pg/mL) in patients who did not develop SIRS/MODS. Hypotension, respiratory dysfunctions, and coagulopathy were particularly more prevailing (p <.005) among the complications that were associated with high prebypass levels of TNF p55 sR. Soluble TNF receptor p55 can be employed as a predictive marker for cytokinemia and the development of SIRS/MODS that may arise from a major insult to the body such as cardiopulmonary bypass.

Pattern of cytokine (IL-6 and IL-10) level as inflammation and anti-inflammation mediator of multiple organ dysfunction syndrome (MODS) in polytrauma.

PubMed

Sapan, Heber Bombang; Paturusi, Idrus; Jusuf, Irawan; Patellongi, Ilhamjaya; Massi, Muh Nasrum; Pusponegoro, Aryono Djuned; Arief, Syafrie Kamsul; Labeda, Ibrahim; Islam, Andi Asadul; Rendy, Leo; Hatta, Mochammad

2016-01-01

Massive injury remains the most common cause of death for productive age group globally. The current immune, inflammatory paradigm, based on an incomplete understanding of the functional integration of the complex host response, remains a major impediment to the development of effective innovative diagnostic and therapeutic effort. This study attempt to investigate the pattern of inflammatory and anti-inflammatory cytokines such as interleukin-6 and 10 (IL-6 and IL-10) and their interaction in severe injury condition with its major complication as multiple organ dysfunction syndrome (MODS) and failure (MOF) after polytrauma. This is multicenter study held at 4 academic Level-1 Trauma center included 54 polytrauma participants. Inclusion criteria were age between 16-60 years old, had new acute episode of polytrauma which defined as injury in ≥2 body region with Injury Severity Score (ISS) ≥16, and the presence of Systemic Inflammation Response Syndrome (SIRS). Serum level of IL-6 and IL-10 were taken on day 2, 3, and 5 after trauma. During hospitalization, samples were observed for the occurrence of MODS or MOF using Sequential Organ Failure Assessment (SOFA) and mortality rate were also noted. Participant were mostly male with mean of age of 35, 9 years old, endured polytrauma caused by traffic accident. Elevation of cytokines (IL-6, IL-10, and IL-6/IL-10 ratio) had directly proportional with MODS and mortality. Threshold level of compensation for severe trauma is IL-6 of 50 pg/mL and trauma load of ISS ≥30. Inflammation reaction greater than this threshold level would result in downhill level of IL-6, IL-10, or IL-6/IL-10 ratio which associated with poor outcome (MODS and death). The elevation of these cytokines level were represent as compensation/adaptive immune system and its fall represent decompensating/failure of immune system after severe trauma. The pattern of IL-6 and IL-10 after polytrauma represent immune system effort to restore homeostasis. Besides cytokines interaction, there must be other factors that contribute to mortality and poor outcome after major trauma. Further study is needed to investigate genomic variant or polymorphism related to trauma.

Close relationship of tissue plasminogen activator-plasminogen activator inhibitor-1 complex with multiple organ dysfunction syndrome investigated by means of the artificial pancreas

PubMed Central

Hoshino, Masami; Haraguchi, Yoshikura; Hirasawa, Hiroyuki; Sakai, Motohiro; Saegusa, Hiroshi; Hayashi, Kazushiro; Horita, Naoki; Ohsawa, Hiroyuki

2001-01-01

Background: Glucose tolerance (GT) has not been taken into consideration in investigations concerning relationships between coagulopathy and multiple organ dysfunction syndrome (MODS), and endothelial cell activation/endothelial cell injury (ECA/ECI) in septic patients, although coagulopathy is known to be influenced by blood glucose level. We investigated those relationships under strict blood glucose control and evaluation of GT with the glucose clamp method by means of the artificial pancreas in nine septic patients with glucose intolerance. The relationships between GT and blood stress related hormone levels (SRH) were also investigated. Methods: The amount of metabolized glucose (M value), as the parameter of GT, was measured by the euglycemic hyperinsulinemic glucose clamp method, in which the blood glucose level was clamped at 80 mg/dl under a continuous insulin infusion rate of 1.12 mU/kg per min, using the artificial pancreas, STG-22. Multiple organ failure (MOF) score was calculated using the MOF criteria of Japanese Association for Critical Care Medicine. Regarding coagulopathy, the following parameters were used: disseminated intravascular coagulation (DIC) score (calculated from the DIC criteria of the Ministry of Health and Welfare of Japan) and the parameters used for calculating DIC score, protein-C, protein-S, plasminogen, antithrombin III (AT-III), plasminogen activator inhibitor-1 (PAI-1), and tissue plasminogen activator-PAI-1 (tPA-PAI-1) complex. Thrombomodulin (TM) was measured as the indicator of ECI. Results: There were no significant correlations between M value and SRH, parameters indicating coagulopathy and the MOF score. The MOF score and blood TM levels were positively correlated with DIC score, thrombin-AT-III complex and tPA-PAI-1 complex, and negatively correlated with blood platelet count. Conclusions: GT was not significantly related to SRH, coagulopathy and MODS under strict blood glucose control. Hypercoagulability was closely related to MODS and ECI. Among the parameters indicating coagulopathy, tPA-PAI-1 complex, which is considered to originate from ECA, seemed to be a sensitive parameter of MODS and ECI, and might be a predictive marker of MODS. The treatment for reducing hypercoagulability and ECA/ECI were thought to be justified as one of the therapies for acutely ill septic patients. PMID:11299067

Epidemiology and outcome analysis of sepsis and organ dysfunction/failure after burns.

PubMed

Belba, Monika Kristaq; Petrela, Elizana Ylber; Belba, Amy Gjergji

2017-09-01

The aim of this prospective study in adult population is to give frequency data (prevalence, incidence) of burn wound sepsis and its consequences (organ dysfunction/failure); to analyze the evolution of the SOFA cumulative score during the disease and relationship between the SOFA score in the 3rd, 7th, 14th and 21th day after burn with mortality. A prospective cohort study was performed among adult patients (age ≥20 years) admitted in the ICU, with major and moderate burns. Sepsis, organ dysfunction, organ failure and mortality were calculated as Cumulative Incidence (CI) and as Incidence rate (IR). Data from patients with sepsis were compared with those without sepsis. Evaluation of SOFA evolution was done with delta score and the influence of the SOFA score in mortality was calculated with AUC of the ROC curve. Period prevalence of sepsis in our adult burned population was 26%. Incidence proportion as CI was 0.3 or 30 patients per 100 adults. Incidence rate (IR) was 6 patients with sepsis per 100 patient-years. Overall morbidity was 88.1% while overall mortality was 11.9%. Mortality in patients with sepsis was 34.4%. Incidence of MOD was 63% while incidence of MOF was 37%. Respective mortality as CI was 7% and 81% while mortality rate as IR was 1.4 per 100 patient-years in patients with MOD and 16.2 per 100 patient-years in patients with MOF. SOFA-3 should be considered a "reliable indicator" at separating survivors from non survivors and SOFA 7, 14, and 21 should be considered excellent in predicting mortality. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

Mechanical ventilation interacts with endotoxemia to induce extrapulmonary organ dysfunction

PubMed Central

O'Mahony, D Shane; Liles, W Conrad; Altemeier, William A; Dhanireddy, Shireesha; Frevert, Charles W; Liggitt, Denny; Martin, Thomas R; Matute-Bello, Gustavo

2006-01-01

Introduction Multiple organ dysfunction syndrome (MODS) is a common complication of sepsis in mechanically ventilated patients with acute respiratory distress syndrome, but the links between mechanical ventilation and MODS are unclear. Our goal was to determine whether a minimally injurious mechanical ventilation strategy synergizes with low-dose endotoxemia to induce the activation of pro-inflammatory pathways in the lungs and in the systemic circulation, resulting in distal organ dysfunction and/or injury. Methods We administered intraperitoneal Escherichia coli lipopolysaccharide (LPS; 1 μg/g) to C57BL/6 mice, and 14 hours later subjected the mice to 6 hours of mechanical ventilation with tidal volumes of 10 ml/kg (LPS + MV). Comparison groups received ventilation but no LPS (MV), LPS but no ventilation (LPS), or neither LPS nor ventilation (phosphate-buffered saline; PBS). Results Myeloperoxidase activity and the concentrations of the chemokines macrophage inflammatory protein-2 (MIP-2) and KC were significantly increased in the lungs of mice in the LPS + MV group, in comparison with mice in the PBS group. Interestingly, permeability changes across the alveolar epithelium and histological changes suggestive of lung injury were minimal in mice in the LPS + MV group. However, despite the minimal lung injury, the combination of mechanical ventilation and LPS resulted in chemical and histological evidence of liver and kidney injury, and this was associated with increases in the plasma concentrations of KC, MIP-2, IL-6, and TNF-α. Conclusion Non-injurious mechanical ventilation strategies interact with endotoxemia in mice to enhance pro-inflammatory mechanisms in the lungs and promote extra-pulmonary end-organ injury, even in the absence of demonstrable acute lung injury. PMID:16995930

Bench-to-bedside review: Angiopoietin signalling in critical illness – a future target?

PubMed Central

van Meurs, Matijs; Kümpers, Philipp; Ligtenberg, Jack JM; Meertens, John HJM; Molema, Grietje; Zijlstra, Jan G

2009-01-01

Multiple organ dysfunction syndrome (MODS) occurs in response to major insults such as sepsis, severe haemorrhage, trauma, major surgery and pancreatitis. The mortality rate is high despite intensive supportive care. The pathophysiological mechanism underlying MODS are not entirely clear, although several have been proposed. Overwhelming inflammation, immunoparesis, occult oxygen debt and other mechanisms have been investigated, and – despite many unanswered questions – therapies targeting these mechanisms have been developed. Unfortunately, only a few interventions, usually those targeting multiple mechanisms at the same time, have appeared to be beneficial. We clearly need to understand better the mechanisms that underlie MODS. The endothelium certainly plays an active role in MODS. It functions at the intersection of several systems, including inflammation, coagulation, haemodynamics, fluid and electrolyte balance, and cell migration. An important regulator of these systems is the angiopoietin/Tie2 signalling system. In this review we describe this signalling system, giving special attention to what is known about it in critically ill patients and its potential as a target for therapy. PMID:19435476

Rhabdomyolysis in a patient complicated with hypopituitarism and multiple organ dysfunction syndrome and the literature review.

PubMed

Zhou, Chuan; Lai, Shichao; Xie, Yong; Zhang, Shu; Lu, Yiping

2018-06-07

Muscular symptoms, including stiffness, myalgia, cramps, and fatigue, are present in the majority of the patients with hypopituitarism, adrenal insufficiency and hypothyroidism, but rhabdomyolysis, the rapid breakdown of skeletal muscle, is a rare manifestation. In most patients who develop rhabdomyolysis, precipitating factors, such as strenuous exercise or use of lipid-lowering drugs, can be identified. We report the case of a 23-year-old male with primary hypopituitarism who developed acute renal impairment (AKI) with rhabdomyolysis after strenuous physical activity (push-ups). His blood test confirmed marked hypopituitarism. Severe elevation of serum CK consistent with rhabdomyolysis was noted and an elevated creatinine indicated AKI and multiple organ dysfunction syndrome (MODS). Patient's condition improved significantly after continuous renal replacement therapy (CRRT), glucocorticoid hormone replacement therapy and aggressive hydration. MODS with rhabdomyolysis in patients with hypothyroidism is quite rare and we expect that this case report adds to the existing literature on this subject. We also emphasize that thyroid and adrenal gland status should be evaluated in patients with unexplained AKI, MODS and presenting with the symptoms of muscle involvement. We respectively reviewed 23 patients with hypopituitarism, adrenal Insufficiency and hypothyroidism induced rhabdomyolysis who were involved in the past 40 years relevant literatures. We report a successfully treated case of rhabdomyolysis, which is a rare but potentially serious complication of hypopituitarism. Screening for endocrine abnormality in patients with elevated muscle enzymes should be considered, since an early diagnosis and prompt treatment is essential to prevent rhabdomyolysis and its consequences. Copyright © 2018. Published by Elsevier Inc.

Recombinant Factor XIII Mitigates Hemorrhagic Shock-Induced Organ Dysfunction

PubMed Central

Zaets, Sergey B.; Xu, Da-Zhong; Lu, Qi; Feketova, Eleonora; Berezina, Tamara L.; Malinina, Inga V.; Deitch, Edwin A.; Olsen, Eva H.

2012-01-01

Background Plasma factor XIII (FXIII) is responsible for stabilization of fibrin clot at the final stage of blood coagulation. Since FXIII has also been shown to modulate inflammation, endothelial permeability, as well as diminish multiple organ dysfunction (MOD) after gut ischemia-reperfusion injury, we hypothesized that FXIII would reduce MOD caused by trauma-hemorrhagic shock (THS). Materials and methods Rats were subjected to a 90 min THS or trauma sham shock (TSS) and treated with either recombinant human FXIII A2 subunit (rFXIII) or placebo immediately after resuscitation with shed blood or at the end of the TSS period. Lung permeability, lung and gut myeloperoxidase (MPO) activity, gut histology, neutrophil respiratory burst, microvascular blood flow in the liver and muscles, and cytokine levels were measured 3 h after the THS or TSS. FXIII levels were measured before THS or TSS and after the 3-h post-shock period. Results THS-induced lung permeability as well as lung and gut MPO activity was significantly lower in rFXIII-treated than in placebo-treated animals. Similarly, rFXIII-treated rats had lower neutrophil respiratory burst activity and less ileal mucosal injury. rFXIII-treated rats also had a higher liver microvascular blood flow compared with the placebo group. Cytokine response was more favorable in rFXIII-treated animals. Trauma-hemorrhagic shock did not cause a drop in FXIII activity during the study period. Conclusions Administration of rFXIII diminishes THS-induced MOD in rats, presumably by preservation of the gut barrier function, limitation of polymorphonuclear leukocyte (PMN) activation, and modulation of the cytokine response. PMID:21276979

Final results from a defibrotide treatment-IND study for patients with hepatic veno-occlusive disease/sinusoidal obstruction syndrome.

PubMed

Kernan, Nancy A; Grupp, Stephan; Smith, Angela R; Arai, Sally; Triplett, Brandon; Antin, Joseph H; Lehmann, Leslie; Shore, Tsiporah; Ho, Vincent T; Bunin, Nancy; Iacobelli, Massimo; Liang, Wei; Hume, Robin; Tappe, William; Soiffer, Robert; Richardson, Paul

2018-05-16

Hepatic veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS) is a potentially life-threatening complication of haematopoietic stem cell transplant (HSCT) conditioning and chemotherapy. Defibrotide is approved for treatment of hepatic VOD/SOS with pulmonary or renal dysfunction [i.e., multi-organ dysfunction (MOD)] after HSCT in the United States and severe VOD/SOS after HSCT in patients aged older than 1 month in the European Union. Defibrotide was available as an investigational drug by an expanded-access treatment programme (T-IND; NCT00628498). In the completed T-IND, the Kaplan-Meier estimated Day +100 survival for 1000 patients with documented defibrotide treatment after HSCT was 58·9% [95% confidence interval (CI), 55·7-61·9%]. Day +100 survival was also analysed by age and MOD status, and post hoc analyses were performed to determine Day +100 survival by transplant type, timing of VOD/SOS onset (≤21 or >21 days) and timing of defibrotide treatment initiation after VOD/SOS diagnosis. Day +100 survival in paediatric patients was 67·9% (95% CI, 63·8-71·6%) and 47·1% (95% CI, 42·3-51·8%) in adults. All patient subgroups without MOD had higher Day +100 survival than those with MOD; earlier defibrotide initiation was also associated with higher Day +100 survival. The safety profile of defibrotide in the completed T-IND study was similar to previous reports. © 2018 The Authors. British Journal of Haematology published by John Wiley & Sons Ltd.

Mortality indicators and risk factors for intra-abdominal hypertension in severe acute pancreatitis.

PubMed

Zhao, J G; Liao, Q; Zhao, Y P; Hu, Y

2014-01-01

This study assessed the risk factors associated with mortality and the development of intra-abdominal hypertension (IAH) in patients with severe acute pancreatitis (SAP). To identify significant risk factors, we assessed the following variables in 102 patients with SAP: age, gender, etiology, serum amylase level, white blood cell (WBC) count, serum calcium level, Acute Physiology and Chronic Health Evaluation II (APACHE-II) score, computed tomography severity index (CTSI) score, pancreatic necrosis, surgical interventions, and multiple organ dysfunction syndrome (MODS). Statistically significant differences were identified using the Student t test and the χ (2) test. Independent risk factors for survival were analyzed by Cox proportional hazards regression. The following variables were significantly related to both mortality and IAH: WBC count, serum calcium level, serum amylase level, APACHE-II score, CTSI score, pancreatic necrosis, pancreatic necrosis >50%, and MODS. However, it was found that surgical intervention had no significant association with mortality. MODS and pancreatic necrosis >50% were found to be independent risk factors for survival in patients with SAP. Mortality and IAH from SAP were significantly related to WBC count, serum calcium level, serum amylase level, APACHE-II score, CTSI score, pancreatic necrosis, and MODS. However, Surgical intervention did not result in higher mortality. Moreover, MODS and pancreatic necrosis >50% predicted a worse prognosis in SAP patients.

Circulating Angiopopietin-1 Correlates With the Clinical Course of Multiple Organ Dysfunction Syndrome and Mortality in Patients With Severe Sepsis

PubMed Central

Lin, Shu-Min; Chung, Fu-Tsai; Kuo, Chih-Hsi; Chou, Pai-Chien; Wang, Tsai-Yu; Chang, Po-Jui; Lo, Yu-Lun; Huang, Chien-Da; Lin, Horng-Chyuan; Wang, Chun-Hua; Kuo, Han-Pin

2015-01-01

Abstract To determine plasma concentrations of angiopoietin (Ang)-1, Ang-2, Tie-2, and vascular endothelial growth factor (VEGF) in patients with sepsis-induced multiple organ dysfunction syndrome (MODS) and determine their association with mortality. The study prospectively recruited 96 consecutive patients with severe sepsis in a l intensive care unit of a tertiary hospital. Plasma Ang-1, Ang-2, Tie-2, and VEGF levels and MODS were determined in patients on days 1, 3, and 7 of sepsis. Univariate and Cox proportional hazards analysis were performed to develop a prognostic model. Days 1, 3, and 7 plasma Ang-1 concentrations were persistently decreased in MODS patients than in non-MODS patients (day1: 4.0 ± 0.5 vs 8.0 ± 0.5 ng/mL, P < 0.0001; day 3, 3.2 ± 0.6 vs 7.3 ± 0.5 ng/mL, P < 0.0001, day 7, 2.8 ± 0.6 vs 10.4 ± 0.7 ng/mL, P < 0.0001). In patients with resolved MODS on day 7 of sepsis, Ang-1 levels were increased from day 1 (4.7 ± 0.6 ng/mL vs 9.1 ± 1.4 ng/mL, n = 43, P = 0.004). Plasma Ang-1 levels were lower in nonsurvivors than in survivors on days 1 (4.0 ± 0.5 vs 7.1 ± 0.5 ng/mL, P < 0.0001), 3 (3.8 ± 0.6 vs 7.1 ± 0.5 ng/mL, P < 0.0001), and 7 (4.7 ± 0.7 vs 11.0 ± 0.8 ng/mL, P < 0.0001) of severe sepsis. In contrast, plasma Ang-2 levels were higher in nonsurvivors than in survivors only on day 1 (15.8 ± 2.0 vs 9.5 ± 1.2 ng/mL, P = 0.035). VEGF and Tie-2 levels were not associated with MODS and mortality. Ang-1 level less than the median value was the only independent predictor of mortality (hazard ratio, 2.57; 95% CI 1.12–5.90, P = 0.025). Persistently decreased Ang-1 levels are associated with MODS and subsequently, mortality in patients with sepsis. PMID:25997069

Bioartificial organ support for hepatic, renal, and hematologic failure.

PubMed

Maguire, P J; Stevens, C; Humes, H D; Shander, A; Halpern, N A; Pastores, S M

2000-10-01

The current strategy to the treatment of SIRS and MODS uses a multidisciplinary approach that emphasizes supportive therapy. Herein, we have presented a futuristic approach that focuses on replacing the function of failed organs using bioartificial technology (Table 1). Bioartificial organ technology may allow the intensivist to provide physiologic organ replacement either as a bridge to transplantation or as a "time-buying" element until native organs that have become acutely dysfunctional or nonfunctional in a variety of clinical settings, can recover their function or regenerate their mass. As bioartificial organ technology matures, it is conceivable as an ultimate goal that non-immunogenic bioartificial organs would be miniaturized or redesigned and acutely placed within the intracorporeal space as replacement organs.

Anti-RAGE antibody ameliorates severe thermal injury in rats through regulating cellular immune function

PubMed Central

Zhu, Xiao-mei; Yao, Yong-ming; Zhang, Li-tian; Dong, Ning; Yu, Yan; Sheng, Zhi-yong

2014-01-01

Aim: The receptor of advanced glycation end products (RAGE) participates in a variety of pathophysiological processes and inflammatory responses. The aim of this study was to investigate the therapeutic potential of an anti-RAGE neutralizing antibody for severe thermal injury in rats, and to determine whether the treatment worked via modulating cellular immune function. Methods: Full-thickness scald injury was induced in Wistar rats, which were treated with the anti-RAGE antibody (1 mg/kg, iv) at 6 h and 24 h after the injury. The rats were sacrificed on d 1, 3, 5, and 7. Blood and spleen samples were harvested to monitor organ function and to analyze dendritic cell (DC) and T cell cytokine profiles. The survival rate was analyzed up to d 7 after the injury. Results: Administration of the antibody significantly increased the 7 d survival rate in thermally injured rats (6.67% in the model group; 33.33% in anti-RAGE group). Treatment with the antibody also attenuated the multiple organ dysfunction syndrome (MODS) following the thermal injury, as shown by significant decreases in the organ dysfunction markers, including serum ALT, AST, blood urea nitrogen, creatinine and CK-MB. Moreover, treatment with the antibody significantly promoted DC maturation and T cell activation in the spleens of thermally injured rats. Conclusion: Blockade of the RAGE axis by the antibody effectively ameliorated MODS and improved the survival rate in thermally injured rats, which may be due to modulation of cellular immune function. PMID:25152026

Increased levels of 3-hydroxykynurenine parallel disease severity in human acute pancreatitis.

PubMed

Skouras, Christos; Zheng, Xiaozhong; Binnie, Margaret; Homer, Natalie Z M; Murray, Toby B J; Robertson, Darren; Briody, Lesley; Paterson, Finny; Spence, Heather; Derr, Lisa; Hayes, Alastair J; Tsoumanis, Andreas; Lyster, Dawn; Parks, Rowan W; Garden, O James; Iredale, John P; Uings, Iain J; Liddle, John; Wright, Wayne L; Dukes, George; Webster, Scott P; Mole, Damian J

2016-09-27

Inhibition of kynurenine 3-monooxygenase (KMO) protects against multiple organ dysfunction (MODS) in experimental acute pancreatitis (AP). We aimed to precisely define the kynurenine pathway activation in relation to AP and AP-MODS in humans, by carrying out a prospective observational study of all persons presenting with a potential diagnosis of AP for 90 days. We sampled peripheral venous blood at 0, 3, 6, 12, 24, 48, 72 and 168 hours post-recruitment. We measured tryptophan metabolite concentrations and analysed these in the context of clinical data and disease severity indices, cytokine profiles and C-reactive protein (CRP) concentrations. 79 individuals were recruited (median age: 59.6 years; 47 males, 59.5%). 57 met the revised Atlanta definition of AP: 25 had mild, 23 moderate, and 9 severe AP. Plasma 3-hydroxykynurenine concentrations correlated with contemporaneous APACHE II scores (R 2  = 0.273; Spearman rho = 0.581; P < 0.001) and CRP (R 2  = 0.132; Spearman rho = 0.455, P < 0.001). Temporal profiling showed early tryptophan depletion and contemporaneous 3-hydroxykynurenine elevation. Furthermore, plasma concentrations of 3-hydroxykynurenine paralleled systemic inflammation and AP severity. These findings support the rationale for investigating early intervention with a KMO inhibitor, with the aim of reducing the incidence and severity of AP-associated organ dysfunction.

Increased levels of 3-hydroxykynurenine parallel disease severity in human acute pancreatitis

PubMed Central

Skouras, Christos; Zheng, Xiaozhong; Binnie, Margaret; Homer, Natalie Z. M.; Murray, Toby B. J.; Robertson, Darren; Briody, Lesley; Paterson, Finny; Spence, Heather; Derr, Lisa; Hayes, Alastair J.; Tsoumanis, Andreas; Lyster, Dawn; Parks, Rowan W.; Garden, O. James; Iredale, John P.; Uings, Iain J.; Liddle, John; Wright, Wayne L.; Dukes, George; Webster, Scott P.; Mole, Damian J.

2016-01-01

Inhibition of kynurenine 3-monooxygenase (KMO) protects against multiple organ dysfunction (MODS) in experimental acute pancreatitis (AP). We aimed to precisely define the kynurenine pathway activation in relation to AP and AP-MODS in humans, by carrying out a prospective observational study of all persons presenting with a potential diagnosis of AP for 90 days. We sampled peripheral venous blood at 0, 3, 6, 12, 24, 48, 72 and 168 hours post-recruitment. We measured tryptophan metabolite concentrations and analysed these in the context of clinical data and disease severity indices, cytokine profiles and C-reactive protein (CRP) concentrations. 79 individuals were recruited (median age: 59.6 years; 47 males, 59.5%). 57 met the revised Atlanta definition of AP: 25 had mild, 23 moderate, and 9 severe AP. Plasma 3-hydroxykynurenine concentrations correlated with contemporaneous APACHE II scores (R2 = 0.273; Spearman rho = 0.581; P < 0.001) and CRP (R2 = 0.132; Spearman rho = 0.455, P < 0.001). Temporal profiling showed early tryptophan depletion and contemporaneous 3-hydroxykynurenine elevation. Furthermore, plasma concentrations of 3-hydroxykynurenine paralleled systemic inflammation and AP severity. These findings support the rationale for investigating early intervention with a KMO inhibitor, with the aim of reducing the incidence and severity of AP-associated organ dysfunction. PMID:27669975

The cell wall components peptidoglycan and lipoteichoic acid from Staphylococcus aureus act in synergy to cause shock and multiple organ failure.

PubMed Central

De Kimpe, S J; Kengatharan, M; Thiemermann, C; Vane, J R

1995-01-01

Although the incidence of Gram-positive sepsis has risen strongly, it is unclear how Gram-positive organisms (without endotoxin) initiate septic shock. We investigated whether two cell wall components from Staphylococcus aureus, peptidoglycan (PepG) and lipoteichoic acid (LTA), can induce the inflammatory response and multiple organ dysfunction syndrome (MODS) associated with septic shock caused by Gram-positive organisms. In cultured macrophages, LTA (10 micrograms/ml), but not PepG (100 micrograms/ml), induces the release of nitric oxide measured as nitrite. PepG, however, caused a 4-fold increase in the production of nitrite elicited by LTA. Furthermore, PepG antibodies inhibited the release of nitrite elicited by killed S. aureus. Administration of both PepG (10 mg/kg; i.v.) and LTA (3 mg/kg; i.v.) in anesthetized rats resulted in the release of tumor necrosis factor alpha and interferon gamma and MODS, as indicated by a decrease in arterial oxygen pressure (lung) and an increase in plasma concentrations of bilirubin and alanine aminotransferase (liver), creatinine and urea (kidney), lipase (pancreas), and creatine kinase (heart or skeletal muscle). There was also the expression of inducible nitric oxide synthase in these organs, circulatory failure, and 50% mortality. These effects were not observed after administration of PepG or LTA alone. Even a high dose of LTA (10 mg/kg) causes only circulatory failure but no MODS. Thus, our results demonstrate that the two bacterial wall components, PepG and LTA, work together to cause systemic inflammation and multiple systems failure associated with Gram-positive organisms. Images Fig. 2 PMID:7479784

High plasma levels of high mobility group box 1 is associated with the risk of sepsis in severe blunt chest trauma patients: a prospective cohort study.

PubMed

Wang, Xiao-Wen; Karki, Avash; Zhao, Xing-Ji; Xiang, Xiao-Yong; Lu, Zhi-Qian

2014-08-02

High mobility group box 1 (HMGB1) is a late mediator of systemic inflammation. Extracellular HMGB1 play a central pathogenic role in critical illness. The purpose of the study was to investigate the association between plasma HMGB1 concentrations and the risk of poor outcomes in patients with severe blunt chest trauma. The plasma concentrations of HMGB1 in patients with severe blunt chest trauma (AIS ≥ 3) were measured by a quantitative enzyme-linked immunosorbent assay at four time points during seven days after admission, and the dynamic release patterns were monitored. The biomarker levels were compared between patients with sepsis and non-sepsis, and between patients with multiple organ dysfunction syndrome (MODS) and non-MODS. The related factors of prognosis were analyzed by using multivariate logistic regression analysis. The short-form 36 was used to evaluate the quality of life of patients at 12 months after injury. Plasma HMGB1 levels were significantly higher both in sepsis and MODS group on post-trauma day 3, 5, and 7 compared with the non-sepsis and non-MODS groups, respectively. Multivariate analysis showed that HMGB1 levels and ISS were independent risk factors for sepsis and MODS in patients with severe blunt chest trauma. Plasma HMGB1 levels were significantly elevated in patients with severe blunt chest trauma. HMGB1 levels were associated with the risk of poor outcome in patients with severe blunt chest trauma. Daily HMGB1 levels measurements is a potential useful tool in the early identification of post-trauma complications. Further studies are needed to determine whether HMGB1 intervention could prevent the development of sepsis and MODS in patients with severe blunt chest trauma.

The budget impact and cost-effectiveness of defibrotide for treatment of veno-occlusive disease with multi-organ dysfunction in patients post-hematopoietic stem cell transplant.

PubMed

Veenstra, David L; Guzauskas, Gregory F; Villa, Kathleen F; Boudreau, Denise M

2017-05-01

A Phase-3 study of defibrotide compared with historical controls demonstrated a 23% improvement in 100-day survival post-hematopoietic stem cell transplantation (HSCT) among patients with veno-occlusive disease with multi-organ dysfunction (VOD with MOD). To estimate the budget impact and cost-effectiveness of introducing defibrotide to a transplant center. The authors developed a budget impact model from the perspective of a bone-marrow transplant center. It was estimated that 2.3% of adults and 4.2% of children would develop VOD with MOD following HSCT based on a retrospective hospital database analysis and the effect that treating patients with defibrotide would have on costs for adult and pediatric centers was estimated. A cost-utility analysis (CUA) was also developed to capture the long-term cost-effectiveness of defibrotide. Projected life expectancies in the two groups were estimated based on trial data, transplant registry data, studies of long-term survival among HSCT patients, and US population life-tables. There was an estimated 3% increase ($330,706) per year in total adult transplantation center costs associated with adopting defibrotide, and a <1% increase ($106,385) for pediatric transplant centers, assuming 100 transplants per year. In the CUA, the lifetime increase in cost per patient was $106,928, life expectancy increased by 3.74 years, and quality-adjusted life-years (QALYs) increased by 2.24. The incremental cost-effectiveness ratio (ICER) was $47,736 per QALY gained; 88% probability defibrotide was cost-effective at a $100,000/QALY threshold. The budget impact of defibrotide for a transplant center is relatively modest compared to the overall cost of transplantation. Defibrotide provides an important survival advantage for VOD with MOD patients, and the life years gained lead to defibrotide being highly cost-effective.

MOD: An In-Situ Organic Detector for the MSR 2003 Mission

NASA Technical Reports Server (NTRS)

Kminek, G.; Bada, J. L.; Botta, O.; Glavin, D. P.; Grunthaner, F. J.; LaBaw, C. C.; Serviss, O. E.

2000-01-01

Looking for organic compounds that are essential for biochemistry or indicative of extraterrestrial organic influx is the primary goal of MOD (Mars Organic Detector). MOD can also quantify adsorbed and chemisorbed water and evolved carbon dioxide.

New insights into the gut as the driver of critical illness and organ failure

PubMed Central

Meng, Mei; Klingensmith, Nathan J.; Coopersmith, Craig M.

2017-01-01

Purpose of review The gut has long been hypothesized to be the “motor” of multiple organ dysfunction syndrome (MODS). This review serves as an update on new data elucidating the role of the gut as the propagator of organ failure in critical illness. Recent findings Under basal conditions, the gut absorbs nutrients and serves as a barrier that prevents approximately 40 trillion intraluminal microbes and their products from causing host injury. However, in critical illness, gut integrity is disrupted with hyperpermeability and increased epithelial apoptosis, allowing contamination of extraluminal sites that are ordinarily sterile. These alterations in gut integrity are further exacerbated in the setting of pre-existing co-morbidities. The normally commensal microflora is also altered in critical illness, with increases in microbial virulence and decreases in diversity, which leads to further pathologic responses within the host. Summary All components of the gut are adversely impacted by critical illness. Gut injury can not only propagate local damage, but can also cause distant injury and organ failure. Understanding how the multifaceted components of the gut interact and how these are perturbed in critical illness may play an important role in turning off the “motor” of MODS in the future. PMID:28092310

Outcome and prognostic factors of malaria-associated acute kidney injury requiring hemodialysis: A single center experience

PubMed Central

Kute, V. B.; Shah, P. R.; Munjappa, B. C.; Gumber, M. R.; Patel, H. V.; Jain, S. H.; Engineer, D. P.; Naresh, V. V. Sai; Vanikar, A. V.; Trivedi, H. L.

2012-01-01

Acute kidney injury (AKI) is one of the most dreaded complications of severe malaria. We carried out prospective study in 2010, to describe clinical characteristics, laboratory parameters, prognostic factors, and outcome in 59 (44 males, 15 females) smear-positive malaria patients with AKI. The severity of illness was assessed using Acute Physiology and Chronic Health Evaluation (APACHE) II, Sequential Organ Failure Assessment (SOFA) score, Multiple Organ Dysfunction Score (MODS), and Glasgow Coma Scale (GCS) scores. All patients received artesunate and hemodialysis (HD). Mean age of patients was 33.63 ± 14 years. Plasmodium falciparum malaria was seen in 76.3% (n = 45), Plasmodium vivax in 16.9% (n = 10), and mixed infection in 6.8% (n = 4) patients. Presenting clinical features were fever (100%), nausea-vomiting (85%), oliguria (61%), abdominal pain/tenderness (50.8%), and jaundice (74.5%). Mean APACHE II, SOFA, MODS, and GCS scores were 18.1 ± 3, 10.16 ± 3.09, 9.71 ± 2.69, and 14.15 ± 1.67, respectively, all were higher among patients who died than among those who survived. APACHE II ≥20, SOFA and MODS scores ≥12 were associated with higher mortality (P < 0.05). 34% patients received blood component transfusion and exchange transfusion was done in 15%. Mean number of HD sessions required was 4.59 ± 3.03. Renal biopsies were performed in five patients (three with patchy cortical necrosis and two with acute tubular necrosis). 81.3% of patients had complete renal recovery and 11.8% succumbed to malaria. Prompt diagnosis, timely HD, and supportive therapy were associated with improved survival and recovery of kidney functions in malarial with AKI. Mortality was associated with higher APACHE II, SOFA, MODS, GCS scores, requirement of inotrope, and ventilator support. PMID:22279340

Importance of increased ultrafiltration volume and impact on mortality: sepsis and cytokine story and the role for CVVH.

PubMed

Ronco, C; Ricci, Z; Bellomo, R

2002-01-01

There is growing interest in extracorporeal blood purification therapies (EBPT) as adjuvants in the complex therapy of sepsis and multiple organ dysfunction syndrome (MODS). Nowadays the only routinely used purification technique is 'renal replacement therapy' (RRT) during acute renal failure (ARF), one of the almost inevitable and deadly components of MODS. RRT has been the first and still is the most utilised and effective type of EBPT. Evidence is growing about its ability to maintain homeostatic balance in critically ill patients, and specifically in septic patients with MODS. Clinical trials have been recently designed to modify or improve these therapies. In detail, the following issues have been currently addressed: effects on blood purification provided by different therapies, adequacy of prescription and delivery of therapy, toxins and solutes to be removed with these techniques. Based on these speculations we will briefly review the current understanding of these issues and the rationale for application of RRT in the intensive care unit (ICU). In particular, we will focus on the importance of increased ultrafiltration volume and its impact on mortality in the general ICU population and in septic patients.

Venlafaxine intoxication with development of takotsubo cardiomyopathy: successful use of extracorporeal life support, intravenous lipid emulsion and CytoSorb®.

PubMed

Schroeder, Ines; Zoller, Michael; Angstwurm, Matthias; Kur, Felix; Frey, Lorenz

2017-07-05

We describe a young patient who ingested 18 g (240 times the daily therapeutic dose) of venlafaxine in a suicide attempt. She developed severe cardiomyopathy in a takotsubo distribution causing cardiogenic shock and multi-organ dysfunction syndrome (MODS). She was successfully treated with intravenous lipid emulsion (ILE), extracorporeal life support (ECLS) and CytoSorb®. This is remarkable as, to the best of the authors' knowledge, this is the highest amount of venlafaxine intake seen in the literature with a nonfatal outcome.

Comparison of the Nosocomial Pneumonia Mortality Prediction (NPMP) model with standard mortality prediction tools.

PubMed

Srinivasan, M; Shetty, N; Gadekari, S; Thunga, G; Rao, K; Kunhikatta, V

2017-07-01

Severity or mortality prediction of nosocomial pneumonia could aid in the effective triage of patients and assisting physicians. To compare various severity assessment scoring systems for predicting intensive care unit (ICU) mortality in nosocomial pneumonia patients. A prospective cohort study was conducted in a tertiary care university-affiliated hospital in Manipal, India. One hundred patients with nosocomial pneumonia, admitted in the ICUs who developed pneumonia after >48h of admission, were included. The Nosocomial Pneumonia Mortality Prediction (NPMP) model, developed in our hospital, was compared with Acute Physiology and Chronic Health Evaluation II (APACHE II), Mortality Probability Model II (MPM 72  II), Simplified Acute Physiology Score II (SAPS II), Multiple Organ Dysfunction Score (MODS), Sequential Organ Failure Assessment (SOFA), Clinical Pulmonary Infection Score (CPIS), Ventilator-Associated Pneumonia Predisposition, Insult, Response, Organ dysfunction (VAP-PIRO). Data and clinical variables were collected on the day of pneumonia diagnosis. The outcome for the study was ICU mortality. The sensitivity and specificity of the various scoring systems was analysed by plotting receiver operating characteristic (ROC) curves and computing the area under the curve for each of the mortality predicting tools. NPMP, APACHE II, SAPS II, MPM 72  II, SOFA, and VAP-PIRO were found to have similar and acceptable discrimination power as assessed by the area under the ROC curve. The AUC values for the above scores ranged from 0.735 to 0.762. CPIS and MODS showed least discrimination. NPMP is a specific tool to predict mortality in nosocomial pneumonia and is comparable to other standard scores. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Relationship Between Beta Cell Dysfunction and Severity of Disease Among Critically Ill Children: A STROBE-Compliant Prospective Observational Study.

PubMed

Liu, Ping-Ping; Lu, Xiu-Lan; Xiao, Zheng-Hui; Qiu, Jun; Zhu, Yi-Min

2016-05-01

Although beta cell dysfunction has been proved to predict prognosis among humans and animals, its prediction on severity of disease remains unclear among children. The present study was aimed to examine the relationship between beta cell dysfunction and severity of disease among critically ill children.This prospective study included 1146 critically ill children, who were admitted to Pediatric Intensive Care Unit (PICU) of Hunan Children's Hospital from November 2011 to August 2013. Information on characteristics, laboratory tests, and prognostic outcomes was collected. Homeostasis model assessment (HOMA)-β, evaluating beta cell function, was used to divide all participants into 4 groups: HOMA-β = 100% (group I, n = 339), 80% ≤ HOMA-β < 100% (group II, n = 71), 40% ≤ HOMA-β < 80% (group III, n = 293), and HOMA-β < 40% (group IV, n = 443). Severity of disease was assessed using the worst Sequential Organ Failure Assessment (SOFA) score, Pediatric Risk of Mortality (PRISM) III score, incidence of organ damage, septic shock, multiple organ dysfunction syndrome (MODS), mechanical ventilation (MV) and mortality. Logistic regression analysis was used to evaluate the risk of developing poor outcomes among patients in different HOMA-β groups, with group I as the reference group.Among 1146 children, incidence of HOMA-β < 100% was 70.41%. C-peptide and insulin declined with the decrement of HOMA-β (P < 0.01). C-reactive protein and procalcitonin levels, rather than white blood cell, were significantly different among 4 groups (P < 0.01). In addition, the worst SOFA score and the worst PRISMIII score increased with declined HOMA-β. For example, the worst SOFA score in group I, II, III, and IV was 1.55 ± 1.85, 1.71 ± 1.93, 1.92 ± 1.63, and 2.18 ± 1.77, respectively. Furthermore, patients with declined HOMA-β had higher risk of developing septic shock, MODS, MV, and mortality, even after adjusting age, gender, myocardial injury, and lung injury. For instance, compared with group I, the multivariate-adjusted odds ratio (95% confidence interval) for developing septic shock was 2.17 (0.59, 8.02), 2.94 (2.18, 6.46), and 2.76 (1.18, 6.46) among patients in group II, III, and IV, respectively.Beta cell dysfunction reflected the severity of disease among critically ill children. Therefore, assessment of beta cell function is critically important to reduce incidence of adverse events in PICU.

A Sphingosine-1 Phosphate agonist (FTY720) limits trauma/hemorrhagic shock induced multiple organ dysfunction syndrome

PubMed Central

Bonitz, Joyce A.; Son, Julie Y.; Chandler, Benjamin; Tomaio, Jacquelyn N.; Qin, Yong; Prescott, Lauriston M.; Feketeova, Eleonora; Deitch, Edwin A.

2014-01-01

BACKGROUND Trauma/hemorrhagic shock is one of the major consequences of battlefield injury as well as civilian trauma. FTY720 (sphingosine-1 phosphate agonist) has the capability to decrease the activity of the innate and adaptive immune systems and, at the same time, maintain endothelial cell barrier function and vascular homeostasis during stress. For this reason, we hypothesize that FTY720, as part of resuscitation therapy, would limit T/HS induced multiple organ dysfunction syndrome (MODS) in a rodent trauma-hemorrhagic shock (T/HS) model. METHODS Rats subjected to trauma/sham-shock (T/SS) or T/HS (30 mm Hg × 90 min), were administered FTY720 (1 mg/kg) post-T/HS during volume resuscitation. Lung injury (permeability to Evans Blue dye), PMN priming (respiratory burst activity), and RBC rigidity were measured. In addition, lymph duct cannulated rats were used to quantify the effect of FTY720 on gut injury (permeability and morphology) and the biologic activity of T/HS vs. T/SS lymph on PMN-RB and RBC deformability. RESULTS T/HS-induced increased lung permeability, PMN priming and RBC rigidity were all abrogated by FTY720. The systemic protective effect of FTY720 was only partially at the gut level, since FTY720 did not prevent T/HS-induced gut injury (morphology or permeability,) however, it did abrogate T/HS lymph-induced increased respiratory burst and RBC rigidity. CONCLUSION FTY720 limited T/HS-induced MODS (lung injury, red cell injury, and neutrophil priming) as well as T/HS lymph bioactivity, although it did not limit gut injury. PMID:25004059

A novel apparatus for non-contact measurement of heart rate variability: a system to prevent secondary exposure of medical personnel to toxic materials under biochemical hazard conditions, in monitoring sepsis or in predicting multiple organ dysfunction syndrome.

PubMed

Matsui, T; Arai, I; Gotoh, S; Hattori, H; Takase, B; Kikuchi, M; Ishihara, M

2005-10-01

The impaired balance of the low-frequency/high-frequency ratio obtained from spectral components of RR intervals can be a diagnostic test for sepsis. In addition, it is known that a reduction of heart rate variability (HRV) is useful in identifying septic patients at risk of the development of multiple organ dysfunction syndrome (MODS). We have reported a non-contact method using a microwave radar to monitor the heart and respiratory rates of a healthy person placed inside an isolator or of experimental animals exposed to toxic materials. With the purpose of preventing secondary exposure of medical personnel to toxic materials under biochemical hazard conditions, we designed a novel apparatus for non-contact measurement of HRV using a 1215 MHz microwave radar, a high-pass filter, and a personal computer. The microwave radar monitors only the small reflected waves from the subject's chest wall, which are modulated by the cardiac and respiratory motion. The high-pass filter enhances the cardiac signal and attenuates the respiratory signal. In a human trial, RR intervals derived from the non-contact apparatus significantly correlated with those derived from ECG (r=0.98, P<0.0001). The non-contact apparatus showed a similar power spectrum of RR intervals to that of ECG. Our non-contact HRV measurement apparatus appears promising for future pre-hospital monitoring of septic patients or for predicting MODS patients, inside isolators or in the field for mass casualties under biochemical hazard circumstances.

Effects of red-cell storage duration on patients undergoing cardiac surgery.

PubMed

Steiner, Marie E; Ness, Paul M; Assmann, Susan F; Triulzi, Darrell J; Sloan, Steven R; Delaney, Meghan; Granger, Suzanne; Bennett-Guerrero, Elliott; Blajchman, Morris A; Scavo, Vincent; Carson, Jeffrey L; Levy, Jerrold H; Whitman, Glenn; D'Andrea, Pamela; Pulkrabek, Shelley; Ortel, Thomas L; Bornikova, Larissa; Raife, Thomas; Puca, Kathleen E; Kaufman, Richard M; Nuttall, Gregory A; Young, Pampee P; Youssef, Samuel; Engelman, Richard; Greilich, Philip E; Miles, Ronald; Josephson, Cassandra D; Bracey, Arthur; Cooke, Rhonda; McCullough, Jeffrey; Hunsaker, Robert; Uhl, Lynne; McFarland, Janice G; Park, Yara; Cushing, Melissa M; Klodell, Charles T; Karanam, Ravindra; Roberts, Pamela R; Dyke, Cornelius; Hod, Eldad A; Stowell, Christopher P

2015-04-09

Some observational studies have reported that transfusion of red-cell units that have been stored for more than 2 to 3 weeks is associated with serious, even fatal, adverse events. Patients undergoing cardiac surgery may be especially vulnerable to the adverse effects of transfusion. We conducted a randomized trial at multiple sites from 2010 to 2014. Participants 12 years of age or older who were undergoing complex cardiac surgery and were likely to undergo transfusion of red cells were randomly assigned to receive leukocyte-reduced red cells stored for 10 days or less (shorter-term storage group) or for 21 days or more (longer-term storage group) for all intraoperative and postoperative transfusions. The primary outcome was the change in Multiple Organ Dysfunction Score (MODS; range, 0 to 24, with higher scores indicating more severe organ dysfunction) from the preoperative score to the highest composite score through day 7 or the time of death or discharge. The median storage time of red-cell units provided to the 1098 participants who received red-cell transfusion was 7 days in the shorter-term storage group and 28 days in the longer-term storage group. The mean change in MODS was an increase of 8.5 and 8.7 points, respectively (95% confidence interval for the difference, -0.6 to 0.3; P=0.44). The 7-day mortality was 2.8% in the shorter-term storage group and 2.0% in the longer-term storage group (P=0.43); 28-day mortality was 4.4% and 5.3%, respectively (P=0.57). Adverse events did not differ significantly between groups except that hyperbilirubinemia was more common in the longer-term storage group. The duration of red-cell storage was not associated with significant differences in the change in MODS. We did not find that the transfusion of red cells stored for 10 days or less was superior to the transfusion of red cells stored for 21 days or more among patients 12 years of age or older who were undergoing complex cardiac surgery. (Funded by the National Heart, Lung, and Blood Institute; RECESS ClinicalTrials.gov number, NCT00991341.).

Pathophysiology of the Gut and the Microbiome in the Host Response.

PubMed

Lyons, John D; Coopersmith, Craig M

2017-03-01

To describe and summarize the data supporting the gut as the motor driving critical illness and multiple organ dysfunction syndrome presented at the National Institute of Child Health and Human Development MODS Workshop (March 26-27, 2015). Summary of workshop keynote presentation. Not applicable. Presented by an expert in the field, the data assessing the role of gastrointestinal dysfunction driving critical illness were described with a focus on identifying knowledge gaps and research priorities. Summary of presentation and discussion supported and supplemented by relevant literature. The understanding of gut dysfunction in critical illness has evolved greatly over time, and the gut is now often considered as the "motor" of critical illness. The association of the gut with critical illness is supported by both animal models and clinical studies. Initially, the association between gut dysfunction and critical illness focused primarily on bacterial translocation into the bloodstream. However, that work has evolved to include other gut-derived products causing distant injury via other routes (e.g., lymphatics). Additionally, alterations in the gut epithelium may be associated with critical illness and influence outcomes. Gut epithelial apoptosis, intestinal hyperpermeability, and perturbations in the intestinal mucus layer have all been associated with critical illness. Finally, there is growing evidence that the intestinal microbiome plays a crucial role in mediating pathology in critical illness. Further research is needed to better understand the role of each of these mechanisms and their contribution to multiple organ dysfunction syndrome in children.

[Reproducing and evaluating a rabbit model of multiple organ dysfunction syndrome after cardiopulmonary resuscitation resulted from asphyxia].

PubMed

Zhang, Dong; Li, Nan; Chen, Ying; Wang, Yu-shan

2013-02-01

To evaluate the reproduction of a model of post resuscitation multiple organ dysfunction syndrome (PR-MODS) after cardiac arrest (CA) in rabbit, in order to provide new methods for post-CA treatment. Thirty-five rabbits were randomly divided into three groups, the sham group (n=5), the 7-minute asphyxia group (n=15), and the 8-minute asphyxia group (n=15). The asphyxia CA model was reproduced with tracheal occlusion. After cardiopulmonary resuscitation (CPR), the ratio of recovery of spontaneous circulation (ROSC), the mortality at different time points and the incidence of systemic inflammatory response syndrome (SIRS) were observed in two asphyxia groups. Creatine kinase isoenzyme (CK-MB), alanine aminotransferase (ALT), creatinine (Cr), glucose (Glu) and arterial partial pressure of oxygen (PaO2) levels in blood were measured in the two asphyxia groups before CPR and 12, 24 and 48 hours after ROSC. The survived rabbits were euthanized at 48 hours after ROSC, and heart, brain, lung, kidney, liver, and intestine were harvested for pathological examination using light microscope. PR-MODS after CA was defined based on the function of main organs and their pathological changes. (1) The incidence of ROSC was 100.0% in 7-minute asphyxia group and 86.7% in 8-minute asphyxia group respectively (P>0.05). The 6-hour mortality in 8-minute asphyxia group was significantly higher than that in 7-minute asphyxia group (46.7% vs. 6.7%, P<0.05), and the mortality of 8-minute asphyxia group at 12 - 48 hours was slightly higher compared with that of 7-minute asphyxia group (all P>0.05). (2) There was a variety of organ dysfunctions in survived rabbits after ROSC, including chemosis, respiratory distress, hypotension, abdominal distension, weakened or disappearance of bowel peristalsis and oliguria. (3) There was no SIRS or associated changes in major organ function in the sham group. SIRS was observed at 12 - 24 hours after ROSC in the two asphyxia groups. CK-MB was increased significantly at 12 hours after ROSC compared with that before asphyxia (7-minute asphyxia group: 786.88±211.84 U/L vs. 468.20±149.45 U/L, 8-minute asphyxia group: 894.88±248.80 U/L vs. 462.11±115.15 U/L, both P<0.05), ALT, Cr and Glu were elevated obviously at 24 hours after ROSC (7-minute asphyxia group ALT: 174.25±36.28 U/L vs. 50.27±9.37 U/L, Cr: 144.25±41.64 μmol/L vs. 67.71±16.47 μmol/L, Glu: 11.21±1.14 mmol/L vs. 5.59±1.10 mmol/L; 8-minute asphyxia group ALT: 205.50±10.61 U/L vs. 51.13±10.37 U/L, Cr: 230.50±88.39 μmol/L vs. 65.93±13.81 μmol/L, Glu: 11.55±0.35 mmol/L vs. 6.41±1.23 mmol/L, all P<0.05), and PaO2 was lowered significantly at 48 hours after ROSC (7-minute asphyxia group: 5.03±0.73 kPa vs. 9.07±1.03 kPa, P<0.05). (4) There were pathological changes in major organ in the survived rabbits at 48 hours after ROSC (only 4 rabbits survived in 7-minute asphyxia group), including infiltration of inflammatory cells, partial cellular degeneration, edema, necrosis and tissue bleeding in major organs. If the SIRS and dysfunction of two or more organ were defined in animals after ROSC, the signs, biochemical markers and nonspecific pathological changes could be accepted to evaluate the PR-MODS.

Extracorporeal therapies in pediatric severe sepsis: findings from the pediatric health-care information system.

PubMed

Ruth, Amanda; McCracken, Courtney E; Fortenberry, James D; Hebbar, Kiran B

2015-11-10

Pediatric severe sepsis (PSS) continues to be a major health problem. Extracorporeal therapies (ETs), defined as extracorporeal membrane oxygenation (ECMO) and RRenal replacement therapyenal replacement therapy (RRT), are becoming more available for utilization in a variety of health conditions. We aim to describe (1) rates of utilization of ET in PSS, (2) outcomes for PSS patients receiving ET, and (3) epidemiologic characteristics of patients receiving ET. We conducted a retrospective review of a prospectively collected database. Data from the Pediatric Health Information System (PHIS) database collected by the Children's Hospital Association (CHA) from 2004-2012 from 43 US children's hospitals' pediatric intensive care units (PICUs) were used. Patients with PSS were defined by (1) International Classification of Diseases, 9th Revision (ICD-9) codes reflecting severe sepsis and septic shock and (2) ICD-9 codes of infection and organ dysfunction as defined by updated Angus criteria. Among the patients with PSS, those with a PHIS flag of ECMO or RRT were identified further as our main cohort. From 2004 to 2012, 636,842 patients were identified from 43 hospitals, and PSS prevalence was 7.7 % (49,153 patients). Nine point eight percent (4795 patients) received at least one form of ET, and the associated mortality rate was 39 %. Mortality rates were 47.8 % for those who received ECMO, 32.3 % in RRT, and 58.0 % in RRT + ECMO. Underlying co-morbidities were found in 3745 patients (78.1 %) who received ET (81 % for ECMO, 77.9 % in RRT, and 71.2 % in those who received both). There was a statistically significant increase in ECMO utilization in patients with at least three organ dysfunctions from 2004 to 2012 (6.9 % versus 10.3 %, P < 0.001) while RRT use declined (24.5 % versus 13.2 %, P < 0.001). After 2009, there was a significant increase in ECMO utilization (3.6 % in 2004-2008 versus 4.0 % in 2009-2012, P = 0.004). ECMO and RRT were used simultaneously in only 500 patients with PSS (1 %). ETs were used in a significant portion of PSS patients with multiple organ dysfunction syndrome (MODS) during this time period. Mortality was significant and increased with increasing organ failure. ECMO use in PSS patients with MODS increased from 2004 to 2012. Further evaluation of ET use in PSS is warranted.

[Clinical effect of compound monoammonium glycyrrhizinate combined with dandelion in treatment of acute paraquat poisoning].

PubMed

Zhao, Y; Jian, X D

2016-07-20

Objective: To investigate the clinical effect of compound monoammonium glycyrrhizinate combined with dandelion in the treatment of acute paraquat poisoning. Methods: A total of 80 patients with acute paraquat poisoning who were admitted to our hospital were enrolled as study subjects and randomly divided into routine treatment group (38 patients) and traditional Chinese medicine (TCM) group (42 patients) . The patients in the TCM group were given compound monoammonium glycyrrhizinate and dandelion in addition to the treatment in the control group. Serum alanine aminotransferase (ALT) , total bilirubin (TBil) , blood urea nitrogen (BUN) , creatinine (Cr) , and arterial blood lactate (Lac) and partial pressure of oxygen (PaO 2 ) during different time periods on day 3, 7, and 9 of treatment were observed in both groups, and ulceration of oral mucosa, pulmonary fibrosis, multiple organ dysfunction syndrome (MODS) , and mortality were compared between the two groups. Results: On days 3, 7, and 9 of treatment, the routine treatment group had significantly higher serum ALT, TBil, BUN, Cr, and arterial blood Lac than the TCM group. The routine treatment group had significantly lower arterial blood PaO 2 than the TCM group, while the TCM group had significantly lower incidence rates of ulceration of oral mucosa, pulmonary fibrosis, and MODS and a significantly lower mortality rate than the routine treatment group ( P <0.05) . Conclusion: In the treatment of patients with acute paraquat poisoning, compound monoammonium glycyrrhizinate combined with dandelion can effectively improve organ function, reduce the incidence of pulmonary fibrosis and MODS, improve the healing rate of oral ulcer, improve prognosis, and reduce mortality rate.

Monocytes, endoplasmic reticulum stress and metabolomics in dogs with multiple organ dysfunction syndrome treated by continuous venovenous hemodiafiltration

PubMed Central

Xu, Yun-Peng; Sui, Xiao-Lu; Zhang, Ai-Sha; Ye, Lei; Gu, Feng-Juan; Chen, Ji-Hong

2017-01-01

Objectives We tried to investigate the mechanism of continuous venovenous hemodiafiltration (CVVHDF) treatment in monocytes function, endoplasmic reticulum (ER) stress signaling pathways, metabolomics and histopathological changes of MODS dogs, and aimed to enhance the understanding of pathogenesis and provide novel avenues to potential therapies. Methods 12 male Beagle dogs were used to develop the stable models of MODS by using hemorrhagic shock plus resuscitation and endotoxemia, and assigned randomly to CVVHDF group (n=6) and MODS group (n=6). The dogs in CVVHDF group were given the typical CVVHDF treatment for 24h after the completion of endotoxin intravenous infusion, while those in MODS group were offered the i.v heparin instead only. Serum sample were collected at five time points, i.e. before anesthesia, 0h, 6h, 12h and 24h after the endotoxin injection (T1˜T5, respectively), and meanwhile, the changes of mRNA, protein and human umbilical vein endothelial cells (HUVECs) apoptosis rates in JNK, CHOP and Caspase-12 were observed before and after interfered by RNA interference technology. Results The levels of DLA-DR, IL-1β and IL-4 were higher than those in MODS group after the CVVHDF treatment, and the early and late apoptosis rates showed downward trend compared with MODS group. In vitro and prior to RNA interference (RNAi), the levels of mRNA and protein expression and HUVECs apoptosis rates of JNK, CHOP and Caspase-12 in CVVHDF group were significantly lower compared to T1 and MODS group respectively. However, the levels of mRNA and protein expression and HUVECs apoptosis rates were significantly lower than those before interfered by RNAi in both two groups. The serum levels of LPCs, ornithine, proline, methionine, etc. were down-regulated while carnitines, FFAs, PC, etc. were increased significantly in MODS (T4), and the serum levels of methionine, proline, arginine and lysine were increased while carnitine, LPCs, PCs, SMs and orthophosporic acid were decreased after 12 hours CVVHDF treatment (T4). Conclusion CVVHDF treatment could reduce the apoptosis of the cells by enhancing the antigen presentation, improving the anti-inflammatory and proinflammatory imbalance and even correcting the metabolic disorder of amino acids and phospholipids. PMID:28380442

Altered Levels of Zinc and N-methyl-D-aspartic Acid Receptor Underlying Multiple Organ Dysfunctions After Severe Trauma

PubMed Central

Wang, Guanghuan; Yu, Xiaojun; Wang, Dian; Xu, Xiaohu; Chen, Guang; Jiang, Xuewu

2015-01-01

Background Severe trauma can cause secondary multiple organ dysfunction syndrome (MODS) and death. Oxidative stress and/or excitatory neurotoxicity are considered as the final common pathway in nerve cell injuries. Zinc is the cofactor of the redox enzyme, and the effect of the excitatory neurotoxicity is related to N-methyl-D-aspartic acid receptor (NMDAR). Material/Methods We investigated the levels of zinc and brainstem NMDAR in a rabbit model of severe trauma. Zinc and serum biochemical profiles were determined. Immunohistochemistry was used to detect brainstem N-methyl-D-aspartic acid receptor 1 (NR1), N-methyl-D-aspartic acid receptor 2A (NR2A), and N-methyl-D-aspartic acid receptor 2B (NR2B) expression. Results Brain and brainstem Zn levels increased at 12 h, but serum Zn decreased dramatically after the trauma. NR1 in the brainstem dorsal regions increased at 6 h after injury and then decreased. NR2A in the dorsal regions decreased to a plateau at 12 h after trauma. The levels of NR2B were lowest in the death group in the brainstem. Serum zinc was positively correlated with NR2A and 2B and negatively correlated with zinc in the brain. Correlations were also found between the brainstem NR2A and that of the dorsal brainstem, as well as between brainstem NR2A and changes in NR2B. There was a negative correlation between zinc and NR2A. Conclusions Severe trauma led to an acute reduction of zinc enhancing oxidative stress and the changes of NMDAR causing the neurotoxicity of the nerve cells. This may be a mechanism for the occurrence of MODS or death after trauma. PMID:26335029

[Mitochondrial and microcirculatory distress syndrome in the critical patient. Therapeutic implications].

PubMed

Navarrete, M L; Cerdeño, M C; Serra, M C; Conejero, R

2013-10-01

Mitochondrial and microcirculatory distress syndrome (MMDS) can occur during systemic inflammatory response syndrome (SIRS), and is characterized by cytopathic tissue hypoxia uncorrected by oxygen transport optimization, and associated with an acquired defect in the use of oxygen and energy production in mitochondria, leading to multiple organ dysfunction (MOD). We examine the pathogenesis of MMDS, new diagnostic methods, and recent therapeutic approaches adapted to each of the three phases in the evolution of the syndrome. In the initial phase, the aim is prevention and early reversal of mitochondrial dysfunction. Once the latter is established, the aim is to restore flow of the electron chain, mitochondrial respiration, and to avoid cellular energy collapse. Finally, in the third (resolution) stage, treatment should focus on stimulating mitochondrial biogenesis and the repair or replacement of damaged mitochondria. Copyright © 2012 Elsevier España, S.L. and SEMICYUC. All rights reserved.

Treatment of severe fluoroacetamide poisoning in patient with combined multiple organ dysfunction syndrome by evidence-based integrated Chinese and Western medicines: A case report.

PubMed

Wen, Wanxin; Gao, Hongxia; Kang, Nini; Lu, Aili; Qian, Caiwen; Zhao, Yuanqi

2017-07-01

Fluoroacetamide poisoning is the acute and severe disease of human, which leads to nervous, digestive, and cardiovascular system damage or even death in a short period of time. We report a case of a 65-year-old woman with loss of consciousness, nausea, and vomiting who was sent to the hospital by passers-by. She was diagnosed with severe fluoroacetamide poisoning with combined multiple organ dysfunction syndrome. When the diagnosis was unclear, we gave gastric lavage, support and symptomatic treatment, and closely with the vital sign. When the diagnosis was clear, based on the evidence of retrieved, muscle injection of acetamide, calcium gluconate, and vitamin C. Traditional Chinese medicine aspect, oral administration of mung bean soup of glycyrrhizae and Da-Cheng-Qi decoction enema. By setting reasonable treatment for patients, she had no special discomfort and complications after treatment. Besides, through 1-month follow-up, it was confirmed that the treatments were effective. Evidence-based integrated Chinese and Western medicines can effectively improve the therapeutic effects in severe fluoroacetamide-poisoned patients with combined MODS.

Defibrotide for the treatment of hepatic veno-occlusive disease/sinusoidal obstruction syndrome following nontransplant-associated chemotherapy: Final results from a post hoc analysis of data from an expanded-access program.

PubMed

Kernan, Nancy A; Richardson, Paul G; Smith, Angela R; Triplett, Brandon M; Antin, Joseph H; Lehmann, Leslie; Messinger, Yoav; Liang, Wei; Hume, Robin; Tappe, William; Soiffer, Robert J; Grupp, Stephan A

2018-06-06

Hepatic veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS) is a potentially fatal complication of conditioning for hematopoietic stem cell transplantation (HSCT) but can occur after nontransplant-associated chemotherapy. Following HSCT, VOD/SOS with multi-organ dysfunction (MOD) may be associated with >80% mortality. Defibrotide is approved to treat severe hepatic VOD/SOS post-HSCT in patients aged >1 month in the European Union and hepatic VOD/SOS with renal or pulmonary dysfunction post-HSCT in the United States. Prior to US approval, defibrotide was available to treat VOD/SOS through an expanded-access treatment (T-IND) program. A post hoc analysis of nontransplant-associated VOD/SOS patients treated with defibrotide initiated within 30 days of starting chemotherapy and followed for 70 days is presented. Patients were diagnosed by Baltimore or modified Seattle criteria or biopsy, and received defibrotide 25 mg/kg/day in four divided doses (≥21 days recommended). Of the 1,154 patients in the T-IND, 137 had nontransplant-associated VOD/SOS, 82 of whom developed VOD/SOS within 30 days of starting chemotherapy. Of them, 66 (80.5%) were aged ≤16 years. Across all the 82 patients, Kaplan-Meier estimated day +70 survival was 74.1%, 65.8% in patients with MOD (n = 38), and 81.3% in patients without MOD (n = 44). By age group, Kaplan-Meier estimated day +70 survival was 80.1% in pediatric patients (n = 66) and 50.0% in adults (n = 16). Treatment-related adverse events occurred in 26.8%. In this post hoc analysis of 82 patients initiating defibrotide within 30 days of starting chemotherapy, Kaplan-Meier estimated survival was 74.1% at 70 days after defibrotide initiation. Safety profile was consistent with prior defibrotide studies. © 2018 The Authors. Pediatric Blood & Cancer Published by Wiley Periodicals, Inc.

Effect of N-acetylcysteine treatment on oxidative stress and inflammation after severe burn.

PubMed

Csontos, C; Rezman, B; Foldi, V; Bogar, L; Drenkovics, L; Röth, E; Weber, G; Lantos, J

2012-05-01

Oxidative stress and inflammation generate edema in burns. The aim of our study was to assess effect of N-acetylcysteine (NAC) on oxidative stress, inflammation, fluid requirement, multiple organ dysfunction (MOD) score and vasoactive drug requirement. In this study 15 patients were on standard therapy, whereas for other 15 patients NAC was supplemented. Blood samples were taken on admission and on the next five consecutive mornings. Levels of malondialdehyde, protein sulfhydril (PSH) groups, reduced gluthation (GSH), activity of myeloperoxidase, catalase and superoxide dismutase enzymes and induced free radical generating capacity were measured as well as concentrations of TNF-α, IL-6, IL-8, and IL-10. MOD score, use of vasopressor agents and fluid utilisation were recorded daily. NAC treatment increased GSH level on days 4-5 (p<0.05) and PSH level on days 2-6 (p<0.05) compared to controls. Plasma IL-6 was lower on days 4-5 (p<0.05), IL-8 on days 4-6 (p<0.05) and IL-10 on days 4-6 (p<0.05) in NAC group. NAC group received less catecholamines than controls (p<0.01) from day 4 without significant differences in MOD score. NAC treatment is associated with a diminished oxidative stress reflected in preserved antioxidant levels, lower inflammation mirrored in lower interleukin levels and less vasopressor requirement. Copyright © 2011 Elsevier Ltd and ISBI. All rights reserved.

Clinical relevance of the interleukin 10 promoter polymorphisms in Chinese Han patients with major trauma: genetic association studies.

PubMed

Zeng, Ling; Gu, Wei; Chen, Kehong; Jiang, Dongpo; Zhang, Lianyang; Du, Dingyuan; Hu, Ping; Liu, Qing; Huang, Suna; Jiang, Jianxin

2009-01-01

An excessive inflammatory response is thought to account for the pathogenesis of sepsis and multiple organ dysfunction syndrome (MODS) after severe trauma. The interleukin-10 (IL-10) is a potent anti-inflammatory cytokine. The objectives of this prospective study were to investigate the distribution of IL-10 promoter polymorphisms in a cohort of 308 Chinese Han patients with major trauma, and to identify associations of IL-10 promoter polymorphisms with IL-10 production and incidence of sepsis and MODS. A total of 308 patients with major trauma were included in this study. The genotypes of polymorphisms -1082, -819 and -592 were determined by polymerase chain reaction-restriction fragment length polymorphism. The IL-10 levels in the supernatants were determined with enzyme-linked immunoabsorbent assay. The -1082A and -592A alleles were significantly associated with lower lipopolysaccharide-induced IL-10 production in an allele-dose dependent fashion. There was no significant difference for the -819 polymorphism. Except for the -1082 polymorphism, the -819 and -592 polymorphisms were not significantly associated with sepsis morbidity rate and MOD scores. Our results further confirm the functionality of the IL-10 promoter single nucleotide polymorphisms in relation to IL-10 production. They also suggest that individual difference in IL-10 production in trauma patients might be at least in part related to genetic variations in the IL-10 promoter region.

Complement receptor 1 variants confer protection from severe malaria in Odisha, India.

PubMed

Panda, Aditya K; Panda, Madhumita; Tripathy, Rina; Pattanaik, Sarit S; Ravindran, Balachandran; Das, Bidyut K

2012-01-01

In Plasmodium falciparum infection, complement receptor-1 (CR1) on erythrocyte's surface and ABO blood group play important roles in formation of rosettes which are presumed to be contributory in the pathogenesis of severe malaria. Although several studies have attempted to determine the association of CR1 polymorphisms with severe malaria, observations remain inconsistent. Therefore, a case control study and meta-analysis was performed to address this issue. Common CR1 polymorphisms (intron 27 and exon 22) and blood group were typed in 353 cases of severe malaria (SM) [97 cerebral malaria (CM), 129 multi-organ dysfunction (MOD), 127 non-cerebral severe malaria (NCSM)], 141 un-complicated malaria and 100 healthy controls from an endemic region of Odisha, India. Relevant publications for meta-analysis were searched from the database. The homozygous polymorphisms of CR1 intron 27 and exon 22 (TT and GG) and alleles (T and G) that are associated with low expression of CR1 on red blood cells, conferred significant protection against CM, MOD and malaria deaths. Combined analysis showed significant association of blood group B/intron 27-AA/exon 22-AA with susceptibility to SM (CM and MOD). Meta-analysis revealed that the CR1 exon 22 low expression polymorphism is significantly associated with protection against severe malaria. The results of the present study demonstrate that common CR1 variants significantly protect against severe malaria in an endemic area.

Change in donor profile influenced the percentage of organs transplanted from multiple organ donors.

PubMed

Meers, C; Van Raemdonck, D; Van Gelder, F; Van Hees, D; Desschans, B; De Roey, J; Vanhaecke, J; Pirenne, J

2009-03-01

We hypothesized that the change in donor profile over the years influenced the percentage of transplantations. We reviewed medical records for all multiple-organ donors (MODs) within our network. The percentage of transplanted organs was compared between 1991-1992 (A) and 2006-2007 (B). In period A, 156 potential MODs were identified compared with 278 in period B. Fifteen potential donors (10%) in period A and 114 (41%) in period B were rejected because they were medically not suitable (40% vs 75%) or there was no family consent (60% vs 25%). Of the remaining effective MODs (141 in period A and 164 in period B), mean (standard deviation = SD) age was 34 (5) years vs 49 (17) years (P < .001). Brain death resulted from craniocerebral trauma in 69% vs 39%, cerebrovascular disease in 24% vs 46%, hypoxia in 4% vs 15%, and brain tumor in 2% vs 0.6% (P < .001). Chest trauma was present in 19% vs 9% (P < .01). The percentage of MODs who received mechanical ventilation for more than 5 days was 8% vs 24% (P < .001). The percentage of organs transplanted in periods A vs B was kidneys, 97% vs 79%; livers, 64% vs 85%; hearts, 60% vs 26%; lungs, 7% vs 35%; and pancreas, 6% vs 13% (P < .001). The number of referred potential MODs increased by 80%, resulting in a small increase in effective MOD organs (17%), mainly because of medical contraindications. The MOD profile changed to older age, fewer traumatic brain deaths, and longer ventilation time. We transplanted more livers, lungs, and pancreases but fewer kidneys and hearts.

Infectious Etiologies and Patient Outcomes in Pediatric Septic Shock.

PubMed

Ames, Stefanie G; Workman, Jennifer K; Olson, Jared A; Korgenski, E Kent; Masotti, Susan; Knackstedt, Elizabeth D; Bratton, Susan L; Larsen, Gitte Y

2017-03-01

Septic shock remains an important cause of death and disability in children. Optimal care requires early recognition and treatment. We evaluated a retrospective cohort of children (age <19) treated in our emergency department (ED) for septic shock during 2008-2012 to investigate the association between timing of antibiotic therapy and outcomes. The exposures were (1) receipt of empiric antibiotics in ≤1 hour and (2) receipt of appropriate antibiotics in ≤1 hour. The primary outcome was development of new or progressive multiple system organ dysfunction syndrome (NP-MODS). The secondary outcome was mortality. Among 321 patients admitted to intensive care, 48% (n = 153) received empiric antibiotics in ≤1 hour. These patients were more ill at presentation with significantly greater median pediatric index of mortality 2 (PIM2) scores and were more likely to receive recommended resuscitation in the ED (61% vs 14%); however, rates of NP-MODS (9% vs 12%) and hospital mortality (7% vs 4%) were similar to those treated later. Early, appropriate antibiotics were administered to 33% (n = 67) of patients with identified or suspected bacterial infection. These patients had significantly greater PIM2 scores but similar rates of NP-MODS (15% vs 15%) and hospital mortality (10% vs 6%) to those treated later. Critically ill children with septic shock treated in a children's hospital ED who received antibiotics in ≤1 hour were significantly more severely ill than those treated later, but they did not have increased risk of NP-MODS or death. © The Author 2016. Published by Oxford University Press on behalf of The Journal of the Pediatric Infectious Diseases Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Metallo-organic decomposition films

NASA Technical Reports Server (NTRS)

Gallagher, B. D.

1985-01-01

A summary of metallo-organic deposition (MOD) films for solar cells was presented. The MOD materials are metal ions compounded with organic radicals. The technology is evolving quickly for solar cell metallization. Silver compounds, especially silver neodecanoate, were developed which can be applied by thick-film screening, ink-jet printing, spin-on, spray, or dip methods. Some of the advantages of MOD are: high uniform metal content, lower firing temperatures, decomposition without leaving a carbon deposit or toxic materials, and a film that is stable under ambient conditions. Molecular design criteria were explained along with compounds formulated to date, and the accompanying reactions for these compounds. Phase stability and the other experimental and analytic results of MOD films were presented.

Protease-resistant modified human β-hexosaminidase B ameliorates symptoms in GM2 gangliosidosis model

PubMed Central

Mizutani, Yasumichi; Sugiyama, Eiji; Tasaki, Chikako; Tsuji, Daisuke; Maita, Nobuo; Hirokawa, Takatsugu; Asanuma, Daisuke; Kamiya, Mako; Sato, Kohei; Setou, Mitsutoshi; Urano, Yasuteru; Togawa, Tadayasu; Otaka, Akira; Sakuraba, Hitoshi

2016-01-01

GM2 gangliosidoses, including Tay-Sachs and Sandhoff diseases, are neurodegenerative lysosomal storage diseases that are caused by deficiency of β-hexosaminidase A, which comprises an αβ heterodimer. There are no effective treatments for these diseases; however, various strategies aimed at restoring β-hexosaminidase A have been explored. Here, we produced a modified human hexosaminidase subunit β (HexB), which we have termed mod2B, composed of homodimeric β subunits that contain amino acid sequences from the α subunit that confer GM2 ganglioside–degrading activity and protease resistance. We also developed fluorescent probes that allow visualization of endocytosis of mod2B via mannose 6-phosphate receptors and delivery of mod2B to lysosomes in GM2 gangliosidosis models. In addition, we applied imaging mass spectrometry to monitor efficacy of this approach in Sandhoff disease model mice. Following i.c.v. administration, mod2B was widely distributed and reduced accumulation of GM2, asialo-GM2, and bis(monoacylglycero)phosphate in brain regions including the hypothalamus, hippocampus, and cerebellum. Moreover, mod2B administration markedly improved motor dysfunction and a prolonged lifespan in Sandhoff disease mice. Together, the results of our study indicate that mod2B has potential for intracerebrospinal fluid enzyme replacement therapy and should be further explored as a gene therapy for GM2 gangliosidoses. PMID:27018595

Protease-resistant modified human β-hexosaminidase B ameliorates symptoms in GM2 gangliosidosis model.

PubMed

Kitakaze, Keisuke; Mizutani, Yasumichi; Sugiyama, Eiji; Tasaki, Chikako; Tsuji, Daisuke; Maita, Nobuo; Hirokawa, Takatsugu; Asanuma, Daisuke; Kamiya, Mako; Sato, Kohei; Setou, Mitsutoshi; Urano, Yasuteru; Togawa, Tadayasu; Otaka, Akira; Sakuraba, Hitoshi; Itoh, Kohji

2016-05-02

GM2 gangliosidoses, including Tay-Sachs and Sandhoff diseases, are neurodegenerative lysosomal storage diseases that are caused by deficiency of β-hexosaminidase A, which comprises an αβ heterodimer. There are no effective treatments for these diseases; however, various strategies aimed at restoring β-hexosaminidase A have been explored. Here, we produced a modified human hexosaminidase subunit β (HexB), which we have termed mod2B, composed of homodimeric β subunits that contain amino acid sequences from the α subunit that confer GM2 ganglioside-degrading activity and protease resistance. We also developed fluorescent probes that allow visualization of endocytosis of mod2B via mannose 6-phosphate receptors and delivery of mod2B to lysosomes in GM2 gangliosidosis models. In addition, we applied imaging mass spectrometry to monitor efficacy of this approach in Sandhoff disease model mice. Following i.c.v. administration, mod2B was widely distributed and reduced accumulation of GM2, asialo-GM2, and bis(monoacylglycero)phosphate in brain regions including the hypothalamus, hippocampus, and cerebellum. Moreover, mod2B administration markedly improved motor dysfunction and a prolonged lifespan in Sandhoff disease mice. Together, the results of our study indicate that mod2B has potential for intracerebrospinal fluid enzyme replacement therapy and should be further explored as a gene therapy for GM2 gangliosidoses.

Assessment of Fetal Myocardial Performance Index in Women with Placenta Previa.

PubMed

Zhang, Na; Sun, Lijuan; Zhang, Lina; Li, Zhen; Han, Jijing; Wu, Qingqing

2017-12-15

BACKGROUND This study investigated whether fetuses of placenta previa pregnancies have cardiac dysfunction by use of a modified myocardial performance index (Mod-MPI). MATERIAL AND METHODS A prospective cross-sectional study was conducted including 178 fetuses at 28-40 weeks of gestation. Eighty-nine fetuses of mothers with placenta previa and without pregnancy complications were recruited (placenta previa group) and matched with 89 fetuses of mothers with normal pregnancies (control group). Fetal cardiac function parameters and perinatal outcomes as well as the Mod-MPI were compared between the 2 groups. RESULTS The median Mod-MPI was significantly increased in fetuses of mothers with placenta previa compared with controls (0.47±0.05 vs. 0.45±0.05; P<0.01). Among fetuses of mothers with or without placenta previa, the Mod-MPI was significantly higher in the incomplete placenta previa group compared with the complete placenta previa group and control group (P<0.01). An increased Mod-MPI in placenta previa pregnancies was independently associated with fetal cord pH <7.2 (odds ratio, 4.8; 95% confidence interval, 0.98-23.54; P=0.003). CONCLUSIONS There is impairment of fetal cardiac function in pregnancies with placenta previa. An increased MPI was independently associated with adverse perinatal outcomes to some extent in the placenta previa pregnancies.

Cloud-based uniform ChIP-Seq processing tools for modENCODE and ENCODE.

PubMed

Trinh, Quang M; Jen, Fei-Yang Arthur; Zhou, Ziru; Chu, Kar Ming; Perry, Marc D; Kephart, Ellen T; Contrino, Sergio; Ruzanov, Peter; Stein, Lincoln D

2013-07-22

Funded by the National Institutes of Health (NIH), the aim of the Model Organism ENCyclopedia of DNA Elements (modENCODE) project is to provide the biological research community with a comprehensive encyclopedia of functional genomic elements for both model organisms C. elegans (worm) and D. melanogaster (fly). With a total size of just under 10 terabytes of data collected and released to the public, one of the challenges faced by researchers is to extract biologically meaningful knowledge from this large data set. While the basic quality control, pre-processing, and analysis of the data has already been performed by members of the modENCODE consortium, many researchers will wish to reinterpret the data set using modifications and enhancements of the original protocols, or combine modENCODE data with other data sets. Unfortunately this can be a time consuming and logistically challenging proposition. In recognition of this challenge, the modENCODE DCC has released uniform computing resources for analyzing modENCODE data on Galaxy (https://github.com/modENCODE-DCC/Galaxy), on the public Amazon Cloud (http://aws.amazon.com), and on the private Bionimbus Cloud for genomic research (http://www.bionimbus.org). In particular, we have released Galaxy workflows for interpreting ChIP-seq data which use the same quality control (QC) and peak calling standards adopted by the modENCODE and ENCODE communities. For convenience of use, we have created Amazon and Bionimbus Cloud machine images containing Galaxy along with all the modENCODE data, software and other dependencies. Using these resources provides a framework for running consistent and reproducible analyses on modENCODE data, ultimately allowing researchers to use more of their time using modENCODE data, and less time moving it around.

Cloud-based uniform ChIP-Seq processing tools for modENCODE and ENCODE

PubMed Central

2013-01-01

Background Funded by the National Institutes of Health (NIH), the aim of the Model Organism ENCyclopedia of DNA Elements (modENCODE) project is to provide the biological research community with a comprehensive encyclopedia of functional genomic elements for both model organisms C. elegans (worm) and D. melanogaster (fly). With a total size of just under 10 terabytes of data collected and released to the public, one of the challenges faced by researchers is to extract biologically meaningful knowledge from this large data set. While the basic quality control, pre-processing, and analysis of the data has already been performed by members of the modENCODE consortium, many researchers will wish to reinterpret the data set using modifications and enhancements of the original protocols, or combine modENCODE data with other data sets. Unfortunately this can be a time consuming and logistically challenging proposition. Results In recognition of this challenge, the modENCODE DCC has released uniform computing resources for analyzing modENCODE data on Galaxy (https://github.com/modENCODE-DCC/Galaxy), on the public Amazon Cloud (http://aws.amazon.com), and on the private Bionimbus Cloud for genomic research (http://www.bionimbus.org). In particular, we have released Galaxy workflows for interpreting ChIP-seq data which use the same quality control (QC) and peak calling standards adopted by the modENCODE and ENCODE communities. For convenience of use, we have created Amazon and Bionimbus Cloud machine images containing Galaxy along with all the modENCODE data, software and other dependencies. Conclusions Using these resources provides a framework for running consistent and reproducible analyses on modENCODE data, ultimately allowing researchers to use more of their time using modENCODE data, and less time moving it around. PMID:23875683

MOD: An Organic Detector for the Future Exploration of Mars

NASA Technical Reports Server (NTRS)

Kminek, G.; Bada, J. L.; Botta, O.; Grunthaner, F.; Glavin, D. P.

1999-01-01

The Mars Organic Detector (MOD) is designed to assess whether organic compounds, possibly associated with life, are present in Martian rock and soil samples. MOD has a detection limit that is at least two orders of magnitude more sensitive than the Viking GCMS. MOD is focused on detecting amino acids, amines and PAH (polycyclic aromatic hydrocarbons). Amino acids play an essential role in biochemistry on Earth and PAH are widespread throughout the universe and can provide an indication of the delivery of meteoritic organic material to Mars. The advantage of MOD is the absence of wet chemistry and its simple and robust design. The sample will be extracted from the mineral matrix (0.1 - 1 g of rock-powder) using sublimation and analyzed with a fluorescence detector. The isolation method is based on the fact that amino acids and PAH are volatile at temperatures greater than 150C. The fluorescence detection scheme is based on UV excitation with LED's, optical filters, PrN diode photon detector and a sample calibration reservoir. Fluorescamine is used as a fluorescing reagent for amino acids and amines, while PAH are naturally fluorescent. There is no sample preparation required and the turnaround time for a single analysis is on the order of minutes.

Scrub Typhus in a Tertiary Care Hospital in North India.

PubMed

Sharma, Navneet; Biswal, Manisha; Kumar, Abhay; Zaman, Kamran; Jain, Sanjay; Bhalla, Ashish

2016-08-03

Scrub typhus, a zoonotic disease caused by the bacterium Orientia tsutsugamushi, has become endemic in many parts of India. We studied the clinical profile of this infection in 228 patients that reported to this tertiary care center from July 2013 to December 2014. The median age of patients was 35 years (interquartile range = 24.5-48.5 years), and 111 were males and 117 females. A high-grade fever occurred in 85%, breathlessness in 42%, jaundice in 32%, abdominal pain in 28%, renal failure in 11%, diarrhea in 10%, rashes in 9%, and seizures in 7%. Common laboratory abnormalities at presentation were a deranged hepatic function in 61%, anemia in 54%, leukopenia in 15%, and thrombocytopenia in 90% of our patients. Acute kidney injury (32%), acute respiratory distress syndrome (ARDS) (25%), and disseminated intravascular coagulation (DIC) (16%) were the commonest complications. A hepatorenal syndrome was seen in 38% and multiple organ dysfunction syndrome (MODS) in 20% patients. The overall case fatality rate was 13.6%. In univariate analysis, ARDS requiring mechanical ventilation, acute kidney injury requiring hemodialysis, hypotension requiring inotropic support, central nervous system dysfunction at presentation, and MODS were inversely associated with survival. Survival was significantly higher in patients that presented with a duration of fever < 10 days compared with those that presented ≥ 12 days (P < 0.05) after onset. In conclusion, scrub typhus has become a leading infectious disease in north India and an important cause of infectious fever. An increasing awareness of this disease coupled with prompt management will go a long way in reducing both morbidity and mortality from this disease. © The American Society of Tropical Medicine and Hygiene.

Intestinal crosstalk – a new paradigm for understanding the gut as the “motor” of critical illness

PubMed Central

Clark, Jessica A; Coopersmith, Craig M

2007-01-01

For more than 20 years, the gut has been hypothesized to be the “motor” of multiple organ dysfunction syndrome (MODS). As critical care research has evolved, there have been multiple mechanisms by which the gastrointestinal tract has been proposed to drive systemic inflammation. Many of these disparate mechanisms have proved to be important in the origin and propagation of critical illness. However, this has led to an unusual situation where investigators describing the gut as a “motor” revving the systemic inflammatory response syndrome (SIRS) are frequently describing wholly different processes to support their claim (i.e. increased apoptosis, altered tight junctions, translocation, cytokine production, crosstalk with commensal bacteria, etc). The purpose of this review is to present a unifying theory as to how the gut drives critical illness. Although the gastrointestinal tract is frequently described simply as “the gut,” it is actually made up of a) an epithelium, b) a diverse and robust immune arm, which contains the majority of immune cells in the body, and c) the commensal bacteria, which contain more cells than are present in the entire host organism. We propose that the intestinal epithelium, the intestinal immune system and the intestine’s endogenous bacteria all play vital roles driving MODS, and the complex crosstalk between these three interrelated portions of the gastrointestinal tract are cumulatively what makes the gut a “motor” of critical illness. PMID:17577136

The predictive value of resting heart rate following osmotherapy in brain injury: back to basics.

PubMed

Hasanpour Mir, Mahsa; Yousefshahi, Fardin; Abdollahi, Mohammad; Ahmadi, Arezoo; Nadjafi, Atabak; Mojtahedzadeh, Mojtaba

2012-12-30

The importance of resting heart rate as a prognostic factor was described in several studies. An elevated heart rate is an independent risk factor for adverse cardiovascular events and total mortality in patients with coronary artery disease, chronic heart failure, and the general population. Also heart rate is elevated in the Multi Organ Dysfunction Syndrome (MODS) and the mortality due to MODS is highly correlated with inadequate sinus tachycardia.To evaluate the value of resting heart rate in predicting mortality in patients with traumatic brain injury along scoring systems like Acute Physiology and Chronic Health Evaluation(APACHE II), Sequential Organ Failure Assessment (SOFA) and Glasgow Coma Score (GCS). By analyzing data which was collected from an open labeled randomized clinical trial that compared the different means of osmotherapy (mannitol vs bolus or infusion hypertonic saline), heart rate, GCS, APACHE II and SOFA score were measured at baseline and daily for 7 days up to 60 days and the relationship between elevated heart rate and mortality during the first 7 days and 60th day were assessed. After adjustments for confounding factors, although there was no difference in mean heart rate between either groups of alive and expired patients, however, we have found a relative correlation between 60th day mortality rate and resting heart rate (P=0.07). Heart rate can be a prognostic factor for estimating mortality rate in brain injury patients along with APACHE II and SOFA scores in patients with brain injury.

Micro-Organ Devices

NASA Technical Reports Server (NTRS)

Gonda, Steven R.; Leslie, Julia; Chang, Robert C.; Starly, Binil; Sun, Wei; Culbertson, Christopher; Holtorf, Heidi

2009-01-01

Micro-organ devices (MODs) are being developed to satisfy an emerging need for small, lightweight, reproducible, biological-experimentati on apparatuses that are amenable to automated operation and that imp ose minimal demands for resources (principally, power and fluids). I n simplest terms, a MOD is a microfluidic device containing a variety of microstructures and assemblies of cells, all designed to mimic a complex in vivo microenvironment by replicating one or more in vivo micro-organ structures, the architectures and composition of the extr acellular matrices in the organs of interest, and the in vivo fluid flows. In addition to microscopic flow channels, a MOD contains one or more micro-organ wells containing cells residing in microscopic e xtracellular matrices and/or scaffolds, the shapes and compositions o f which enable replication of the corresponding in vivo cell assembl ies and flows.

Assessment of Fetal Myocardial Performance Index in Women with Placenta Previa

PubMed Central

Zhang, Na; Sun, Lijuan; Zhang, Lina; Li, Zhen; Han, Jijing; Wu, Qingqing

2017-01-01

Background This study investigated whether fetuses of placenta previa pregnancies have cardiac dysfunction by use of a modified myocardial performance index (Mod-MPI). Material/Methods A prospective cross-sectional study was conducted including 178 fetuses at 28–40 weeks of gestation. Eighty-nine fetuses of mothers with placenta previa and without pregnancy complications were recruited (placenta previa group) and matched with 89 fetuses of mothers with normal pregnancies (control group). Fetal cardiac function parameters and perinatal outcomes as well as the Mod-MPI were compared between the 2 groups. Results The median Mod-MPI was significantly increased in fetuses of mothers with placenta previa compared with controls (0.47±0.05 vs. 0.45±0.05; P<0.01). Among fetuses of mothers with or without placenta previa, the Mod-MPI was significantly higher in the incomplete placenta previa group compared with the complete placenta previa group and control group (P<0.01). An increased Mod-MPI in placenta previa pregnancies was independently associated with fetal cord pH <7.2 (odds ratio, 4.8; 95% confidence interval, 0.98–23.54; P=0.003). Conclusions There is impairment of fetal cardiac function in pregnancies with placenta previa. An increased MPI was independently associated with adverse perinatal outcomes to some extent in the placenta previa pregnancies. PMID:29242496

Serum selenium and glutathione peroxidase-3 activity: biomarkers of systemic inflammation in the critically ill?

PubMed

Manzanares, William; Biestro, Alberto; Galusso, Federico; Torre, Maria H; Mañay, Nelly; Pittini, Gustavo; Facchin, Gianella; Hardy, Gil

2009-05-01

To confirm the influence of systemic inflammatory response syndrome (SIRS) on selenium (Se) levels and prospectively evaluate the relationship between serum Se concentration [Se], glutathione peroxidase activity [GPx-3] and injury severity in patients at the time of intensive care unit (ICU) admission. Prospective, observational study. Multidisciplinary University Hospital ICU. A total of 36 ICU patients and 23 healthy volunteer subjects (HVS). Healthy volunteer subjects were designated as controls (Group 1). ICU patients were divided into three groups: without SIRS (Group 2); with SIRS (Group 3); with SIRS and multiple organ dysfunction syndrome (MODS) (Group 4). The latter groups had APACHE II scores >15. [GPx-3] and [Se] were determined by standard methods within the first 48 h of admission to ICU. Kruskal-Wallis and Mann-Whitney U test were used for analysis of non-parametric continuous variables. The predictive value of [Se] and [GPx-3] for SIRS was calculated using a receiver operating characteristics (ROC) analysis. In SIRS and MODS patients [GPx-3] and [Se] decreased significantly (P = 0.0001 and P = 0.002, respectively). After ICU admission [GPx-3] and [Se] had a predictive value for SIRS ([GPx-3] sensitivity: 90%, specificity: 86.2% (cut-off value: 0.5 U/mL); [Se]: sensitivity 90%, specificity 72.4% (cut-off value: 60 microg/L). [Se] had predictive value for ICU mortality (P = 0.034). Systemic inflammatory response syndrome and MODS were associated with early decreases in [Se] and [GPx-3]. Low [Se] and [GPx-3] after ICU admission had a predictive value for SIRS, which may aid future selection of patients who could benefit from Se supplementation.

The predictive value of resting heart rate following osmotherapy in brain injury: back to basics

PubMed Central

2012-01-01

Background The importance of resting heart rate as a prognostic factor was described in several studies. An elevated heart rate is an independent risk factor for adverse cardiovascular events and total mortality in patients with coronary artery disease, chronic heart failure, and the general population. Also heart rate is elevated in the Multi Organ Dysfunction Syndrome (MODS) and the mortality due to MODS is highly correlated with inadequate sinus tachycardia. To evaluate the value of resting heart rate in predicting mortality in patients with traumatic brain injury along scoring systems like Acute Physiology and Chronic Health Evaluation(APACHE II), Sequential Organ Failure Assessment (SOFA) and Glasgow Coma Score (GCS). Method By analyzing data which was collected from an open labeled randomized clinical trial that compared the different means of osmotherapy (mannitol vs bolus or infusion hypertonic saline), heart rate, GCS, APACHE II and SOFA score were measured at baseline and daily for 7 days up to 60 days and the relationship between elevated heart rate and mortality during the first 7 days and 60th day were assessed. Results After adjustments for confounding factors, although there was no difference in mean heart rate between either groups of alive and expired patients, however, we have found a relative correlation between 60th day mortality rate and resting heart rate (P=0.07). Conclusion Heart rate can be a prognostic factor for estimating mortality rate in brain injury patients along with APACHE II and SOFA scores in patients with brain injury. PMID:23351393

MOD silver metallization for photovoltaics

NASA Technical Reports Server (NTRS)

Vest, G. M.; Vest, R. W.

1985-01-01

The feasibility of utilizing metallo-organic decomposition (MOD) silver inks were investigated for front contact metallization of solar cells. Generic synthesis procedures were developed for all metallo-organic compounds investigated. Silver neodecanoate was found to be the most suitable silver metallo-organic compound for use in thick film inks, but the quality of the inks was found to be highly dependent on its purity. Although neither the process nor inks were completely optimized for solar cell front contact metallization, they show great promise for this application.

APCAP--activated protein C in acute pancreatitis: a double-blind randomized human pilot trial.

PubMed

Pettilä, Ville; Kyhälä, Lea; Kylänpää, Marja-Leena; Leppäniemi, Ari; Tallgren, Minna; Markkola, Antti; Puolakkainen, Pauli; Repo, Heikki; Kemppainen, Esko

2010-01-01

Previous human studies have shown low activity of protein C (APC) in severe acute pancreatitis (SAP). This, together with the findings in animal models, suggests that activated protein C (APC) may protect against pancreatic injury and ameliorate the disease. We, therefore, evaluated its effect on multiple organ dysfunction (MOD) measured by the SOFA (Sequential Organ Failure Assessment) and on organ-failure-free days, and the safety of APC in SAP. A prospective double blind randomized pilot study was use. The study occurred in one university hospital tertiary intensive care unit (ICU) with eight beds. The patients were chosen according to the following inclusion criteria: 1) Those admitted to the hospital < 96 h from the onset of pain, 2) Those who had a three-fold increase in serum amylase over normal upper range or/and in whom computed tomography (CT) verification of SAP was noted, 3) Those who had one or more organ dysfunction (OD), and 4) Those in whom less than 48 hours had passed since their first OD. Of a total of 215 adult patients with SAP screened between June 2003 and August 2007, 158 fulfilled the study inclusion criteria. After exclusions 32 patients were randomized to the study. The intervention consisted of APC (N = 16) administered intravenously for 96 hours with a dose of 24 μg/kg/hour or placebo (N = 16) with a similar infusion rate. The sample size for the study was calculated according to the primary end-point: the change in SOFA during study drug infusion (Days 0 and 5). Comparisons between the study groups were performed using patient-related changes and calculation of difference in means (DIM, 95% CIs) and regarding categorical variables with Fisher's exact test. For all comparisons P < 0.05 was considered significant. No serious bleeding was detected clinically or by CT scans in either group. No significant difference in SOFA score change between the APC and placebo groups was found (difference in means (DIM) +2.3, 95% CI -0.7 to +5.3). Treatment with APC was associated with an increase in serum levels of both total and conjugated bilirubin. No differences in ventilator-free days, in renal replacement therapy-free days, in vasopressor-free days, or in days alive outside the hospital were detected. No serious bleeding or differences in the evolution of MOD were detected between APC and the placebo. Instead we found an increase in serum bilirubin in the APC group compared to the placebo group in patients with SAP. ClinicalTrials.gov NCT01017107.

[The influence of different asphyxia time on the reproduction of multiply organ dysfunction model after cardiopulmonary resuscitation following cardiac arrest in rabbit].

PubMed

Zhang, Dong; Wang, Yu-shan; Li, Nan; Chen, Ying

2011-06-01

To explore the effects of different asphyxia time on the reproduction of multiply organ dysfunction syndrome in rabbit after cardiopulmonary resuscitation (CPR-MODS) for cardiac arrest, in order to provide a method to reproduce an animal model of CPR-MODS for further research of cardiopulmonary resuscitation (CPR). The rabbit cardiac arrest was caused by asphyxia as a result of clamping the trachea. Thirty rabbits were divided into 7-minute asphyxia group and 8-minute asphyxia group by means of random number table with 15 rabbits in each group. The rate of resumption of spontaneous circulation (ROSC), the mortality at different time points and the occurrence incidence of systemic inflammatory response syndrome (SIRS) of two groups were observed after CPR and the ROSC. The levels of serum tumor necrosis factor-α (TNF-α), myocardial MB-isoenzyme of creatine kinase (CK-MB), alanine aminotransferase (ALT), creatinine (Cr), glucose (Glu) and arterial partial pressure of oxygen (PaO₂) before resuscitation and 12, 24 and 48 hours after ROSC were measured simultaneously in the two groups. The incidence of CPR-MODS was calculated. The CPR time (seconds) in 7-minute asphyxia group was significantly shorter than that in 8-minute asphyxia group (147.60±22.09 vs. 193.08±23.07, P<0.01). The ROSC rate of 7-minute asphyxia group and 8-minute asphyxia group was 100.00% and 86.67%, respectively, and there was no significant difference. The incidence of MODS in the rabbits surviving more than 24 hours after ROSC was 100% in both groups. The mortality at 6 hours after ROSC in 7-minute asphyxia group was remarkably lower than that of 8-minute asphyxia group (6.67% vs. 46.67%, P<0.05). All the rabbits in 8-minute asphyxia group died at 48 hours. The incidence of SIRS after ROSC was 100% in both groups. Compared with that before asphyxiation, the level of serum TNF-α (ng/L) as well as CK-MB (U/L) increased significantly at 12 hours after ROSC in both groups (TNF-α in 7-minute asphyxia group: 100.71±20.43 vs. 49.13±8.64, in 8-minute asphyxia group: 118.09±21.90 vs. 48.48±6.70; CK-MB in 7-minute asphyxia group: 786.88±211.84 vs. 468.20±149.45, in 8-minute asphyxia group: 894.88±248.80 vs. 462.11±115.15, all P<0.05). There was a significant elevation of ALT (U/L) and Glu (mmol/L) at 24 hours after ROSC (ALT in 7-minute asphyxia group: 174.25±36.28 vs. 50.27±9.37, in 8-minute asphyxia group: 205.50±10.61 vs. 51.13±10.37; Glu in 7-minute asphyxia group: 11.21±1.14 vs. 5.59±1.10, in 8-minute asphyxia group: 11.55±0.35 vs. 6.41±1.23, all P<0.05). Cr (μmol/L) was significantly higher at 12 hours after ROSC in 8-minute asphyxia group (98.83±16.70 vs. 65.93±13.81), while it was elevated at 24 hours in 7-minute asphyxia group (144.25±41.64 vs. 67.71±16.47, both P<0.05). PaO₂ in both groups was significantly higher at 12 hours after ROSC and significantly decreased at 24 hours. The model of cardiac arrest caused by 7 minutes asphyxia provided more possibility and feasibility for the subsequent study of reproducing CPR-MODS model.

Integrated Micro-Chip Amino Acid Chirality Detector for MOD

NASA Technical Reports Server (NTRS)

Glavin, D. P.; Bada, J. L.; Botta, O.; Kminek, G.; Grunthaner, F.; Mathies, R.

2001-01-01

Integration of a micro-chip capillary electrophoresis analyzer with a sublimation-based extraction technique, as used in the Mars Organic Detector (MOD), for the in-situ detection of amino acids and their enantiomers on solar system bodies. Additional information is contained in the original extended abstract.

NetMOD version 1.0 user's manual

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

Merchant, Bion John

2014-01-01

NetMOD (Network Monitoring for Optimal Detection) is a Java-based software package for conducting simulation of seismic networks. Specifically, NetMOD simulates the detection capabilities of seismic monitoring networks. Network simulations have long been used to study network resilience to station outages and to determine where additional stations are needed to reduce monitoring thresholds. NetMOD makes use of geophysical models to determine the source characteristics, signal attenuation along the path between the source and station, and the performance and noise properties of the station. These geophysical models are combined to simulate the relative amplitudes of signal and noise that are observed atmore » each of the stations. From these signal-to-noise ratios (SNR), the probability of detection can be computed given a detection threshold. This manual describes how to configure and operate NetMOD to perform seismic detection simulations. In addition, NetMOD is distributed with a simulation dataset for the Comprehensive Nuclear-Test-Ban Treaty Organization (CTBTO) International Monitoring System (IMS) seismic network for the purpose of demonstrating NetMOD's capabilities and providing user training. The tutorial sections of this manual use this dataset when describing how to perform the steps involved when running a simulation.« less

Clinical and paraclinical profile, and predictors of outcome in 90 cases of scrub typhus, Meghalaya, India.

PubMed

Sivarajan, Sunuraj; Shivalli, Siddharudha; Bhuyan, Debomallya; Mawlong, Michael; Barman, Rittwick

2016-10-05

India is an integral component of "tsutsugamushi triangle" which depicts a part of the globe endemic to scrub typhus. Owing to frequent outbreaks witnessed in different parts of the country in the recent past, scrub typhus is described as a re-emerging infectious disease in India. The present study aimed to study the clinical and paraclinical profile, complications and predictors of outcome among 90 cases of scrub typhus diagnosed in a hospital of north-eastern India from Sept 2011 to Aug 2012. A longitudinal study was conducted in a hospital of Meghalaya, India between Sept 2011 and Aug 2012. Diagnosis of scrub typhus was arrived by SD BIOLINE tsutsugamushi (solid phase immunochromatographic assay) rapid diagnostic test for antibodies (IgM, IgG or IgA). Descriptive analyses of age, gender, geographic area, symptoms and signs, treatment, laboratory findings, complications, and outcome were conducted. Relative risk (RR) with 95 % confidence interval (CI) was computed for Multiple Organ Dysfunction Syndrome (MODS) and mortality. Binary logistic regression was applied to the significant correlates (P < 0.05) on univariate analysis to identify the predictors of MODS and mortality in scrub typhus. As many as 662 clinically suspected scrub typhus patients were tested and 90 (13.6 %) were diagnosed to have scrub typhus. Out of 90 patients, 52.2 % (n = 47) were males and their mean (SD) age was 36.29 (13.38) years. Fever of <7 days (n = 75, 83.3 %), myalgia (n = 56, 62.2 %), pain abdomen (n = 24, 26.7 %), headache (n = 24, 26.7 %), nausea/vomiting (n = 21, 23.3 %), dry cough (n = 21, 23.3 %), hepatomegaly (n = 24, 26.7 %), splenomegaly (n = 22, 24.4 %), and lymphadenopathy (n = 20, 22.2 %) were the predominant clinical features. Eschar was seen in 10 patients (11.1 %). One third (n = 30) of the patients developed at least one systemic complication. Acute hepatitis (n = 15, 16.7 %), pneumonitis (n = 14, 15.6 %), and acute kidney injury (n = 11, 12.2 %) were the common complications. MODS was seen in 14.4 % (n = 13) and 38.5 % (n = 5) of the patients with MODS died. Overall, case fatality rate was 5.15 % (n = 5). On univariate analysis, platelets <100 000/mm 3 , serum creatinine >1.5 mg/dl, and transaminase (AST, ALT or both) >500 U/L were associated with MODS (P < 0.001) and mortality (P < 0.05). In addition, serum bilirubin >3 mg/dl was also associated with MODS (P < 0.001). On applying binary logistic regression, serum creatinine >1.5 mg/dl was a predictor of MODS (OR: 76.1, 95 % CI: 4.9-1175.6) and mortality (OR: 18.03, 95 % CI: 1.38-235.1). In this study setting, approximately one-seventh (13.6 %) of the acute undifferentiated febrile illness were due to scrub typhus. Systemic complications were common (33.3 %). Serum creatinine >1.5 mg/dl was a predictor of MODS and mortality.

Developing Coherent, Concise and Comprehensive User Requirements Using the MoD Architectural Framework (MODAF)

DTIC Science & Technology

2005-06-01

PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES...PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10. SPONSOR/MONITOR’S ACRONYM(S) 11. SPONSOR/MONITOR’S REPORT...Prescribed by ANSI Std Z39-18 2 D CBM(A)/07/10/06 14 March 2005 DEVELOPING USER REQUIREMENTS USING THE MOD ARCHITECHTURAL FRAMEWORK (MODAF

[Clinical characteristics and prognosis in patients with high plasma level of procalcitonin: an analysis in 188 patients].

PubMed

Pan, Chuli; Cui, Wei; Zhou, Feifei; Tu, Junwei; Lin, Xiuhui; Li, Libin; Zhang, Gensheng

2017-07-01

To investigate the clinical characteristics and prognosis of patients with high level of plasma procalcitonin (PCT > 100 μg/L), and to improve the clinician's understanding, diagnosis and treatment of this kind of patients. A retrospective study was conducted. The clinical data of patients with plasma PCT over 100 μg/L within 48 hours of admission admitted to Second Affiliated Hospital of Zhejiang University School of Medicine from February 2013 to December 2016 were collected, and the clinical characteristics were analyzed. The patients were divided into survival and death groups according to 28-day prognosis. The general data and laboratory parameters including vital signs, 24-hour urine output, routine blood test, blood biochemical tests, coagulation parameters, myocardial enzymes and arterial blood gas analysis were collected. The risk factors of mortality were analyzed using multi-logistic regression analysis. 188 patients with high level of plasma PCT were enrolled. There were 128 male patients (68.1%) with the average age of 62 (49, 75) years. Most patients were admitted in intensive care unit (ICU, 70.7%, 133/188). Major diagnosis was sepsis (91.0%), followed by multiple organ dysfunction syndrome (MODS, 57.4%), post large operation of thorax and abdomen (20.7%), trauma/burns (13.8%) and post-cardiopulmonary resuscitation (CPR, 6.4%). Of all the 188 patients, 115 patients survived and 73 died with a mortality of 38.8%. The parameters in the death group, including the percentages of MODS (84.9% vs. 40.0%), trauma/burns (26.0% vs. 6.1%), post-CPR (13.7% vs. 1.7%), ventilator support (82.2% vs. 40.9%) and shock (100.0% vs. 60.0%), the numbers of principal diagnosis [2.0 (2.0, 3.0) vs. 2.0 (1.0, 2.0)], acute physiology and chronic health evaluation II score [APACHE II score: 24 (19, 28) vs. 14 (10, 16)] and sequential organ failure assessment (SOFA) score [16.0 (12.5, 18.0) vs. 9.0 (6.0, 12.0)], as well as liver function, coagulation parameters, myocardial enzymes and lactic acid (Lac) levels were significantly higher than those in the survival group, but the platelet (PLT) count in the death group was significantly lower than that in the survival group [×10 9 /L: 62.00 (21.50, 111.00) vs. 93.00 (53.00, 136.00), all P < 0.05]. The parameters with statistical significance in the univariate analysis were enrolled in the multiple factor logistic regression analysis, which showed that patient with a high score of APACHE II [odds ratio (OR) = 1.290, 95% confidence interval (95%CI) = 1.121-1.484, P = 0.000] or the occurrence of MODS (OR = 7.264, 95%CI = 1.762-29.941, P = 0.006) at admission had a poor prognosis. The primary patients with high levels of plasma PCT (> 100 μg/L) were diagnosed with sepsis, MODS, trauma and post-CPR, complicated with respiratory and circulatory insufficiency. These factors of trauma, MODS and cardiac arrest, and some laboratory parameters including PLT, Lac, liver function, coagulation spectrum, and cardiac enzymes were correlated with the prognosis of the patients with high levels of plasma PCT. High APACHE II score and the incidence of MODS might be independent predictors of poor prognosis in the patients with high levels of plasma PCT.

Changes in hemostasis caused by different replacement fluids and outcome in therapeutic plasma exchange in pediatric patients in a retrospective single center study.

PubMed

Witt, Volker; Pichler, Herbert; Beiglboeck, Elisabeth; Kursten, Friedrich; Weidner, Lisa

2017-02-01

Therapeutic plasma exchange (TPE) is a generally accepted and frequently performed procedure for numerous therapeutic indications in adults. Slowly, TPE is also becoming more and more popular in the treatment of pediatric patients. Although, we know that TPE is safe in pediatric patients, the outcome of children treated with TPE is rarely reported. Furthermore, there are only general recommendations regarding the plasma replacement fluid for children and these are adopted from adults. Data concerning outcome and the influence of different types of replacement fluids on hemostasis in children are scarce. We retrospectively evaluated 324 TPE treatments performed in 35 patients between 2008 and 2013 in our level 4 institution for pediatric hematology and oncology. The plasmapheresis procedures were categorized into three groups based on the replacement fluid used. The first group received solvent/detergent-treated (S/D) plasma (70.0% of patients), the second group was administered 5% human albumin (7.7% of patients) and the third group was treated with a combination of human albumin 5% and S/D plasma (22.3% of patients). To assess hemostasis, data on INR, aPTT, fibrinogen and ATIII were collected before and after plasmapheresis from the patients' charts. A modified Multi Organ Dysfunction Syndrome (MODS) Index was used to classify organ failure. Patient outcome, survival rate and adverse events were evaluated. We found a significant increase in the INR by 35.83% and of the aPTT by 18.53% within the human albumin group. The INR and aPTT of patients allocated to the S/D plasma group decreased by 1.58% and 15.77% on average, respectively. The combination group revealed a mild increase of the INR (9.47%), accompanied by a reduction of aPTT (5.97%). Furthermore we found that the survival rate was significantly associated with a MODS Index of <2 (p<0.001). Overall, the number of adverse events was low (1.2%) and none of these were considered life-threatening. Hemostasis could be preserved in a clinically acceptable range for a variety of underlying diseases with SD plasma alone or in combination with human albumin. Based on our results we would recommend practitioners to closely pre-estimate the hemostatic situation before using human albumin alone in critically ill pediatric patients with a limited ability to produce coagulation factors. The outcome of the patients in our collective exprience is correlated to the extent of organ dysfunction. Therefore further controlled studies are highly recommended. Copyright © 2017 Elsevier Ltd. All rights reserved.

Epitaxial strain effect in perovskite RENiO3 films (RE = La-Eu) prepared by metal organic decomposition

NASA Astrophysics Data System (ADS)

Ikeda, Ai; Manabe, Takaaki; Naito, Michio

2014-10-01

We report the synthesis of perovskite RENiO3 films (RE = La, Pr, Nd, Sm, and Eu) by metal organic decomposition (MOD). The RENiO3 family is an ideal system for studying the metal-insulator transition due to the simplicity of the materials. One of the drawbacks is that the bulk synthesis of the RENiO3 requires processing at high oxygen pressures to stabilize Ni3+. Fundamentally, MOD is similar to solid-state reaction, but it turned out that the MOD synthesis tends to stabilize RENiO3 without the need for high oxygen pressure. The films prepared by MOD show high crystallinity and low resistivity. Furthermore, we have investigated the epitaxial strain effect and observed a dramatic effect in PrNiO3 and NdNiO3 films on LaAlO3 substrates. The metal-insulator transition in the PrNiO3 films on LaAlO3 is fully suppressed, whereas the metal-insulator transition temperature is considerably lowered in the NdNiO3 films on LaAlO3.

Elevated levels of von Willebrand factor and high mobility group box 1 (HMGB1) are associated with disease severity and clinical outcome of scrub typhus.

PubMed

Chen, Hongliu; Ning, Zong; Qiu, Ying; Liao, Yuanli; Chang, Haihua; Ai, Yuanyuan; Wei, Yinghua; Deng, Yiming; Shen, Ying

2017-08-01

This study aimed to investigate whether von Willebrand factor (vWF) and high mobility group box 1 (HMGB1) are associated with the severity and clinical outcome of scrub typhus and to seek novel biomarkers for surveillance and prediction of the prognosis of this infection. Serum concentrations of vWF and HMGB1 were measured twice by ELISA for scrub typhus patients (n=103), once prior to doxycycline therapy and then on day 7 of doxycycline therapy; concentrations were measured once for healthy controls (n=32). Among the total 103 patients enrolled, 38 had disease complicated by multiple organ dysfunction syndrome (MODS). Serum concentrations of vWF and HMGB1 were significantly higher in all the patients than in the healthy controls, both prior to doxycycline treatment and on day 7 of doxycycline treatment (p<0.01). Furthermore, serum levels of vWF, HMGB1, and creatinine (SCr) in the patients with MODS increased distinctly, while the platelet (PLT) count diminished markedly compared to the levels in patients without MODS (p<0.01). The concentration of vWF was positively correlated with that of HMGB1 (r=0.764, p<0.001) and SCr (r=0.528, p<0.001), but negatively correlated with the PLT count (r=-0.632, p<0.001). Both HMGB1 and vWF were significantly associated with mortality in scrub typhus (area under the curve (AUC)=0.864, p=0.001, and AUC=0.862, p=0.001, respectively). Elevated levels of vWF and HMGB1 are associated with the severity and clinical outcome of scrub typhus. These represent possible new biomarkers for use in the assessment and prognostic prediction of this infection. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

[A model of multiple organ injury induced by Klebsiella pneumoniae pneumonia in aged rats].

PubMed

Li, Jian-sheng; Wang, Shou-fu; Qin, Jin-li; Zhang, Hui-jian; Li, Su-yun; Yu, Hai-bin; Wang, Feng; Liu, Si-hua; Li, Ya

2009-04-01

To reproduce a model of bacterial multiple organ injury (MOI) in aged rats. Male Sprague-Dawley (SD) rats were used. The young rats were divided into young control group (YCG, n=10) and young model group (YMG, n=15), and the elderly, aged control group (ACG, n=10) and aged model group (AMG, n=25). The model of rats with Klebsiella pneumoniae pneumonia was produced by tracheal instillation of the bacteria, and injury to various organs was observed and evaluated with changes in biochemical parameters, pathological pictures and mortality. Between YMG and AMG, the mortality rates were 33.33% (5/15) and 60.00% (15/25), respectively, at 24 hours after instillation of the bacteria. Compared with YCG and ACG, the neutrophil percentage and white blood cell (WBC) counts in peripheral blood increased significantly in YMG and AMG groups (all P<0.01), the rates of dysfunction of the lungs, the heart and the liver, were 60%-100%. The respiratory dysfunction was evidenced by an increase in the arterial partial pressure of carbon dioxide (PaCO(2), P<0.01), and a decrease in the arterial partial pressure of oxygen (PaO(2), P<0.05 or P<0.01). Myocardial dysfunction was shown by a the sharp increase in creatine kinase (CK), creatine kinase isoenzyme MB (CK-MB) and lactate dehydrogenase (LDH), and that of the liver by changes in alanine aminotransferase (ALT) and aspartate aminotransferase (AST, P<0.05 or P<0.01). The pathological changes under light and electronic microscopy were obvious, and the main feature was infiltration of the inflammatory cells. Compared with YMG, PaO(2) in AMG dropped significantly, PaCO(2) increased, CK, CK-MB, LDH, ALT and AST also increased significantly (P<0.05 or P<0.01). The scores of pathological injury in the lungs, the heart and the small intestine in the AMG were obviously higher than that in YMG group (all P<0.05), and the same was trend in the liver and the kidney. The model of bacterial MOI in aged rats is reproduced successfully, and it mimics the pathogenesis of multiple organ dysfunction syndrome (MODS) which initiates from infection in the lungs. The model is simple and convenient to replicate with a high success rate. The MOI in the aged rats is characterized by the severity of the organ injury and a high mortality rate.

[Comparative analysis of the clinical characteristics of orthopedic inpatients in Lushan and Wenchuan earthquakes].

PubMed

Shi, Xiao-Jun; Wang, Guang-Lin; Pei, Fu-Xing; Song, Yue-Ming; Yang, Tian-Fu; Tu, Chong-Qi; Huang, Fu-Guo; Liu, Hao; Lin, Wei

2013-10-18

To systematically analyze and compare the clinical characteristics of orthopedic inpatients in Lushan and Wenchuan earthquake, so as to provide useful references for future earthquakes injury rescue. Based on the orthopedic inpatients in Lushan and Wenchuan earthquakes, the data of the age, gender, injury causes, body injured parts and speed of transport were classified and compared. The duration of patients admitted to hospital lasted long and the peak appeared late in Wenchuan earthquake, which is totally opposed to Lushan earthquake. There was no significant difference in the patient's age and gender between the two earthquakes. However, the occurrence rate of crush syndrome, amputation, gas gangrene, vascular injury and multiple organ dysfunction syndrome (MODS) in Wenchuan earthquake was much higher than that in Lushan earthquake. Blunt traumas or crush-related injuries (79.6%) are the major injury cause in Wenchuan earthquake, however, high falling injuries and falls (56.8%) are much higher than blunt trauma or crush-related injuries (39.2%) in Lushan earthquake. The incidence rate of foot fractures, spine fractures and multiple fractures in Lushan earthquake was higher than that in Wenchuan earthquake, but that of open fractures and lower limb fractures was lower than that in Wenchuan earthquake. The rapid rescue scene is the cornerstone of successful treatment, early rescue and transport obviously reduce the incidence of the wound infection, crush syndrome, MODS and amputation. Popularization of correct knowledge of emergency shelters will help to reduce the damage caused by blindly jumping or escaping while earthquake happens.

Ink-jet printing of silver metallization for photovoltaics

NASA Technical Reports Server (NTRS)

Vest, R. W.

1986-01-01

The status of the ink-jet printing program at Purdue University is described. The drop-on-demand printing system was modified to use metallo-organic decomposition (MOD) inks. Also, an IBM AT computer was integrated into the ink-jet printer system to provide operational functions and contact pattern configuration. The integration of the ink-jet printing system, problems encountered, and solutions derived were described in detail. The status of ink-jet printing using a MOD ink was discussed. The ink contained silver neodecanate and bismuth 2-ethylhexanoate dissolved in toluene; the MOD ink decomposition products being 99 wt% AG, and 1 wt% Bi.

MOD silver metallization for photovoltaics

NASA Technical Reports Server (NTRS)

Vest, G. M.; Vest, R. W.

1984-01-01

The development of flat plate solar arrays is reported. Photovoltaic cells require back side metallization and a collector grid system on the front surface. Metallo-organic decomposition (MOD) silver films can eliminate most of the present problems with silver conductors. The objectives are to: (1) identify and characterize suitable MO compounds; (2) develop generic synthesis procedures for the MO compounds; (3) develop generic fabrication procedures to screen printable MOD silver inks; (4) optimize processing conditions to produce grid patterns and photovoltaic cells; and (5) develop a model which describes the adhesion between the fired silver film and the silicon surface.

Control of artificial pinning centers in REBCO coated conductors derived from the trifluoroacetate metal-organic deposition process

NASA Astrophysics Data System (ADS)

Izumi, T.; Nakaoka, K.

2018-07-01

The metal-organic deposition (MOD) process using metal trifluoroacetate salts (TFA) has the advantages of low-cost and high-scalability for the fabrication of REBa2Cu3O y (REBCO, RE: rare earth elements) superconducting coated conductors (CCs) with high critical current density, in principle, because of its non-vacuum process. For the magnetic applications of CCs such as motors, magnetic resonance imaging and superconducting magnetic energy storage, further improvement of superconducting performance under magnetic fields is required. However, the in-field superconducting performance of REBCO CCs derived from the TFA-MOD process had been inferior to those derived from the vapor-phase process. In order to improve the in-field performance, the size control of the artificial pinning centers has been known as an effective way. In the early stage, the BaZrO3 (BZO) material, which was one of the effective materials in the CCs by the vapor-phase process, was also introduced in the TFA-MOD-derived CCs. The unique feature of the BZO material in the TFA-MOD process is the shape. The BZO in the TFA-MOD process formed the particle shape, although in the vapor-phase process it has a rod shape with a long axis elongating along the thickness direction. In addition, a special heat treatment for refining the BZO particles was developed, which is called the ‘interim heat treatment’. This heating profile made the in-field characteristics higher, although they were still lower than those of the vapor-phase process. Then, the new MOD process including ‘ultra-thin once coating’ was recently developed for further refinement of the BZO particles. The characteristics of the new TFA-MOD-derived CCs in magnetic fields have become compatible with those of the CCs derived from the vapor-phase process.

Defibrotide for Patients with Hepatic Veno-Occlusive Disease/Sinusoidal Obstruction Syndrome: Interim Results from a Treatment IND Study.

PubMed

Richardson, Paul G; Smith, Angela R; Triplett, Brandon M; Kernan, Nancy A; Grupp, Stephan A; Antin, Joseph H; Lehmann, Leslie; Shore, Tsiporah; Iacobelli, Massimo; Miloslavsky, Maja; Hume, Robin; Hannah, Alison L; Nejadnik, Bijan; Soiffer, Robert J

2017-06-01

Hepatic veno-occlusive disease, or sinusoidal obstruction syndrome (VOD/SOS), is a serious and potentially fatal complication of conditioning for hematopoietic stem cell transplantation (HSCT) or of chemotherapy regimens alone. Defibrotide is a complex mixture of single-stranded polydeoxyribonucleotides that is approved in the United States for treating hepatic VOD/SOS with renal or pulmonary dysfunction post-HSCT and in the European Union, Israel, and South Korea for treating severe hepatic VOD/SOS post-HSCT. Defibrotide was previously available in the United States as an investigational drug through a treatment protocol (treatment IND) study. Interim results of that large, treatment IND study of patients with VOD/SOS and with or without multiorgan dysfunction (MOD; also known as multiorgan failure) are presented here. Defibrotide was administered i.v. at 6.25 mg/kg every 6 hours (25 mg/kg/day), with a recommended treatment duration of at least 21 days. Enrolled patients (n = 681) were diagnosed with VOD/SOS based on Baltimore or modified Seattle criteria or liver biopsy analysis. Among the 573 HSCT recipients, 288 (50.3%; 95% confidence interval [CI], 46.2% to 54.4%) were alive at day +100 post-HSCT. Day +100 survival for the pediatric (≤16 years) and adult (>16 years) subgroups was 54.5% (95% CI, 49.1% to 60.0%; n = 174 of 319) and 44.9% (95% CI, 38.8% to 51.0%; n = 114 of 254), respectively. In the MOD subgroup, 159 of 351 patients (45.3%; 95% CI, 40.1% to 50.5%) of patients were alive at day +100 post-HSCT. Treatment with defibrotide was generally well tolerated, and drug-related toxicities were consistent with previous studies. Adverse events were reported in 69.6% of safety-evaluable patients (399 of 573). Other than VOD/SOS and associated MOD symptoms, the most commonly reported treatment-emergent adverse event was hypotension (13.8%). Day +100 survival results observed in this trial were consistent with results seen in previous trials of defibrotide for VOD/SOS in adult and pediatric patients. These data support the potential benefit of defibrotide in treating a VOD/SOS patient population that includes those with and without MOD. Copyright © 2017 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

NetMOD Version 2.0 User?s Manual.

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

Merchant, Bion J.

2015-10-01

NetMOD ( Net work M onitoring for O ptimal D etection) is a Java-based software package for conducting simulation of seismic, hydracoustic, and infrasonic networks. Specifically, NetMOD simulates the detection capabilities of monitoring networks. Network simulations have long been used to study network resilience to station outages and to determine where additional stations are needed to reduce monitoring thresholds. NetMOD makes use of geophysical models to determine the source characteristics, signal attenuation along the path between the source and station, and the performance and noise properties of the station. These geophysical models are combined to simulate the relative amplitudes ofmore » signal and noise that are observed at each of the stations. From these signal-to-noise ratios (SNR), the probability of detection can be computed given a detection threshold. This manual describes how to configure and operate NetMOD to perform detection simulations. In addition, NetMOD is distributed with simulation datasets for the Comprehensive Nuclear-Test-Ban Treaty Organization (CTBTO) International Monitoring System (IMS) seismic, hydroacoustic, and infrasonic networks for the purpose of demonstrating NetMOD's capabilities and providing user training. The tutorial sections of this manual use this dataset when describing how to perform the steps involved when running a simulation. ACKNOWLEDGEMENTS We would like to thank the reviewers of this document for their contributions.« less

DYSFUNCTION OF VARIOUS ORGAN SYSTEMS INDUCED BY SEPSIS WITH UNDERLYING SEVERE MYELOMIC DISEASES AND PROSTATE CANCER (CASE REPORT).

PubMed

Ratiani, L; Intskirveli, N; Goliadze, L; Chkhikvadze, T; Koptonashvili, L; Khuchua, E

2018-02-01

A 65-year-old male patient, unconscious, was admitted into the clinic by the Ambulance. From the patient's medical history it was revealed that several hours before the admission in the clinic the following symptoms were present: shortness of breath, fever, hypotonia, consciousness inhibition, because of which emergency brigade was called and was brought by the Emergency Brigade. The history is loaded by chronic pathologies: myeloma disease, prostate cancer, ciliary arrhythmia, heart failure; received several courses of polichemotherapy, last ten days has been treated for pneumonia with antibiotics of ceftriaxone group in outpatient setting. It is also noteworthy that for the last three months dysfunction of musculoskeletal system with muscle weakness, restricted motion has been present. Clinically there was present dysfunction syndrome of several organs: disorder of function of several organs that required emergency intervention, recovery chance was very low, correlation with morbidity in PIRO was high. By investigation it is known, that as SIRS aggravates, and turns into septic shock, lethal index increases, especially when the underlying severe diseases are present. On basis of certain data we can conclude that the severity of the disease may have some compatibility with results, although it is alteration of further clinical status of initial stage that has the closest compatibility with results. Sepsis toward MODS experiences progress with lethal results. Mortality rate in the patients with acute respiratory deficiency increases from 50% to 80%. In most patients with sepsis syndrome, who have 3 or more organs damaged, lethality is more than 90%. In this certain case organ systems that are mostly involved in the process during the sepsis, are respiratory, blood, renal and cardiovascular systems, were all involved , in the mentioned case a reasonable symptomatic and pathognomic treatment and the appropriate measures led to the recovery of the above mentioned patient. Sepsis syndrome is developed when the balance between the substances that contribute to the inflammation and anti-inflammatory substances is violated. By the mentioned case there is sepsis - induced polyorganic insufficiency with underlying severe somatic pathological condition, with violation of hemodynamics. Clinically the insufficiency of all the organic systems developed at the background of cardio-respiratory-cerebral insufficiency, with functional insufficiency of all the organ systems and violation of buffer system. With reasonable pathognomic and symptomatic treatment eradication of vicious circle was possible. The patient was discharged from the clinic with positive clinic-laboratory recovery. The condition is stable. Neurological status -contact, adequate, with high capacity to work, and with an achievement of 2 year remission.

Clinical profile and improving mortality trend of scrub typhus in South India.

PubMed

Varghese, George M; Trowbridge, Paul; Janardhanan, Jeshina; Thomas, Kurien; Peter, John V; Mathews, Prasad; Abraham, Ooriapadickal C; Kavitha, M L

2014-06-01

Scrub typhus, a bacterial zoonosis caused by Orientia tsutsugamushi, may cause multiorgan dysfunction syndrome (MODS) and is associated with significant mortality. This study was undertaken to document the clinical and laboratory manifestations and complications and to study time trends and factors associated with mortality in patients with scrub typhus infection. This retrospective study, done at a university teaching hospital, included 623 patients admitted between 2005 and 2010 with scrub typhus. The diagnosis was established by a positive IgM ELISA and/or pathognomonic eschar with PCR confirmation where feasible. The clinical and laboratory profile, course in hospital, and outcome were documented. Factors associated with mortality were analyzed using multivariate logistic regression analysis. The most common presenting symptoms were fever (100%), nausea/vomiting (54%), shortness of breath (49%), headache (46%), cough (38%), and altered sensorium (26%). An eschar was present in 43.5% of patients. Common laboratory findings included elevated transaminases (87%), thrombocytopenia (79%), and leukocytosis (46%). MODS was seen in 34% of patients. The overall case-fatality rate was 9.0%. Features of acute lung injury were observed in 33.7%, and 29.5% required ventilatory support. On multivariate analysis, shock requiring vasoactive agents (relative risk (RR) 10.5, 95% confidence interval (CI) 4.2-25.7, p<0.001), central nervous system (CNS) dysfunction (RR 5.1, 95% CI 2.4-10.7, p<0.001), and renal failure (RR 3.6, 95% CI 1.7-7.5, p=0.001) were independent predictors of mortality. Over 4 years, a decreasing trend was observed in the mortality rate. Scrub typhus can manifest with potentially life-threatening complications such as lung injury, shock, and meningoencephalitis. MODS occurred in a third of our patients. The overall case-fatality rate was 9%, with shock, renal failure, and CNS associated with a higher mortality. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

A matter of hand: Causal links between hand dominance, structural organization of fronto-parietal attention networks, and variability in behavioural responses to transcranial magnetic stimulation.

PubMed

Cazzoli, Dario; Chechlacz, Magdalena

2017-01-01

Considerable evidence suggests that, on a group level, human visuospatial attention is asymmetrically organized, with a right-hemispheric dominance. The asymmetrical organization of the superior longitudinal fasciculus (SLF) has been shown to account for the right-hemispheric dominance in visual attention. However, such account is by no means universal, and large individual differences in asymmetrical performance on visuospatial tasks have been reported. Furthermore, the variability in the SLF lateralization has been shown to correlate with behavioural asymmetries. Continuous theta burst stimulation (cTBS) enables to temporarily interfere with cortical activity. cTBS applied over the posterior parietal cortex (PPC) has been previously used to systematically study attentional asymmetries. Interestingly, large individual differences in the effectiveness of stimulation have been reported. In accordance with earlier both animal and human studies, one possible cause underlying these striking individual differences might lie in the structural organization of frontoparietal pathways subserving visuospatial attention. Thus, the current study employed diffusion tractography to examine the relationship between the variability in the structural organization of the SLF and the individual differences in attentional shifts induced by a modified cTBS (cTBS mod ; triplets of pulses at 30 Hz, repeated at 6 Hz) applied over the IPS, as measured by a line bisection task. Consistent with previous studies, on a group level, cTBS mod applied over the right intraparietal sulcus (IPS) triggered a rightward bisection bias shift, and there were no significant effects of cTBS mod applied over the left IPS. However, further analyses demonstrated that both handedness and structural variability (as assessed based on hindrance modulated orientational anisotropy) within the middle and the ventral branches of the SLF predicted individual differences in the cTBS mod -induced attentional shifts. Our study thus suggests that the effects of cTBS mod over the IPS may depend on intra-hemispheric interactions between cortical loci controlling visual attention. To conclude, our findings provide converging evidence for the notion put forward previously that inter-individual variability in the structural organization of intra-hemispheric frontoparietal connections has important implications for the functional models of human visual attention. Moreover, we hypothesize that this may also be relevant for the understanding of attentional disorders and their rehabilitation. Copyright © 2016 Elsevier Ltd. All rights reserved.

Structural and mechanistic basis of differentiated inhibitors of the acute pancreatitis target kynurenine-3-monooxygenase

NASA Astrophysics Data System (ADS)

Hutchinson, Jonathan P.; Rowland, Paul; Taylor, Mark R. D.; Christodoulou, Erica M.; Haslam, Carl; Hobbs, Clare I.; Holmes, Duncan S.; Homes, Paul; Liddle, John; Mole, Damian J.; Uings, Iain; Walker, Ann L.; Webster, Scott P.; Mowat, Christopher G.; Chung, Chun-Wa

2017-06-01

Kynurenine-3-monooxygenase (KMO) is a key FAD-dependent enzyme of tryptophan metabolism. In animal models, KMO inhibition has shown benefit in neurodegenerative diseases such as Huntington's and Alzheimer's. Most recently it has been identified as a target for acute pancreatitis multiple organ dysfunction syndrome (AP-MODS); a devastating inflammatory condition with a mortality rate in excess of 20%. Here we report and dissect the molecular mechanism of action of three classes of KMO inhibitors with differentiated binding modes and kinetics. Two novel inhibitor classes trap the catalytic flavin in a previously unobserved tilting conformation. This correlates with picomolar affinities, increased residence times and an absence of the peroxide production seen with previous substrate site inhibitors. These structural and mechanistic insights culminated in GSK065(C1) and GSK366(C2), molecules suitable for preclinical evaluation. Moreover, revising the repertoire of flavin dynamics in this enzyme class offers exciting new opportunities for inhibitor design.

Structural and mechanistic basis of differentiated inhibitors of the acute pancreatitis target kynurenine-3-monooxygenase.

PubMed

Hutchinson, Jonathan P; Rowland, Paul; Taylor, Mark R D; Christodoulou, Erica M; Haslam, Carl; Hobbs, Clare I; Holmes, Duncan S; Homes, Paul; Liddle, John; Mole, Damian J; Uings, Iain; Walker, Ann L; Webster, Scott P; Mowat, Christopher G; Chung, Chun-Wa

2017-06-12

Kynurenine-3-monooxygenase (KMO) is a key FAD-dependent enzyme of tryptophan metabolism. In animal models, KMO inhibition has shown benefit in neurodegenerative diseases such as Huntington's and Alzheimer's. Most recently it has been identified as a target for acute pancreatitis multiple organ dysfunction syndrome (AP-MODS); a devastating inflammatory condition with a mortality rate in excess of 20%. Here we report and dissect the molecular mechanism of action of three classes of KMO inhibitors with differentiated binding modes and kinetics. Two novel inhibitor classes trap the catalytic flavin in a previously unobserved tilting conformation. This correlates with picomolar affinities, increased residence times and an absence of the peroxide production seen with previous substrate site inhibitors. These structural and mechanistic insights culminated in GSK065(C1) and GSK366(C2), molecules suitable for preclinical evaluation. Moreover, revising the repertoire of flavin dynamics in this enzyme class offers exciting new opportunities for inhibitor design.

Structural and mechanistic basis of differentiated inhibitors of the acute pancreatitis target kynurenine-3-monooxygenase

PubMed Central

Hutchinson, Jonathan P.; Rowland, Paul; Taylor, Mark R. D.; Christodoulou, Erica M.; Haslam, Carl; Hobbs, Clare I.; Holmes, Duncan S.; Homes, Paul; Liddle, John; Mole, Damian J.; Uings, Iain; Walker, Ann L.; Webster, Scott P.; Mowat, Christopher G.; Chung, Chun-wa

2017-01-01

Kynurenine-3-monooxygenase (KMO) is a key FAD-dependent enzyme of tryptophan metabolism. In animal models, KMO inhibition has shown benefit in neurodegenerative diseases such as Huntington's and Alzheimer's. Most recently it has been identified as a target for acute pancreatitis multiple organ dysfunction syndrome (AP-MODS); a devastating inflammatory condition with a mortality rate in excess of 20%. Here we report and dissect the molecular mechanism of action of three classes of KMO inhibitors with differentiated binding modes and kinetics. Two novel inhibitor classes trap the catalytic flavin in a previously unobserved tilting conformation. This correlates with picomolar affinities, increased residence times and an absence of the peroxide production seen with previous substrate site inhibitors. These structural and mechanistic insights culminated in GSK065(C1) and GSK366(C2), molecules suitable for preclinical evaluation. Moreover, revising the repertoire of flavin dynamics in this enzyme class offers exciting new opportunities for inhibitor design. PMID:28604669

Current views on the mechanisms of immune responses to trauma and infection

PubMed Central

Michalak, Grzegorz; Słotwiński, Robert

2015-01-01

According to the World Health Organization, post-traumatic mortality rates are still very high and show an increasing tendency. Disorders of innate immune response that may increase the risk of serious complications play a key role in the immunological system response to trauma and infection. The mechanism of these disorders is multifactorial and is still poorly understood. The changing concepts of systemic inflammatory response syndrome (SIRS) and compensatory anti-inflammatory response syndrome (CARS) early inflammatory response, presented in this work, have been extended to genetic studies. Overexpression of genes and increased production of immune response mediators are among the main causes of multiple organ dysfunction syndrome (MODS). Changes in gene expression detected early after injury precede the occurrence of subsequent complications with a typical clinical picture. Rapid depletion of energy resources leads to immunosuppression and persistent inflammation and immune suppression catabolism syndrome (PICS). Early diagnosis of immune disorders and appropriate nutritional therapy can significantly reduce the incidence of complications, length of hospital stay, and mortality. The study presents the development of knowledge and current views explaining the mechanisms of the immune response to trauma and infection. PMID:26557036

Evaluation of effect of hybrid bioartificial liver using end-stage liver disease model

PubMed Central

Liu, Qing; Duan, Zhong-Ping; Huang, Chun; Zhao, Chun-Hui

2004-01-01

AIM: To study the role of hybrid bioartificial liver (HBL) in clearing proinflammatory cytokines and endotoxin in patients with acute and sub-acute liver failure and the effects of HBL on systemic inflammatory syndrome (SIRS) and multiple organ dysfunction syndrome (MODS). METHODS: Five cases with severe liver failure (3 acute and 2 subacute) were treated with HBL. The clinical signs and symptoms, total bilirubin (TBIL), serum ammonia, endotoxin TNF-α, IL-6 and prothrombin activity (PTA), cholinesterase (CHE) were recorded before, during and after treatment. The end-stage liver disease (MELD) was used for the study. RESULTS: Two patients were bridged for spontaneous recovery and 1 patient was bridged for OLT successfully. Another 2 patients died on d 8 and d 21. The spontaneous recovery rate was 30.0%. PTA and CHE in all patients were significantly increased (P < 0.01), while the serum TBIL, endotoxin,TNF-α, IL-6 were decreased. MELD score (mean 43.6) predicted 100% deaths within 3 mo before treatment with HBL. After treatment with HBL, four out of 5 patients had decreased MELD scores (mean 36.6). The MELD score predicted 66% mortalities. CONCLUSION: The proinflammatory cytokines (TNFα, IL-6 and endotoxin)can be significantly removed by hybrid bioartificial liver and HBL appears to be effective in blocking SIRS and MODS in patients with acute and sub-acute liver failure. MELD is a reliable measure for predicting short-term mortality risk in patients with end-stage liver disease. The prognostic result also corresponds to clinical outcome. PMID:15112365

Mars Organic Detector III: a versatile instrument for detection of bio-organic signatures on Mars

NASA Astrophysics Data System (ADS)

Skelley, Alison M.; Grunthaner, Frank J.; Bada, Jeffrey L.; Mathies, Richard A.

2003-07-01

Recent advances in the development of microfabricated lab-on-a-chip analysis systems have enhanced the feasibility and capabilities of in situ chemical and biochemical analyzers. While a wide variety of bio-organic molecules can be probed, we have focused our initial studies on the development of an amino acid analyzer with the hypothesis that extraterrestrial life would be based on homochiral amino acid polymers. In previous work, we developed a prototype electrophoresis chip, detection system and analysis method where the hydrolyzed amino acids were labeled with fluorescein and then analyzed in minutes via a capillary zone electrophoresis (CZE) separation in the presence of cyclodextrin as the chiral recognition agent. In more recent work, we have demonstrated the feasibility of performing amino acid composition and chirality analyses using fluorescamine as the labeling reagent. Fluorescamine is advantageous because it reacts more rapidly with amino acids, has a low fluorescence background and because such a chemistry would interface directly with the Mars Organic Detector (MOD-I) concept being developed at Scripps. A more advanced analysis system called MOD-III is introduced here with the ability to analyze zwitterionic amino acids, nucleobases, sugars, and organic acids and bases using novel capture matrix chemistries. MOD-III, which is enabled by the nanoliter valves, pumps and reactors presented here, will provide a wide spectrum of organic chemical analyses and is suitable for a variety of in situ missions.

ISS Operations Cost Reductions Through Automation of Real-Time Planning Tasks

NASA Technical Reports Server (NTRS)

Hall, Timothy A.; Clancey, William J.; McDonald, Aaron; Toschlog, Jason; Tucker, Tyson; Khan, Ahmed; Madrid, Steven (Eric)

2011-01-01

In 2007 the Johnson Space Center s Mission Operations Directorate (MOD) management team challenged their organizations to find ways to reduce the cost of operations for supporting the International Space Station (ISS) in the Mission Control Center (MCC). Each MOD organization was asked to define and execute projects that would help them attain cost reductions by 2012. The MOD Operations Division Flight Planning Branch responded to this challenge by launching several software automation projects that would allow them to greatly improve console operations and reduce ISS console staffing and intern reduce operating costs. These tasks ranged from improving the management and integration mission plan changes, to automating the uploading and downloading of information to and from the ISS and the associated ground complex tasks that required multiple decision points. The software solutions leveraged several different technologies including customized web applications and implementation of industry standard web services architecture; as well as engaging a previously TRL 4-5 technology developed by Ames Research Center (ARC) that utilized an intelligent agent-based system to manage and automate file traffic flow, archive data, and generate console logs. These projects to date have allowed the MOD Operations organization to remove one full time (7 x 24 x 365) ISS console position in 2010; with the goal of eliminating a second full time ISS console support position by 2012. The team will also reduce one long range planning console position by 2014. When complete, these Flight Planning Branch projects will account for the elimination of 3 console positions and a reduction in staffing of 11 engineering personnel (EP) for ISS.

The Pathway Tools software.

PubMed

Karp, Peter D; Paley, Suzanne; Romero, Pedro

2002-01-01

Bioinformatics requires reusable software tools for creating model-organism databases (MODs). The Pathway Tools is a reusable, production-quality software environment for creating a type of MOD called a Pathway/Genome Database (PGDB). A PGDB such as EcoCyc (see http://ecocyc.org) integrates our evolving understanding of the genes, proteins, metabolic network, and genetic network of an organism. This paper provides an overview of the four main components of the Pathway Tools: The PathoLogic component supports creation of new PGDBs from the annotated genome of an organism. The Pathway/Genome Navigator provides query, visualization, and Web-publishing services for PGDBs. The Pathway/Genome Editors support interactive updating of PGDBs. The Pathway Tools ontology defines the schema of PGDBs. The Pathway Tools makes use of the Ocelot object database system for data management services for PGDBs. The Pathway Tools has been used to build PGDBs for 13 organisms within SRI and by external users.

Phase Evolution of YBa2Cu3O7-x films by all-chemical solution deposition route for coated conductors

NASA Astrophysics Data System (ADS)

Zhao, Yue; Tang, Xiao; Wu, Wei; Grivel, Jean-Claude

2014-05-01

In order to understand the all-chemical-solution-deposition (CSD) processes for manufacturing coated conductors, we investigated the phase evolution of YBa2Cu3O7 (YBCO) films deposited by a low-fluorine metal-organic solution deposition (LF-MOD) method on CSD derived Ce0.9La0.1O2/Gd2Zr2O7/NiW. It is shown that the phase transition from the pyrolyzed film to fully converted YBCO film in the LF-MOD process is similar to that in typical trifluoroacetates-metal organic deposition (TFA-MOD) processes even though the amount of TFA in the solution is reduced by almost one half compared with typical TFA-MOD cases. Moreover, we found that the formation of impurities (mainly BaCeO3, NiWO4 and NiO) is strongly related to the annealing temperature, i.e., the diffusion controlled reactions become intensive from 760 oC, which might be connected with the poor structural and superconducting properties of the films deposited at high sintering temperatures. Based on these results, the optimized growth conditions of YBCO films were established, and a high critical current density (Jc) of about 2 MA/cm2 (77 K, self field) is achieved in a 200 nm thick YBCO film in the architecture made by our all CSD route.

New or Progressive Multiple Organ Dysfunction Syndrome in Pediatric Severe Sepsis: A Sepsis Phenotype With Higher Morbidity and Mortality.

PubMed

Lin, John C; Spinella, Philip C; Fitzgerald, Julie C; Tucci, Marisa; Bush, Jenny L; Nadkarni, Vinay M; Thomas, Neal J; Weiss, Scott L

2017-01-01

To describe the epidemiology, morbidity, and mortality of new or progressive multiple organ dysfunction syndrome in children with severe sepsis. Secondary analysis of a prospective, cross-sectional, point prevalence study. International, multicenter PICUs. Pediatric patients with severe sepsis identified on five separate days over a 1-year period. None. Of 567 patients from 128 PICUs in 26 countries enrolled, 384 (68%) developed multiple organ dysfunction syndrome within 7 days of severe sepsis recognition. Three hundred twenty-seven had multiple organ dysfunction syndrome on the day of sepsis recognition. Ninety-one of these patients developed progressive multiple organ dysfunction syndrome, whereas an additional 57 patients subsequently developed new multiple organ dysfunction syndrome, yielding a total proportion with severe sepsis-associated new or progressive multiple organ dysfunction syndrome of 26%. Hospital mortality in patients with progressive multiple organ dysfunction syndrome was 51% compared with patients with new multiple organ dysfunction syndrome (28%) and those with single-organ dysfunction without multiple organ dysfunction syndrome (10%) (p < 0.001). Survivors of new or progressive multiple organ dysfunction syndrome also had a higher frequency of moderate to severe disability defined as a Pediatric Overall Performance Category score of greater than or equal to 3 and an increase of greater than or equal to 1 from baseline: 22% versus 29% versus 11% for progressive, new, and no multiple organ dysfunction syndrome, respectively (p < 0.001). Development of new or progressive multiple organ dysfunction syndrome is common (26%) in severe sepsis and is associated with a higher risk of morbidity and mortality than severe sepsis without new or progressive multiple organ dysfunction syndrome. Our data support the use of new or progressive multiple organ dysfunction syndrome as an important outcome in trials of pediatric severe sepsis although efforts are needed to validate whether reducing new or progressive multiple organ dysfunction syndrome leads to improvements in more definitive morbidity and mortality endpoints.

Promoter polymorphisms in the ATP binding cassette transporter gene influence production of cell-derived microparticles and are highly associated with susceptibility to severe malaria in humans.

PubMed

Sahu, Upasana; Mohapatra, Biranchi N; Kar, Shantanu K; Ranjit, Manoranjan

2013-04-01

Microparticle (MP) efflux is known to be mediated by the ABCA1 protein, and the plasma level of these cell-derived MPs is elevated considerably during human malarial infection. Therefore, two polymorphisms at positions -477 and -320 in the promoter of the ABCA1 gene were genotyped and tested for association with the plasma MP level in four groups of malaria patients segregated according to the clinical severity, i.e., cerebral malaria (CM), multiorgan dysfunction (MOD), noncerebral severe malaria, and uncomplicated malaria (UM). The TruCount tube-based flow cytometric method was used for the exact quantification of different cell-derived MPs in patients. Polymorphisms in the ABCA1 gene promoter were analyzed by use of the PCR/two-primer-pair method, followed by restriction fragment length polymorphism, in 428 malaria patients. The level of circulating plasma MPs was significantly higher in febrile patients with Plasmodium falciparum infection, especially in CM patients compared to healthy individuals. The homozygous wild-type -477 and -320 genotype was observed to be significantly higher in patients with severe malaria. These patients also showed marked increases in the plasma MP numbers compared to UM patients. We report here for the first time an association of ABCA1 promoter polymorphisms with susceptibility to severe malaria, especially to CM and MOD, indicating the protective effect of the mutant variant of the polymorphism. We hypothesize that the -477T and -320G polymorphisms affect the downregulation of MP efflux and may be a predictor of organ complication during P. falciparum malarial infections.

Precocious Metamorphosis in the Juvenile Hormone–Deficient Mutant of the Silkworm, Bombyx mori

PubMed Central

Daimon, Takaaki; Kozaki, Toshinori; Niwa, Ryusuke; Kobayashi, Isao; Furuta, Kenjiro; Namiki, Toshiki; Uchino, Keiro; Banno, Yutaka; Katsuma, Susumu; Tamura, Toshiki; Mita, Kazuei; Sezutsu, Hideki; Nakayama, Masayoshi; Itoyama, Kyo; Shimada, Toru; Shinoda, Tetsuro

2012-01-01

Insect molting and metamorphosis are intricately governed by two hormones, ecdysteroids and juvenile hormones (JHs). JHs prevent precocious metamorphosis and allow the larva to undergo multiple rounds of molting until it attains the proper size for metamorphosis. In the silkworm, Bombyx mori, several “moltinism” mutations have been identified that exhibit variations in the number of larval molts; however, none of them have been characterized molecularly. Here we report the identification and characterization of the gene responsible for the dimolting (mod) mutant that undergoes precocious metamorphosis with fewer larval–larval molts. We show that the mod mutation results in complete loss of JHs in the larval hemolymph and that the mutant phenotype can be rescued by topical application of a JH analog. We performed positional cloning of mod and found a null mutation in the cytochrome P450 gene CYP15C1 in the mod allele. We also demonstrated that CYP15C1 is specifically expressed in the corpus allatum, an endocrine organ that synthesizes and secretes JHs. Furthermore, a biochemical experiment showed that CYP15C1 epoxidizes farnesoic acid to JH acid in a highly stereospecific manner. Precocious metamorphosis of mod larvae was rescued when the wild-type allele of CYP15C1 was expressed in transgenic mod larvae using the GAL4/UAS system. Our data therefore reveal that CYP15C1 is the gene responsible for the mod mutation and is essential for JH biosynthesis. Remarkably, precocious larval–pupal transition in mod larvae does not occur in the first or second instar, suggesting that authentic epoxidized JHs are not essential in very young larvae of B. mori. Our identification of a JH–deficient mutant in this model insect will lead to a greater understanding of the molecular basis of the hormonal control of development and metamorphosis. PMID:22412378

Successful outcome after intravenous gasoline injection.

PubMed

Domej, Wolfgang; Mitterhammer, Heike; Stauber, Rudolf; Kaufmann, Peter; Smolle, Karl Heinz

2007-12-01

Gasoline, ingested intentionally or accidentally, is toxic. The majority of reported cases of gasoline intoxication involve oral ingestion or inhalation. Data are scarce on complications and outcomes following hydrocarbon poisoning by intravenous injection. Following a suicide attempt by intravenous self-injection of 10 ml of gasoline, a 26-year-old medical student was admitted to the intensive care unit (ICU) with hemoptysis, symptoms of acute respiratory failure, chest pain, and severe abdominal cramps. Gas exchange was severely impaired and a chest x-ray indicated chemical pneumonitis. Initial treatment consisted of mechanical ventilation, supportive hyperventilation, administration of nitrogen oxide (NO), and prednisone. Unfortunately, the patient developed multi-organ dysfunction syndrome (MODS) complicated by life-threatening severe vasoplegia within 24 hours after gasoline injection. High doses of vasopressors along with massive amounts of parenteral fluids were necessary. Despite fluid replacement, renal function worsened and required hemofiltration on 5 sequential days. After 12 days of intensive care management, the patient recovered completely and was discharged to a psychiatric care facility. Intravenous gasoline injection causes major injury to the lungs, the organ bearing the first capillary bed encountered. Treatment of gasoline poisoning is symptomatic because no specific antidote is available. Early and aggressive supportive care may be conducive to a favorable outcome with minimal residual pulmonary sequelae.

[Resuscitation principles in severe acute pancreatitis complicated by multiple organ dysfunctions].

PubMed

Purcaru, F; Ghelase, F; Gugilă, I; Curcă, T; Nemeş, R; Georgescu, I; Chiuţu, L; Surlin, V

1997-01-01

The first part renders very synthetically a few of the principal pathogenetical mechanisms implicated in PA, as well as general data about MODS, and then tackles therapeutical principles of great organic disfunction, the therapy of septic states and nutrition in PA. Hemodynamics dysfunction--the therapeutical objectives are correlated with the principal mechanisms implicated in cardio-vascular disfunction (the grown level of some myocardial depressive factors, the shortcoming of peripheral vascular resistance, a.s.o.). The therapeutical principles covets the volemic restoration, inotropic therapy, the correction of hydro-ionic and acido-basic disorders, the vasomotor therapy, the CID's correction, the myocardium protection against the free radicals of oxygen. The therapy is recommended to be individualized depending on the clinical data and the monitoring of some parameters (T.A, P.V.C., intrapulmonary pressure, EKG, hematocrit value, a.s.o.). Pulmonary disfunction--includes the therapy of some clinical forms of pulmonary complications, the restrictive syndrome, infections, the pulmonary shunt, the atelectasis and insists on ARDS which is a complication with vital implications. The therapy of curdling disorders--recommends blood, derivatives, antiprotease, the substitution of the consumed curdling factors, as well as the removal of the pathogenic factors which disturb the coagulation-coagulolysis equilibrium. Purge proceedings--covet the elimination from the organism of the toxic agents which generate cell-organic lesions. That's why it is moot the elimination of the pancreatic toxins before reaching the circulation (the thoracic tube draining and peritoneal lavage) as well as extrarenal purge proceedings (hemodialysis, hemofiltration and hemodiafiltration) with their benefits and limits. The sepsis and the immunotherapy--are tackled based on recent data from literature which besides antibiotherapy insists on the neutralization of various toxins and mediators by means of monoclonal and polyclonal antibodies, anti TFL antibodies, IL, a.s.o. Nutrition--is different presented, parenterally and enterally, each of them with their benefits and limits and with the recommendation to be used by means of the clinical form. There are mentioned some other additional treatments (pain removing, antagonisms of H2 receptors, inflammation and cytotoxicity inhibition, gastric decompression, a.s.o.).

Systemic Inflammatory Response Syndrome, Quick Sequential Organ Function Assessment, and Organ Dysfunction: Insights From a Prospective Database of ED Patients With Infection.

PubMed

Williams, Julian M; Greenslade, Jaimi H; McKenzie, Juliet V; Chu, Kevin; Brown, Anthony F T; Lipman, Jeffrey

2017-03-01

A proposed revision of sepsis definitions has abandoned the systemic inflammatory response syndrome (SIRS), defined organ dysfunction as an increase in total Sequential Organ Function Assessment (SOFA) score of ≥ 2, and conceived "qSOFA" (quick SOFA) as a bedside indicator of organ dysfunction. We aimed to (1) determine the prognostic impact of SIRS, (2) compare the diagnostic accuracy of SIRS and qSOFA for organ dysfunction, and (3) compare standard (Sepsis-2) and revised (Sepsis-3) definitions for organ dysfunction in ED patients with infection. Consecutive ED patients admitted with presumed infection were prospectively enrolled over 3 years. Sufficient observational data were collected to calculate SIRS, qSOFA, SOFA, comorbidity, and mortality. We enrolled 8,871 patients, with SIRS present in 4,176 (47.1%). SIRS was associated with increased risk of organ dysfunction (relative risk [RR] 3.5) and mortality in patients without organ dysfunction (OR 3.2). SIRS and qSOFA showed similar discrimination for organ dysfunction (area under the receiver operating characteristic curve, 0.72 vs 0.73). qSOFA was specific but poorly sensitive for organ dysfunction (96.1% and 29.7%, respectively). Mortality for patients with organ dysfunction was similar for Sepsis-2 and Sepsis-3 (12.5% and 11.4%, respectively), although 29% of patients with Sepsis-3 organ dysfunction did not meet Sepsis-2 criteria. Increasing numbers of Sepsis-2 organ system dysfunctions were associated with greater mortality. SIRS was associated with organ dysfunction and mortality, and abandoning the concept appears premature. A qSOFA score ≥ 2 showed high specificity, but poor sensitivity may limit utility as a bedside screening method. Although mortality for organ dysfunction was comparable between Sepsis-2 and Sepsis-3, more prognostic and clinical information is conveyed using Sepsis-2 regarding number and type of organ dysfunctions. The SOFA score may require recalibration. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

NetMOD v. 1.0

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

Merchant, Bion J

2015-12-22

NetMOD is a tool to model the performance of global ground-based explosion monitoring systems. The version 2.0 of the software supports the simulation of seismic, hydroacoustic, and infrasonic detection capability. The tool provides a user interface to execute simulations based upon a hypothetical definition of the monitoring system configuration, geophysical properties of the Earth, and detection analysis criteria. NetMOD will be distributed with a project file defining the basic performance characteristics of the International Monitoring System (IMS), a network of sensors operated by the Comprehensive Nuclear-Test-Ban Treaty Organization (CTBTO). Network modeling is needed to be able to assess and explainmore » the potential effect of changes to the IMS, to prioritize station deployment and repair, and to assess the overall CTBTO monitoring capability currently and in the future. Currently the CTBTO uses version 1.0 of NetMOD, provided to them in early 2014. NetMOD will provide a modern tool that will cover all the simulations currently available and allow for the development of additional simulation capabilities of the IMS in the future. NetMOD simulates the performance of monitoring networks by estimating the relative amplitudes of the signal and noise measured at each of the stations within the network based upon known geophysical principles. From these signal and noise estimates, a probability of detection may be determined for each of the stations. The detection probabilities at each of the stations may then be combined to produce an estimate of the detection probability for the entire monitoring network.« less

Integration of a Micro-Chip Amino Acid Chirality Detector into the MOD Instrument Concept

NASA Technical Reports Server (NTRS)

Bada, Jeffrey L.; Grunthaner, Frank; Mathies, Richard

2004-01-01

The MOD (Mars Organic Detector) instrument concept consists of a sublimation apparatus for organic compound isolation connected to a microfabricated microfluidic analyzer containing a sipper, pumps and a separation channel for organic compound characterization. The target organic compounds are amino acids and polycyclic aromatic hydrocarbons (PAHs). Solid samples are placed within the sublimation apparatus and heated to release organic compounds which sublime onto a cold finger. Half of the cold finger is coated with fluorescamine. which reacts with amino acids and other primary amines to generate an intense fluorescent derivative while the other half is uncoated and is used to directly detect PAH fluorescence, A capillary sipper is then used to dissolve and sample the labeled amino acids and integrated microfabricated pumps transport the labeled amino acids to the chip for analysis. The sample is separated using capillary zone electrophoresis (CZE) together with chiral dextrins to determine amino acid composition and chirality. During the grant period, the following steps have been completed toward the development of a robust instrument and chemistry.

OM/OC Ratio and Specific Attenuation Coefficient in Ambient Particulate Matter at a Rural Site in Southern Ontario: Implications for Aerosol Aging and Emission Sources

NASA Astrophysics Data System (ADS)

Chan, T. W.; Huang, L.; Leaitch, R.; Sharma, S.; Brook, J.; Slowik, J.; Abbatt, J.

2008-05-01

Carbonaceous species (organic carbon (OC) and elemental carbon (EC)) contribute a large portion of atmospheric fine particle mass and influence air quality, human health, and climate forcing. However, their emission sources and atmospheric aging processes are not well understood. The OM/OC ratio, defined as the organic mass per unit OC mass, is useful to understand the degree of oxidation of aerosol particles in atmospheric processes. We define the modified BC/EC (mod BC/EC) ratio as the ratio of the non-scattering corrected absorption coefficient per unit mass of EC. The mod BC/EC ratio has a similar meaning as the site specific attenuation coefficient, which is an important parameter used to convert light absorption measurements to black carbon mass. The mod BC/EC ratio can vary due to light scattering effect on absorption measurements, in which the oxygenated organics may play a role. The pyrolysis organic carbon (POC) is defined as the carbon mass fraction obtained at T= 870°C under a pure helium environment using the thermal separation method [Huang et al., 2006]. Since POC mass is generally proportional to the amount of oxygenated OC, studying the relationships among OC, EC, POC, as well as OM/OC and mod BC/EC ratios may help us understand the mechanisms of aerosol aging from different emission sources. Two 1-month field studies were conducted at a rural site in southern Ontario (NW of Toronto) during fall 2005 and spring 2007. Quartz filter samples were collected and analyzed for OC, POC, and EC concentrations using a thermal/optical method [Huang et al., 2006]. Together with the total organic matter measured by an Aerodyne Aerosol Mass Spectrometer (AMS) and the absorption coefficient obtained from a Particle Soot Absorption Photometer (PSAP), the OM/OC and mod BC/EC ratios for ambient aerosols were obtained. Our results show that when air mass was mainly from south, OC, POC, and EC were relatively high, with average ratios of OC/EC, OM/OC, and POC/EC as 1.94, 1.41, and 0.52, respectively; this indicates significant anthropogenic impacts and relatively large portion of oxygenated OC, which might be due to either primary emissions or photo-chemical reactions occurred in a short period of time. When air mass was mainly from north, OC, POC, and EC were much lower, with average ratios of OC/EC, OM/OC, and POC/EC as 3.10, 1.20, and 0.79, respectively; this suggests less influence from anthropogenic emissions and relatively aged air mass from biogenic-source dominated clean air. Using POC, we estimate the specific attenuation at the site to be 5.8 m2 g-1 independent of the air mass origin. The relationships among OM/OC, mod BC/EC, and POC will be further discussed. References: Huang, L., Brook, J.R., Zhang, W., Li, S.M., Graham, L., Ernst, D., Chivulescu, A., and Lu, G. (2006) Stable isotope measurements of carbon fractions (OC/EC) in airborne particulate: a new dimension for source characterization and apportionment, Atmospheric Environment, 40, 2690-2705.

Advanced development of TFA-MOD coated conductors

NASA Astrophysics Data System (ADS)

Rupich, M. W.; Li, X.; Sathyamurthy, S.; Thieme, C.; Fleshler, S.

2011-11-01

American Superconductor is manufacturing 2G wire for initial commercial applications. The 2G wire properties satisfy the requirements for these initial projects; however, improvements in the critical current, field performance and cost are required to address the broad range of potential commercial and military applications. In order to meet the anticipated the performance and cost requirements, AMSC's R&D effort is focused on two major areas: (1) higher critical current and (2) enhanced flux pinning. AMSC's current 2G production wire, designed around a 0.8 μm thick YBCO layer deposited by a Metal Organic Deposition (MOD) process, carries a critical current in the range of 200-300 A/cm-w (77 K, sf). Achieving higher critical current requires increasing the thickness of the YBCO layer. This paper describes recent progress at AMSC on increasing the critical current of MOD-YBCO films using processes compatible with low-cost, high-rate manufacturing.

From malignant hypertension to hypertension-MOD: a modern definition for an old but still dangerous emergency.

PubMed

Cremer, A; Amraoui, F; Lip, G Y H; Morales, E; Rubin, S; Segura, J; Van den Born, B J; Gosse, P

2016-08-01

The prevalence of malignant hypertension has clearly fallen with the advent of anti-hypertensive medication but has remained stable over the past 30-40 years in spite of progress in diagnosis and management of hypertension. A diagnosis of malignant hypertension is usually based on the association of severely elevated blood pressure with a Keith and Wagener stage III or IV retinopathy. We believe that this definition can be reconsidered for several reasons. Although simple and pragmatic, this definition corresponds to a time when there were few techniques for assessment of hypertensive target organ involvement, and does not take into account involvement of kidney, brain and heart; whereas the overall prognosis largely depends on how much they are affected. On the contrary, the acute blood pressure level and especially diastolic should not be a hard diagnostic criterion as it does not itself constitute the prognosis of the condition. We propose to consider that malignant hypertension with retinopathy is only one of a number of possible presentation(s) of acute hypertension with multi organ damage (hypertension multi organ damage (MOD)) and that the recognition of these hypertensive emergencies, when retinopathy is lacking, be based on acute elevation of BP associated with impairment of at least three different target organs. The objective of a new and expanded definition is to facilitate recognition of these true emergencies. The condition is more common than usually perceived and would have a much worse prognosis than the usual forms of hypertension. Early recognition and management of hypertension-MOD are fundamental to any improvement in prognosis.

[Diagnostic value of integral scoring systems in assessing the severity of acute pancreatitis and patient's condition].

PubMed

Vinnik, Y S; Dunaevskaya, S S; Antufrieva, D A

2015-01-01

The aim of the study was to evaluate the diagnostic value of specific and nonspecific scoring systems Tolstoy-Krasnogorov score, Ranson, BISAP, Glasgow, MODS 2, APACHE II and CTSI, which used at urgent pancreatology for estimation the severity of acute pancreatitis and status of patient. 1550 case reports of patients which had inpatient surgical treatment at Road clinical hospital at the station Krasnoyarsk from 2009 till 2013 were analyzed. Diagnosis of severe acute pancreatitis and its complications were determined based on anamnestic data, physical exami- nation, clinical indexes, ultrasonic examination and computed tomography angiography. Specific and nonspecific scores (scoring system of estimation by Tolstoy-Krasnogorov, Ranson, Glasgow, BISAP, MODS 2, APACHE II, CTSI) were used for estimation the severity of acute pancreatitis and patient's general condition. Effectiveness of these scoring systems was determined based on some parameters: accuracy (Ac), sensitivity (Se), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV). Most valuables score for estimation of acute pancreatitis's severity is BISAP (Se--98.10%), for estimation of organ failure--MODS 2 (Sp--100%, PPV--100%) and APACHE II (Sp--100%, PPV--100%), for detection of pancreatonecrosis sings--CTSI (Sp--100%, NPV--100%), for estimation of need for intensive care--MODS 2 (Sp--100%, PPV--100%, NPV--96.29%) and APACHE II (Sp--100%, PPV--100%, NPV--97.21%), for prediction of lethality--MODS 2 (Se-- 100%, Sp--98.14%, NPV--100%) and APACHE II (Se--95.00%, NPV-.99.86%). Most effective scores for estimation of acute pancreatitis's severity are Score of estimation by Tolstoy-Krasnogorov, Ranson, Glasgow and BISAP Scoring systems MODS 2, APACHE I high specificity and positive predictive value allow using it at clinical practice.

A biphasic epigenetic switch controls immunoevasion, virulence and niche adaptation in non-typeable Haemophilus influenzae.

PubMed

Atack, John M; Srikhanta, Yogitha N; Fox, Kate L; Jurcisek, Joseph A; Brockman, Kenneth L; Clark, Tyson A; Boitano, Matthew; Power, Peter M; Jen, Freda E-C; McEwan, Alastair G; Grimmond, Sean M; Smith, Arnold L; Barenkamp, Stephen J; Korlach, Jonas; Bakaletz, Lauren O; Jennings, Michael P

2015-07-28

Non-typeable Haemophilus influenzae contains an N(6)-adenine DNA-methyltransferase (ModA) that is subject to phase-variable expression (random ON/OFF switching). Five modA alleles, modA2, modA4, modA5, modA9 and modA10, account for over two-thirds of clinical otitis media isolates surveyed. Here, we use single molecule, real-time (SMRT) methylome analysis to identify the DNA-recognition motifs for all five of these modA alleles. Phase variation of these alleles regulates multiple proteins including vaccine candidates, and key virulence phenotypes such as antibiotic resistance (modA2, modA5, modA10), biofilm formation (modA2) and immunoevasion (modA4). Analyses of a modA2 strain in the chinchilla model of otitis media show a clear selection for ON switching of modA2 in the middle ear. Our results indicate that a biphasic epigenetic switch can control bacterial virulence, immunoevasion and niche adaptation in an animal model system.

Speciation and Toxic Emissions from On road Vehicles, and Particulate Matter Emissions from Light-Duty Gasoline Vehicles in MOVES201X

EPA Science Inventory

Updated methane, non-methane organic gas, and volatile organic compound calculations based on speciation data. Updated speciation and toxic emission rates for new model year 2010 and later heavy-duty diesel engines. Updated particulate matter emission rates for 2004 and later mod...

Role of Su(Hw) zinc finger 10 and interaction with CP190 and Mod(mdg4) proteins in recruiting the Su(Hw) complex to chromatin sites in Drosophila.

PubMed

Melnikova, Larisa; Kostyuchenko, Margarita; Parshikov, Alexander; Georgiev, Pavel; Golovnin, Anton

2018-01-01

Su(Hw) belongs to the class of proteins that organize chromosome architecture and boundaries/insulators between regulatory domains. This protein contains a cluster of 12 zinc finger domains most of which are responsible for binding to three different modules in the consensus site. Su(Hw) forms a complex with CP190 and Mod(mdg4)-67.2 proteins that binds to well-known Drosophila insulators. To understand how Su(Hw) performs its activities and binds to specific sites in chromatin, we have examined the previously described su(Hw)f mutation that disrupts the 10th zinc finger (ZF10) responsible for Su(Hw) binding to the upstream module. The results have shown that Su(Hw)f loses the ability to interact with CP190 in the absence of DNA. In contrast, complete deletion of ZF10 does not prevent the interaction between Su(Hw)Δ10 and CP190. Having studied insulator complex formation in different mutant backgrounds, we conclude that both association with CP190 and Mod(mdg4)-67.2 partners and proper organization of DNA binding site are essential for the efficient recruitment of the Su(Hw) complex to chromatin insulators.

Abrupt reflow enhances cytokine-induced proinflammatory activation of endothelial cells during simulated shock and resuscitation.

PubMed

Li, Ranran; Zijlstra, Jan G; Kamps, Jan A A M; van Meurs, Matijs; Molema, Grietje

2014-10-01

Circulatory shock and resuscitation are associated with systemic hemodynamic changes, which may contribute to the development of MODS (multiple organ dysfunction syndrome). In this study, we used an in vitro flow system to simulate the consecutive changes in blood flow as occurring during hemorrhagic shock and resuscitation in vivo. We examined the kinetic responses of different endothelial genes in human umbilical vein endothelial cells preconditioned to 20 dyne/cm unidirectional laminar shear stress for 48 h to flow cessation and abrupt reflow, respectively, as well as the effect of flow cessation and reflow on tumor necrosis factor-α (TNF-α)-induced endothelial proinflammatory activation. Endothelial CD31 and VE-cadherin were not affected by the changes in flow in the absence or presence of TNF-α. The messenger RNA levels of proinflammatory molecules E-selectin, VCAM-1 (vascular cell adhesion molecule 1), and IL-8 (interleukin 8) were significantly induced by flow cessation respectively acute reflow, whereas ICAM-1 (intercellular adhesion molecule 1) was downregulated on flow cessation and induced by subsequent acute reflow. Flow cessation also affected the Ang/Tie2 (Angiopoietin/Tie2 receptor tyrosine kinase) system by downregulating Tie2 and inducing its endothelial ligand Ang2, an effect that was further extended on acute reflow. Furthermore, the induction of proinflammatory adhesion molecules by TNF-α under flow cessation was significantly enhanced on subsequent acute reflow. This study demonstrated that flow alterations per se during shock and resuscitation contribute to endothelial activation and that these alterations interact with proinflammatory factors coexisting in vivo such as TNF-α. The abrupt reflow-related enhancement of cytokine-induced endothelial proinflammatory activation supports the concept that sudden regain of flow during resuscitation has an aggravating effect on endothelial activation, which may play a significant role in vascular dysfunction and consequent organ injury. This study implies that the improvement of resuscitation strategies and the pharmacological interference with proinflammatory signaling cascades at the right time of resuscitation of shock patients may be beneficial to regain and/or maintain organ function in patients after circulatory shock.

Clinical Epidemiology of SIRS and Sepsis in Newly Admitted Children.

PubMed

Ganjoo, Sheetal; Ahmad, Kaisar; Qureshi, Umar Amin; Mir, Zahed Hussain

2015-08-01

To assess the clinical and demographic profile of Systemic Inflammatory Response Syndrome (SIRS) and sepsis, among newly admitted children in different age groups in a hospital in North India. This prospective study was conducted at a referral care centre in Northern India. All children, age group 0 to <18 y, admitted on days selected for study were screened and those with abnormal temperature and abnormal leukocyte count were included for further assessment. A total of twenty "24 h" periods were randomly chosen during the study period. Patients were assessed according to age specific vital signs and laboratory values to diagnose Systemic Inflammatory Response Syndrome (SIRS) and sepsis and to gain clinical and demographic data. The criteria laid at International consensus conference, 2002, were used to define patients as SIRS, Sepsis, Severe sepsis and Septic shock. During the study period, a total of 865 patients were screened for SIRS. Prevalence of SIRS amongst hospitalised children was 23 % (n = 201). Seventy nine percent (n = 159) of patients had infection associated SIRS and 21 % (42) had non-infective SIRS. Sixty four percent (n = 129) SIRS patients had uncomplicated sepsis, 15 % (n = 30) patients fulfilled criteria for severe sepsis. Out of the latter 30, 19 had septic shock. Organ dysfunction in SIRS was noted in 25 % (n = 51). 37.25 % (n = 19) had multiple organ dysfunction syndrome (MODS). The most common organism isolated was Staphylococcus aureus (n = 9). Focus of infection in majority was pulmonary (44 %). Mean duration of antibiotic therapy and hospital stay in the SIRS group were 6.4 and 6.5 d respectively. In the group without SIRS, mean duration were 2.44 d and 3.07 d respectively The differences were statistically significant. In conclusion, the proportion of sepsis contributing to SIRS is high in a tertiary care hospital. Therefore rapid recognition of SIRS is essential. Goal directed treatment of sepsis is also important so that high mortality associated with severe sepsis and septic shock are prevented.

[Multiple organ failure after spontaneous return of circulation in cardiac arrest in children].

PubMed

Carbayo, Tania; de la Mata, Alba; Sánchez, Marina; López-Herce, Jesús; Del Castillo, Jimena; Carrillo, Angel

2017-07-01

To assess the frequency of the multiple organ failure and the prognostic value of multiple organ failure scores in children who have recovered from an in-hospital cardiac arrest. A single centre, observational, and retrospective study was conducted on children between 1 month and 16 years old who suffered an in-hospital cardiac arrest and achieved return of spontaneous circulation (ROSC). In the first 24-48hours and between the fifth and the seventh day after ROSC, a record was made of the scores on paediatric severity (PRISM and PIM II) and multiple organ failure scales (PELOD and P-MODS), along with the clinical and analytical data, and including monitoring and treatment, mortality and cause of death. Of the total of 41 children studied, 70.7% male were male, and the median age was 38 months. The overall mortality during admission was 41.5%, with 14.6% dying in the first 48hours, and 7.6% in the following 3 to 5 days. In the first 48hours, clinical severity and multiple organ failure scores were higher in the patients that died than in survivors (PRISM 29 vs. 21) P=.125, PIM II (26.8% vs. 9.2%) P=.02, PELOD (21 vs. 12) P=.005, and P-MODS (9 vs. 6) P=.001. Between the fifth and seventh day, the scores on the four scales were also higher in patients who died, but only those of the PELOD (20.5 vs. 11) p=.002 and P-MODS (6.5 vs. 3) P=.003 reached statistical significance. Mortality in children after return of spontaneous circulation after cardiac arrest is high. The multiple organ failure after return of spontaneous circulation after cardiac arrest in children is associated with increased mortality. Copyright © 2016 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

Number of organ dysfunctions predicts mortality in emergency department patients with suspected infection: a multicenter validation study.

PubMed

Jessen, Marie K; Skibsted, Simon; Shapiro, Nathan I

2017-06-01

The aim of this study was to validate the association between number of organ dysfunctions and mortality in emergency department (ED) patients with suspected infection. This study was conducted at two medical care center EDs. The internal validation set was a prospective cohort study conducted in Boston, USA. The external validation set was a retrospective case-control study conducted in Aarhus, Denmark. The study included adult patients (>18 years) with clinically suspected infection. Laboratory results and clinical data were used to assess organ dysfunctions. Inhospital mortality was the outcome measure. Multivariate logistic regression was used to determine the independent mortality odds for number and types of organ dysfunctions. We enrolled 4952 (internal) and 483 (external) patients. The mortality rate significantly increased with increasing number of organ dysfunctions: internal validation: 0 organ dysfunctions: 0.5% mortality, 1: 3.6%, 2: 9.5%, 3: 17%, and 4 or more: 37%; external validation: 2.2, 6.7, 17, 41, and 57% mortality (both P<0.001 for trend). Age-adjusted and comorbidity-adjusted number of organ dysfunctions remained an independent predictor. The effect of specific types of organ dysfunction on mortality was most pronounced for hematologic [odds ratio (OR) 3.3 (95% confidence interval (CI) 2.0-5.4)], metabolic [OR 3.3 (95% CI 2.4-4.6); internal validation], and cardiovascular dysfunctions [OR 14 (95% CI 3.7-50); external validation]. The number of organ dysfunctions predicts sepsis mortality.

Extracorporeal blood purification therapy for sepsis and systemic inflammation: its biological rationale.

PubMed

Bellomo, R; Baldwin, I; Ronco, C

2001-01-01

EBPTs represent a promising new approach to the adjuvant treatment of severe sepsis, septic shock and MODS. Their technology is rapidly evolving and pilot animal and human studies are now taking place to prepare the territory for the first large randomized controlled trial. The rationale for EBPT is reasonable and the initial data are encouraging. The correct technology and molecular targeting, however, are still being explored. Once the best technology has been determined, it is likely that phase II and phase III trials will be performed to test the hypothesis that these therapies can indeed alter mortality in severe inflammatory multiorgan dysfunction.

Lactate Clearance and Normalization and Prolonged Organ Dysfunction in Pediatric Sepsis.

PubMed

Scott, Halden F; Brou, Lina; Deakyne, Sara J; Fairclough, Diane L; Kempe, Allison; Bajaj, Lalit

2016-03-01

To evaluate whether lactate clearance and normalization during emergency care of pediatric sepsis is associated with lower rates of persistent organ dysfunction. This was a prospective cohort study of 77 children <18 years of age in the emergency department with infection and acute organ dysfunction per consensus definitions. In consented patients, lactate was measured 2 and/or 4 hours after an initial lactate; persistent organ dysfunction was assessed through laboratory and physician evaluation at 48 hours. A decrease of ≥ 10% from initial to final level was considered lactate clearance; a final level < 2 mmol/L was considered lactate normalization. Relative risk (RR) with 95% CIs, adjusted in a log-binomial model, was used to evaluate associations between lactate clearance/normalization and organ dysfunction. Lactate normalized in 62 (81%) patients and cleared in 70 (91%). The primary outcome, persistent 48-hour organ dysfunction, was present in 32 (42%). Lactate normalization was associated with decreased risk of persistent organ dysfunction (RR 0.46, 0.29-0.73; adjusted RR 0.47, 0.29-0.78); lactate clearance was not (RR 0.70, 0.35-1.41; adjusted RR 0.75, 0.38-1.50). The association between lactate normalization and decreased risk of persistent organ dysfunction was retained in the subgroups with initial lactate ≥ 2 mmol/L and hypotension. In children with sepsis and organ dysfunction, lactate normalization within 4 hours was associated with decreased persistent organ dysfunction. Serial lactate level measurement may provide a useful prognostic tool during the first hours of resuscitation in pediatric sepsis. Copyright © 2016 Elsevier Inc. All rights reserved.

Specific Etiologies Associated With the Multiple Organ Dysfunction Syndrome in Children: Part 2.

PubMed

Upperman, Jeffrey S; Bucuvalas, John C; Williams, Felicia N; Cairns, Bruce A; Cox, Charles S; Doctor, Allan; Tamburro, Robert F

2017-03-01

To describe a number of conditions and therapies associated with multiple organ dysfunction syndrome presented as part of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Multiple Organ Dysfunction Workshop (March 26-27, 2015). In addition, the relationship between burn injuries and multiple organ dysfunction syndrome is also included although it was not discussed at the workshop. Literature review, research data, and expert opinion. Not applicable. Moderated by an expert from the field, issues relevant to the association of multiple organ dysfunction syndrome with a variety of conditions and therapies were presented, discussed, and debated with a focus on identifying knowledge gaps and the research priorities. Summary of presentations and discussion supported and supplemented by relevant literature. Sepsis and trauma are the two conditions most commonly associated with multiple organ dysfunction syndrome both in children and adults. However, many other pathophysiologic processes may result in multiple organ dysfunction syndrome. In this article, we discuss conditions such as liver failure and pancreatitis, pathophysiologic processes such as ischemia and hypoxia, and injuries such as trauma and burns. Additionally, therapeutic interventions such as medications, blood transfusions, transplantation may also precipitate and contribute to multiple organ dysfunction syndrome. The purpose of this article is to describe the association of multiple organ dysfunction syndrome with a variety of conditions and therapies in an attempt to identify similarities, differences, and opportunities for therapeutic intervention.

The genome sequence of Geobacter metallireducens: features of metabolism, physiology and regulation common and dissimilar to Geobacter sulfurreducens

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

Aklujkar, Muktak; Krushkal, Julia; DiBartolo, Genevieve

Background. The genome sequence of Geobacter metallireducens is the second to be completed from the metal-respiring genus Geobacter, and is compared in this report to that of Geobacter sulfurreducens in order to understand their metabolic, physiological and regulatory similarities and differences. Results. The experimentally observed greater metabolic versatility of G. metallireducens versus G. sulfurreducens is borne out by the presence of more numerous genes for metabolism of organic acids including acetate, propionate, and pyruvate. Although G. metallireducens lacks a dicarboxylic acid transporter, it has acquired a second succinate dehydrogenase/fumarate reductase complex, suggesting that respiration of fumarate was important until recentlymore » in its evolutionary history. Vestiges of the molybdate (ModE) regulon of G. sulfurreducens can be detected in G. metallireducens, which has lost the global regulatory protein ModE but retained some putative ModE-binding sites and multiplied certain genes of molybdenum cofactor biosynthesis. Several enzymes of amino acid metabolism are of different origin in the two species, but significant patterns of gene organization are conserved. Whereas most Geobacteraceae are predicted to obtain biosynthetic reducing equivalents from electron transfer pathways via a ferredoxin oxidoreductase, G. metallireducens can derive them from the oxidative pentose phosphate pathway. In addition to the evidence of greater metabolic versatility, the G. metallireducens genome is also remarkable for the abundance of multicopy nucleotide sequences found in intergenic regions and even within genes. Conclusion. The genomic evidence suggests that metabolism, physiology Background. The genome sequence of Geobacter metallireducens is the second to be completed from the metal-respiring genus Geobacter, and is compared in this report to that of Geobacter sulfurreducens in order to understand their metabolic, physiological and regulatory similarities and differences. Results. The experimentally observed greater metabolic versatility of G. metallireducens versus G. sulfurreducens is borne out by the presence of more numerous genes for metabolism of organic acids including acetate, propionate, and pyruvate. Although G. metallireducens lacks a dicarboxylic acid transporter, it has acquired a second succinate dehydrogenase/fumarate reductase complex, suggesting that respiration of fumarate was important until recently in its evolutionary history. Vestiges of the molybdate (ModE) regulon of G. sulfurreducens can be detected in G. metallireducens, which has lost the global regulatory protein ModE but retained some putative ModE-binding sites and multiplied certain genes of molybdenum cofactor biosynthesis. Several enzymes of amino acid metabolism are of different origin in the two species, but significant patterns of gene organization are conserved. Whereas most Geobacteraceae are predicted to obtain biosynthetic reducing equivalents from electron transfer pathways via a ferredoxin oxidoreductase, G. metallireducens can derive them from the oxidative pentose phosphate pathway. In addition to the evidence of greater metabolic versatility, the G. metallireducens genome is also remarkable for the abundance of multicopy nucleotide sequences found in intergenic regions and even within genes. Conclusion. The genomic evidence suggests that metabolism, physiology and regulation of gene expression in G. metallireducens may be dramatically different from other Geobacteraceae.« less

Control of substrate oxidation in MOD cerawwwmic coating on low-activation ferritic steel with reduced-pressure atmosphere

NASA Astrophysics Data System (ADS)

Tanaka, Teruya; Muroga, Takeo

2014-12-01

An Er2O3 ceramic coating fabricated using the metal-organic decomposition (MOD) method on a Cr2O3-covered low-activation ferritic steel JLF-1 substrate was examined to improve hydrogen permeation barrier performance of the coating. The Cr2O3 layer was obtained before coating by heat treating the substrate at 700 °C under reduced pressures of <5 × 10-3 Pa and 5 Pa. The Cr2O3 layer was significantly stable even with heat treatment at 700 °C in air. This layer prevented further production of Fe2O3, which has been considered to degrade coating performance. An MOD Er2O3 coating with a smooth surface was successfully obtained on a Cr2O3-covered JLF-1 substrate by dip coating followed by drying and baking. Preprocessing to obtain a Cr2O3 layer would provide flexibility in the coating process for blanket components and ducts. Moreover, the Cr2O3 layer suppressed hydrogen permeation through the JLF-1 substrate. While further optimization of the coating fabrication process is required, it would be possible to suppress hydrogen permeation significantly by multilayers of Cr2O3 and MOD oxide ceramic.

76 FR 22112 - National Human Genome Research Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-20

... Emphasis Panel, Special Emphasis Panel (SEP)--Model Organism database (MOD). Date: June 20, 2011. Time: 8 a.m. to 5 p.m. Agenda: To review and evaluate grant applications. Place: Crystal Gateway Marriott...

Acid anhydrides: a simple route to highly pure organometallic solutions for superconducting films

NASA Astrophysics Data System (ADS)

Roma, N.; Morlens, S.; Ricart, S.; Zalamova, K.; Moreto, J. M.; Pomar, A.; Puig, T.; Obradors, X.

2006-06-01

The presence of impurities in the precursor metal carboxylate solutions for the preparation of epitaxial thin films by metal organic decomposition (MOD) is substantially avoided by the use of acid anhydrides. In particular, trifluoroacetic anhydride (TFAA) was used for the synthesis of the starting Y, Ba and Cu trifluoroacetates used in YBa2Cu3O7-x (YBCO) preparation by the MOD process. In this way, highly stable organometallic precursors and a short pyrolysis process could be used leading to YBCO films with high critical currents (Jc >=2-4 MA cm-2 at 77 K). Furthermore, the reproducibility of the results has been ascertained.

Strong Flux Pinning of Nano-Sized Ysz Particles in Ybco Films Prepared by Mod Method

NASA Astrophysics Data System (ADS)

Ye, S.; Suo, H. L.; Liu, M.; Tang, X.; Wu, Z. P.; Zhao, Y.; Zhou, M. L.

The YBCO films with doped YSZ nanoparticles have been prepared successfully by metal organic doepositon method using trifluoroacetates (TFA-MOD) through dissolving Zr organic salt into the YBCO precursor solution. The doped films have well in-plane and out-plane textures detected by both XRD Φ-scan and ω-scan. The YSZ nanoparticles with the size of about 5 ~ 15 nm were observed on the surface of the YBCO films using both FE-SEM and TEM. By comparing the superconducting properties, it was found that the doped YBCO films had lower Tc than that of undoped YBCO films. However, as increasing the applied magnetic field, Jc of the doped YBCO films were much better than that of undoped one. The Jc was as higher as 2.5 times than that of undoped YBCO film at 77 K and 1 T applied field.

Relation of antioxidant status at admission and disease severity and outcome in dogs naturally infected with Babesia canis canis.

PubMed

Crnogaj, Martina; Cerón, José Joaquin; Šmit, Iva; Kiš, Ivana; Gotić, Jelena; Brkljačić, Mirna; Matijatko, Vesna; Rubio, Camila Peres; Kučer, Nada; Mrljak, Vladimir

2017-04-24

Canine babesiosis is caused by species of the Babesia genus and has become an emerging disease worldwide. To the authors' knowledge there are no reports in which antioxidants have been analyzed in different presentations of canine babesiosis or in which the prognostic value of antioxidants has been studied. The aim of this study was to evaluate whether oxidative stress could be related to the severity and outcome of canine babesiosis. For this purpose a profile consisting of four antioxidant biomarkers (superoxide dismutase - SOD, glutathione peroxidase - GPx, catalase, total antioxidant status - TAS) and malondialdehyde - MDA as an oxidant biomarker (previously evaluated, here studied for comparative purposes) were evaluated in dogs with canine babesiosis of different clinical severity and outcomes. The study was conducted with a sample of 40 dogs suffering from babesiosis (further divided into uncomplicated, one complication and multiple organ dysfunction syndrome - MODS group) and 30 healthy dogs (control group). Additionally, the babesiosis group was divided according to the anaemia into non-anaemic, mildly anaemic, moderately anaemic and severely anaemic dogs. The results of our study showed significantly decreased SOD, catalase and TAS values in diseased dogs compared to controls, while there were no significant differences in GPx between these groups. Dogs that developed MODS showed lower activities of SOD and GPx and higher MDA values compared to dogs with uncomplicated babesiosis as well as with dogs that developed one complication. Superoxide dismutase, catalase and GPx were negatively correlated whereas MDA was positively correlated with the lethal outcome of the disease. Furthermore, this study detected more pronounced decrease in antioxidant biomarkers (SOD, GPx and catalase) in dogs with moderate anaemia compared to those with mild anaemia. The results of this study showed changes in biomarkers related to the antioxidant status of dogs naturally infected with B. canis canis. These biomarkers could be used as indicators of disease severity and outcome in dogs suffering from babesiosis.

Platelets Induce Apoptosis during Sepsis in a Contact-Dependent Manner That Is Inhibited by GPIIb/IIIa Blockade

PubMed Central

Sharron, Matthew; Hoptay, Claire E.; Wiles, Andrew A.; Garvin, Lindsay M.; Geha, Mayya; Benton, Angela S.; Nagaraju, Kanneboyina; Freishtat, Robert J.

2012-01-01

Purpose End-organ apoptosis is well-described in progressive sepsis and Multiple Organ Dysfunction Syndrome (MODS), especially where platelets accumulate (e.g. spleen and lung). We previously reported an acute sepsis-induced cytotoxic platelet phenotype expressing serine protease granzyme B. We now aim to define the site(s) of and mechanism(s) by which platelet granzyme B induces end-organ apoptosis in sepsis. Methods End-organ apoptosis in murine sepsis (i.e. polymicrobial peritonitis) was analyzed by immunohistochemistry. Platelet cytotoxicity was measured by flow cytometry following 90 minute ex vivo co-incubation with healthy murine splenocytes. Sepsis progression was measured via validated preclinical murine sepsis score. Measurements and Main Results There was evident apoptosis in spleen, lung, and kidney sections from septic wild type mice. In contrast, there was a lack of TUNEL staining in spleens and lungs from septic granzyme B null mice and these mice survived longer following induction of sepsis than wild type mice. In co-incubation experiments, physical separation of septic platelets from splenocytes by a semi-permeable membrane reduced splenocyte apoptosis to a rate indistinguishable from negative controls. Chemical separation by the platelet GPIIb/IIIa receptor inhibitor eptifibatide decreased apoptosis by 66.6±10.6% (p = 0.008). Mice treated with eptifibatide in vivo survived longer following induction of sepsis than vehicle control mice. Conclusions In sepsis, platelet granzyme B-mediated apoptosis occurs in spleen and lung, and absence of granzyme B slows sepsis progression. This process proceeds in a contact-dependent manner that is inhibited ex vivo and in vivo by the platelet GPIIb/IIIa receptor inhibitor eptifibatide. The GPIIb/IIIa inhibitors and other classes of anti-platelet drugs may be protective in sepsis. PMID:22844498

Superior mesenteric vein thrombosis - unusual management of unusual complication of Whipple procedure.

PubMed

Huťan, Martin; Bartko, Christian; Slyško, Roman; Sekáč, Jaroslav; Prochotský, Augustín; Majeský, Ivan; Skultéty, Ján

2014-01-01

Pancreatoduodenectomy is an extensive procedure carrying risk of a number of postoperative complications. Of these the most common are surgical site infections (SSI), bleeding, delayed gastric emptying, and anastomotic leakage. However, the most serious complications are ones, that are rare, clinically hardly diagnosed, and if untreated, leading to the death of a patient. Among the latter complications is thrombosis of superior mesenteric vein. Its clinical signs are unspecific and diagnostics complicated. Treatment requires aggressive approach. If this is absent, intestinal necrosis with septic state, Multiple Organ Dysfunction Syndrome (MODS) and Multiple Organ Failure (MOF) lead to a death of a patient. Authors present a case of a patient after pancreatoduodenectomy, complicated by the thrombosis of superior mesenteric vein. Patient was managed by resection of the necrotic bowel, venous decompression by venous bypass from superior mesenteric vein to the right ovarian vein, and open abdomen with negative pressure wound therapy (NPWT). Patient suffered severe abdominal sepsis with need for intensive organ support. Abdomen was definitely closed on fourth NPWT redress. Patient healed without any further complications, is well and was released to the ambulatory setting. Superior mesenteric vein (VMS) thrombosis is a rare complication. It diagnosis requires high level of vigilance and once diagnosed, aggressive therapy is essential. Two goals of surgical treatment exist: resection of the necrotic bowel and facilitation of the blood outflow. Mesenteroovarian anastomosis is one of the options in treatment of thrombosis of VMS if thrombectomy is not feasible. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Characterization of nanosized TiO2 synthesized inside a porous glass ceramic monolith by metallo-organic decomposition process

NASA Astrophysics Data System (ADS)

Mazali, Italo Odone; Alves, Oswaldo Luiz

2005-01-01

This work reports the preparation of TiO2 by decomposition of a metallo-organic precursor (MOD process) in the pores of an α-NbPO5 glass-ceramic monolith (PGC-NbP) and the study of the TiO2 anatase-rutile transition phase. The impregnation of titanium di-(propoxy)-di-(2-ethylhexanoate) in the PGC-NbP was confirmed by diffuse reflectance infrared spectroscopy. In the restrictive porous environment the decomposition of the metallo-organic compound exhibits a lower initial decomposition temperature but a higher final decomposition temperature, in comparison to the free precursor. The pure TiO2 rutile phase is formed only above 700 °C when the titanium precursor is decomposed outside the pores. The TiO2 anatase obtained inside the PGC-NbP was stabilized up to 750 °C and exhibits a smaller average crystallite size in comparison with the MOD process performed without PGC-NbP. Furthemore, the temperature of the TiO2 anatase-rutile transformation depends on crystallite size, which was provided by XRD and Raman spectroscopy. The precursor impregnation-decomposition cycle revealed a linear mass increment inside PGC-NbP. Micro-Raman spectroscopy shows the presence of a gradient concentration of the TiO2 inside the PGC-NbP. The use of the MOD process in the PGC-NbP pores has several advantages: control of the amount and the nature of the phase formed and preservation of the pore structure of PGC-NbP for subsequent treatments and reactions.

Waste Minimization in Circuit Board Manufacturing by PARMOD(TM) Technology

DTIC Science & Technology

1998-06-24

a foil package in air or in a plastic syringe. Thermogravimetric Analysis (TGA) Ink samples were evaluated using thermogravimetric analysis in...DTA Differential Thermal Analysis FEP Fluorinated Ethylene Propylene (Teflon®) FTIR Fourier Transform Infrared spectroscopy MOD Metallo-Organic...Decomposition ROM Reactive Organic Medium SEM Scanning Electron Microscopy TGA Thermal Gravimetry Analysis Torr Unit of pressure (one mm mercury

EAST Organizes Drosophila Insulator Proteins in the Interchromosomal Nuclear Compartment and Modulates CP190 Binding to Chromatin

PubMed Central

Golovnin, Anton; Melnikova, Larisa; Shapovalov, Igor; Kostyuchenko, Margarita; Georgiev, Pavel

2015-01-01

Recent data suggest that insulators organize chromatin architecture in the nucleus. The best studied Drosophila insulator proteins, dCTCF (a homolog of the vertebrate insulator protein CTCF) and Su(Hw), are DNA-binding zinc finger proteins. Different isoforms of the BTB-containing protein Mod(mdg4) interact with Su(Hw) and dCTCF. The CP190 protein is a cofactor for the dCTCF and Su(Hw) insulators. CP190 is required for the functional activity of insulator proteins and is involved in the aggregation of the insulator proteins into specific structures named nuclear speckles. Here, we have shown that the nuclear distribution of CP190 is dependent on the level of EAST protein, an essential component of the interchromatin compartment. EAST interacts with CP190 and Mod(mdg4)-67.2 proteins in vitro and in vivo. Over-expression of EAST in S2 cells leads to an extrusion of the CP190 from the insulator bodies containing Su(Hw), Mod(mdg4)-67.2, and dCTCF. In consistent with the role of the insulator bodies in assembly of protein complexes, EAST over-expression led to a striking decrease of the CP190 binding with the dCTCF and Su(Hw) dependent insulators and promoters. These results suggest that EAST is involved in the regulation of CP190 nuclear localization. PMID:26489095

GMODWeb: a web framework for the generic model organism database

PubMed Central

O'Connor, Brian D; Day, Allen; Cain, Scott; Arnaiz, Olivier; Sperling, Linda; Stein, Lincoln D

2008-01-01

The Generic Model Organism Database (GMOD) initiative provides species-agnostic data models and software tools for representing curated model organism data. Here we describe GMODWeb, a GMOD project designed to speed the development of model organism database (MOD) websites. Sites created with GMODWeb provide integration with other GMOD tools and allow users to browse and search through a variety of data types. GMODWeb was built using the open source Turnkey web framework and is available from . PMID:18570664

To develop a regional ICU mortality prediction model during the first 24 h of ICU admission utilizing MODS and NEMS with six other independent variables from the Critical Care Information System (CCIS) Ontario, Canada.

PubMed

Kao, Raymond; Priestap, Fran; Donner, Allan

2016-01-01

Intensive care unit (ICU) scoring systems or prediction models evolved to meet the desire of clinical and administrative leaders to assess the quality of care provided by their ICUs. The Critical Care Information System (CCIS) is province-wide data information for all Ontario, Canada level 3 and level 2 ICUs collected for this purpose. With the dataset, we developed a multivariable logistic regression ICU mortality prediction model during the first 24 h of ICU admission utilizing the explanatory variables including the two validated scores, Multiple Organs Dysfunctional Score (MODS) and Nine Equivalents Nursing Manpower Use Score (NEMS) followed by the variables age, sex, readmission to the ICU during the same hospital stay, admission diagnosis, source of admission, and the modified Charlson Co-morbidity Index (CCI) collected through the hospital health records. This study is a single-center retrospective cohort review of 8822 records from the Critical Care Trauma Centre (CCTC) and Medical-Surgical Intensive Care Unit (MSICU) of London Health Sciences Centre (LHSC), Ontario, Canada between 1 Jan 2009 to 30 Nov 2012. Multivariable logistic regression on training dataset (n = 4321) was used to develop the model and validate by bootstrapping method on the testing dataset (n = 4501). Discrimination, calibration, and overall model performance were also assessed. The predictors significantly associated with ICU mortality included: age (p < 0.001), source of admission (p < 0.0001), ICU admitting diagnosis (p < 0.0001), MODS (p < 0.0001), and NEMS (p < 0.0001). The variables sex and modified CCI were not significantly associated with ICU mortality. The training dataset for the developed model has good discriminating ability between patients with high risk and those with low risk of mortality (c-statistic 0.787). The Hosmer and Lemeshow goodness-of-fit test has a strong correlation between the observed and expected ICU mortality (χ (2) = 5.48; p > 0.31). The overall optimism of the estimation between the training and testing data set ΔAUC = 0.003, indicating a stable prediction model. This study demonstrates that CCIS data available after the first 24 h of ICU admission at LHSC can be used to create a robust mortality prediction model with acceptable fit statistic and internal validity for valid benchmarking and monitoring ICU performance.

Prevalence of multiple organ dysfunction in the pediatric intensive care unit: Pediatric Risk of Mortality III versus Pediatric Logistic Organ Dysfunction scores for mortality prediction

PubMed Central

Hamshary, Azza Abd Elkader El; Sherbini, Seham Awad El; Elgebaly, HebatAllah Fadel; Amin, Samah Abdelkrim

2017-01-01

Objectives To assess the frequency of primary multiple organ failure and the role of sepsis as a causative agent in critically ill pediatric patients; and calculate and evaluate the accuracy of the Pediatric Risk of Mortality III (PRISM III) and Pediatric Logistic Organ Dysfunction (PELOD) scores to predict the outcomes of critically ill children. Methods Retrospective study, which evaluated data from patients admitted from January to December 2011 in the pediatric intensive care unit of the Children's Hospital of the University of Cairo. Results Out of 237 patients in the study, 72% had multiple organ dysfunctions, and 45% had sepsis with multiple organ dysfunctions. The mortality rate in patients with multiple organ dysfunction was 73%. Independent risk factors for death were mechanical ventilation and neurological failure [OR: 36 and 3.3, respectively]. The PRISM III score was more accurate than the PELOD score in predicting death, with a Hosmer-Lemeshow X2 (Chi-square value) of 7.3 (df = 8, p = 0.5). The area under the curve was 0.723 for PRISM III and 0.78 for PELOD. Conclusion A multiple organ dysfunctions was associated with high mortality. Sepsis was the major cause. Pneumonia, diarrhea and central nervous system infections were the major causes of sepsis. PRISM III had a better calibration than the PELOD for prognosis of the patients, despite the high frequency of the multiple organ dysfunction syndrome. PMID:28977260

B61 Mod 12 Life Extension Program Tailkit Assembly (B61 Mod 12 LEP TKA)

DTIC Science & Technology

2013-12-01

Selected Acquisition Report (SAR) RCS: DD-A&T(Q&A)823-468 B61 Mod 12 Life Extension Program Tailkit Assembly ( B61 Mod 12 LEP TKA...REPORT TYPE 3. DATES COVERED 00-00-2013 to 00-00-2013 4. TITLE AND SUBTITLE B61 Mod 12 Life Extension Program Tailkit Assembly ( B61 Mod 12 LEP...REPORT unclassified b. ABSTRACT unclassified c. THIS PAGE unclassified Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std Z39-18 B61 Mod 12

Prediction of global and local model quality in CASP8 using the ModFOLD server.

PubMed

McGuffin, Liam J

2009-01-01

The development of effective methods for predicting the quality of three-dimensional (3D) models is fundamentally important for the success of tertiary structure (TS) prediction strategies. Since CASP7, the Quality Assessment (QA) category has existed to gauge the ability of various model quality assessment programs (MQAPs) at predicting the relative quality of individual 3D models. For the CASP8 experiment, automated predictions were submitted in the QA category using two methods from the ModFOLD server-ModFOLD version 1.1 and ModFOLDclust. ModFOLD version 1.1 is a single-model machine learning based method, which was used for automated predictions of global model quality (QMODE1). ModFOLDclust is a simple clustering based method, which was used for automated predictions of both global and local quality (QMODE2). In addition, manual predictions of model quality were made using ModFOLD version 2.0--an experimental method that combines the scores from ModFOLDclust and ModFOLD v1.1. Predictions from the ModFOLDclust method were the most successful of the three in terms of the global model quality, whilst the ModFOLD v1.1 method was comparable in performance to other single-model based methods. In addition, the ModFOLDclust method performed well at predicting the per-residue, or local, model quality scores. Predictions of the per-residue errors in our own 3D models, selected using the ModFOLD v2.0 method, were also the most accurate compared with those from other methods. All of the MQAPs described are publicly accessible via the ModFOLD server at: http://www.reading.ac.uk/bioinf/ModFOLD/. The methods are also freely available to download from: http://www.reading.ac.uk/bioinf/downloads/. Copyright 2009 Wiley-Liss, Inc.

SIRS score on admission and initial concentration of IL-6 as severe acute pancreatitis outcome predictors.

PubMed

Gregoric, Pavle; Pavle, Gregoric; Sijacki, Ana; Ana, Sijacki; Stankovic, Sanja; Sanja, Stankovic; Radenkovic, Dejan; Dejan, Radenkovic; Ivancevic, Nenad; Nenad, Ivancevic; Karamarkovic, Aleksandar; Aleksandar, Karamarkovic; Popovic, Nada; Nada, Popovic; Karadzic, Borivoje; Borivoje, Karadzic; Stijak, Lazar; Stefanovic, Branislav; Branislav, Stefanovic; Milosevic, Zoran; Zoran, Milosević; Bajec, Djordje; Djordje, Bajec

2010-01-01

Early recognition of severe form of acute pancreatitis is important because these patients need more agressive diagnostic and therapeutical approach an can develope systemic complications such as: sepsis, coagulopathy, Acute Lung Injury (ALI), Acute Respiratory Distress Syndrome (ARDS), Multiple Organ Dysfunction Syndrome (MODS), Multiple Organ Failure (MOF). To determine role of the combination of Systemic Inflammatory Response Syndrome (SIRS) score and serum Interleukin-6 (IL-6) level on admission as predictor of illness severity and outcome of Severe Acute Pancreatitis (SAP). We evaluated 234 patients with first onset of SAP appears in last twenty four hours. A total of 77 (33%) patients died. SIRS score and serum IL-6 concentration were measured in first hour after admission. In 105 patients with SIRS score 3 and higher, initial measured IL-6 levels were significantly higher than in the group of remaining 129 patients (72 +/- 67 pg/mL, vs 18 +/- 15 pg/mL). All nonsurvivals were in the first group, with SIRS score 3 and 4 and initial IL-6 concentration 113 +/- 27 pg/mL. The values of C-reactive Protein (CRP) measured after 48h, Acute Physiology and Chronic Health Evaluation (APACHE II) score on admission and Ranson score showed the similar correlation, but serum amylase level did not correlate significantly with Ranson score, IL-6 concentration and APACHE II score. The combination of SIRS score on admission and IL-6 serum concentration can be early, predictor of illness severity and outcome in SAP.

The impact of duration of organ dysfunction on the outcome of patients with severe sepsis and septic shock.

PubMed

Freitas, Flávio G R; Salomão, Reinaldo; Tereran, Nathalia; Mazza, Bruno Franco; Assunção, Murillo; Jackiu, Mirian; Fernandes, Haggeas; Machado, Flávia Ribeiro

2008-08-01

This study aimed to assess the impact of the duration of organ dysfunction on the outcome of patients with severe sepsis or septic shock. Clinical data were collected from hospital charts of patients with severe sepsis and septic shock admitted to a mixed intensive care unit from November 2003 to February 2004. The duration of organ dysfunction prior to diagnosis was correlated with mortality. Results were considered significant if p<0.05. Fifty-six patients were enrolled. Mean age was 55.6+/-20.7 years, mean APACHE II score was 20.6+/-6.9, and mean SOFA score was 7.9+/-3.7. Thirty-six patients (64.3%) had septic shock. The mean duration of organ dysfunction was 1.9+/-1.9 days. Within the univariate analysis, the variables correlated with hospital mortality were: age (p=0.015), APACHE II (p=0.008), onset outside the intensive care unit (p=0.05), blood glucose control (p=0.05) and duration of organ dysfunction (p=0.0004). In the multivariate analysis, only a duration of organ dysfunction persisting longer than 48 hours correlated with mortality (p=0.004, OR: 8.73 (2.37-32.14)), whereas the APACHE II score remained only a slightly significant factor (p=0.049, OR: 1.11 (1.00-1.23)). Patients who received therapeutic interventions within the first 48 hours after the onset of organ dysfunction exhibited lower mortality (32.1% vs. 82.1%, p=0.0001). These findings suggest that the diagnosis of organ dysfunction is not being made in a timely manner. The time elapsed between the onset of organ dysfunction and initiation of therapeutic intervention can be quite long, and this represents an important determinant of survival in cases of severe sepsis and septic shock.

The Development and Uses of EPA's SPECIATE Database

EPA Science Inventory

SPECIATE is the U.S. Environmental Protection Agency's (EPA) repository of volatile organic compounds (VOC) and particulate matter (PM) speciation profiles of air pollution sources. These source profiles can be used to (l) provide input to chemical mass balance (CMB) receptor mod...

The Epidemiology of Hospital Death Following Pediatric Severe Sepsis: When, Why, and How Children With Sepsis Die.

PubMed

Weiss, Scott L; Balamuth, Fran; Hensley, Josey; Fitzgerald, Julie C; Bush, Jenny; Nadkarni, Vinay M; Thomas, Neal J; Hall, Mark; Muszynski, Jennifer

2017-09-01

The epidemiology of in-hospital death after pediatric sepsis has not been well characterized. We investigated the timing, cause, mode, and attribution of death in children with severe sepsis, hypothesizing that refractory shock leading to early death is rare in the current era. Retrospective observational study. Emergency departments and ICUs at two academic children's hospitals. Seventy-nine patients less than 18 years old treated for severe sepsis/septic shock in 2012-2013 who died prior to hospital discharge. None. Time to death from sepsis recognition, cause and mode of death, and attribution of death to sepsis were determined from medical records. Organ dysfunction was assessed via daily Pediatric Logistic Organ Dysfunction-2 scores for 7 days preceding death with an increase greater than or equal to 5 defined as worsening organ dysfunction. The median time to death was 8 days (interquartile range, 1-12 d) with 25%, 35%, and 49% of cumulative deaths within 1, 3, and 7 days of sepsis recognition, respectively. The most common cause of death was refractory shock (34%), then multiple organ dysfunction syndrome after shock recovery (27%), neurologic injury (19%), single-organ respiratory failure (9%), and nonseptic comorbidity (6%). Early deaths (≤ 3 d) were mostly due to refractory shock in young, previously healthy patients while multiple organ dysfunction syndrome predominated after 3 days. Mode of death was withdrawal in 72%, unsuccessful cardiopulmonary resuscitation in 22%, and irreversible loss of neurologic function in 6%. Ninety percent of deaths were attributable to acute or chronic manifestations of sepsis. Only 23% had a rise in Pediatric Logistic Organ Dysfunction-2 that indicated worsening organ dysfunction. Refractory shock remains a common cause of death in pediatric sepsis, especially for early deaths. Later deaths were mostly attributable to multiple organ dysfunction syndrome, neurologic, and respiratory failure after life-sustaining therapies were limited. A pattern of persistent, rather than worsening, organ dysfunction preceded most deaths.

Serotonin and the neuropeptide PDF initiate and extend opposing behavioral states in C. elegans.

PubMed

Flavell, Steven W; Pokala, Navin; Macosko, Evan Z; Albrecht, Dirk R; Larsch, Johannes; Bargmann, Cornelia I

2013-08-29

Foraging animals have distinct exploration and exploitation behaviors that are organized into discrete behavioral states. Here, we characterize a neuromodulatory circuit that generates long-lasting roaming and dwelling states in Caenorhabditis elegans. We find that two opposing neuromodulators, serotonin and the neuropeptide pigment dispersing factor (PDF), each initiate and extend one behavioral state. Serotonin promotes dwelling states through the MOD-1 serotonin-gated chloride channel. The spontaneous activity of serotonergic neurons correlates with dwelling behavior, and optogenetic modulation of the critical MOD-1-expressing targets induces prolonged dwelling states. PDF promotes roaming states through a Gαs-coupled PDF receptor; optogenetic activation of cAMP production in PDF receptor-expressing cells induces prolonged roaming states. The neurons that produce and respond to each neuromodulator form a distributed circuit orthogonal to the classical wiring diagram, with several essential neurons that express each molecule. The slow temporal dynamics of this neuromodulatory circuit supplement fast motor circuits to organize long-lasting behavioral states. Copyright © 2013 Elsevier Inc. All rights reserved.

Serotonin and the Neuropeptide PDF Initiate and Extend Opposing Behavioral States in C. elegans

PubMed Central

Flavell, Steven W.; Pokala, Navin; Macosko, Evan Z.; Albrecht, Dirk R.; Larsch, Johannes; Bargmann, Cornelia I.

2013-01-01

SUMMARY Foraging animals have distinct exploration and exploitation behaviors that are organized into discrete behavioral states. Here we characterize a neuromodulatory circuit that generates long-lasting roaming and dwelling states in Caenorhabditis elegans. We find that two opposing neuromodulators, serotonin and the neuropeptide pigment dispersing factor (PDF), each initiate and extend one behavioral state. Serotonin promotes dwelling states through the MOD-1 serotonin-gated chloride channel. The spontaneous activity of serotonergic neurons correlates with dwelling behavior, and optogenetic modulation of the critical MOD-1-expressing targets induces prolonged dwelling states. PDF promotes roaming states through a Gαs-coupled PDF receptor; optogenetic activation of cAMP production in PDF receptor-expressing cells induces prolonged roaming states. The neurons that produce and respond to each neuromodulator form a distributed circuit orthogonal to the classical wiring diagram, with several essential neurons that express each molecule. The slow temporal dynamics of this neuromodulatory circuit supplement fast motor circuits to organize long-lasting behavioral states. PMID:23972393

A Field Evaluation of the Hardy TB MODS Kit™ for the Rapid Phenotypic Diagnosis of Tuberculosis and Multi-Drug Resistant Tuberculosis

PubMed Central

Martin, Laura; Coronel, Jorge; Faulx, Dunia; Valdez, Melissa; Metzler, Mutsumi; Crudder, Chris; Castillo, Edith; Caviedes, Luz; Grandjean, Louis; Rodriguez, Mitzi; Friedland, Jon S.; Gilman, Robert H.; Moore, David A. J.

2014-01-01

Background Even though the WHO-endorsed, non-commercial MODS assay offers rapid, reliable TB liquid culture and phenotypic drug susceptibility testing (DST) at lower cost than any other diagnostic, uptake has been patchy. In part this reflects misperceptions about in-house assay quality assurance, but user convenience of one-stop procurement is also important. A commercial MODS kit was developed by Hardy Diagnostics (Santa Maria, CA, USA) with PATH (Seattle, WA, USA) to facilitate procurement, simplify procedures through readymade media, and enhance safety with a sealing silicone plate lid. Here we report the results from a large-scale field evaluation of the MODS kit in a government service laboratory. Methods & Findings 2446 sputum samples were cultured in parallel in Lowenstein-Jensen (LJ), conventional MODS and in the MODS kit. MODS kit DST was compared with conventional MODS (direct) DST and proportion method (indirect) DST. 778 samples (31.8%) were Mycobacterium tuberculosis culture-positive. Compared to conventional MODS the sensitivity, specificity, positive, and negative predictive values (95% confidence intervals) of the MODS Kit were 99.3% (98.3–99.8%), 98.3% (97.5–98.8%), 95.8% (94.0–97.1%), and 99.7% (99.3–99.9%). Median (interquartile ranges) time to culture-positivity (and rifampicin and isoniazid DST) was 10 (9–13) days for conventional MODS and 8.5 (7–11) for MODS Kit (p<0.01). Direct rifampicin and isoniazid DST in MODS kit was almost universally concordant with conventional MODS (97.9% agreement, 665/679 evaluable samples) and reference indirect DST (97.9% agreement, 687/702 evaluable samples). Conclusions MODS kit delivers performance indistinguishable from conventional MODS and offers a convenient, affordable alternative with enhanced safety from the sealing silicone lid. The availability in the marketplace of this platform, which conforms to European standards (CE-marked), readily repurposed for second-line DST in the near future, provides a fresh opportunity for improving equity of access to TB diagnosis and first and second-line DST in settings where the need is greatest. PMID:25225802

A field evaluation of the Hardy TB MODS Kit™ for the rapid phenotypic diagnosis of tuberculosis and multi-drug resistant tuberculosis.

PubMed

Martin, Laura; Coronel, Jorge; Faulx, Dunia; Valdez, Melissa; Metzler, Mutsumi; Crudder, Chris; Castillo, Edith; Caviedes, Luz; Grandjean, Louis; Rodriguez, Mitzi; Friedland, Jon S; Gilman, Robert H; Moore, David A J

2014-01-01

Even though the WHO-endorsed, non-commercial MODS assay offers rapid, reliable TB liquid culture and phenotypic drug susceptibility testing (DST) at lower cost than any other diagnostic, uptake has been patchy. In part this reflects misperceptions about in-house assay quality assurance, but user convenience of one-stop procurement is also important. A commercial MODS kit was developed by Hardy Diagnostics (Santa Maria, CA, USA) with PATH (Seattle, WA, USA) to facilitate procurement, simplify procedures through readymade media, and enhance safety with a sealing silicone plate lid. Here we report the results from a large-scale field evaluation of the MODS kit in a government service laboratory. 2446 sputum samples were cultured in parallel in Lowenstein-Jensen (LJ), conventional MODS and in the MODS kit. MODS kit DST was compared with conventional MODS (direct) DST and proportion method (indirect) DST. 778 samples (31.8%) were Mycobacterium tuberculosis culture-positive. Compared to conventional MODS the sensitivity, specificity, positive, and negative predictive values (95% confidence intervals) of the MODS Kit were 99.3% (98.3-99.8%), 98.3% (97.5-98.8%), 95.8% (94.0-97.1%), and 99.7% (99.3-99.9%). Median (interquartile ranges) time to culture-positivity (and rifampicin and isoniazid DST) was 10 (9-13) days for conventional MODS and 8.5 (7-11) for MODS Kit (p<0.01). Direct rifampicin and isoniazid DST in MODS kit was almost universally concordant with conventional MODS (97.9% agreement, 665/679 evaluable samples) and reference indirect DST (97.9% agreement, 687/702 evaluable samples). MODS kit delivers performance indistinguishable from conventional MODS and offers a convenient, affordable alternative with enhanced safety from the sealing silicone lid. The availability in the marketplace of this platform, which conforms to European standards (CE-marked), readily repurposed for second-line DST in the near future, provides a fresh opportunity for improving equity of access to TB diagnosis and first and second-line DST in settings where the need is greatest.

Conceptual design of the 7 megawatt Mod-5B wind turbine generator

NASA Technical Reports Server (NTRS)

Douglas, R. R.

1982-01-01

Similar to MOD-2, the MOD-5B wind turbine generator system is designed for the sole purpose of providing electrical power for distribution by a major utility network. The objectives of the MOD-2 and MOD-5B programs are essentially identical with one important exception; the cost-of-electricity (COE) target is reduced from 4 cent/Kwhr on MOD-2 to 3 cent/Kwhr on MOD-5B, based on mid 1977 dollars and large quantity production. The MOD-5B concept studies and eventual concept selection confirmed that the program COE targets could not only be achieved but substantially bettered. Starting from the established MOD-2 technology as a base, this achievement resulted from a combination of concept changes, size changes, and design refinements. The result of this effort is a wind turbine system that can compete with conventional power generation over significant geographical areas, increasing commercial market potential by an order of magnitude.

Bladder, bowel, and sexual dysfunction in Parkinson's disease.

PubMed

Sakakibara, Ryuji; Kishi, Masahiko; Ogawa, Emina; Tateno, Fuyuki; Uchiyama, Tomoyuki; Yamamoto, Tatsuya; Yamanishi, Tomonori

2011-01-01

Bladder dysfunction (urinary urgency/frequency), bowel dysfunction (constipation), and sexual dysfunction (erectile dysfunction) (also called "pelvic organ" dysfunctions) are common nonmotor disorders in Parkinson's disease (PD). In contrast to motor disorders, pelvic organ autonomic dysfunctions are often nonresponsive to levodopa treatment. The brain pathology causing the bladder dysfunction (appearance of overactivity) involves an altered dopamine-basal ganglia circuit, which normally suppresses the micturition reflex. By contrast, peripheral myenteric pathology causing slowed colonic transit (loss of rectal contractions) and central pathology causing weak strain and paradoxical anal sphincter contraction on defecation (PSD, also called as anismus) are responsible for the bowel dysfunction. In addition, hypothalamic dysfunction is mostly responsible for the sexual dysfunction (decrease in libido and erection) in PD, via altered dopamine-oxytocin pathways, which normally promote libido and erection. The pathophysiology of the pelvic organ dysfunction in PD differs from that in multiple system atrophy; therefore, it might aid in differential diagnosis. Anticholinergic agents are used to treat bladder dysfunction in PD, although these drugs should be used with caution particularly in elderly patients who have cognitive decline. Dietary fibers, laxatives, and "prokinetic" drugs such as serotonergic agonists are used to treat bowel dysfunction in PD. Phosphodiesterase inhibitors are used to treat sexual dysfunction in PD. These treatments might be beneficial in maximizing the patients' quality of life.

Soil Quality under Riparian Forest at Different Stages of Ecological Succession and Cultivated with Sugarcane

NASA Astrophysics Data System (ADS)

Silva, Luiz Gabriel; Casagrande, José Carlos; Colato, Alexandre; Soares, Marcio Roberto; Perissatto Meneghin, Silvana

2014-05-01

This work aimed at evaluating the quality of the soil through its chemical, physical and microbiological attributes, using additive pondered model, as well as studying the characteristics of the linear method of combination of data, figures of merit (FoMs), the process of assigning weights and standard score functions, using measurements collected in three areas (two riparian forests and a commercial crop of sugarcane) in two soil types (Oxisol and Podzol) located on the dam shores of Sugar Mill Saint Lucia-Araras/SP. The soil was sampled in the depths of 0-0.2 and 0.2-0.4m, and was determined some of its chemical attributes (nutrient content and organic matter, cationic exchange capacity - CEC, etc.), physical (particle size distribution, density and porosity) and microbiological (microbial biomass and basal respiration). Two models were built, one containing two hierarchical levels of FoMs (Mod1), and another containing three levels (Mod2), in order to try to isolate FoMs highly correlated from each other within a top-level FoM. At FoMs of Mod1 were assigned various combinations of weights, and those of Mod2 were assigned weights from three methods, distribution from fixed value, classification and pair-wise comparison. In the Mod1, in virtually all combinations of weights used, values of Soil Quality Index (SQI) were superior in older forests, while the most recent forest presented the lowest SQI, for both types of soil. The variation of SQI values obtained from the sets of weights used also differed between the combinations tested, with the set of values of the ancient forest showing smaller amplitude. It could also be observed that the sets of values of Oxisol showed higher SQI and lower amplitude in relation to that of Podzol. It was observed that these facts are due mainly to the soil organic matter content (MO), which differs between the vegetations and soil types, and influences many parameters used in the model. Thus, in the structures where MO had greater weight, the values of SQI have tended to be more discrepant between the combinations with upper and lower level of MO. In the case of Mod2, regardless of the method of allocation of weight used, it has not been possible to find clear distinction among the three physiognomies used, despite having been detected clear difference between the two types of soil, with the higher values to those presenting the Oxisol and Podzol. This situation can lead to consideration of what might be more interesting to use various combinations of random weights that a specific combination chosen empirically.

Pitfalls in gastrointestinal permeability measurement in ICU patients with multiple organ failure using differential sugar absorption.

PubMed

Oudemans-van Straaten, Heleen M; van der Voort, Peter J; Hoek, Frans J; Bosman, Rob J; van der Spoel, Johan I; Zandstra, Durk F

2002-02-01

To assess whether gastrointestinal permeability (GIP) at intensive care unit (ICU) admission, measured by differential sugar absorption, is related to severity of disease and multiple organ failure (MOF). Post hoc, to analyse the relation between the urinary sugar recovery and renal function. Prospective observational cohort study. Eighteen-bed general ICU of a teaching hospital. Sixty-four ventilated patients admitted with MOF. GIP was assessed within 24 h using cellobiose (C), sucrose (S) and mannitol (M) absorption. Severity of disease: APACHE II and III, SAPS II and MPM II systems. Organ failure: SOFA, MODS and Goris score. The median urinary recovery of C was 0.147% (range 0.004-2.145%), of S 0.249% (0.001-3.656%) and of M 10.7% (0.6-270%). In 16 patients, M recovery was over 100% of the oral dose. They received red blood cell transfusion (RBC). In the non-transfused, the median cellobiose/mannitol (CM) ratio was 0.015 (0.0004-0.550). CM ratio was not related to severity of disease and inversely related to the SOFA score ( r=-0.30, p=0.04). Post hoc regression analysis showed that recoveries of C, S and M were positively related to urinary volume. Recoveries of C and S, but not of M, were positively related to creatinine clearance. The CM ratio corrected for diuresis, but was inversely related to creatinine clearance. Differential C, S and M absorption testing is unreliable after RBC transfusion, since bank blood contains mannitol. The excretion of C and S, but not of M, is limited by renal dysfunction. Differential sugar absorption is not reliable to test GIP in MOF patients, since non-permeability related factors act as confounders.

OD (Organization Development) Interventions that Enhance Equal Opportunity.

DTIC Science & Technology

1983-09-01

aide to aaesam mod Identify by week nim obe) Socialization process Socialization model Self-esteem Organization form and structure Equal Opportunity...itself speaks to the way individuals are socialized into the Navy or a perceived lack of socialization . 7 pi ’..7 ’ .. . . 7 Today the Equal ... equal opportunity. Analysis of five different dimensions of the socialization process can be thought of as distinct "tactics" which managers (agents

In Vitro and in Vivo Characterization of MOD-4023, a Long-Acting Carboxy-Terminal Peptide (CTP)-Modified Human Growth Hormone.

PubMed

Hershkovitz, Oren; Bar-Ilan, Ahuva; Guy, Rachel; Felikman, Yana; Moschcovich, Laura; Hwa, Vivian; Rosenfeld, Ron G; Fima, Eyal; Hart, Gili

2016-02-01

MOD-4023 is a novel long-acting version of human growth hormone (hGH), containing the carboxy-terminal peptide (CTP) of human chorionic gonadotropin (hCG). MOD-4023 is being developed as a treatment for adults and children with growth hormone deficiency (GHD), which would require fewer injections than currently available GH formulations and thus reduce patient discomfort and increase compliance. This study characterizes MOD-4023's binding affinities for the growth hormone receptor, as well as the pharmacokinetic and pharmacodynamics, toxicology, and safety profiles of repeated dosing of MOD-4023 in Sprague-Dawley rats and Rhesus monkeys. Although MOD-4023 exhibited reduced in vitro potency and lower affinity to the GH receptor than recombinant hGH (rhGH), administration of MOD-4023 every 5 days in rats and monkeys resulted in exposure comparable to daily rhGH, and the serum half-life of MOD-4023 was significantly longer. Repeated administration of MOD-4023 led to elevated levels of insulin-like growth factor 1 (IGF-1), and twice-weekly injections of MOD-4023 resulted in larger increase in weight gain with fewer injections and a lower accumulative hGH dose. Thus, the increased half-life of MOD-4023 in comparison to hGH may increase the frequency of protein-receptor interactions and compensate for its decreased in vitro potency. MOD-4023 was found to be well-tolerated in rats and monkeys, with minimal adverse events, suggesting an acceptable safety profile. These results provide a basis for the continued clinical development of MOD-4023 as a novel treatment of GHD in children and adults.

The General Electric MOD-1 wind turbine generator program

NASA Technical Reports Server (NTRS)

Poor, R. H.; Hobbs, R. B.

1979-01-01

The design, fabrication, installation and checkout of MOD-1, a megawatt class wind turbine generator which generates utility grade electrical power, is described. A MOD-1/MOD-1A tradeoff study is discussed.

Method for forming hermetic seals

NASA Technical Reports Server (NTRS)

Gallagher, Brian D.

1987-01-01

The firmly adherent film of bondable metal, such as silver, is applied to the surface of glass or other substrate by decomposing a layer of solution of a thermally decomposable metallo-organic deposition (MOD) compound such as silver neodecanoate in xylene. The MOD compound thermally decomposes into metal and gaseous by-products. Sealing is accomplished by depositing a layer of bonding metal, such as solder or a brazing alloy, on the metal film and then forming an assembly with another high melting point metal surface such as a layer of Kovar. When the assembly is heated above the temperature of the solder, the solder flows, wets the adjacent surfaces and forms a hermetic seal between the metal film and metal surface when the assembly cools.

Automotive Stirling engine development program

NASA Technical Reports Server (NTRS)

Farrell, R.; Hindes, C.; Battista, R.; Connelly, M.; Cronin, M.; Howarth, R.; Donahue, A.; Slate, E.; Stotts, R.; Lacy, R.

1988-01-01

The study of high power kinematic Stirling engines for transportation use, testing of Mod I and Mod II Stirling engines, and component development activities are summarized. Mod II development testing was performed to complete the development of the basic engine and begin characterization of performance. Mod I engines were used for Mod II component development and to obtain independent party (U.S. Air Force) evaluation of Stirling engine vehicle performance.

Diagnosis of Pulmonary Tuberculosis in HIV-Positive Patients by Microscopic Observation Drug Susceptibility Assay ▿

PubMed Central

Ha, Dang Thi Minh; Lan, Nguyen Thi Ngoc; Kiet, Vo Sy; Wolbers, Marcel; Hang, Hoang Thi Thanh; Day, Jeremy; Hien, Nguyen Quang; Tien, Nguyen Anh; An, Pham Thuy; Anh, Truong Thi; Oanh, Do Thi Tuong; Hoa, Chau Luong; Chau, Nguyen Thi Minh; Hai, Nguyen Ngoc; Binh, Ngo Thanh; Ngoc, Le Hong; Phuong, Doan Thanh; Quyet, Tran Van; Tuyen, Nguyen Thi Bich; Ha, Vo Thi; Nho, Nguyen Thi; Hoa, Dai Viet; Anh, Phan Thi Hoang; Dung, Nguyen Huy; Farrar, Jeremy; Caws, Maxine

2010-01-01

The microscopic observation drug susceptibility assay (MODS) is a novel and promising test for the early diagnosis of tuberculosis (TB). We evaluated the MODS assay for the early diagnosis of TB in HIV-positive patients presenting to Pham Ngoc Thach Hospital for Tuberculosis and Lung Diseases in southern Vietnam. A total of 738 consecutive sputum samples collected from 307 HIV-positive individuals suspected of TB were tested by smear, MODS, and the mycobacteria growth indicator tube method (MGIT). The diagnostic sensitivity and specificity of MODS compared to the microbiological gold standard (either smear or MGIT) were 87 and 93%, respectively. The sensitivities of smear, MODS, and MGIT were 57, 71, and 75%, respectively, against clinical gold standard (MODS versus smear, P < 0.001; MODS versus MGIT, P = 0.03). The clinical gold standard was defined as patients who had a clinical examination and treatment consistent with TB, with or without microbiological confirmation. For the diagnosis of smear-negative patients, the sensitivities of MODS and MGIT were 38 and 45%, respectively (P = 0.08). The median times to detection using MODS and MGIT were 8 and 11 days, respectively, and they were 11 and 17 days, respectively, for smear-negative samples. The original bacterial/fungal contamination rate of MODS was 1.1%, while it was 2.6% for MGIT. The cross-contamination rate of MODS was 4.7%. In conclusion, MODS is a sensitive, specific, and rapid test that is appropriate for the detection of HIV-associated TB; its cost and ease of use make it particularly useful in resource-limited settings. PMID:20926704

Tungsten Transport Protein A (WtpA) in Pyrococcus furiosus: the First Member of a New Class of Tungstate and Molybdate Transporters

PubMed Central

Bevers, Loes E.; Hagedoorn, Peter-Leon; Krijger, Gerard C.; Hagen, Wilfred R.

2006-01-01

A novel tungstate and molybdate binding protein has been discovered from the hyperthermophilic archaeon Pyrococcus furiosus. This tungstate transport protein A (WtpA) is part of a new ABC transporter system selective for tungstate and molybdate. WtpA has very low sequence similarity with the earlier-characterized transport proteins ModA for molybdate and TupA for tungstate. Its structural gene is present in the genome of numerous archaea and some bacteria. The identification of this new tungstate and molybdate binding protein clarifies the mechanism of tungstate and molybdate transport in organisms that lack the known uptake systems associated with the ModA and TupA proteins, like many archaea. The periplasmic protein of this ABC transporter, WtpA (PF0080), was cloned and expressed in Escherichia coli. Using isothermal titration calorimetry, WtpA was observed to bind tungstate (dissociation constant [KD] of 17 ± 7 pM) and molybdate (KD of 11 ± 5 nM) with a stoichiometry of 1.0 mol oxoanion per mole of protein. These low KD values indicate that WtpA has a higher affinity for tungstate than do ModA and TupA and an affinity for molybdate similar to that of ModA. A displacement titration of molybdate-saturated WtpA with tungstate showed that the tungstate effectively replaced the molybdate in the binding site of the protein. PMID:16952940

Validating the WHO Maternal Near Miss Tool in a high-income country.

PubMed

Witteveen, Tom; de Koning, Ilona; Bezstarosti, Hans; van den Akker, Thomas; van Roosmalen, Jos; Bloemenkamp, Kitty W

2016-01-01

This study was performed to assess the applicability of the WHO Maternal Near Miss Tool (MNM Tool) and the organ dysfunction criteria in a high-income country. The MNM tool was applied to 2552 women who died of pregnancy-related causes or sustained severe acute maternal morbidity between August 2004 and August 2006 in one of the 98 hospitals with a maternity unit in the Netherlands. Fourteen (0.6%) cases had insufficient data for application. Each case was assessed according to the three main "MNM categories" specified in the MNM tool and their subcategory criteria: five disease-, four intervention- and seven organ dysfunction-based criteria. Potentially life-threatening conditions (disease-based inclusions) and life-threatening cases (organ dysfunction-based inclusions) were differentiated according to WHO methodology. Outcomes were incidence of all (sub)categories and case-fatality rates. Of the 2538 cases, 2308 (90.9%) women fulfilled disease-based, 2116 (83.4%) intervention-based and 1024 (40.3%) organ dysfunction-based criteria. Maternal death occurred in 48 women, of whom 23 (47.9%) fulfilled disease-based, 33 (68.8%) intervention-based and 31 (64.6%) organ dysfunction-based criteria. Case-fatality rates were 23/2308 (1.0%) for cases fulfilling the disease-based criteria, 33/2116 (1.6%) for intervention-based criteria and 31/1024 (3.0%) for women fulfilling the organ dysfunction-based criteria. In the Netherlands, where advanced laboratory and clinical monitoring are available, organ dysfunction-based criteria of the MNM tool failed to identify nearly two-thirds of sustained severe acute maternal morbidity cases and more than one-third of maternal deaths. Disease-based criteria remain important, and using only organ dysfunction-based criteria would lead to underestimating severe acute maternal morbidity. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

Transcriptome analysis of Stagonospora nodorum: gene models, effectors, metabolism and pantothenate dispensability

USDA-ARS?s Scientific Manuscript database

The wheat pathogen Stagonospora nodorum, causal organism of the wheat disease Stagonospora nodorum blotch, has emerged as a model for the Dothideomycetes, a large fungal taxon that includes many important plant pathogens. The initial annotation of the genome assembly included 16 586 nuclear gene mod...

Transcriptome analysis of Stagonospora nodorum; gene models, effectors, metabolism and pantothenate dispensability

USDA-ARS?s Scientific Manuscript database

The wheat pathogen Stagonospora nodorum, causal organism of the wheat disease Stagonospora nodorum blotch, has emerged as a model for the Dothideomycetes, a large fungal taxon that includes many important plant pathogens. The initial annotation of the genome assembly included 16 586 nuclear gene mod...

R-modafinil attenuates nicotine-taking and nicotine-seeking behavior in alcohol-preferring rats.

PubMed

Wang, Xiao-Fei; Bi, Guo-Hua; He, Yi; Yang, Hong-Ju; Gao, Jun-Tao; Okunola-Bakare, Oluyomi M; Slack, Rachel D; Gardner, Eliot L; Xi, Zheng-Xiong; Newman, Amy Hauck

2015-06-01

(±)-Modafinil (MOD) is used clinically for the treatment of sleep disorders and has been investigated as a potential medication for the treatment of psychostimulant addiction. However, the therapeutic efficacy of (±)-MOD for addiction is inconclusive. Herein we used animal models of self-administration and in vivo microdialysis to study the pharmacological actions of R-modafinil (R-MOD) and S-modafinil (S-MOD) on nicotine-taking and nicotine-seeking behavior, and mechanisms underlying such actions. We found that R-MOD is more potent and effective than S-MOD in attenuating nicotine self-administration in Long-Evans rats. As Long-Evans rats did not show a robust reinstatement response to nicotine, we used alcohol-preferring rats (P-rats) that display much higher reinstatement responses to nicotine than Long-Evans rats. We found that R-MOD significantly inhibited intravenous nicotine self-administration, nicotine-induced reinstatement, and nicotine-associated cue-induced drug-seeking behavior in P-rats. R-MOD alone neither sustained self-administration in P-rats previously self-administering nicotine nor reinstated extinguished nicotine-seeking behavior. The in vivo brain microdialysis assays demonstrated that R-MOD alone produced a slow-onset moderate increase in extracellular DA. Pretreatment with R-MOD dose-dependently blocked nicotine-induced dopamine (DA) release in the nucleus accumbens (NAc) in both naive and nicotine self-administrating rats, suggesting a DA-dependent mechanism underlying mitigation of nicotine's effects. In conclusion, the present findings support further investigation of R-MOD for treatment of nicotine dependence in humans.

R-Modafinil Attenuates Nicotine-Taking and Nicotine-Seeking Behavior in Alcohol-Preferring Rats

PubMed Central

Wang, Xiao-Fei; Bi, Guo-Hua; He, Yi; Yang, Hong-Ju; Gao, Jun-Tao; Okunola-Bakare, Oluyomi M; Slack, Rachel D; Gardner, Eliot L; Xi, Zheng-Xiong; Newman, Amy Hauck

2015-01-01

(±)-Modafinil (MOD) is used clinically for the treatment of sleep disorders and has been investigated as a potential medication for the treatment of psychostimulant addiction. However, the therapeutic efficacy of (±)-MOD for addiction is inconclusive. Herein we used animal models of self-administration and in vivo microdialysis to study the pharmacological actions of R-modafinil (R-MOD) and S-modafinil (S-MOD) on nicotine-taking and nicotine-seeking behavior, and mechanisms underlying such actions. We found that R-MOD is more potent and effective than S-MOD in attenuating nicotine self-administration in Long–Evans rats. As Long–Evans rats did not show a robust reinstatement response to nicotine, we used alcohol-preferring rats (P-rats) that display much higher reinstatement responses to nicotine than Long–Evans rats. We found that R-MOD significantly inhibited intravenous nicotine self-administration, nicotine-induced reinstatement, and nicotine-associated cue-induced drug-seeking behavior in P-rats. R-MOD alone neither sustained self-administration in P-rats previously self-administering nicotine nor reinstated extinguished nicotine-seeking behavior. The in vivo brain microdialysis assays demonstrated that R-MOD alone produced a slow-onset moderate increase in extracellular DA. Pretreatment with R-MOD dose-dependently blocked nicotine-induced dopamine (DA) release in the nucleus accumbens (NAc) in both naive and nicotine self-administrating rats, suggesting a DA-dependent mechanism underlying mitigation of nicotine's effects. In conclusion, the present findings support further investigation of R-MOD for treatment of nicotine dependence in humans. PMID:25613829

Development of an automated MODS plate reader to detect early growth of Mycobacterium tuberculosis.

PubMed

Comina, G; Mendoza, D; Velazco, A; Coronel, J; Sheen, P; Gilman, R H; Moore, D A J; Zimic, M

2011-06-01

In this work, an automated microscopic observation drug susceptibility (MODS) plate reader has been developed. The reader automatically handles MODS plates and after autofocussing digital images are acquired of the characteristic microscopic cording structures of Mycobacterium tuberculosis, which are the identification method utilized in the MODS technique to detect tuberculosis and multidrug resistant tuberculosis. In conventional MODS, trained technicians manually move the MODS plate on the stage of an inverted microscope while trying to locate and focus upon the characteristic microscopic cording colonies. In centres with high tuberculosis diagnostic demand, sufficient time may not be available to adequately examine all cultures. An automated reader would reduce labour time and the handling of M. tuberculosis cultures by laboratory personnel. Two hundred MODS culture images (100 from tuberculosis positive and 100 from tuberculosis negative sputum samples confirmed by a standard MODS reading using a commercial microscope) were acquired randomly using the automated MODS plate reader. A specialist analysed these digital images with the help of a personal computer and designated them as M. tuberculosis present or absent. The specialist considered four images insufficiently clear to permit a definitive reading. The readings from the 196 valid images resulted in a 100% agreement with the conventional nonautomated standard reading. The automated MODS plate reader combined with open-source MODS pattern recognition software provides a novel platform for high throughput automated tuberculosis diagnosis. © 2011 The Authors Journal of Microscopy © 2011 Royal Microscopical Society.

Atrial function as a guide to timing of intervention in mitral valve prolapse with mitral regurgitation.

PubMed

Ring, Liam; Rana, Bushra S; Wells, Francis C; Kydd, Anna C; Dutka, David P

2014-03-01

The purpose of this study was to determine the clinical utility of left atrial (LA) functional indexes in patients with mitral valve prolapse (MVP) and mitral regurgitation (MR). Timing of surgery for MVP remains challenging. We hypothesized that assessment of LA function may provide diagnostic utility in these patients. We studied 192 consecutive patients in sinus rhythm with MVP, classified into 3 groups: moderate or less MR (MOD group, n = 54); severe MR without surgical indication (SEV group, n = 52); and severe MR with ≥1 surgical indication (SURG group, n = 86). Comparison was made with 50 control patients. Using 2D speckle imaging, average peak contractile, conduit, and reservoir atrial strain was recorded. Using Simpson's method we recorded maximal left atrial volume (LAVmax) and minimal left atrial volume (LAVmin), from which the total left atrial emptying fraction (TLAEF) was derived: (LAVmax-LAVmin)/LAVmax × 100%. TLAEF was similar in the MOD and control groups (61% vs. 57%; p = NS), was reduced in the SEV group (55%; p < 0.001 vs. control group), and markedly lower in the SURG group (40%; p < 0.001 vs. other groups). Reservoir strain demonstrated a similar pattern. Contractile strain was similarly reduced in the MOD and SEV groups (MOD 15%; SEV 14%; p = NS; both p < 0.05 vs. control group 20%) and further reduced in the SURG group (8%; p < 0.001 vs. other groups). By multivariate analysis, TLAEF (odds ratio [OR]: 0.78; p < 0.001), reservoir strain (OR: 0.91; p = 0.028), and contractile strain (OR: 0.86; p = 0.021) were independent predictors of severe MR requiring surgery. Using receiver-operating characteristic analysis, TLAEF <50% demonstrated 91% sensitivity and 92% specificity for predicting MVP with surgical indication (area under the curve: 0.96; p < 0.001). We report the changes in left atrial function in humans with MVP and the relationship of LA dysfunction to clinical indications for mitral valve surgery. We propose that the findings support the utility of quantitative assessment of atrial function by echocardiography as an additional tool to guide the optimum timing of surgery for MVP. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

ISS Operations Cost Reductions Through Automation of Real-Time Planning Tasks

NASA Technical Reports Server (NTRS)

Hall, Timothy A.

2011-01-01

In 2008 the Johnson Space Center s Mission Operations Directorate (MOD) management team challenged their organization to find ways to reduce the costs of International Space station (ISS) console operations in the Mission Control Center (MCC). Each MOD organization was asked to identify projects that would help them attain a goal of a 30% reduction in operating costs by 2012. The MOD Operations and Planning organization responded to this challenge by launching several software automation projects that would allow them to greatly improve ISS console operations and reduce staffing and operating costs. These projects to date have allowed the MOD Operations organization to remove one full time (7 x 24 x 365) ISS console position in 2010; with the plan of eliminating two full time ISS console support positions by 2012. This will account for an overall 10 EP reduction in staffing for the Operations and Planning organization. These automation projects focused on utilizing software to automate many administrative and often repetitive tasks involved with processing ISS planning and daily operations information. This information was exchanged between the ground flight control teams in Houston and around the globe, as well as with the ISS astronaut crew. These tasks ranged from managing mission plan changes from around the globe, to uploading and downloading information to and from the ISS crew, to even more complex tasks that required multiple decision points to process the data, track approvals and deliver it to the correct recipient across network and security boundaries. The software solutions leveraged several different technologies including customized web applications and implementation of industry standard web services architecture between several planning tools; as well as a engaging a previously research level technology (TRL 2-3) developed by Ames Research Center (ARC) that utilized an intelligent agent based system to manage and automate file traffic flow, archiving f data, and generating console logs. This technology called OCAMS (OCA (Orbital Communication System) Management System), is now considered TRL level 9 and is in daily use in the Mission Control Center in support of ISS operations. These solutions have not only allowed for improved efficiency on console; but since many of the previously manual data transfers are now automated, many of the human error prone steps have been removed, and the quality of the planning products has improved tremendously. This has also allowed our Planning Flight Controllers more time to focus on the abstract areas of the job, (like the complexities of planning a mission for 6 international crew members with a global planning team), instead of being burdened with the administrative tasks that took significant time each console shift to process. The resulting automation solutions have allowed the Operations and Planning organization to realize significant cost savings for the ISS program through 2020 and many of these solutions could be a viable

Automotive Stirling Engine Development Program

NASA Technical Reports Server (NTRS)

Nightingale, N.; Ernst, W.; Richey, A.; Simetkosky, M.; Smith, G.; Antonelli, M. (Editor)

1983-01-01

Mod I engine testing and test results, the test of a Mod I engine in the United States, Mod I engine characterization and analysis, Mod I Transient Test Bed fuel economy, Mod I-A engine performance are discussed. Stirling engine reference engine manufacturing and reduced size studies, components and subsystems, and the study and test of low-cost casting alloys are also covered. The overall program philosophy is outlined, and data and results are presented.

Automotive Stirling engine development program

NASA Technical Reports Server (NTRS)

Nightingale, N.; Ernst, W.; Richey, A.; Simetkosky, M.; Smith, G.; Rohdenburg, C.; Vatsky, A.; Antonelli, M. (Editor)

1983-01-01

Activities performed on Mod I engine testing and test results, testing of the Mod I engine in the United States, Mod I engine characterization and analyses, Mod I Transient Test Bed fuel economy, upgraded Mod I performance and testing, Stirling engine reference engine manufacturing and reduced size studied, components and subsystems, and the study and test of low cost casting alloys are summarized. The overall program philosophy is outlined, and data and results are presented.

Validation of the MODIS MOD21 and MOD11 land surface temperature and emissivity products in an arid area of Northwest China

NASA Astrophysics Data System (ADS)

Li, H.; Yang, Y.; Yongming, D.; Cao, B.; Qinhuo, L.

2017-12-01

Land surface temperature (LST) is a key parameter for hydrological, meteorological, climatological and environmental studies. During the past decades, many efforts have been devoted to the establishment of methodology for retrieving the LST from remote sensing data and significant progress has been achieved. Many operational LST products have been generated using different remote sensing data. MODIS LST product (MOD11) is one of the most commonly used LST products, which is produced using a generalized split-window algorithm. Many validation studies have showed that MOD11 LST product agrees well with ground measurements over vegetated and inland water surfaces, however, large negative biases of up to 5 K are present over arid regions. In addition, land surface emissivity of MOD11 are estimated by assigning fixed emissivities according to a land cover classification dataset, which may introduce large errors to the LST product due to misclassification of the land cover. Therefore, a new MODIS LSE&E product (MOD21) is developed based on the temperature emissivity separation (TES) algorithm, and the water vapor scaling (WVS) method has also been incorporated into the MODIS TES algorithm for improving the accuracy of the atmospheric correction. The MOD21 product will be released with MODIS collection 6 Tier-2 land products in 2017. Due to the MOD21 products are not available right now, the MODTES algorithm was implemented including the TES and WVS methods as detailed in the MOD21 Algorithm Theoretical Basis Document. The MOD21 and MOD11 C6 LST products are validated using ground measurements and ASTER LST products collected in an arid area of Northwest China during the Heihe Watershed Allied Telemetry Experimental Research (HiWATER) experiment. In addition, lab emissivity spectra of four sand dunes in the Northwest China are also used to validate the MOD21 and MOD11 emissivity products.

Long-Acting C-Terminal Peptide-Modified hGH (MOD-4023): Results of a Safety and Dose-Finding Study in GHD Children.

PubMed

Zelinska, Nataliya; Iotova, Violeta; Skorodok, Julia; Malievsky, Oleg; Peterkova, Valentina; Samsonova, Lubov; Rosenfeld, Ron G; Zadik, Zvi; Jaron-Mendelson, Michal; Koren, Ronit; Amitzi, Leanne; Raduk, Dmitri; Hershkovitz, Oren; Hart, Gili

2017-05-01

Daily injections are required for growth hormone (GH) replacement therapy, which may cause low compliance as a result of inconvenience and distress in patients. C-terminal peptide-modified human GH (MOD-4023) is developed for once-a-week dosing regimen in GH-deficient (GHD) adults and children. The present trial was a safety and dose-finding study for weekly MOD-4023 in GHD children. A multicenter, open-label, randomized, controlled phase 2 study in children with GHD, evaluating the safety, tolerability, pharmacokinetics/pharmacodynamics, and efficacy of three different weekly MOD-4023 doses, compared with daily recombinant human GH (r-hGH). The trial was conducted in 14 endocrinology centers in Europe. Fifty-three prepubertal children with GHD completed 12 months of treatment with either MOD-4023 (N = 42) or r-hGH (N = 11). C-terminal peptide-modified hGH (MOD-4023) was administered weekly at a dose of either 0.25, 0.48, or 0.66 mg/kg/wk and compared with daily hGH at a dose of 0.24 mg/kg/wk. MOD-4023 showed an estimated half-life approximately fivefold to 10-fold longer when compared with daily r-hGH. Insulin-like growth factor (IGF)-I and IGF-binding peptide 3 showed a dose-dependent increase during MOD-4023 treatment. IGF-I standard deviation score for MOD-4023 did not exceed +2. All MOD-4023 cohorts demonstrated adequate catch-up growth. The 0.66 mg/kg/wk dose demonstrated efficacy closest to daily r-hGH. No serious adverse events were observed during MOD-4023 treatment, and its tolerability was consistent with known properties of r-hGH. This study confirms the long-acting properties of MOD-4023 and shows a promising safety and tolerability profile. This provides support for initiation of a phase 3 study in GHD children using a single weekly injection of MOD-4023. Copyright © 2017 by the Endocrine Society

Mod-1 Wind Turbine at Boone, North Carolina

NASA Image and Video Library

1979-06-21

A Mod-1 2000-kilowatt wind turbine designed by National Aeronautics and Space Administration (NASA) Lewis Research Center and constructed in Boone, North Carolina. The wind turbine program was a joint program between NASA and the Energy Research and Development Administration (ERDA) during the 1970s to develop less expensive forms of energy. NASA Lewis was assigned the responsibility of developing large horizontal-axis wind turbines. The program included a series of increasingly powerful wind turbines, designated: Mod-0A, Mod-1, WTS-4, and Mod-5. The program’s first device was a Mod-0 100-kilowatt wind turbine test bed at NASA’s Plum Brook Station. There were four Mod-0A 200-kilowatt turbines built in New Mexico, Hawaii, Puerto Rico, and Rhode Island. The 2000-kilowatt wind turbine in North Carolina, seen here, was the only Mod-1 machine constructed. The two-bladed, 200-foot diameter device was built in May 1979 and began operation that September. The Mod-1 turbine performed exceedingly well and was fully integrated into the local power grid. NASA researchers also used the North Carolina device to study its effect on noise and television transmission.

Mental health screening in women with severe pelvic organ prolapse, chronic fourth-degree obstetric tear and genital tract fistula in western Uganda.

PubMed

Krause, Hannah G; Hall, Barbara A; Ng, Shu-Kay; Natukunda, Harriet; Singasi, Isaac; Goh, Judith T W

2017-06-01

High levels of mental health dysfunction have been identified in women with genital tract fistula. The aim of this study was to use the General Health Questionnaire-28 (GHQ-28) to screen women in western Uganda with severe pelvic organ prolapse, chronic fourth-degree obstetric tear and genital tract fistula for risk of mental health dysfunction. Women undergoing surgery for severe pelvic organ prolapse, chronic fourth-degree obstetric tear, and genital tract fistula were interviewed using the GHQ-28 to screen for the risk of mental health dysfunction. A total of 125 women completed the GHQ-28, including 22 with pelvic organ prolapse, 47 with fourth-degree obstetric tear, 21 with genital tract fistula, and 35 controls. Nearly all women with these serious gynaecological conditions were positive for the risk of mental health dysfunction. In the domain assessing symptoms of severe depression, women with fourth-degree obstetric tear and genital tract fistula scored higher than women with pelvic organ prolapse. A significant risk of mental health dysfunction was identified in women with severe pelvic organ prolapse and chronic fourth-degree obstetric tear. These rates are similar to the high rates of mental health dysfunction in women with genital tract fistula. Identification and management of mental health dysfunction in women with these conditions should be a priority.

Mod 1 ICS TI Report: ICS Conversion of a 140% HPGe Detector

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

Bounds, John Alan

This report evaluates the Mod 1 ICS, an electrically cooled 140% HPGe detector. It is a custom version of the ORTEC Integrated Cooling System (ICS) modified to make it more practical for us to use in the field. Performance and operating characteristics of the Mod 1 ICS are documented, noting both pros and cons. The Mod 1 ICS is deemed a success. Recommendations for a Mod 2 ICS, a true field prototype, are provided.

ModFOLD6: an accurate web server for the global and local quality estimation of 3D protein models.

PubMed

Maghrabi, Ali H A; McGuffin, Liam J

2017-07-03

Methods that reliably estimate the likely similarity between the predicted and native structures of proteins have become essential for driving the acceptance and adoption of three-dimensional protein models by life scientists. ModFOLD6 is the latest version of our leading resource for Estimates of Model Accuracy (EMA), which uses a pioneering hybrid quasi-single model approach. The ModFOLD6 server integrates scores from three pure-single model methods and three quasi-single model methods using a neural network to estimate local quality scores. Additionally, the server provides three options for producing global score estimates, depending on the requirements of the user: (i) ModFOLD6_rank, which is optimized for ranking/selection, (ii) ModFOLD6_cor, which is optimized for correlations of predicted and observed scores and (iii) ModFOLD6 global for balanced performance. The ModFOLD6 methods rank among the top few for EMA, according to independent blind testing by the CASP12 assessors. The ModFOLD6 server is also continuously automatically evaluated as part of the CAMEO project, where significant performance gains have been observed compared to our previous server and other publicly available servers. The ModFOLD6 server is freely available at: http://www.reading.ac.uk/bioinf/ModFOLD/. © The Author(s) 2017. Published by Oxford University Press on behalf of Nucleic Acids Research.

Molecular characterization of a microbial consortium involved in methane oxidation coupled to denitrification under micro-aerobic conditions

PubMed Central

Liu, Jingjing; Sun, Faqian; Wang, Liang; Ju, Xi; Wu, Weixiang; Chen, Yingxu

2014-01-01

Methane can be used as an alternative carbon source in biological denitrification because it is nontoxic, widely available and relatively inexpensive. A microbial consortium involved in methane oxidation coupled to denitrification (MOD) was enriched with nitrite and nitrate as electron acceptors under micro-aerobic conditions. The 16S rRNA gene combined with pmoA phylogeny of methanotrophs and nirK phylogeny of denitrifiers were analysed to reveal the dominant microbial populations and functional microorganisms. Real-time quantitative polymerase chain reaction results showed high numbers of methanotrophs and denitrifiers in the enriched consortium. The 16S rRNA gene clone library revealed that Methylococcaceae and Methylophilaceae were the dominant populations in the MOD ecosystem. Phylogenetic analyses of pmoA gene clone libraries indicated that all methanotrophs belonged to Methylococcaceae, a type I methanotroph employing the ribulose monophosphate pathway for methane oxidation. Methylotrophic denitrifiers of the Methylophilaceae that can utilize organic intermediates (i.e. formaldehyde, citrate and acetate) released from the methanotrophs played a vital role in aerobic denitrification. This study is the first report to confirm micro-aerobic denitrification and to make phylogenetic and functional assignments for some members of the microbial assemblages involved in MOD. PMID:24245852

Modafinil Activates Phasic Dopamine Signaling in Dorsal and Ventral Striata

PubMed Central

Bobak, Martin J.; Weber, Matthew W.; Doellman, Melissa A.; Schuweiler, Douglas R.; Athens, Jeana M.; Juliano, Steven A.

2016-01-01

Modafinil (MOD) exhibits therapeutic efficacy for treating sleep and psychiatric disorders; however, its mechanism is not completely understood. Compared with other psychostimulants inhibiting dopamine (DA) uptake, MOD weakly interacts with the dopamine transporter (DAT) and modestly elevates striatal dialysate DA, suggesting additional targets besides DAT. However, the ability of MOD to induce wakefulness is abolished with DAT knockout, conversely suggesting that DAT is necessary for MOD action. Another psychostimulant target, but one not established for MOD, is activation of phasic DA signaling. This communication mode during which burst firing of DA neurons generates rapid changes in extracellular DA, the so-called DA transients, is critically implicated in reward learning. Here, we investigate MOD effects on phasic DA signaling in the striatum of urethane-anesthetized rats with fast-scan cyclic voltammetry. We found that MOD (30–300 mg/kg i.p.) robustly increases the amplitude of electrically evoked phasic-like DA signals in a time- and dose-dependent fashion, with greater effects in dorsal versus ventral striata. MOD-induced enhancement of these electrically evoked amplitudes was mediated preferentially by increased DA release compared with decreased DA uptake. Principal component regression of nonelectrically evoked recordings revealed negligible changes in basal DA with high-dose MOD (300 mg/kg i.p.). Finally, in the presence of the D2 DA antagonist, raclopride, low-dose MOD (30 mg/kg i.p.) robustly elicited DA transients in dorsal and ventral striata. Taken together, these results suggest that activation of phasic DA signaling is an important mechanism underlying the clinical efficacy of MOD. PMID:27733628

Infection Associated Secondary Hemophagocytic Lymphohistiocytosis in Sepsis Syndromes - A Tip of an Iceberg.

PubMed

Agarwal, Arun; Agarwal, Aakanksha

2016-10-01

Hemophagocytic lymphohistiocytosis (HLH) is a rare, underdiagnosed, fatal and devastating hyperinflammatory syndrome that has gained increasing recognition over the past decade. Patients with HLH present with clinical and laboratory evidence of uncontrolled inflammation. Delay in diagnosis and management inevitably leads to a rapidly progressive and fatal course. In this case series, we present 7 cases of secondary HLH (sHLH) in adults with their presentation, course, and outcomes. We retrospectively looked at the 7 cases of secondary HLH who were diagnosed and managed in our institute between January 2013 and august 2015. Medical records were retrieved from medical records department and data analyzed and tabulated. The median age at diagnosis was 35 years (age range 26-72 years). Diagnosis was based on HLH 2004 diagnostic criteria. We report profile of 7 adult patients with sHLH. All patients had a short history of illness (<2 weeks) and presented uniformly with prolonged fever, bi or trilineage cytopenia and multiorgan dysfunction syndrome (MODS) at admission or developed MODS during the course of their illness. None of them had prediagnosed HLH. All patients fulfilled 5 to 6 of 8 criteria as per HLH 2014 diagnostic criteria. The median length of hospital stay was 12 days (range 7-50 days) and the median time to diagnosis was 5 days (range 3 to 21 days). Mortality was 57%. HLH is a rare and under-diagnosed clinical syndrome and is rapidly fatal if not diagnosed and managed timely. The cases reported in literature probably represent a tip of an iceberg of large number of undiagnosed cases mostly labeled as sepsis with MODS in critical care units. sHLH should be suspected in any patient who present with persistent and prolonged fever, transaminitis, cytopenia, and high serum Ferritin or dramatically rising serial serum Ferritin. Early diagnosis and prompt aggressive treatment are vital for patients' survival and favorable outcome.

Infection Associated Secondary Hemophagocytic Lymphohistiocytosis in Sepsis Syndromes - A Tip of an Iceberg.

PubMed

Agarwal, Arun; Agarwal, Aakanksha

2017-10-01

Hemophagocytic lymphohistiocytosis (HLH) is a rare, underdiagnosed, fatal and devastating hyperinflammatory syndrome that has gained increasing recognition over the past decade. Patients with HLH present with clinical and laboratory evidence of uncontrolled inflammation. Delay in diagnosis and management inevitably leads to a rapidly progressive and fatal course. In this case series, we present 7 cases of secondary HLH (sHLH) in adults with their presentation, course, and outcomes. We retrospectively looked at the 7 cases of secondary HLH who were diagnosed and managed in our institute between January 2013 and august 2015. Medical records were retrieved from medical records department and data analyzed and tabulated. The median age at diagnosis was 35 years (age range 26-72 years). Diagnosis was based on HLH 2004 diagnostic criteria. We report profile of 7 adult patients with sHLH. All patients had a short history of illness (<2 weeks) and presented uniformly with prolonged fever, bi or trilineage cytopenia and multiorgan dysfunction syndrome (MODS) at admission or developed MODS during the course of their illness. None of them had prediagnosed HLH. All patients fulfilled 5 to 6 of 8 criteria as per HLH 2014 diagnostic criteria. The median length of hospital stay was 12 days (range 7-50 days) and the median time to diagnosis was 5 days (range 3 to 21 days). Mortality was 57%. HLH is a rare and under-diagnosed clinical syndrome and is rapidly fatal if not diagnosed and managed timely. The cases reported in literature probably represent a tip of an iceberg of large number of undiagnosed cases mostly labeled as sepsis with MODS in critical care units. sHLH should be suspected in any patient who present with persistent and prolonged fever, transaminitis, cytopenia, and high serum Ferritin or dramatically rising serial serum Ferritin. Early diagnosis and prompt aggressive treatment are vital for patients' survival and favorable outcome.

Early Assessment of Pancreatic Infections and Overall Prognosis in Severe Acute Pancreatitis by Procalcitonin (PCT)

PubMed Central

Rau, Bettina M.; Kemppainen, Esko A.; Gumbs, Andrew A.; Büchler, Markus W.; Wegscheider, Karl; Bassi, Claudio; Puolakkainen, Pauli A.; Beger, Hans G.

2007-01-01

Background: Pancreatic infections and sepsis are major complications in severe acute pancreatitis (AP) with significant impact on management and outcome. We investigated the value of Procalcitonin (PCT) for identifying patients at risk to develop pancreatic infections in severe AP. Methods: A total of 104 patients with predicted severe AP were enrolled in five European academic surgical centers within 96 hours of symptom onset. PCT was measured prospectively by a semi-automated immunoassay in each center, C-reactive protein (CRP) was routinely assessed. Both parameters were monitored over a maximum of 21 consecutive days and in weekly intervals thereafter. Results: In contrast to CRP, PCT concentrations were significantly elevated in patients with pancreatic infections and associated multiorgan dysfunction syndrome (MODS) who all required surgery (n = 10) and in nonsurvivors (n = 8) early after onset of symptoms. PCT levels revealed only a moderate increase in patients with pancreatic infections in the absence of MODS (n = 7), all of whom were managed nonoperatively without mortality. A PCT value of ≥3.5 ng/mL on 2 consecutive days was superior to CRP ≥430 mg/L for the assessment of infected necrosis with MODS or nonsurvival as determined by ROC analysis with a sensitivity and specificity of 93% and 88% for PCT and 40% and 100% for CRP, respectively (P < 0.01). The single or combined prediction of the two major complications was already possible on the third and fourth day after onset of symptoms with a sensitivity and specificity of 79% and 93% for PCT ≥3.8 ng/mL compared with 36% and 97% for CRP ≥430 mg/L, respectively (P = 0.002). Conclusion: Monitoring of PCT allows early and reliable assessment of clinically relevant pancreatic infections and overall prognosis in AP. This single test parameter significantly contributes to an improved stratification of patients at risk to develop major complications. PMID:17457167

The genome sequence of Geobacter metallireducens: features of metabolism, physiology and regulation common and dissimilar to Geobacter sulfurreducens

PubMed Central

2009-01-01

Background The genome sequence of Geobacter metallireducens is the second to be completed from the metal-respiring genus Geobacter, and is compared in this report to that of Geobacter sulfurreducens in order to understand their metabolic, physiological and regulatory similarities and differences. Results The experimentally observed greater metabolic versatility of G. metallireducens versus G. sulfurreducens is borne out by the presence of more numerous genes for metabolism of organic acids including acetate, propionate, and pyruvate. Although G. metallireducens lacks a dicarboxylic acid transporter, it has acquired a second putative succinate dehydrogenase/fumarate reductase complex, suggesting that respiration of fumarate was important until recently in its evolutionary history. Vestiges of the molybdate (ModE) regulon of G. sulfurreducens can be detected in G. metallireducens, which has lost the global regulatory protein ModE but retained some putative ModE-binding sites and multiplied certain genes of molybdenum cofactor biosynthesis. Several enzymes of amino acid metabolism are of different origin in the two species, but significant patterns of gene organization are conserved. Whereas most Geobacteraceae are predicted to obtain biosynthetic reducing equivalents from electron transfer pathways via a ferredoxin oxidoreductase, G. metallireducens can derive them from the oxidative pentose phosphate pathway. In addition to the evidence of greater metabolic versatility, the G. metallireducens genome is also remarkable for the abundance of multicopy nucleotide sequences found in intergenic regions and even within genes. Conclusion The genomic evidence suggests that metabolism, physiology and regulation of gene expression in G. metallireducens may be dramatically different from other Geobacteraceae. PMID:19473543

Effects of accidental hypothermia on posttraumatic complications and outcome in multiple trauma patients.

PubMed

Mommsen, P; Andruszkow, H; Frömke, C; Zeckey, C; Wagner, U; van Griensven, M; Frink, M; Krettek, C; Hildebrand, F

2013-01-01

Accidental hypothermia seems to predispose multiple trauma patients to the development of posttraumatic complications, such as Systemic Inflammatory Response Syndrome (SIRS), sepsis, Multiple Organ Dysfunction Syndrome (MODS), and increased mortality. However, the role of accidental hypothermia as an independent prognostic factor is controversially discussed. The aim of the present study was to evaluate the incidence of accidental hypothermia in multiple trauma patients and its effects on the development of posttraumatic complications and mortality. Inclusion criteria for patients in this retrospective study (2005-2009) were an Injury Severity Score (ISS) ≥16, age ≥16 years, admission to our Level I trauma centre within 6h after the accident. Accidental hypothermia was defined as body temperature less than 35°C measured within 2 h after admission, but always before first surgical procedure in the operation theatre. The association between accidental hypothermia and the development of posttraumatic complications as well as mortality was investigated. Statistical analysis was performed with χ(2)-test, Student's t-test, ANOVA and logistic regression. Statistical significance was considered at p<0.05. 310 multiple trauma patients were enrolled in the present study. Patients' mean age was 41.9 (SD 17.5) years, the mean injury severity score was 29.7 (SD 10.2). The overall incidence of accidental hypothermia was 36.8%. The overall incidence of posttraumatic complications was 77.4% (SIRS), 42.9% (sepsis) and 7.4% (MODS), respectively. No association was shown between accidental hypothermia and the development of posttraumatic complications. Overall, 8.7% died during the posttraumatic course. Despite an increased mortality rate in hypothermic patients, hypothermia failed to be an independent risk factor for mortality in multivariate analysis. Accidental hypothermia is very common in multiply injured patients. However, it could be assumed that the increase of mortality in hypothermic patients is primarily caused by the injury severity and does not reflect an independent adverse effect of hypothermia. Furthermore, hypothermia was not shown to be an independent risk factor for posttraumatic complications. Copyright © 2011 Elsevier Ltd. All rights reserved.

Acute management and outcome of multiple trauma patients with pelvic disruptions

PubMed Central

2012-01-01

Introduction Data on prehospital and trauma-room fluid management of multiple trauma patients with pelvic disruptions are rarely reported. Present trauma algorithms recommend early hemorrhage control and massive fluid resuscitation. By matching the German Pelvic Injury Register (PIR) with the TraumaRegister DGU (TR) for the first time, we attempt to assess the initial fluid management for different Tile/OTA types of pelvic-ring fractures. Special attention was given to the patient's posttraumatic course, particularly intensive care unit (ICU) data and patient outcome. Methods A specific match code was applied to identify certain patients with pelvic disruptions from both PIR and TR anonymous trauma databases, admitted between 2004 and 2009. From the resulting intersection set, a retrospective analysis was done of prehospital and trauma-room data, length of ICU stay, days of ventilation, incidence of multiple organ dysfunction syndrome (MODS), sepsis, and mortality. Results In total, 402 patients were identified. Mean ISS was 25.9 points, and the mean of patients with ISS ≥16 was 85.6%. The fracture distribution was as follows: 19.7% type A, 29.4% type B, 36.6% type C, and 14.3% isolated acetabular and/or sacrum fractures. The type B/C, compared with type A fractures, were related to constantly worse vital signs that necessitated a higher volume of fluid and blood administration in the prehospital and/or the trauma-room setting. This group of B/C fractures were also related to a significantly higher presence of concomitant injuries and related to increased ISS. This was related to increased ventilation and ICU stay, increased rate of MODS, sepsis, and increased rate of mortality, at least for the type C fractures. Approximately 80% of the dead had sustained type B/C fractures. Conclusions The present study confirms the actuality of traditional trauma algorithms with initial massive fluid resuscitation in the recent therapy of multiple trauma patients with pelvic disruptions. Low-volume resuscitation seems not yet to be accepted in practice in managing this special patient entity. Mechanically unstable pelvic-ring fractures type B/C (according to the Tile/OTA classification) form a distinct entity that must be considered notably in future trauma algorithms. PMID:22913820

Can the Pediatric Logistic Organ Dysfunction-2 Score on Day 1 Be Used in Clinical Criteria for Sepsis in Children?

PubMed

Leclerc, Francis; Duhamel, Alain; Deken, Valérie; Grandbastien, Bruno; Leteurtre, Stéphane

2017-08-01

A recent task force has proposed the use of Sequential Organ Failure Assessment in clinical criteria for sepsis in adults. We sought to evaluate the predictive validity for PICU mortality of the Pediatric Logistic Organ Dysfunction-2 and of the "quick" Pediatric Logistic Organ Dysfunction-2 scores on day 1 in children with suspected infection. Secondary analysis of the database used for the development and validation of the Pediatric Logistic Organ Dysfunction-2. Nine university-affiliated PICUs in Europe. Only children with hypotension-low systolic blood pressure or low mean blood pressure using age-adapted cutoffs-and lactatemia greater than 2 mmol/L were considered in shock. We developed the quick Pediatric Logistic Organ Dysfunction-2 score on day 1 including tachycardia, hypotension, and altered mentation (Glasgow < 11): one point for each variable (range, 0-3). Outcome was mortality at PICU discharge. Discrimination (Area under receiver operating characteristic curve-95% CI) and calibration (goodness of fit test) of the scores were studied. This study included 862 children with suspected infection (median age: 12.3 mo; mortality: n = 60 [7.0%]). Area under the curve of the Pediatric Logistic Organ Dysfunction-2 score on day 1 was 0.91 (0.86-0.96) in children with suspected infection, 0.88 (0.79-0.96) in those with low systolic blood pressure and hyperlactatemia, and 0.91 (0.85-0.97) in those with low mean blood pressure and hyperlactatemia; calibration p value was 0.03, 0.36, and 0.49, respectively. A Pediatric Logistic Organ Dysfunction-2 score on day 1 greater than or equal to 8 reflected an overall risk of mortality greater than or equal to 9.3% in children with suspected infection. Area under the curve of the quick Pediatric Logistic Organ Dysfunction-2 score on day 1 was 0.82 (0.76-0.87) with systolic blood pressure or mean blood pressure; calibration p value was 0.89 and 0.72, respectively. A score greater than or equal to 2 reflected a mortality risk greater than or equal to 19.8% with systolic blood pressure and greater than or equal to 15.9% with mean blood pressure. Among children admitted to PICU with suspected infection, Pediatric Logistic Organ Dysfunction-2 score on day 1 was highly predictive of PICU mortality suggesting its use to standardize definitions and diagnostic criteria of pediatric sepsis. Further studies are needed to determine the usefulness of the quick Pediatric Logistic Organ Dysfunction-2 score on day 1 outside of the PICU.

ModSAF Software Architecture Design and Overview Document

DTIC Science & Technology

1993-12-20

ADVANCED DISTRIBUTED SIMULATIONTECHNOLOGY AD-A282 740 ModSAF SOFTWARE ARCHITECTURE DESIGN AND OVERVIEW DOCUMENT Ver 1.0 - 20 December 1993 D T...AND SUBTITLE 5. FUNDING NUMBERS MOdSAF SOFTWARE ARCHITECTURE DESIGN AND OVERVIEW DOCUMENT C N61339-91-D-O00, Delivery Order (0021), ModSAF (CDRL A004) 6

BC4GO: a full-text corpus for the BioCreative IV GO Task

USDA-ARS?s Scientific Manuscript database

Gene function curation via Gene Ontology (GO) annotation is a common task among Model Organism Database (MOD) groups. Due to its manual nature, this task is time-consuming and labor-intensive, and thus considered one of the bottlenecks in literature curation. There have been many previous attempts a...

Construction of a Mod-0A Wind Turbine in Clayton, New Mexico

NASA Image and Video Library

1977-11-21

TA Mod-0A 200-kilowatt wind turbine designed by National Aeronautics and Space Administration (NASA) Lewis Research Center and constructed in Clayton, New Mexico. The wind turbine program was a joint effort by NASA and the Energy Research and Development Administration (ERDA) during the 1970s to develop less expensive forms of energy. NASA Lewis was assigned the responsibility of developing large horizontal-axis wind turbines. The program included a series of increasingly powerful wind turbines, designated: Mod-0A, Mod-1, WTS-4, and Mod-5. The program’s first device was a Mod-0 100-kilowatt wind turbine test bed built at NASA’s Plum Brook Station. This Mod-0A 200-kilowatt turbine built in Clayton in 1977 was the program’s second device. It included a 125-foot long blade atop a 100-foot tall tower. The Mod-0A was designed to determine the turbine’s operating problems, integrate the system with the local utilities, and assess the attitude of the local community. There were additional Mod-0A turbines built in Culebra, Puerto Rico; Block Island, Rhode Island; and Oahu, Hawaii. The Mod-0A turbines were initially unreliable and suffered issues with the durability of the rotor blade. Lewis engineers addressed the problems, and the wind turbines proved to be reliable and efficient devices that operated for a number of years. The information gained from these early models was vital to the design and improvement of the later generations.

Effects of different titanium zirconium implant surfaces on initial supragingival plaque formation.

PubMed

John, Gordon; Becker, Jürgen; Schwarz, Frank

2017-07-01

The aim of the current study was the evaluation of biofilm development on different implant surfaces. Initial biofilm formation was investigated on five different implant surfaces, machined titanium (MTi), modified machined acid-etched titanium (modMATi), machined titanium zirconium (MTiZr), modified machined and acid-etched titanium zirconium (modMATiZr) and sandblasted large grid and acid-etched titanium zirconium surface (SLATiZr) for 24 and 48 h. Biocompatibility was tested after tooth brushing of the samples via cell viability testing with human gingival fibroblasts. After 24 h of biofilm collection, mean plaque surface was detected in the following descending order: After 24 h: MTiZr > MTi > SLATiZr > modMATiZr > modMATi. Both M surfaces showed significant higher biofilm formation than the other groups. After 48 h: MTiZr > MTi > SLATiZr > modMATiZr > modMATi. After tooth brushing: SLATiZr > modMATi > modMATiZr > MTi > MTiZr. All native samples depicted significant higher cell viability than their corresponding surfaces after biofilm removal procedure. The TiZr groups especially the modMATiZr group showed slower and less biofilm formation. In combination with the good biocompatibility, both modMA surfaces seem to be interesting candidates for surfaces in transgingival implant design. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Heparin-Binding Protein Measurement Improves the Prediction of Severe Infection With Organ Dysfunction in the Emergency Department

PubMed Central

Arnold, Ryan; Boyd, John H.; Zindovic, Marko; Zindovic, Igor; Lange, Anna; Paulsson, Magnus; Nyberg, Patrik; Russell, James A.; Pritchard, David; Christensson, Bertil; Åkesson, Per

2015-01-01

Objectives: Early identification of patients with infection and at risk of developing severe disease with organ dysfunction remains a difficult challenge. We aimed to evaluate and validate the heparin-binding protein, a neutrophil-derived mediator of vascular leakage, as a prognostic biomarker for risk of progression to severe sepsis with circulatory failure in a multicenter setting. Design: A prospective international multicenter cohort study. Setting: Seven different emergency departments in Sweden, Canada, and the United States. Patients: Adult patients with a suspected infection and at least one of three clinical systemic inflammatory response syndrome criteria (excluding leukocyte count). Intervention: None. Measurements and Main Results: Plasma levels of heparin-binding protein, procalcitonin, C-reactive protein, lactate, and leukocyte count were determined at admission and 12–24 hours after admission in 759 emergency department patients with suspected infection. Patients were defined depending on the presence of infection and organ dysfunction. Plasma samples from 104 emergency department patients with suspected sepsis collected at an independent center were used to validate the results. Of the 674 patients diagnosed with an infection, 487 did not have organ dysfunction at enrollment. Of these 487 patients, 141 (29%) developed organ dysfunction within the 72-hour study period; 78.0% of the latter patients had an elevated plasma heparin-binding protein level (> 30 ng/mL) prior to development of organ dysfunction (median, 10.5 hr). Compared with other biomarkers, heparin-binding protein was the best predictor of progression to organ dysfunction (area under the receiver operating characteristic curve = 0.80). The performance of heparin-binding protein was confirmed in the validation cohort. Conclusion: In patients presenting at the emergency department, heparin-binding protein is an early indicator of infection-related organ dysfunction and a strong predictor of disease progression to severe sepsis within 72 hours. PMID:26468696

Automotive Stirling Engine Mod 1 Design Review, Volume 1

NASA Technical Reports Server (NTRS)

1982-01-01

Risk assessment, safety analysis of the automotive stirling engine (ASE) mod I, design criteria and materials properties for the ASE mod I and reference engines, combustion are flower development, and the mod I engine starter motor are discussed. The stirling engine system, external heat system, hot engine system, cold engine system, and engine drive system are also discussed.

B61 Mod 12 Life Extension Program Tailkit Assembly (B61 Mod 12 LEP TKA)

DTIC Science & Technology

2015-12-01

Selected Acquisition Report ( SAR ) RCS: DD-A&T(Q&A)823-468 B61 Mod 12 Life Extension Program Tailkit Assembly (B61 Mod 12 LEP TKA) As of FY 2017... SAR March 23, 2016 10:38:20 UNCLASSIFIED 2 Table of Contents Common Acronyms and Abbreviations for MDAP Programs 3 Program Information...Unit Cost B61 Mod 12 LEP TKA December 2015 SAR March 23, 2016 10:38:20 UNCLASSIFIED 3 PB - President’s Budget PE - Program Element PEO - Program

Department of the Navy Justification of Estimates for Fiscal Year 1984 Submitted to Congress January 1983. Operation & Maintenance, Navy. Book 2. Budget Activity 7: Central Supply & Maintenance.

DTIC Science & Technology

1983-01-01

Sidewinder TD Mods 2/1,291 3/1,762 4/5,540 Cost $130 $252 $573 Snarrow TD Mods 5/2,045 2/186 6/564 Cost $556 $110 $419 Shrike TD Mods -/- 4/2,930 3/2,307 Cost...574 $713 Standard Arm TO/Mods 1/87 ?/351 ?/296 Cost $72 $180 $158 Phoenix TD /Mods 4/889 4/554 3/642 Cost $219 $120 $?67 7 29 Activity Group: Air...Launched Weapons Rework (cont’d) III. Performance Criteria and Evaluation FY 1982 FY 1983 FY 1984 (cont’d) Harpoon TD /Mods 6/396 16/2,512 14/1,195

Effect of milk replacer feeding rate and functional fatty acids on dairy calf performance and digestion of nutrients.

PubMed

Hill, T M; Quigley, J D; Suarez-Mena, F X; Bateman, H G; Schlotterbeck, R L

2016-08-01

Calves fed large amounts of milk replacer (MR) gain more body weight preweaning than calves fed less MR; however, postweaning growth may be reduced because of impaired digestion of nutrients. This was explored in the current research, as was the inclusion of functional fatty acids (NT) that could ameliorate some poor growth and digestion issues in calves fed large amounts of MR. Two MR rates [moderate (MOD) or aggressive (AGG)] with and without NT were compared using 48 male Holstein calves initially 3d old (43±1.5kg of body weight) randomly assigned to treatments. The MOD rate was fed at 0.66kg of dry matter (DM) for 49d. The AGG rate was fed for 4d at 0.66kg of DM, 4d at 0.96kg of DM, then 34d at 1.31kg of DM, followed by 0.66kg of DM for the last 7d. Calves were completely weaned at 49d. The MR contained 27% crude protein and 17% fat. The textured starter was 20% crude protein. Starter and water were fed free-choice for the first 56d when calves were housed in individual pens. From 56 to 112d, calves were grouped (4 calves/pen), maintaining the same MR rate and NT treatments, and fed starter blended with 5% chopped grass hay free-choice with free-choice water. Digestibility was estimated from fecal collections made on d 19 to 23, 40 to 44, and 52 to 56. Data were analyzed as a completely randomized design with a factorial arrangement of MR rate and NT using repeated measures with a mixed procedure. Fiber and starch digestion increased with age and was lower for AGG versus MOD. Calf average daily gain and hip width change were greater before approximately 6wk of age for AGG versus MOD, but this was reversed from approximately 6 to 16wk. Calves fed AGG had lower average daily gain per unit intake of DM, crude protein, and metabolizable energy from 8 to 16wk than calves fed MOD. Preweaning starter intake was less for calves fed AGG versus MOD. Calves fed AGG had greater body weight gain than MOD over 112d, but hip width change did not differ. Feeding NT improved digestibility of organic matter, DM, neutral detergent fiber, and acid detergent fiber (over 50% improvement for neutral detergent fiber and acid detergent fiber), which resulted in 10.7kg (13%) more body weight gain and 1.4cm (16%) more hip width change over 112d. This was a greater improvement in growth than the difference in AGG and MOD programs over 112d. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Mod-0A Wind Turbine in Block Island, Rhode Island

NASA Image and Video Library

1979-06-21

A Mod-0A 200-kilowatt wind turbine designed by National Aeronautics and Space Administration (NASA) Lewis Research Center and constructed in Block Island, Rhode Island. The wind turbine program was a joint program between NASA and the Energy Research and Development Administration (ERDA) during the 1970s to develop less expensive forms of energy. NASA Lewis was assigned the responsibility of developing large horizontal-axis wind turbines. The program included a series of increasingly powerful wind turbines, designated: Mod-0A, Mod-1, WTS-4, and Mod-5. The program’s first device was a Mod-0 100-kilowatt wind turbine test bed at NASA’s Plum Brook Station. This Mod-0A 200-kilowatt turbine, completed in 1977, was the program’s second-generation device. It included a 125-foot diameter blade atop a 100-foot tall tower. This early wind turbine was designed determine its operating problems, integrate with the local utilities, and assess the attitude of the local community. There were additional Mod-0A turbines built in Culebra, Puerto Rico; Clayton, New Mexico; and Oahu, Hawaii. The Mod-0A turbines suffered durability issues with the rotor blade and initially appeared unreliable. NASA engineers addressed the problems, and the turbines proved to be reliable and efficient devices that operated for a number of years. The information gained from these early models was vital to the design and improvement of the later generations.

Proof without Words: Squares Modulo 3

ERIC Educational Resources Information Center

Nelsen, Roger B.

2013-01-01

Using the fact that the sum of the first n odd numbers is n[superscript 2], we show visually that n[superscript 2] is the same as 0 (mod 3) when n is the same as 0 (mod 3), and n[superscript 2] is the same as 1 (mod 3) when n is the same as plus or minus 1 (mod 3).

Estimation of crop gross primary production (GPP): fAPAR_chl versus MOD15A2 FPAR

USDA-ARS?s Scientific Manuscript database

Within leaf chloroplasts chlorophylls absorb photosynthetically active radiation (PAR) for photosynthesis (PSN). The MOD15A2 FPAR (fraction of PAR absorbed by canopy, i.e., fAPARcanopy) product has been widely used to compute absorbed PAR for PSN (APARPSN). The MOD17A2 algorithm uses MOD15A2 FPAR i...

Cardio-renal syndromes: a systematic approach for consensus definition and classification.

PubMed

Ronco, Claudio; Ronco, Federico

2012-03-01

The "Cardio-Renal Syndrome" (CRS) is a disorder of the heart and kidneys whereby acute or chronic dysfunction in one organ may induce acute or chronic dysfunction of the other. The general definition has been expanded to five subtypes reflecting the primacy of organ dysfunction and the time-frame of the syndrome: CRS type I: acute worsening of heart function (AHF-ACS) leading to kidney injury and/or dysfunction. CRS type II: chronic abnormalities in heart function (CHF-CHD) leading to kidney injury or dysfunction. CRS type III: acute worsening of kidney function (AKI) leading to heart injury and/or dysfunction. CRS type IV: chronic kidney disease (CKD) leading to heart injury, disease and/or dysfunction. CRS type V: systemic conditions leading to simultaneous injury and/or dysfunction of heart and kidney. Different pathophysiological mechanisms are involved in the combined dysfunction of heart and kidney in these five types of the syndrome.

MOD-5A wind turbine generator program design report: Volume 1: Executive Summary

NASA Technical Reports Server (NTRS)

1984-01-01

The design, development and analysis of the 7.3 MW MOD-5A wind turbine generator covering work performed between July 1980 and June 1984 is discussed. The report is divided into four volumes: Volume 1 summarizes the entire MOD-5A program, Volume 2 discusses the conceptual and preliminary design phases, Volume 3 describes the final design of the MOD-5A, and Volume 4 contains the drawings and specifications developed for the final design. Volume 1, the Executive Summary, summarizes all phases of the MOD-5A program. The performance and cost of energy generated by the MOD-5A are presented. Each subsystem - the rotor, drivetrain, nacelle, tower and foundation, power generation, and control and instrumentation subsystems - is described briefly. The early phases of the MOD-5A program, during which the design was analyzed and optimized, and new technologies and materials were developed, are discussed. Manufacturing, quality assurance, and safety plans are presented. The volume concludes with an index of volumes 2 and 3.

Hurricane IKE Recovery Efforts - MOD Volunteers

NASA Image and Video Library

2008-09-18

Hurricane IKE Recovery Efforts - MOD Volunteers Location: Clear LAke Area Subject: MOD Volunteers assist fellow employees at their homes during the recovery from hurricane IKE. Photographer: Tom Murray (USA Photographer)

Experience and Assessment of the DOE/NASA Mod-1 2000 Kw Wind Turbine Generator at Boone, North Carolina

NASA Technical Reports Server (NTRS)

Collins, J. L.; Shaltens, R. K.; Poor, R. H.; Barton, R. S.

1982-01-01

The Mod 1 program objectives are defined. The Mod 1 wind turbine is described. In addition to the steel blade operated on the wind turbine, a composite blade was designed and manufactured. During the early phase of the manufacturing cycle of Mod 1A configuration was designed that identified concepts such as partial span control, a soft tower, and upwind teetered rotors that were incorporated in second and third generation industry designs. The Mod 1 electrical system performed as designed, with voltage flicker characteristics within acceptable utility limits.

Dietary choline requirements of women: effects of estrogen and genetic variation123

PubMed Central

Fischer, Leslie M; da Costa, Kerry-Ann; Kwock, Lester; Galanko, Joseph

2010-01-01

Background: Choline is obtained from the diet and from the biosynthesis of phosphatidylcholine. Phosphatidylcholine is catalyzed by the enzyme phosphatidylethanolamine-N-methyltransferase (PEMT), which is induced by estrogen. Because they have lower estrogen concentrations, postmenopausal women are more susceptible to the risk of organ dysfunction in response to a low-choline diet. A common genetic polymorphism (rs12325817) in the PEMT gene can also increase this risk. Objective: The objective was to determine whether the risk of low choline–related organ dysfunction increases with the number of alleles of rs12325817 in premenopausal women and whether postmenopausal women (with or without rs12325817) treated with estrogen are more resistant to developing such symptoms. Design: Premenopausal women (n = 27) consumed a choline-sufficient diet followed by a very-low-choline diet until they developed organ dysfunction (or for 42 d), which was followed by a high-choline diet. Postmenopausal women (n = 22) were placed on the same diets but were first randomly assigned to receive estrogen or a placebo. The women were monitored for organ dysfunction and plasma choline metabolites and were genotyped for rs12325817. Results: A dose-response effect of rs12325817 on the risk of choline-related organ dysfunction was observed in premenopausal women: 80%, 43%, and 13% of women with 2, 1, or 0 alleles, respectively, developed organ dysfunction. Among postmenopausal women, 73% who received placebo but only 18% who received estrogen developed organ dysfunction during the low-choline diet. Conclusions: Because of their lower estrogen concentrations, postmenopausal women have a higher dietary requirement for choline than do premenopausal women. Choline requirements for both groups of women are further increased by rs12325817. This trial was registered at clinicaltrials.gov as NCT00065546. PMID:20861172

Dietary choline requirements of women: effects of estrogen and genetic variation.

PubMed

Fischer, Leslie M; da Costa, Kerry-Ann; Kwock, Lester; Galanko, Joseph; Zeisel, Steven H

2010-11-01

Choline is obtained from the diet and from the biosynthesis of phosphatidylcholine. Phosphatidylcholine is catalyzed by the enzyme phosphatidylethanolamine-N-methyltransferase (PEMT), which is induced by estrogen. Because they have lower estrogen concentrations, postmenopausal women are more susceptible to the risk of organ dysfunction in response to a low-choline diet. A common genetic polymorphism (rs12325817) in the PEMT gene can also increase this risk. The objective was to determine whether the risk of low choline-related organ dysfunction increases with the number of alleles of rs12325817 in premenopausal women and whether postmenopausal women (with or without rs12325817) treated with estrogen are more resistant to developing such symptoms. Premenopausal women (n = 27) consumed a choline-sufficient diet followed by a very-low-choline diet until they developed organ dysfunction (or for 42 d), which was followed by a high-choline diet. Postmenopausal women (n = 22) were placed on the same diets but were first randomly assigned to receive estrogen or a placebo. The women were monitored for organ dysfunction and plasma choline metabolites and were genotyped for rs12325817. A dose-response effect of rs12325817 on the risk of choline-related organ dysfunction was observed in premenopausal women: 80%, 43%, and 13% of women with 2, 1, or 0 alleles, respectively, developed organ dysfunction. Among postmenopausal women, 73% who received placebo but only 18% who received estrogen developed organ dysfunction during the low-choline diet. Because of their lower estrogen concentrations, postmenopausal women have a higher dietary requirement for choline than do premenopausal women. Choline requirements for both groups of women are further increased by rs12325817. This trial was registered at clinicaltrials.gov as NCT00065546.

Cause for Concern or Moral Panic? The Prospects of the Swedish Mods in Retrospect

ERIC Educational Resources Information Center

Alm, Susanne; Nilsson, Anders

2011-01-01

The Swedish mods of the 1960s frightened the parental generation like few other youth cultures. Was the concern justified--was the mod culture a hotbed of social maladjustment? Or would the mods come to live conventional lives to the same extent as their peers? We present analyses from a large longitudinal study allowing for a follow-up of…

Mod-2 wind turbine system development. Volume 2: Detailed report

NASA Technical Reports Server (NTRS)

1982-01-01

Progress in the design, fabrication, and testing of a wind turbine system is reported. The development of the MOD-2 wind turbine through acceptance testing and initial operational evaluation is documented. The MOD-2 project intends to develop early commercialization of wind energy. The first wind turbine farm (three MOD-2 units) are now being operated at the Bonneville Power Administration site near Goldendale, Washington.

Cost-effectiveness analysis of microscopic observation drug susceptibility test versus Xpert MTB/Rif test for diagnosis of pulmonary tuberculosis in HIV patients in Uganda.

PubMed

Walusimbi, Simon; Kwesiga, Brendan; Rodrigues, Rashmi; Haile, Melles; de Costa, Ayesha; Bogg, Lennart; Katamba, Achilles

2016-10-10

Microscopic Observation Drug Susceptibility (MODS) and Xpert MTB/Rif (Xpert) are highly sensitive tests for diagnosis of pulmonary tuberculosis (PTB). This study evaluated the cost effectiveness of utilizing MODS versus Xpert for diagnosis of active pulmonary TB in HIV infected patients in Uganda. A decision analysis model comparing MODS versus Xpert for TB diagnosis was used. Costs were estimated by measuring and valuing relevant resources required to perform the MODS and Xpert tests. Diagnostic accuracy data of the tests were obtained from systematic reviews involving HIV infected patients. We calculated base values for unit costs and varied several assumptions to obtain the range estimates. Cost effectiveness was expressed as costs per TB patient diagnosed for each of the two diagnostic strategies. Base case analysis was performed using the base estimates for unit cost and diagnostic accuracy of the tests. Sensitivity analysis was performed using a range of value estimates for resources, prevalence, number of tests and diagnostic accuracy. The unit cost of MODS was US$ 6.53 versus US$ 12.41 of Xpert. Consumables accounted for 59 % (US$ 3.84 of 6.53) of the unit cost for MODS and 84 % (US$10.37 of 12.41) of the unit cost for Xpert. The cost effectiveness ratio of the algorithm using MODS was US$ 34 per TB patient diagnosed compared to US$ 71 of the algorithm using Xpert. The algorithm using MODS was more cost-effective compared to the algorithm using Xpert for a wide range of different values of accuracy, cost and TB prevalence. The cost (threshold value), where the algorithm using Xpert was optimal over the algorithm using MODS was US$ 5.92. MODS versus Xpert was more cost-effective for the diagnosis of PTB among HIV patients in our setting. Efforts to scale-up MODS therefore need to be explored. However, since other non-economic factors may still favour the use of Xpert, the current cost of the Xpert cartridge still needs to be reduced further by more than half, in order to make it economically competitive with MODS.

Aerial Refueling Clearance Initiation Request

DTIC Science & Technology

2016-07-14

and receiver agencies. The AR Clearance Initiation Request document recognizes the requirement for definitive aerial refueling agreements between...and contractual tanker support requests from one organization or nation to another. The AR Clearance Initiation Request document is not intended to...proprietary, sensitive, classified or otherwise restricted information. ARSAG documents, as prepared, are not DOD, MOD or NATO standards, but provide

Evaluating the Auto-MODS Assay, a Novel Tool for Tuberculosis Diagnosis for Use in Resource-Limited Settings

PubMed Central

Wang, Linwei; Mohammad, Sohaib H.; Li, Qiaozhi; Rienthong, Somsak; Rienthong, Dhanida; Nedsuwan, Supalert; Mahasirimongkol, Surakameth; Yasui, Yutaka

2014-01-01

There is an urgent need for simple, rapid, and affordable diagnostic tests for tuberculosis (TB) to combat the great burden of the disease in developing countries. The microscopic observation drug susceptibility assay (MODS) is a promising tool to fill this need, but it is not widely used due to concerns regarding its biosafety and efficiency. This study evaluated the automated MODS (Auto-MODS), which operates on principles similar to those of MODS but with several key modifications, making it an appealing alternative to MODS in resource-limited settings. In the operational setting of Chiang Rai, Thailand, we compared the performance of Auto-MODS with the gold standard liquid culture method in Thailand, mycobacterial growth indicator tube (MGIT) 960 plus the SD Bioline TB Ag MPT64 test, in terms of accuracy and efficiency in differentiating TB and non-TB samples as well as distinguishing TB and multidrug-resistant (MDR) TB samples. Sputum samples from clinically diagnosed TB and non-TB subjects across 17 hospitals in Chiang Rai were consecutively collected from May 2011 to September 2012. A total of 360 samples were available for evaluation, of which 221 (61.4%) were positive and 139 (38.6%) were negative for mycobacterial cultures according to MGIT 960. Of the 221 true-positive samples, Auto-MODS identified 212 as positive and 9 as negative (sensitivity, 95.9%; 95% confidence interval [CI], 92.4% to 98.1%). Of the 139 true-negative samples, Auto-MODS identified 135 as negative and 4 as positive (specificity, 97.1%; 95% CI, 92.8% to 99.2%). The median time to culture positivity was 10 days, with an interquartile range of 8 to 13 days for Auto-MODS. Auto-MODS is an effective and cost-sensitive alternative diagnostic tool for TB diagnosis in resource-limited settings. PMID:25378569

Insulation of Enhancer-Promoter Communication by a Gypsy Transposon Insert in the Drosophila cut Gene: Cooperation between Suppressor of Hairy-wing and Modifier of mdg4 Proteins

PubMed Central

Gause, Maria; Morcillo, Patrick; Dorsett, Dale

2001-01-01

The Drosophila mod(mdg4) gene products counteract heterochromatin-mediated silencing of the white gene and help activate genes of the bithorax complex. They also regulate the insulator activity of the gypsy transposon when gypsy inserts between an enhancer and promoter. The Su(Hw) protein is required for gypsy-mediated insulation, and the Mod(mdg4)-67.2 protein binds to Su(Hw). The aim of this study was to determine whether Mod(mdg4)-67.2 is a coinsulator that helps Su(Hw) block enhancers or a facilitator of activation that is inhibited by Su(Hw). Here we provide evidence that Mod(mdg4)-67.2 acts as a coinsulator by showing that some loss-of-function mod(mdg4) mutations decrease enhancer blocking by a gypsy insert in the cut gene. We find that the C terminus of Mod(mdg4)-67.2 binds in vitro to a region of Su(Hw) that is required for insulation, while the N terminus mediates self-association. The N terminus of Mod(mdg4)-67.2 also interacts with the Chip protein, which facilitates activation of cut. Mod(mdg4)-67.2 truncated in the C terminus interferes in a dominant-negative fashion with insulation in cut but does not significantly affect heterochromatin-mediated silencing of white. We infer that multiple contacts between Su(Hw) and a Mod(mdg4)-67.2 multimer are required for insulation. We theorize that Mod(mdg4)-67.2 usually aids gene activation but can also act as a coinsulator by helping Su(Hw) trap facilitators of activation, such as the Chip protein. PMID:11416154

The Modified Frontal Behavioral Inventory (FBI-mod) for Patients with Frontotemporal Lobar Degeneration, Alzheimer's Disease, and Mild Cognitive Impairment.

PubMed

Suhonen, Noora-Maria; Hallikainen, Ilona; Hänninen, Tuomo; Jokelainen, Jari; Krüger, Johanna; Hall, Anette; Pikkarainen, Maria; Soininen, Hilkka; Remes, Anne M

2017-01-01

While behavioral symptoms are both early and prevalent features of behavioral variant frontotemporal dementia (bvFTD), they can be present in other types of dementia as well, including Alzheimer's disease (AD) and even mild cognitive impairment (MCI). The Frontal Behavioral Inventory (FBI) was specifically developed to capture the behavioral and personality changes in bvFTD; it has also been modified into a self-administered caregiver questionnaire (FBI-mod). We examined the utility of the FBI-mod in differentiating bvFTD (n = 26), primary progressive aphasia (PPA) (n = 7), AD (n = 53), and MCI (n = 50) patients, and investigated how the FBI-mod may be associated with neuropsychological measures. The bvFTD patients scored significantly higher as compared to all other patient groups on the FBI-mod Total (p < 0.005), Negative (p < 0.005), and Positive (p < 0.01) scores. The cut-off point for the FBI-mod Total score that best discriminated the bvFTD and AD patients in our sample was 16, thus substantially lower than reported for the original FBI. For the bvFTD group, only mild correlations emerged between the FBI-mod and the cognitive measures. However, significant correlations between the FBI-mod and depressive symptoms as measured by the BDI-II were found for bvFTD. This suggests that while behavioral symptoms appear independent from cognitive deficits in bvFTD, they may nevertheless be interrelated with depressive symptoms. We conclude that the FBI-mod is an easily administered behavioral scale that can aid in differential diagnosis of bvFTD and should be used in clinical practice. The FBI-mod may further be considered as an outcome measure in clinical trials.

Brahma regulates a specific trans-splicing event at the mod(mdg4) locus of Drosophila melanogaster

PubMed Central

Yu, Simei; Waldholm, Johan; Böhm, Stefanie; Visa, Neus

2014-01-01

The mod(mdg4) locus of Drosophila melanogaster contains several transcription units encoded on both DNA strands. The mod(mdg4) pre-mRNAs are alternatively spliced, and a very significant fraction of the mature mod(mdg4) mRNAs are formed by trans-splicing. We have studied the transcripts derived from one of the anti-sense regions within the mod(mdg4) locus in order to shed light on the expression of this complex locus. We have characterized the expression of anti-sense mod(mdg4) transcripts in S2 cells, mapped their transcription start sites and cleavage sites, identified and quantified alternatively spliced transcripts, and obtained insight into the regulation of the mod(mdg4) trans-splicing. In a previous study, we had shown that the alternative splicing of some mod(mdg4) transcripts was regulated by Brahma (BRM), the ATPase subunit of the SWI/SNF chromatin-remodeling complex. Here we show, using RNA interference and overexpression of recombinant BRM proteins, that the levels of BRM affect specifically the abundance of a trans-spliced mod(mdg4) mRNA isoform in both S2 cells and larvae. This specific effect on trans-splicing is accompanied by a local increase in the density of RNA polymerase II and by a change in the phosphorylation state of the C-terminal domain of the large subunit of RNA polymerase II. Interestingly, the regulation of the mod(mdg4) splicing by BRM is independent of the ATPase activity of BRM, which suggests that the mechanism by which BRM modulates trans-splicing is independent of its chromatin-remodeling activity. PMID:24526065

Early organ-specific mitochondrial dysfunction of jejunum and lung found in rats with experimental acute pancreatitis

PubMed Central

Mittal, Anubhav; Hickey, Anthony JR; Chai, Chau C; Loveday, Benjamin PT; Thompson, Nichola; Dare, Anna; Delahunt, Brett; Cooper, Garth JS; Windsor, John A; Phillips, Anthony RJ

2011-01-01

Introduction Multiple organ dysfunction is the main cause of death in severe acute pancreatitis. Primary mitochondrial dysfunction plays a central role in the development and progression of organ failure in critical illness. The present study investigated mitochondrial function in seven tissues during early experimental acute pancreatitis. Methods Twenty-eight male Wistar rats (463 ± 2 g; mean ± SEM) were studied. Group 1 (n = 8), saline control; Group 2 (n = 6), caerulein-induced mild acute pancreatitis; Group 3 (n = 7) sham surgical controls; and Group 4 (n = 7), taurocholate-induced severe acute pancreatitis. Animals were euthanased at 6 h from the induction of acute pancreatitis and mitochondrial function was assessed in the heart, lung, liver, kidney, pancreas, duodenum and jejunum by mitochondrial respirometry. Results Significant early mitochondrial dysfunction was present in the pancreas, lung and jejunum in both models of acute pancreatitis, however, the Heart, liver, kidney and duodenal mitochondria were unaffected. Conclusions The present study provides the first description of early organ-selective mitochondrial dysfunction in the lung and jejunum during acute pancreatitis. Research is now needed to identify the underlying pathophysiology behind the organ selective mitochondrial dysfunction, and the potential benefits of early mitochondrial-specific therapies in acute pancreatitis. PMID:21492333

High speed production of YBCO precursor films by advanced TFA-MOD process

NASA Astrophysics Data System (ADS)

Ichikawa, H.; Nakaoka, K.; Miura, M.; Sutoh, Y.; Nakanishi, T.; Nakai, A.; Yoshizumi, M.; Izumi, T.; Shiohara, Y.

2009-10-01

YBa 2Cu 3O 7-y (YBCO) long tapes derived from the metal-organic deposition (MOD) method using the starting solution containing trifluoroacetate (TFA) have been developed with high critical currents ( I c) over 200 A/cm-width. However, high speed production of YBCO films is simultaneously necessary to satisfy the requirements of electric power device applications in terms of cost and the amounts of the tapes. In this work, we developed a new TFA-MOD starting solution using F-free salt of Y, TFA salt of Ba and Cu-Octylate for application to the coating/calcination process and discussed several issues by using the Multi-turn (MT) Reel-to-Reel (RTR) system calcination furnace for the purpose of high throughput without degradation of the properties. The coating system was improved for uniform deposition qualities in both longitudinal and transversal directions. YBCO films using the new starting solution at the traveling rate of 10 m/h in coating/calcination by the MT-RTR calcination furnace showed the values of the critical current density of 1.6 MA/cm 2 as thick as 1.5 μm at 77 K under the self fields after firing at the high heating rate in the crystallization.

Molecular characterization of a microbial consortium involved in methane oxidation coupled to denitrification under micro-aerobic conditions.

PubMed

Liu, Jingjing; Sun, Faqian; Wang, Liang; Ju, Xi; Wu, Weixiang; Chen, Yingxu

2014-01-01

Methane can be used as an alternative carbon source in biological denitrification because it is nontoxic, widely available and relatively inexpensive. A microbial consortium involved in methane oxidation coupled to denitrification (MOD) was enriched with nitrite and nitrate as electron acceptors under micro-aerobic conditions. The 16S rRNA gene combined with pmoA phylogeny of methanotrophs and nirK phylogeny of denitrifiers were analysed to reveal the dominant microbial populations and functional microorganisms. Real-time quantitative polymerase chain reaction results showed high numbers of methanotrophs and denitrifiers in the enriched consortium. The 16S rRNA gene clone library revealed that Methylococcaceae and Methylophilaceae were the dominant populations in the MOD ecosystem. Phylogenetic analyses of pmoA gene clone libraries indicated that all methanotrophs belonged to Methylococcaceae, a type I methanotroph employing the ribulose monophosphate pathway for methane oxidation. Methylotrophic denitrifiers of the Methylophilaceae that can utilize organic intermediates (i.e. formaldehyde, citrate and acetate) released from the methanotrophs played a vital role in aerobic denitrification. This study is the first report to confirm micro-aerobic denitrification and to make phylogenetic and functional assignments for some members of the microbial assemblages involved in MOD. © 2013 The Authors. Microbial Biotechnology published by John Wiley & Sons Ltd and Society for Applied Microbiology.

Second-line drug susceptibility breakpoints for Mycobacterium tuberculosis using the MODS assay.

PubMed

Trollip, A P; Moore, D; Coronel, J; Caviedes, L; Klages, S; Victor, T; Romancenco, E; Crudu, V; Ajbani, K; Vineet, V P; Rodrigues, C; Jackson, R L; Eisenach, K; Garfein, R S; Rodwell, T C; Desmond, E; Groessl, E J; Ganiats, T G; Catanzaro, A

2014-02-01

To establish breakpoint concentrations for the fluoroquinolones (moxifloxacin [MFX] and ofloxacin [OFX]) and injectable second-line drugs (amikacin [AMK], kanamycin [KM] and capreomycin [CPM]) using the microscopic observation drug susceptibility (MODS) assay. A multinational study conducted between February 2011 and August 2012 in Peru, India, Moldova and South Africa. In the first phase, breakpoints for the fluoroquinolones and injectable second-line drugs (n = 58) were determined. In the second phase, MODS second-line drug susceptibility testing (DST) as an indirect test was compared to MGIT™ DST (n = 89). In the third (n = 30) and fourth (n = 156) phases, we determined the reproducibility and concordance of MODS second-line DST directly from sputum. Breakpoints for MFX (0.5 μg/ml), OFX (1 μg/ml), AMK (2 μg/ml), KM (5 μg/ml) and CPM (2.5 μg/ml) were determined. In all phases, MODS results were highly concordant with MGIT DST. The few discrepancies suggest that the MODS breakpoint concentrations for some drugs may be too low. MODS second-line DST yielded comparable results to MGIT second-line DST, and is thus a promising alternative. Further studies are needed to confirm the accuracy of the drug breakpoints and the reliability of MODS second-line DST as a direct test.

Risk of Erectile Dysfunction in Transfusion-naive Thalassemia Men

PubMed Central

Chen, Yu-Guang; Lin, Te-Yu; Lin, Cheng-Li; Dai, Ming-Shen; Ho, Ching-Liang; Kao, Chia-Hung

2015-01-01

Abstract Based on the mechanism of pathophysiology, thalassemia major or transfusion-dependent thalassemia patients may have an increased risk of developing organic erectile dysfunction resulting from hypogonadism. However, there have been few studies investigating the association between erectile dysfunction and transfusion-naive thalassemia populations. We constructed a population-based cohort study to elucidate the association between transfusion-naive thalassemia populations and organic erectile dysfunction This nationwide population-based cohort study involved analyzing data from 1998 to 2010 obtained from the Taiwanese National Health Insurance Research Database, with a follow-up period extending to the end of 2011. We identified men with transfusion-naive thalassemia and selected a comparison cohort that was frequency-matched with these according to age, and year of diagnosis thalassemia at a ratio of 1 thalassemia man to 4 control men. We analyzed the risks for transfusion-naive thalassemia men and organic erectile dysfunction by using Cox proportional hazards regression models. In this study, 588 transfusion-naive thalassemia men and 2337 controls were included. Total 12 patients were identified within the thalassaemia group and 10 within the control group. The overall risks for developing organic erectile dysfunction were 4.56-fold in patients with transfusion-naive thalassemia men compared with the comparison cohort after we adjusted for age and comorbidities. Our long-term cohort study results showed that in transfusion-naive thalassemia men, there was a higher risk for the development of organic erectile dysfunction, particularly in those patients with comorbidities. PMID:25837766

Risk of erectile dysfunction in transfusion-naive thalassemia men: a nationwide population-based retrospective cohort study.

PubMed

Chen, Yu-Guang; Lin, Te-Yu; Lin, Cheng-Li; Dai, Ming-Shen; Ho, Ching-Liang; Kao, Chia-Hung

2015-04-01

Based on the mechanism of pathophysiology, thalassemia major or transfusion-dependent thalassemia patients may have an increased risk of developing organic erectile dysfunction resulting from hypogonadism. However, there have been few studies investigating the association between erectile dysfunction and transfusion-naive thalassemia populations. We constructed a population-based cohort study to elucidate the association between transfusion-naive thalassemia populations and organic erectile dysfunction. This nationwide population-based cohort study involved analyzing data from 1998 to 2010 obtained from the Taiwanese National Health Insurance Research Database, with a follow-up period extending to the end of 2011. We identified men with transfusion-naive thalassemia and selected a comparison cohort that was frequency-matched with these according to age, and year of diagnosis thalassemia at a ratio of 1 thalassemia man to 4 control men. We analyzed the risks for transfusion-naive thalassemia men and organic erectile dysfunction by using Cox proportional hazards regression models. In this study, 588 transfusion-naive thalassemia men and 2337 controls were included. Total 12 patients were identified within the thalassaemia group and 10 within the control group. The overall risks for developing organic erectile dysfunction were 4.56-fold in patients with transfusion-naive thalassemia men compared with the comparison cohort after we adjusted for age and comorbidities. Our long-term cohort study results showed that in transfusion-naive thalassemia men, there was a higher risk for the development of organic erectile dysfunction, particularly in those patients with comorbidities.

[Dysfunctional workplace organization and mobbing. 4 representative cases].

PubMed

Albini, Elisa; Benedetti, Laura; Giordano, S; Punzi, Silvia; Cassitto, Maria Grazia

2003-01-01

Stress and psychological harassment at work are increasing worldwide, according to International Agencies (European Community, NIOSH) and to most authors. To describe typical working situations responsible for distress and mobbing, with the aim of early diagnosis and effectiveness of therapy and rehabilitation. Four cases are reported as representative of dysfunctional organization producing distress and pathology or inducing mobbing behavior or mobbing without clear organization responsibilities. In all cases dysfunctional organization appeared to have played a significant role even though not always a direct one. Also, common characteristics were highlighted in the three cases where mobbing was recognized.

Bladder, Bowel, and Sexual Dysfunction in Parkinson's Disease

PubMed Central

Sakakibara, Ryuji; Kishi, Masahiko; Ogawa, Emina; Tateno, Fuyuki; Uchiyama, Tomoyuki; Yamamoto, Tatsuya; Yamanishi, Tomonori

2011-01-01

Bladder dysfunction (urinary urgency/frequency), bowel dysfunction (constipation), and sexual dysfunction (erectile dysfunction) (also called “pelvic organ” dysfunctions) are common nonmotor disorders in Parkinson's disease (PD). In contrast to motor disorders, pelvic organ autonomic dysfunctions are often nonresponsive to levodopa treatment. The brain pathology causing the bladder dysfunction (appearance of overactivity) involves an altered dopamine-basal ganglia circuit, which normally suppresses the micturition reflex. By contrast, peripheral myenteric pathology causing slowed colonic transit (loss of rectal contractions) and central pathology causing weak strain and paradoxical anal sphincter contraction on defecation (PSD, also called as anismus) are responsible for the bowel dysfunction. In addition, hypothalamic dysfunction is mostly responsible for the sexual dysfunction (decrease in libido and erection) in PD, via altered dopamine-oxytocin pathways, which normally promote libido and erection. The pathophysiology of the pelvic organ dysfunction in PD differs from that in multiple system atrophy; therefore, it might aid in differential diagnosis. Anticholinergic agents are used to treat bladder dysfunction in PD, although these drugs should be used with caution particularly in elderly patients who have cognitive decline. Dietary fibers, laxatives, and “prokinetic” drugs such as serotonergic agonists are used to treat bowel dysfunction in PD. Phosphodiesterase inhibitors are used to treat sexual dysfunction in PD. These treatments might be beneficial in maximizing the patients' quality of life. PMID:21918729

Mobility on Demand Operational Concept Report.

DOT National Transportation Integrated Search

2017-09-10

This operational concept report provides an overview of the Mobility on Demand (MOD) concept and its evolution, description of the MOD ecosystem in a supply and demand framework, and its stakeholders and enablers. Leveraging the MOD ecosystem framewo...

MOD-2 wind turbine system concept and preliminary design report. Volume 2: Detailed report

NASA Technical Reports Server (NTRS)

1979-01-01

The configuration development of the MOD-2 wind turbine system (WTS) is documented. The MOD-2 WTS project is a continuation of DOE programs to develop and achieve early commercialization of wind energy. The MOD-2 is design optimized for commercial production rates which, in multiunit installations, will be integrated into a utility power grid and achieve a cost of electricity at less than four cents per kilowatt hour.

Vascular Factors and Cognitive Dysfunction in Alzheimer Disease.

PubMed

Pąchalska, Maria; Bidzan, Leszek; Bidzan, Mariola; Góral-Półrola, Jolanta

2015-11-12

The purpose of the present study was to assess the influence of vascular factors on the degree of intensity and rate of progression of cognitive disorders in the course of Alzheimer Disease (AD). The research group consisted of 39 persons, all of whom were diagnosed with AD according to the NINCDS/ADRDA criteria. We divided these patients into 2 subgroups, based on the vascular factors measured by the modified Hachinski Ischemic Scale (Ha-mod): group A, without the vascular component (HA-mod score of 0-1 point), and group B, with the vascular component (a score over 1 point). Cognitive functions were evaluated at baseline and again 2 years later, using the Cognitive Part of the Alzheimer Disease Assessment Scale (ADAS-cog). We found that the patients from subgroup B, with the stronger vascular component, demonstrated the highest intensity of cognitive disorders at baseline, both in terms of the overall ADAS-cog score, and in the subscores for ideational praxis, orientation, spoken language ability, comprehension of spoken language, and word-finding difficulty in spontaneous speech. Another variable which was connected with the intensity of dementia was age. After 2 years, however, the rate of progression of cognitive disorders was not significantly different between the 2 groups. The severity of vascular factors correlates directly with the intensity of cognitive disturbances. At the 2-year follow-up examination, however, no correlation was observed in the research group between greater vascular involvement and more rapid progression of cognitive disorders, as measured by the ADAS-cog scale.

Pediatric Multiple Organ Dysfunction Syndrome: Promising Therapies.

PubMed

Doctor, Allan; Zimmerman, Jerry; Agus, Michael; Rajasekaran, Surender; Bubeck Wardenburg, Juliane; Fortenberry, James; Zajicek, Anne; Mairson, Emma; Typpo, Katri

2017-03-01

To describe the state of the science, identify knowledge gaps, and offer potential future research questions regarding promising therapies for children with multiple organ dysfunction syndrome presented during the Eunice Kennedy Shriver National Institute of Child Health and Human Development Workshop on Pediatric Multiple Organ Dysfunction Syndrome (March 26-27, 2015). Literature review, research data, and expert opinion. Not applicable. Moderated by an expert from the field, issues relevant to the association of multiple organ dysfunction syndrome with a variety of conditions were presented, discussed, and debated with a focus on identifying knowledge gaps and research priorities. Summary of presentations and discussion supported and supplemented by relevant literature. Among critically ill children, multiple organ dysfunction syndrome is relatively common and associated with significant morbidity and mortality. For outcomes to improve, effective therapies aimed at preventing and treating this condition must be discovered and rigorously evaluated. In this article, a number of potential opportunities to enhance current care are highlighted including the need for a better understanding of the pharmacokinetics and pharmacodynamics of medications, the effect of early and optimized nutrition, and the impact of effective glucose control in the setting of multiple organ dysfunction syndrome. Additionally, a handful of the promising therapies either currently being implemented or developed are described. These include extracorporeal therapies, anticytokine therapies, antitoxin treatments, antioxidant approaches, and multiple forms of exogenous steroids. For the field to advance, promising therapies and other therapies must be assessed in rigorous manner and implemented accordingly.

Inadequate treatment of ventilator-associated pneumonia: risk factors and impact on outcomes.

PubMed

Teixeira, P J Z; Seligman, R; Hertz, F T; Cruz, D B; Fachel, J M G

2007-04-01

Initial antibiotic therapy is an important determinant of clinical outcomes in ventilator-associated pneumonia (VAP). Several studies have investigated this issue, with conflicting results. This study investigated risk factors of inadequate empirical antimicrobial therapy and its impact on outcomes for patients with a clinical diagnosis of VAP. The primary outcome was adequacy of antimicrobial therapy. Secondary outcomes were duration of mechanical ventilation, hospital and intensive care unit (ICU) lengths of stay, and mortality due to VAP. Mean age was 62.9+/-15.2 years, mean APACHE (Acute Physiological Assessment and Chronic Health Evaluation) II score was 20.1+/-8.1 and mean MODS (Multiple Organ Dysfunction Score) was 3.7+/-2.5. Sixty-nine (45.7%) of 151 patients with a clinical diagnosis of VAP received inadequate antimicrobial treatment for VAP initially. There were 100 (66.2%) episodes of VAP caused by multidrug-resistant pathogens, of which 56% were inadequately treated, whereas the rate of inadequate antimicrobial therapy for VAP caused by susceptible-drug pathogens was 25.5% (P<0.001). Multiple logistic regression analysis revealed that the risk of inadequate antimicrobial treatment was more than twice as great for patients with late-onset VAP [odds ratio (OR), 2.93; 95% confidence interval (CI), 1.30-6.64; P=0.01], and more than three times for patients with VAP caused by multidrug-resistant pathogens (OR, 3.07; 95% CI, 1.29-7.30; P=0.01) or with polymicrobial VAP (OR, 3.67; 95% CI, 1.21-11.12; P=0.02). Inadequate antimicrobial treatment was associated with higher mortality for patients with VAP. Two of three independent risk factors for treatment inadequacy were associated with the isolation and identification of micro-organisms.

Effect of milk replacer program on calf performance and digestion of nutrients in dairy calves to 4 months of age.

PubMed

Hill, T M; Quigley, J D; Bateman, H G; Suarez-Mena, F X; Dennis, T S; Schlotterbeck, R L

2016-10-01

Calves fed >0.7kg of dry matter from milk replacer (MR) typically have greater growth preweaning but lower growth postweaning. This is partially explained by lower digestibility of starter due to less development of the rumen at and after weaning; however, it is unclear when digestibility matures postweaning to levels typical of mature ruminants. Thus, we fed Holstein calves (initially 2 to 3d of age) 3 MR programs (MOD=0.66kg daily for 39d, and then 0.33kg daily for 3d, n=15 calves; HIMOD=0.88kg daily for 5d, then 1.1kg daily for 23d, then 0.66kg daily for 18d, and then 0.33kg daily for 3d, n=16 calves; HI=0.88kg daily for 5d, then 1.1kg daily for 37d, and then 0.56kg daily for 7d, n=15 calves). The MR consisted of 28% crude protein and 20% fat and was reconstituted to 14% solids and fed at 0630 and 1400 h daily. A 39% starch textured starter (19% crude protein) was fed free-choice for the first 56d of a nursery trial with calves in individual pens. From 56 to 112d, calves were grouped by MR program into pens of 3 to 4 calves and offered a starter with the same ingredient composition blended with 5% chopped grass hay for ad libitum consumption. Digestion was estimated at 11 and 16wk. Measurements in the first and second 56d were analyzed separately in a completely randomized design using repeated measurements when applicable. Preplanned contrasts of MOD versus HIMOD and MOD versus HI were used to separate means. Milk replacer dry matter intake was 26.6, 42.4, and 48.7kg in calves fed MOD, HIMOD, and HI, respectively. Starter intake was less for calves fed HIMOD and HI versus MOD from 3 to 8wk. Efficiency of metabolizable energy and protein used for body weight gain did not differ among programs. During the second 56d, body weight gain and hip width changes were greater for calves fed MOD than HI. Total 112-d body weight gain and total hip width changes were 101.4, 101.3, and 101.7kg, and 9.0, 9.1, and 8.7cm for MOD, HIMOD, and HI, respectively. Digestibility of all nutrients except starch were greater at 16 versus 11wk of age. Digestibility of dry matter, organic matter, neutral detergent fiber, and acid detergent fiber were less for HI versus MOD at 11wk of age explaining much of the why postweaning body weight gain advantages were lost postweaning in calves fed the HI program. Feeding more than 0.66kg of dry matter intake from a MR during the preweaning phase did not increase total body weight or hip width gain from 0 to 4mo of age. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

PREFACE: Modern Technologies in Industrial Engineering (ModTech2015)

NASA Astrophysics Data System (ADS)

Oanta, E.; Comaneci, R.; Carausu, C.; Placzek, M.; Cohal, V.; Topala, P.; Nedelcu, D.

2015-11-01

The dominant feature of the current stage of society development is the update, refinement and innovation of the technological processes and products whose ultimate goal is to satisfy the market requirements. New and modern technologies should be considered in terms of their applicability in industry while the materials can lead to an increase in the quality of the end products. Replacing the existing technologies with innovative and eco-efficient technologies can contribute to an added value increase in the production of new materials. Materials are one of the most dynamic and prospective fields, with applications in all other fields. The development of new advanced materials and technologies shall contribute to the procurement of a wide range of reliable products, with competitive prices and worldwide performance, high sensitivity and functionality, user-friendly and reduced energy consumption, for different industrial applications. Research in the field of advanced/intelligent materials supposes a fundamental, experimental, laboratory and technological research and its approach has to be linked to the application. This involves, even for the niche fields, complex projects which result in scientific issues in top journals, patents and functional models. The third edition of ModTech International Conference was held in Mamaia, Romania, between June 17-20, with the Professional Association in Modern Manufacturing Technologies, ModTech, as main organizer, and the Constanta Maritime University, Constanta, Romania, Silesian University of Technology, Gliwice, Poland, the Technical University of Chisinau, Republic of Moldova and the Donetsk National Technical University, Donetsk, Ukraine as co-organizers. The ModTech2015 International Conference brought together representatives of technology and materials manufacturers, various universities, professional associations and research institutes that exchanged the latest knowledge on the conference topics. This edition was attended by 140 participants from 17 countries. The authors and co-authors were from various countries worldwide, namely: Sweden, China, Switzerland, Romania, Serbia, Germany, Netherlands, Belgium, France, South Korea, Taiwan, Poland, USA, Slovenia, Turkey, Republic of Moldova, Russia, Finland, Japan, Ukraine, Portugal, Uzbekistan, Iraq, Italy and India. The Keynote Speakers were as follows: Prof. Esteban Broitman - Linkoping University, Sweden; Prof. Ziyi Ge - NIMTE, Chinese Academy of Sciences, Ningbo, China; Prof. Thomas Graule - EMPA, Switzerland; prof. Razvan Tamas - Constanta Maritime University, Romania; Prof. Rainer Gadow - University of Stuttgart, Germany; Prof. Marcel Van de Voorde - DELFT University of Technology, Netherlands; Prof. Chris Lacor - Vrije University, Brussels, Belgium; Prof. Fiqiri Hodaj - National Polytechnique Institute of Grenoble, France; Prof. Hong Seok Park - University of Ulsan, South Korea; Prof. Der-Jang Liaw - National Taiwan University of Science and Technology, Taiwan; Prof. Petrica Vizureanu - Gheorghe Asachi Technical University of Iasi, Romania. The main publications of ModTech2015 International Conference are as follows: IOP Conference Series: Materials Science and Engineering, United Kingdom, Indian Journal of Engineering & Materials Sciences (IJEMS) and International Journal of Modern Manufacturing Technologies (IJMMT).

A Tale of Two Paradigms: The Impact of Psychological Capital and Reinforcing Feedback on Problem Solving and Innovation

ERIC Educational Resources Information Center

Luthans, Fred; Youssef, Carolyn M.; Rawski, Shannon L.

2011-01-01

This study drew from two distinct paradigms: the social cognitively based emerging field of positive organizational behavior or POB and the more established behaviorally based area of organizational behavior modification or OB Mod. The intent was to show that both can contribute to complex challenges facing today's organizations. Using a…

Changes in Impedance at the Electrode-Skin Interface of Surface EMG Electrodes During Long-Term EMG Recordings

DTIC Science & Technology

2001-10-25

1Laboratoire de Modélisation et Sûreté des Systèmes, Université de Technologie de Troyes , Troyes , France 2Institut de Myologie, GH Pitié-Salpêtrière...Technologie de Troyes , Troyes , France Performing Organization Report Number Sponsoring/Monitoring Agency Name(s) and Address(es) US Army Research

Feasibility of using auto Mod-MPI system, a novel technique for automated measurement of fetal modified myocardial performance index.

PubMed

Lee, M-Y; Won, H-S; Jeon, E-J; Yoon, H C; Choi, J Y; Hong, S J; Kim, M-J

2014-06-01

To evaluate the reproducibility of measurement of the fetal left modified myocardial performance index (Mod-MPI) determined using a novel automated system. This was a prospective study of 116 ultrasound examinations from 110 normal singleton pregnancies at 12 + 1 to 37 + 1 weeks' gestation. Two experienced operators each measured the left Mod-MPI twice manually and twice automatically using the Auto Mod-MPI system. Intra- and interoperator reproducibility were assessed using intraclass correlation coefficients (ICCs) and the manual and automated measurements obtained by the more experienced operator were compared using Bland-Altman plots and ICCs. Both operators successfully measured the left Mod-MPI in all cases using the Auto Mod-MPI system. For both operators, intraoperator reproducibility was higher when performing automated measurements (ICC = 0.967 and 0.962 for Operators 1 and 2, respectively) than when performing manual measurements (ICC = 0.857 and 0.856 for Operators 1 and 2, respectively). Interoperator agreement was also better for automated than for manual measurements (ICC = 0.930 vs 0.723, respectively). There was good agreement between the automated and manual values measured by the more experienced operator. The Auto Mod-MPI system is a reliable technique for measuring fetal left Mod-MPI and demonstrates excellent reproducibility. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd.

COMPARISON OF DIFFERENT TRUNK ENDURANCE TESTING METHODS IN COLLEGE‐AGED INDIVIDUALS

PubMed Central

Krier, Amber D.; Nelson, Julie A.; Rogers, Michael A.; Stuke, Zachariah O.; Smith, Barbara S.

2012-01-01

Objective: Determine the reliability of two different modified (MOD1 and MOD2) testing methods compared to a standard method (ST) for testing trunk flexion and extension endurance. Participants: Twenty‐eight healthy individuals (age 26.4 ± 3.2 years, height 1.75 ± m, weight 71.8 ± 10.3 kg, body mass index 23.6 ± 3.4 m/kg2). Method: Trunk endurance time was measured in seconds for flexion and extension under the three different stabilization conditions. The MOD1 testing procedure utilized a female clinician (70.3 kg) and MOD2 utilized a male clinician (90.7 kg) to provide stabilization as opposed to the ST method of belt stabilization. Results: No significant differences occurred between flexion and extension times. Intraclass correlations (ICCs3,1) for the different testing conditions ranged from .79 to .95 (p <.000) and are found in Table 3. Concurrent validity using the ST flexion times as the gold standard coefficients were .95 for MOD1 and .90 for MOD2. For ST extension, coefficients were .91 and .80, for MOD1 and MOD2 respectively (p <.01). Conclusions: These methods proved to be a reliable substitute for previously accepted ST testing methods in normal college‐aged individuals. These modified testing procedures can be implemented in athletic training rooms and weight rooms lacking appropriate tables for the ST testing. Level of Evidence: 3 PMID:23091786

Validation of microscopic observation drug susceptibility testing for rapid, direct rifampicin and isoniazid drug susceptibility testing in patients receiving tuberculosis treatment

PubMed Central

Coronel, J; Roper, M H; Herrera, C; Bonilla, C; Jave, O; Gianella, C; Sabogal, I; Huancaré, V; Leo, E; Tyas, A; Mendoza-Ticona, A; Caviedes, L; Moore, D A J; Drancourt, M

2014-01-01

Drug susceptibility testing (DST) is often needed in patients clinically failing tuberculosis (TB) therapy. Most studies of phenotypic direct drug susceptibility tests, such as microscopic observation drug susceptibility (MODS) tests, have been performed in patients not receiving TB treatment. The effect of ongoing TB treatment on the performance of MODS direct DST has not been previously explored, but patients failing such therapy constitute an important target group. The aim of this study was to determine the performance of MODS direct rifampicin and isoniazid DST in patients clinically failing first-line TB treatment, and to compare MODS direct DST with indirect proportion method DST. Sputa from 264 TB patients were cultured in parallel in Lowenstein–Jensen (LJ) and MODS assays; strains were tested for rifampicin and isoniazid susceptibility by the proportion method at the national reference laboratory. Ninety-three samples were culture-positive by LJ and MODS (concordance of 96%; kappa 0.92). With conventional MODS plate DST reading (performed on the same day as the sample is classified as culture-positive), the isoniazid DST concordance was 96.8% (kappa 0.89), and the concordance for rifampicin susceptibility testing was 92.6% (kappa 0.80). Reading of MODS DST plates 1 week after cultures had been determined to be culture-positive improved overall performance marginally—the isoniazid DST concordance was 95.7% (kappa 0.85); and the rifampicin DST concordance was 96.8% (kappa 0.91). Sensitivity for detection of multidrug-resistant TB was 95.8%. MODS testing provided reliable rifampicin and isoniazid DST results for samples obtained from patients receiving TB therapy. A modified DST reading schedule for such samples, with a final reading 1 week after a MODS culture turns positive, marginally improves the concordance with reference DST. PMID:24107197

Automotive Stirling Engine Development Project

NASA Technical Reports Server (NTRS)

Ernst, William D.; Shaltens, Richard K.

1997-01-01

The development and verification of automotive Stirling engine (ASE) component and system technology is described as it evolved through two experimental engine designs: the Mod 1 and the Mod 2. Engine operation and performance and endurance test results for the Mod 1 are summarized. Mod 2 engine and component development progress is traced from the original design through hardware development, laboratory test, and vehicle installation. More than 21,000 hr of testing were accomplished, including 4800 hr with vehicles that were driven more dm 59,000 miles. Mod 2 engine dynamometer tests demonstrated that the engine system configuration had accomplished its performance goals for power (60 kW) and efficiency (38.5%) to within a few percent. Tests with the Mod 2 engine installed in a delivery van demonstrated combined metro-highway fuel economy improvements consistent with engine performance goals and the potential for low emission levels. A modified version of the Mod 2 has been identified as a manufacturable design for an ASE. As part of the ASE project, the Industry Test and Evaluation Program (ITEP), NASA Technology Utilization (TU) project, and the industry-funded Stirling Natural Gas Engine program were undertaken to transfer ASE technology to end users. The results of these technology transfer efforts are also summarized.

40 CFR Appendix V to Part 86 - The Standard Road Cycle (SRC)

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) CONTROL OF EMISSIONS FROM NEW AND IN-USE HIGHWAY VEHICLES AND ENGINES (CONTINUED) Pt. 86, App. V... engine) Idle 10 sec 0 1 Mod accel to 30 MPH 4 1 Cruise at 30 MPH for 1/4 lap 0 1 Mod. decel to 20 MPH −5 1 Mod accel to 30 MPH 4 1 Cruise at 30 MPH for 1/4 lap 0 1 Mod. decel to stop −5 1 Idle 5 sec 0 1...

40 CFR Appendix V to Part 86 - The Standard Road Cycle (SRC)

Code of Federal Regulations, 2012 CFR

2012-07-01

... (CONTINUED) CONTROL OF EMISSIONS FROM NEW AND IN-USE HIGHWAY VEHICLES AND ENGINES (CONTINUED) Pt. 86, App. V... engine) Idle 10 sec 0 1 Mod accel to 30 MPH 4 1 Cruise at 30 MPH for 1/4 lap 0 1 Mod. decel to 20 MPH −5 1 Mod accel to 30 MPH 4 1 Cruise at 30 MPH for 1/4 lap 0 1 Mod. decel to stop −5 1 Idle 5 sec 0 1...

40 CFR Appendix V to Part 86 - The Standard Road Cycle (SRC)

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) CONTROL OF EMISSIONS FROM NEW AND IN-USE HIGHWAY VEHICLES AND ENGINES Pt. 86, App. V Appendix V... engine) Idle 10 sec 0 1 Mod accel to 30 MPH 4 1 Cruise at 30 MPH for 1/4 lap 0 1 Mod. decel to 20 MPH −5 1 Mod accel to 30 MPH 4 1 Cruise at 30 MPH for 1/4 lap 0 1 Mod. decel to stop −5 1 Idle 5 sec 0 1...

[Organ damage and cardiorenal syndrome in acute heart failure].

PubMed

Casado Cerrada, Jesús; Pérez Calvo, Juan Ignacio

2014-03-01

Heart failure is a complex syndrome that affects almost all organs and systems of the body. Signs and symptoms of organ dysfunction, in particular kidney dysfunction, may be accentuated or become evident for the first time during acute decompensation of heart failure. Cardiorenal syndrome has been defined as the simultaneous dysfunction of both the heart and the kidney, regardless of which of the two organs may have suffered the initial damage and regardless also of their previous functional status. Research into the mechanisms regulating the complex relationship between the two organs is prompting the search for new biomarkers to help physicians detect renal damage in subclinical stages. Hence, a preventive approach to renal dysfunction may be adopted in the clinical setting in the near future. This article provides a general overview of cardiorenal syndrome and an update of the physiopathological mechanisms involved. Special emphasis is placed on the role of visceral congestion as an emergent mechanism in this syndrome. Copyright © 2014 Elsevier España, S.L. All rights reserved.

Twenty Years of Research on the Alcator C-Mod Tokamak

NASA Astrophysics Data System (ADS)

Greenwald, Martin

2013-10-01

Alcator C-Mod is a compact, high-field tokamak, whose unique design and operating parameters have produced a wealth of new and important results since its start in 1993, contributing data that extended tests of critical physical models into new parameter ranges and into new regimes. Using only RF for heating and current drive with innovative launching structures, C-Mod operates routinely at very high power densities. Research highlights include direct experimental observation of ICRF mode-conversion, ICRF flow drive, demonstration of Lower-Hybrid current drive at ITER-like densities and fields and, using a set of powerful new diagnostics, extensive validation of advanced RF codes. C-Mod spearheaded the development of the vertical-target divertor and has always operated with high-Z metal plasma facing components--an approach adopted for ITER. C-Mod has made ground-breaking discoveries in divertor physics and plasma-material interactions at reactor-like power and particle fluxes and elucidated the critical role of cross-field transport in divertor operation, edge flows and the tokamak density limit. C-Mod developed the I-mode and EDA H-mode regimes which have high performance without large ELMs and with pedestal transport self-regulated by short-wavelength electromagnetic waves. C-Mod has carried out pioneering studies of intrinsic rotation and found that self-generated flow shear can be strong enough to significantly modify transport. C-Mod made the first quantitative link between pedestal temperature and H-mode performance, showing that the observed self-similar temperature profiles were consistent with critical-gradient-length theories and followed up with quantitative tests of nonlinear gyrokinetic models. Disruption studies on C-Mod provided the first observation of non-axisymmetric halo currents and non-axisymmetric radiation in mitigated disruptions. Work supported by U.S. DoE

Mission Operations Directorate - Success Legacy of the Space Shuttle Program (Overview of the Evolution and Success Stories from MOD During the Space Shuttle program)

NASA Technical Reports Server (NTRS)

Azbell, Jim A.

2011-01-01

In support of the Space Shuttle Program, as well as NASA's other human space flight programs, the Mission Operations Directorate (MOD) at the Johnson Space Center has become the world leader in human spaceflight operations. From the earliest programs - Mercury, Gemini, Apollo - through Skylab, Shuttle, ISS, and our Exploration initiatives, MOD and its predecessors have pioneered ops concepts and emphasized a history of mission leadership which has added value, maximized mission success, and built on continual improvement of the capabilities to become more efficient and effective. This paper provides specific examples that illustrate how MOD's focus on building and contributing value with diverse teams has been key to their successes both with the US space industry and the broader international community. This paper will discuss specific examples for the Plan, Train, Fly, and Facilities aspects within MOD. This paper also provides a discussion of the joint civil servant/contractor environment and the relative badge-less society within MOD. Several Shuttle mission related examples have also been included that encompass all of the aforementioned MOD elements and attributes, and are used to show significant MOD successes within the Shuttle Program. These examples include the STS-49 Intelsat recovery and repair, the (post-Columbia accident) TPS inspection process and the associated R-Bar Pitch Maneuver for ISS missions, and the STS-400 rescue mission preparation efforts for the Hubble Space Telescope repair mission. Since their beginning, MOD has consistently demonstrated their ability to evolve and respond to an ever changing environment, effectively prepare for the expected and successfully respond to the unexpected, and develop leaders, expertise, and a culture that has led to mission and Program success.

Microcolony culture techniques for tuberculosis diagnosis: a systematic review.

PubMed

Leung, E; Minion, J; Benedetti, A; Pai, M; Menzies, D

2012-01-01

There is considerable demand for quicker and more affordable yet accurate diagnostic tools for tuberculosis (TB). The microscopic observation drug susceptibility (MODS) assay and the thin-layer agar (TLA) assay are inexpensive, rapid microcolony-based culture methods. A systematic review and meta-analysis was performed to assess the accuracy and other test characteristics of MODS and TLA compared to a reference standard of traditional solid or liquid culture. Pooled estimates of sensitivity and specificity and their 95% confidence intervals were estimated with an exact binomial likelihood random effects meta-analysis. A total of 21 eligible studies were identified, 12 that evaluated MODS, seven that evaluated TLA and two that evaluated both. The overall pooled sensitivity and specificity of MODS were respectively 92% (95%CI 87-97) and 96% (90-100), and for TLA they were respectively 87% (95%CI 79-94) and 98% (95%CI 94-100), although there was considerable heterogeneity of results. When the studies were restricted to those assessing accuracy of MODS in sputum samples only, the sensitivity was 96% (95%CI 94-98) and the specificity 96% (95%CI 89-100). The mean intervals from reception of specimens to results were 9.2 days with MODS and 11.5 days with TLA; contamination rates averaged 6.6% with MODS and 12.3% with TLA; materials and supplies costs averaged US$1.48 for MODS and US$2.42 for TLA. MODS and TLA appear to be accurate and rapid yet inexpensive diagnostic tools for active TB. However, this review did not find sufficient evidence on the feasibility and costs of implementation of these tests, nor on the impact of these tests on patient outcomes.

TOPICAL REVIEW: Review of a chemical approach to YBa2Cu3O7-x-coated superconductors—metalorganic deposition using trifluoroacetates

NASA Astrophysics Data System (ADS)

Araki, Takeshi; Hirabayashi, Izumi

2003-11-01

Large-area, uniform, high critical current density (Jc) YBa2Cu3O7-x (YBCO) superconductor films are now routinely obtained by metalorganic deposition using trifluoroacetates (TFA-MOD). This method does not require any expensive vacuum apparatus at any time during the whole process. Thus, TFA-MOD is regarded as one of the most suitable candidates for fabricating a YBCO tape for many high-power applications. This method originated from an electron beam process using BaF2 developed by Mankiewich et al. Afterwards, Gupta et al reported using TFA-MOD to prepare a similar precursor film. These two ex situ processes used fluorides instead of BaCO3 to avoid the fatal deterioration in Jc, which is caused in the resulting films through metal carboxylic groups. Fluorides not only avoid such deterioration but also lead to perfectly c-axis-oriented epitaxial crystal growth. In conventional metalorganic deposition, nucleation in the precursor film causes random orientation in the resulting film. However, in TFA-MOD, nanocrystallites in the precursor film never cause such disorder. Furthermore, during the firing process of TFA-MOD, water and HF gas diffuse quickly between the film surface and growth front of the YBCO layer. This diffusion never limits the growth rate of YBCO. What distinguishes TFA-MOD from conventional metalorganic deposition? What happens during heat treatment? In this paper, we discuss all the TFA-MOD processes and the peculiar growth scheme of the YBCO layer in TFA-MOD using the model of a quasi-liquid network. In addition, we review the history of TFA-MOD and recent results and discuss the prospects of future applications.

Effect of extracorporeal cytokine removal on vascular barrier function in a septic shock patient.

PubMed

David, Sascha; Thamm, Kristina; Schmidt, Bernhard M W; Falk, Christine S; Kielstein, Jan T

2017-01-01

Sepsis and septic shock are major healthcare problems, affecting millions of individuals around the world each year. Pathophysiologically, septic multiple organ dysfunction (MOD) is a life-threatening condition caused by an overwhelming systemic inflammatory response of the host's organism to an infection. We experimentally tested if high circulating cytokine levels might increase vascular permeability-a critical hallmark of the disease-and if this phenomenon can be reversed by therapeutic cytokine removal (CytoSorb®) in an exemplary patient. A 32-year-old Caucasian female presented with septic shock and accompanying acute kidney injury (Sequential Organ Failure Assessment (SOFA) = 18) to our ICU. In spite of a broad anti-infective regimen, adequate fluid resuscitation, and high doses of inotropics and catecholamines, she remained refractory hypotensive. The extraordinary severity of septic shock suggested an immense overwhelming host response assumingly accompanied by a notable cytokine storm such as known from patients with toxic shock syndrome. Thus, a CytoSorb® filter was added to the dialysis circuit to remove excess shock-perpetuating cytokines. To analyze the endothelial phenotype in vitro before and after extracorporeal cytokine removal, we tested the septic shock patient's serum on human umbilical vein endothelial cells (HUVECs). The effect on endothelial integrity was assessed both on the morphological (fluorescent immunocytochemistry for VE-cadherin and F-actin) and functional (transendothelial electrical resistance (TER)) level that was recorded in real time with an "electric cell-substrate impedance sensing" (ECIS) system (ibidi). We found (1) severe alterations of cell-cell contacts and the cytoskeletal architecture and (2) profound functional permeability changes, the putative cellular correlate of the clinical vascular leakage syndrome. However, the endothelial barrier was protected from these profound adverse effects when HUVECs were challenged with septic shock serum that was collected after extracorporeal cytokine removal. Beneficial observations of extracorporeal cytokine removal in septic shock patients might-at least in part-be promoted via protection of vascular barrier function.

Large wind turbine generators. [NASA program status and potential costs

NASA Technical Reports Server (NTRS)

Thomas, R. L.; Donovon, R. M.

1978-01-01

The large wind turbine portion of the Federal Wind Energy Program consists of two major project efforts: (1) the Mod-0 test bed project for supporting research technology, and (2) the large experimental wind turbines for electric utility applications. The Mod-0 has met its primary objective of providing the entire wind energy program with early operations and performance data. The large experimental wind turbines to be tested in utility applications include three of the Mod-0A (200 kW) type, one Mod-1 (2000 kW), and possibly several of the Mod-2 (2500 kW) designs. This paper presents a description of these wind turbine systems, their programmatic status, and a summary of their potential costs.

Operational results for the experimental DOE/NASA Mod-OA wind turbine project

NASA Astrophysics Data System (ADS)

Shaltens, R. K.; Birchenough, A. G.

The Mod-OA wind turbine project which was to gain early experience in the operation of large wind turbines in a utility environment is discussed. The Mod-OA wind turbines were a first generation design, and even though not cost effective, the operating experience and performance characteristics had a significant effect on the design and development of the second and third generation machines. The Mod-OA machines were modified as a result of the operational experience, particularly the blade development and control system strategy. The results of study to investigate the interaction of a Mod-OA wind turbine with an isolated diesel generation system are discussed. The machine configuration, its advantages and disadvantages and the machine performance and availability are discussed.

Operational results for the experimental DOE/NASA Mod-OA wind turbine project

NASA Technical Reports Server (NTRS)

Shaltens, R. K.; Birchenough, A. G.

1983-01-01

The Mod-OA wind turbine project which was to gain early experience in the operation of large wind turbines in a utility environment is discussed. The Mod-OA wind turbines were a first generation design, and even though not cost effective, the operating experience and performance characteristics had a significant effect on the design and development of the second and third generation machines. The Mod-OA machines were modified as a result of the operational experience, particularly the blade development and control system strategy. The results of study to investigate the interaction of a Mod-OA wind turbine with an isolated diesel generation system are discussed. The machine configuration, its advantages and disadvantages and the machine performance and availability are discussed.

Protocolized Treatment Is Associated With Decreased Organ Dysfunction in Pediatric Severe Sepsis.

PubMed

Balamuth, Fran; Weiss, Scott L; Fitzgerald, Julie C; Hayes, Katie; Centkowski, Sierra; Chilutti, Marianne; Grundmeier, Robert W; Lavelle, Jane; Alpern, Elizabeth R

2016-09-01

To determine whether treatment with a protocolized sepsis guideline in the emergency department was associated with a lower burden of organ dysfunction by hospital day 2 compared to nonprotocolized usual care in pediatric patients with severe sepsis. Retrospective cohort study. Tertiary care children's hospital from January 1, 2012, to March 31, 2014. Patients older than 56 days old and younger than 18 years old with international consensus defined severe sepsis and who required PICU admission within 24 hours of emergency department arrival were included. The exposure was the use of a protocolized emergency department sepsis guideline. The primary outcome was complete resolution of organ dysfunction by hospital day 2. One hundred eighty nine subjects were identified during the study period. Of these, 121 (64%) were treated with the protocolized emergency department guideline and 68 were not. There were no significant differences between the groups in age, sex, race, number of comorbid conditions, emergency department triage level, or organ dysfunction on arrival to the emergency department. Patients treated with protocolized emergency department care were more likely to be free of organ dysfunction on hospital day 2 after controlling for sex, comorbid condition, indwelling central venous catheter, Pediatric Index of Mortality-2 score, and timing of antibiotics and IV fluids (adjusted odds ratio, 4.2; 95% CI, 1.7-10.4). Use of a protocolized emergency department sepsis guideline was independently associated with resolution of organ dysfunction by hospital day 2 compared to nonprotocolized usual care. These data indicate that morbidity outcomes in children can be improved with the use of protocolized care.

Organ dysfunction, injury and failure in acute heart failure: from pathophysiology to diagnosis and management. A review on behalf of the Acute Heart Failure Committee of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC).

PubMed

Harjola, Veli-Pekka; Mullens, Wilfried; Banaszewski, Marek; Bauersachs, Johann; Brunner-La Rocca, Hans-Peter; Chioncel, Ovidiu; Collins, Sean P; Doehner, Wolfram; Filippatos, Gerasimos S; Flammer, Andreas J; Fuhrmann, Valentin; Lainscak, Mitja; Lassus, Johan; Legrand, Matthieu; Masip, Josep; Mueller, Christian; Papp, Zoltán; Parissis, John; Platz, Elke; Rudiger, Alain; Ruschitzka, Frank; Schäfer, Andreas; Seferovic, Petar M; Skouri, Hadi; Yilmaz, Mehmet Birhan; Mebazaa, Alexandre

2017-07-01

Organ injury and impairment are commonly observed in patients with acute heart failure (AHF), and congestion is an essential pathophysiological mechanism of impaired organ function. Congestion is the predominant clinical profile in most patients with AHF; a smaller proportion presents with peripheral hypoperfusion or cardiogenic shock. Hypoperfusion further deteriorates organ function. The injury and dysfunction of target organs (i.e. heart, lungs, kidneys, liver, intestine, brain) in the setting of AHF are associated with increased risk for mortality. Improvement in organ function after decongestive therapies has been associated with a lower risk for post-discharge mortality. Thus, the prevention and correction of organ dysfunction represent a therapeutic target of interest in AHF and should be evaluated in clinical trials. Treatment strategies that specifically prevent, reduce or reverse organ dysfunction remain to be identified and evaluated to determine if such interventions impact mortality, morbidity and patient-centred outcomes. This paper reflects current understanding among experts of the presentation and management of organ impairment in AHF and suggests priorities for future research to advance the field. © 2017 The Authors. European Journal of Heart Failure © 2017 European Society of Cardiology.

The neurobiology of modafinil as an enhancer of cognitive performance and a potential treatment for substance use disorders

PubMed Central

Mereu, Maddalena; Bonci, Antonello; Newman, Amy Hauck; Tanda, Gianluigi

2013-01-01

Rationale and Objectives Modafinil (MOD) and its R-enantiomer (R-MOD) are approved medications for narcolepsy and other sleep disorders. They have also been used, off label, as cognitive enhancers in populations of patients with mental disorders, including substance abusers that demonstrate impaired cognitive function. A debated non-medical use of MOD in healthy individuals to improve intellectual performance is raising questions about its potential abuse liability in this population. Results and Conclusions MOD has low micromolar affinity for the dopamine transporter (DAT). Inhibition of dopamine (DA) reuptake via the DAT explains the enhancement of DA levels in several brain areas, an effect shared with psychostimulants like cocaine, methylphenidate and the amphetamines. However, its neurochemical effects and anatomical pattern of brain area activation differ from typical psychostimulants and are consistent with its beneficial effects on cognitive performance processes such as attention, learning, and memory. At variance with typical psychostimulants, MOD shows very low, if any, abuse liability, in spite of its use as a cognitive enhancer by otherwise healthy individuals. Finally, recent clinical studies have focused on the potential use of MOD as a medication for treatment of drug abuse, but have not shown consistent outcomes. However, positive trends in several result measures suggest that medications that improve cognitive function, like MOD or R-MOD, may be beneficial for treatment of substance use disorders in certain patient populations. PMID:23934211

Over-current carrying characteristics of rectangular-shaped YBCO thin films prepared by MOD method

NASA Astrophysics Data System (ADS)

Hotta, N.; Yokomizu, Y.; Iioka, D.; Matsumura, T.; Kumagai, T.; Yamasaki, H.; Shibuya, M.; Nitta, T.

2008-02-01

A fault current limiter (FCL) may be manufactured at competitive qualities and prices by using rectangular-shaped YBCO films which are prepared by metal-organic deposition (MOD) method, because the MOD method can produce large size elements with a low-cost and non-vacuum technique. Prior to constructing a superconducting FCL (SFCL), AC over-current carrying experiments were conducted for 120 mm long elements where YBCO thin film of about 200 nm in thickness was coated on sapphire substrate with cerium oxide (CeO2) interlayer. In the experiments, only single cycle of the ac damping current of 50 Hz was applied to the pure YBCO element without protective metal coating or parallel resistor and the magnitude of the current was increased step by step until the breakdown phenomena occurred in the element. In each experiment, current waveforms flowing through the YBCO element and voltage waveform across the element were measured to get the voltage-current characteristics. The allowable over-current and generated voltage were successfully estimated for the pure YBCO films. It can be pointed out that the lower n-value trends to bring about the higher allowable over-current and the higher withstand voltage more than tens of volts. The YBCO film having higher n-value is sensitive to the over-current. Thus, some protective methods such as a metal coating should be employed for applying to the fault current limiter.

The diagnosis and management of progressive dysfunction of health care organizations.

PubMed

Chervenak, Frank A; McCullough, Laurence B

2005-04-01

This paper presents an ethically justified approach to the diagnosis and management of progressive dysfunction of health care organizational cultures. We explain the concept of professional integrity in terms of the ethical concept of the cofiduciary responsibility of physicians and health care organizations. We identify the ethical features of a healthy health care organization and the spectrum of progressive dysfunction of organizational cultures from cynical through wonderland and Kafkaesque to postmodern. Physicians should respond to cynical health care organizations by creating moral enclaves of professional integrity for the main purpose of confrontation and reform, to wonderland organizations by strengthening moral enclaves for the main purpose of resisting self-deception, to Kafkaesque organizations by strengthening moral enclaves still further for the main purpose of defending professional integrity (adopting a Machiavellian appearance of virtue as necessary), and to postmodern organizations by creating moral fortresses and, should these fail, quitting.

78 FR 69805 - Periodic Reporting (Proposals Six Through Nine)

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-21

... MODS Operation Groups for Productivity Calculations The Postal Service states that Proposal Eight would... MODS productivity data (TPF or TPH per workhour) for a variety of operation groups related to letter, flat, parcel, and bundle sorting. The MODS productivity data are used to parameterize a number of cost...

Moving Past "Hello World": Learning to Mod in an Online Affinity Space

ERIC Educational Resources Information Center

Subramanian, Shree Durga

2012-01-01

Game modding has increasingly become a mainstream and "cutting edge" medium to foster a broad range of critical software design and programming practices to learners coming from wide-ranging educational and professional backgrounds. Participatory practices, like game modding, are highly interest-driven and entail intense engagement with…

Automotive Stirling Engine Development Program

NASA Technical Reports Server (NTRS)

Nightingale, N.; Richey, A.; Farrell, R.; Riecke, G.; Ernst, W.; Howarth, R.; Cronin, M.; Simetkosky, M.; Smith, G.; Meacher, J.

1985-01-01

Development test activities on Mod I engines directed toward evaluating technologies for potential inclusion in the Mod II engine are summarized. Activities covered include: test of a 12-tube combustion gas recirculation combustor; manufacture and flow-distribution test of a two-manifold annular heater head; piston rod/piston base joint; single-solid piston rings; and a digital air/fuel concept. Also summarized are results of a formal assessment of candidate technologies for the Mod II engine, and preliminary design work for the Mod II. The overall program philosophy weight is outlined, and data and test results are presented.

Multimission Modular Spacecraft Ground Support Software System (MMS/GSSS) state-of-the-art computer systems/ compatibility study

NASA Technical Reports Server (NTRS)

1980-01-01

The compatibility of the Multimission Modular Spacecraft (MMS) Ground Support Software System (GSSS), currently operational on a ModComp IV/35, with the VAX 11/780 system is discussed. The compatibility is examined in various key areas of the GSSS through the results of in depth testing performed on the VAX 11/780 and ModComp IV/35 systems. The compatibility of the GSSS with the ModComp CLASSIC is presented based upon projections from ModComp supplied literature.

A Literature Survey of Reverberation Modeling: With Emphasis on Bellhop Compatibility for Operational Applications

DTIC Science & Technology

2010-09-01

modèles à orientation opérationnelle ( comparativement à ceux orientés vers la recherche) qui pourraient être compatibles avec le modèle de propagation...concentre sur les modèles à orientation opérationnelle (en sacrifiant un certain degré d’exactitude pour accroître la réactivité, comparativement aux modèles...these modeling efforts are not applicable to Bellhop because they are designed specifically to take advantage of the normal mode decomposition

Lods, wrods, and mods: the interpretation of lod scores calculated under different models.

PubMed

Hodge, S E; Elston, R C

1994-01-01

In this paper we examine the relationships among classical lod scores, "wrod" scores (lod scores calculated under the wrong genetic model), and "mod" scores (lod scores maximized over genetic model parameters). We compare the behavior of these scores when the state of nature is linkage to their behavior when the state of nature is no linkage. We describe sufficient conditions for mod scores to be valid and discuss their use to determine the correct genetic model. We show that lod scores represent a likelihood-ratio test for independence. We explain the "ascertainment-assumption-free" aspect of using mod scores to determine mode of inheritance and we set this aspect into a well-established statistical framework. Finally, we summarize practical guidelines for the use of mod scores.

Bioactivation of organic nitrates and the mechanism of nitrate tolerance.

PubMed

Klemenska, Emila; Beresewicz, Andrzej

2009-01-01

Organic nitrates, such as nitroglycerin, are commonly used in the therapy of cardiovascular disease. Long-term therapy with these drugs, however, results in the rapid development of nitrate tolerance, limiting their hemodynamic and anti-ischemic efficacy. In addition, nitrate tolerance is associated with the expression of potentially deleterious modifications such as increased oxidative stress, endothelial dysfunction, and sympathetic activation. In this review we discuss current concepts regarding the mechanisms of organic nitrate bioactivation, nitrate tolerance, and nitrate-mediated oxidative stress and endothelial dysfunction. We also examine how hydralazine may prevent nitrate tolerance and related endothelial dysfunction.

Performance of Linear and Nonlinear Two-Leaf Light Use Efficiency Models at Different Temporal Scales

DOE PAGES

Wu, Xiaocui; Ju, Weimin; Zhou, Yanlian; ...

2015-02-25

The reliable simulation of gross primary productivity (GPP) at various spatial and temporal scales is of significance to quantifying the net exchange of carbon between terrestrial ecosystems and the atmosphere. This study aimed to verify the ability of a nonlinear two-leaf model (TL-LUEn), a linear two-leaf model (TL-LUE), and a big-leaf light use efficiency model (MOD17) to simulate GPP at half-hourly, daily and 8-day scales using GPP derived from 58 eddy-covariance flux sites in Asia, Europe and North America as benchmarks. Model evaluation showed that the overall performance of TL-LUEn was slightly but not significantly better than TL-LUE at half-hourlymore » and daily scale, while the overall performance of both TL-LUEn and TL-LUE were significantly better (p < 0.0001) than MOD17 at the two temporal scales. The improvement of TL-LUEn over TL-LUE was relatively small in comparison with the improvement of TL-LUE over MOD17. However, the differences between TL-LUEn and MOD17, and TL-LUE and MOD17 became less distinct at the 8-day scale. As for different vegetation types, TL-LUEn and TL-LUE performed better than MOD17 for all vegetation types except crops at the half-hourly scale. At the daily and 8-day scales, both TL-LUEn and TL-LUE outperformed MOD17 for forests. However, TL-LUEn had a mixed performance for the three non-forest types while TL-LUE outperformed MOD17 slightly for all these non-forest types at daily and 8-day scales. The better performance of TL-LUEn and TL-LUE for forests was mainly achieved by the correction of the underestimation/overestimation of GPP simulated by MOD17 under low/high solar radiation and sky clearness conditions. TL-LUEn is more applicable at individual sites at the half-hourly scale while TL-LUE could be regionally used at half-hourly, daily and 8-day scales. MOD17 is also an applicable option regionally at the 8-day scale.« less

Performance of Linear and Nonlinear Two-Leaf Light Use Efficiency Models at Different Temporal Scales

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

Wu, Xiaocui; Ju, Weimin; Zhou, Yanlian

The reliable simulation of gross primary productivity (GPP) at various spatial and temporal scales is of significance to quantifying the net exchange of carbon between terrestrial ecosystems and the atmosphere. This study aimed to verify the ability of a nonlinear two-leaf model (TL-LUEn), a linear two-leaf model (TL-LUE), and a big-leaf light use efficiency model (MOD17) to simulate GPP at half-hourly, daily and 8-day scales using GPP derived from 58 eddy-covariance flux sites in Asia, Europe and North America as benchmarks. Model evaluation showed that the overall performance of TL-LUEn was slightly but not significantly better than TL-LUE at half-hourlymore » and daily scale, while the overall performance of both TL-LUEn and TL-LUE were significantly better (p < 0.0001) than MOD17 at the two temporal scales. The improvement of TL-LUEn over TL-LUE was relatively small in comparison with the improvement of TL-LUE over MOD17. However, the differences between TL-LUEn and MOD17, and TL-LUE and MOD17 became less distinct at the 8-day scale. As for different vegetation types, TL-LUEn and TL-LUE performed better than MOD17 for all vegetation types except crops at the half-hourly scale. At the daily and 8-day scales, both TL-LUEn and TL-LUE outperformed MOD17 for forests. However, TL-LUEn had a mixed performance for the three non-forest types while TL-LUE outperformed MOD17 slightly for all these non-forest types at daily and 8-day scales. The better performance of TL-LUEn and TL-LUE for forests was mainly achieved by the correction of the underestimation/overestimation of GPP simulated by MOD17 under low/high solar radiation and sky clearness conditions. TL-LUEn is more applicable at individual sites at the half-hourly scale while TL-LUE could be regionally used at half-hourly, daily and 8-day scales. MOD17 is also an applicable option regionally at the 8-day scale.« less

Skeletal Muscle and Lymphocyte Mitochondrial Dysfunctions in Septic Shock Trigger ICU-Acquired Weakness and Sepsis-Induced Immunoparalysis.

PubMed

Maestraggi, Quentin; Lebas, Benjamin; Clere-Jehl, Raphaël; Ludes, Pierre-Olivier; Chamaraux-Tran, Thiên-Nga; Schneider, Francis; Diemunsch, Pierre; Geny, Bernard; Pottecher, Julien

2017-01-01

Fundamental events driving the pathological processes of septic shock-induced multiorgan failure (MOF) at the cellular and subcellular levels remain debated. Emerging data implicate mitochondrial dysfunction as a critical factor in the pathogenesis of sepsis-associated MOF. If macrocirculatory and microcirculatory dysfunctions undoubtedly participate in organ dysfunction at the early stage of septic shock, an intrinsic bioenergetic failure, sometimes called "cytopathic hypoxia," perpetuates cellular dysfunction. Short-term failure of vital organs immediately threatens patient survival but long-term recovery is also severely hindered by persistent dysfunction of organs traditionally described as nonvital, such as skeletal muscle and peripheral blood mononuclear cells (PBMCs). In this review, we will stress how and why a persistent mitochondrial dysfunction in skeletal muscles and PBMC could impair survival in patients who overcome the first acute phase of their septic episode. First, muscle wasting protracts weaning from mechanical ventilation, increases the risk of mechanical ventilator-associated pneumonia, and creates a state of ICU-acquired muscle weakness, compelling the patient to bed. Second, failure of the immune system ("immunoparalysis") translates into its inability to clear infectious foci and predisposes the patient to recurrent nosocomial infections. We will finally emphasize how mitochondrial-targeted therapies could represent a realistic strategy to promote long-term recovery after sepsis.

Efficacy of Genetically Modified Bt Toxins Alone and in Combinations Against Pink Bollworm Resistant to Cry1Ac and Cry2Ab

PubMed Central

Tabashnik, Bruce E.; Fabrick, Jeffrey A.; Unnithan, Gopalan C.; Yelich, Alex J.; Masson, Luke; Zhang, Jie; Bravo, Alejandra; Soberón, Mario

2013-01-01

Evolution of resistance in pests threatens the long-term efficacy of insecticidal proteins from Bacillus thuringiensis (Bt) used in sprays and transgenic crops. Previous work showed that genetically modified Bt toxins Cry1AbMod and Cry1AcMod effectively countered resistance to native Bt toxins Cry1Ab and Cry1Ac in some pests, including pink bollworm (Pectinophora gossypiella). Here we report that Cry1AbMod and Cry1AcMod were also effective against a laboratory-selected strain of pink bollworm resistant to Cry2Ab as well as to Cry1Ab and Cry1Ac. Resistance ratios based on the concentration of toxin killing 50% of larvae for the resistant strain relative to a susceptible strain were 210 for Cry2Ab, 270 for Cry1Ab, and 310 for Cry1Ac, but only 1.6 for Cry1AbMod and 2.1 for Cry1AcMod. To evaluate the interactions among toxins, we tested combinations of Cry1AbMod, Cry1Ac, and Cry2Ab. For both the resistant and susceptible strains, the net results across all concentrations tested showed slight but significant synergism between Cry1AbMod and Cry2Ab, whereas the other combinations of toxins did not show consistent synergism or antagonism. The results suggest that the modified toxins might be useful for controlling populations of pink bollworm resistant to Cry1Ac, Cry2Ab, or both. PMID:24244692

Influence of genetic variability at the surfactant proteins A and D in community-acquired pneumonia: a prospective, observational, genetic study

PubMed Central

2011-01-01

Introduction Genetic variability of the pulmonary surfactant proteins A and D may affect clearance of microorganisms and the extent of the inflammatory response. The genes of these collectins (SFTPA1, SFTPA2 and SFTPD) are located in a cluster at 10q21-24. The objective of this study was to evaluate the existence of linkage disequilibrium (LD) among these genes, and the association of variability at these genes with susceptibility and outcome of community-acquired pneumonia (CAP). We also studied the effect of genetic variability on SP-D serum levels. Methods Seven non-synonymous polymorphisms of SFTPA1, SFTPA2 and SFTPD were analyzed. For susceptibility, 682 CAP patients and 769 controls were studied in a case-control study. Severity and outcome were evaluated in a prospective study. Haplotypes were inferred and LD was characterized. SP-D serum levels were measured in healthy controls. Results The SFTPD aa11-C allele was significantly associated with lower SP-D serum levels, in a dose-dependent manner. We observed the existence of LD among the studied genes. Haplotypes SFTPA1 6A2 (P = 0.0009, odds ration (OR) = 0.78), SFTPA2 1A0 (P = 0.002, OR = 0.79), SFTPA1-SFTPA2 6A2-1A0 (P = 0.0005, OR = 0.77), and SFTPD-SFTPA1-SFTPA2 C-6A2-1A0 (P = 0.00001, OR = 0.62) were underrepresented in patients, whereas haplotypes SFTPA2 1A10 (P = 0.00007, OR = 6.58) and SFTPA1-SFTPA2 6A3-1A (P = 0.0007, OR = 3.92) were overrepresented. Similar results were observed in CAP due to pneumococcus, though no significant differences were now observed after Bonferroni corrections. 1A10 and 6A-1A were associated with higher 28-day and 90-day mortality, and with multi-organ dysfunction syndrome (MODS) and acute respiratory distress syndrome (ARDS) respectively. SFTPD aa11-C allele was associated with development of MODS and ARDS. Conclusions Our study indicates that missense single nucleotide polymorphisms and haplotypes of SFTPA1, SFTPA2 and SFTPD are associated with susceptibility to CAP, and that several haplotypes also influence severity and outcome of CAP. PMID:21310059

Mod-2 wind turbine system concept and preliminary design report. Volume 1: Executive summary

NASA Technical Reports Server (NTRS)

1979-01-01

The configuration development of the MOD-2 wind turbine system is presented. The MOD-2 is design optimized for commercial production rates which, in multi-unit installations, will be integrated into a utility power grid and achieve a cost of electricity at less than 4 cents per kilowatt hour.

Automotive Stirling Engine Development Program

NASA Technical Reports Server (NTRS)

Nightingale, N.; Ernst, W.; Richey, A.; Simetkosky, M.; Antonelli, M. (Editor)

1982-01-01

Activities performed on Mod I engine testing and test results; the manufacture, assembly, and test of a Mod I engine in the United States; design initiation of the Mod I-A engine system; transient performance testing; Stirling reference engine manufacturing and reduced size studies; components and subsystems; and the study and test of low cost alloys are summarized.

The Imaging Modulography Technique Revisited for High-Definition Intravascular Ultrasound: Theoretical Framework.

PubMed

Tacheau, Antoine; Le Floc'h, Simon; Finet, Gérard; Doyley, Marvin M; Pettigrew, Roderic I; Cloutier, Guy; Ohayon, Jacques

2016-03-01

Mechanical characterization of atherosclerotic lesions remains an essential step for the detection of vulnerable plaques (VPs). Recently, an intravascular ultrasound (IVUS) elasticity reconstruction method (iMOD) has been tested in vivo by our group. The major limitation of iMOD is the need to estimate the strain field in the entire VP despite attenuated depth penetration signals when using high-definition (HD) IVUS systems. Therefore, an extended iMOD approach (E-iMOD) was designed and applied to coronary lesions of patients imaged in vivo with IVUS. The E-iMOD method (i) quantified necrotic core areas with a mean absolute relative error of 3.5 ± 3.5% and (ii) identified Young's moduli of the necrotic cores and fibrous regions with mean values of 5.7 ± 0.8 kPa and 794.5 ± 22.0 kPa instead of 5 kPa and 800 kPa, respectively. This study demonstrates the potential of the improved HD-IVUS modulography technique E-iMOD to characterize coronary VPs. Copyright © 2016 World Federation for Ultrasound in Medicine & Biology. All rights reserved.

Rapid, Efficient Detection and Drug Susceptibility Testing of Mycobacterium tuberculosis in Sputum by Microscopic Observation of Broth Cultures

PubMed Central

Caviedes, Luz; Lee, Tien-Shun; Gilman, Robert H.; Sheen, Patricia; Spellman, Emily; Lee, Ellen H.; Berg, Douglas E.; Montenegro-James, Sonia

2000-01-01

Inexpensive, rapid, and reliable methods of detecting infection by and drug susceptibility of Mycobacterium tuberculosis (MTB) are crucial to the control of tuberculosis. The novel microscopic observation broth-drug susceptibility assay (MODS) detects early growth of MTB in liquid medium, allowing more timely diagnosis and drug susceptibility testing. Sputum samples from hospitalized patients in Peru were analyzed by using stains, culture, and PCR. Sensitivity of MODS (92%) compared favorably with the most sensitive of the other culture methods (93%). Sputum samples positive for tuberculosis were tested for susceptibility to isoniazid and rifampin with the microwell alamar blue assay (MABA) and MODS. In 89% of cases, there was concordance between MODS and MABA. Of the diagnostic and susceptibility testing methods used, MODS yielded results most rapidly (median, 9.0 and 9.5 days, respectively). MODS is a rapid, inexpensive, sensitive, and specific method for MTB detection and susceptibility testing; it is particularly appropriate for use in developing countries burdened by significant infection rates and increasing numbers of multiple-drug-resistant cases. PMID:10699023

Rapid, efficient detection and drug susceptibility testing of Mycobacterium tuberculosis in sputum by microscopic observation of broth cultures. The Tuberculosis Working Group in Peru.

PubMed

Caviedes, L; Lee, T S; Gilman, R H; Sheen, P; Spellman, E; Lee, E H; Berg, D E; Montenegro-James, S

2000-03-01

Inexpensive, rapid, and reliable methods of detecting infection by and drug susceptibility of Mycobacterium tuberculosis (MTB) are crucial to the control of tuberculosis. The novel microscopic observation broth-drug susceptibility assay (MODS) detects early growth of MTB in liquid medium, allowing more timely diagnosis and drug susceptibility testing. Sputum samples from hospitalized patients in Peru were analyzed by using stains, culture, and PCR. Sensitivity of MODS (92%) compared favorably with the most sensitive of the other culture methods (93%). Sputum samples positive for tuberculosis were tested for susceptibility to isoniazid and rifampin with the microwell alamar blue assay (MABA) and MODS. In 89% of cases, there was concordance between MODS and MABA. Of the diagnostic and susceptibility testing methods used, MODS yielded results most rapidly (median, 9.0 and 9.5 days, respectively). MODS is a rapid, inexpensive, sensitive, and specific method for MTB detection and susceptibility testing; it is particularly appropriate for use in developing countries burdened by significant infection rates and increasing numbers of multiple-drug-resistant cases.

Une modélisation de haut niveau des stratégies d'écriture motrice d'enfants en scolarité primaire : approche bayésienne

NASA Astrophysics Data System (ADS)

Zaarour, I.; El-Eter, B.; Leray, P.; Heutte, L.; Labiche, J.; Mellier, D.; Zoaeter, M.

2005-05-01

L'objectif de cette étude est de découvrir des stratégies d'écriture motrices des enfants en scolarité primaire en adoptant un modèle graphique probabiliste (réseaux bayésiens). Nous représentons une stratégie d'écriture par une variable cachée et nous construisons ainsi un modèle global hiérarchique pour pouvoir lier les stratégies locales aux stratégies globales et modéliser la dépendance probabiliste entre variables et stratégies. Ce modèle hiérarchique, appris à partir des données réelles, nous a permis de découvrir des stratégies consistantes et robustes. Ces résultats nous a permis de favoriser une modélisation temporelle et dynamique des stratégies d'écriture motrices indépendantes de l'âge scolaire.

Effectiveness of physical exam signs for early detection of critical illness in pediatric systemic inflammatory response syndrome.

PubMed

Scott, Halden F; Donoghue, Aaron J; Gaieski, David F; Marchese, Ronald F; Mistry, Rakesh D

2014-11-19

Early detection of compensated pediatric septic shock requires diagnostic tests that are sensitive and specific. Four physical exam signs are recommended for detecting pediatric septic shock prior to hypotension (cold extremities, mental status, capillary refill, peripheral pulse quality); this study tested their ability to detect patients who develop organ dysfunction among a cohort of undifferentiated pediatric systemic inflammatory response syndrome patients. A prospective cohort of 239 pediatric emergency department patients <19 years with fever and tachycardia and undergoing phlebotomy were enrolled. Physicians recorded initial physical exams on a standardized form. Abstraction of the medical record determined outcomes including organ dysfunction, intensive care unit stay, serious bacterial infection, and therapies. Organ dysfunction occurred in 13/239 (5.4%) patients. Presence of at least one sign was significantly associated with organ dysfunction (Relative Risk: 2.71, 95% CI: 1.05-6.99), and presence of at least two signs had a Relative Risk = 4.98 (95% CI: 1.82-13.58). The sensitivity of exam findings ranged from 8-54%, specificity from 84-98%. Signs were associated with increased risk of intensive care and fluid bolus, but not with serious bacterial infection, intravenous antibiotics or admission. Altered mental status and peripheral pulse quality were significantly associated with organ dysfunction, while abnormal capillary refill time and presence of cold, mottled extremities were not. Certain recommended physical exam signs were associated with increased risk of organ dysfunction, a rare outcome in this undifferentiated pediatric population with fever and tachycardia. Sensitivity was low, while specificity was high. Additional research into optimally sensitive and specific diagnostic strategies is needed.

Immune thrombocytopenia with multi-organ dysfunction syndrome as a rare presentation of scrub typhus: a case report.

PubMed

Ittyachen, Abraham M; Abraham, Saramma P; Krishnamoorthy, Smitha; Vijayan, Anuroopa; Kokkat, Jayamohan

2017-10-06

Scrub typhus is an acute infectious illness caused by Orientia tsutsugamushi. It is endemic to a part of the world known as the "tsutsugamushi triangle". Humans are accidental hosts in this zoonotic disease. About a third of patients admitted with scrub typhus have evidence of multi-organ dysfunction. Multi-organ dysfunction secondary to scrub typhus carries a high mortality rate. We report a 65-year old lady who was admitted in a Tertiary Care Center in the state of Kerala in India, with 7 day history of fever, myalgia and reduced urine output. Head to foot examination revealed the presence of an eschar on her chest. One week prior to the onset of her illness she had gone trekking through a hilly forest area. She was clinically suspected to have scrub typhus, which was later confirmed with laboratory tests. She developed multi-organ dysfunction syndrome secondary to this illness. Though there was an improvement in the multi-organ dysfunction, thrombocytopenia alone failed to improve. Bone marrow study was done which was suggestive of immune thrombocytopenia. Patient was given a course of steroids with which the thrombocytopenia improved. Failure of platelet count to normalize even after there has been a general improvement of other markers of multi-organ dysfunction in scrub typhus should prompt the clinician to consider other potential causes of thrombocytopenia. An unusual finding as this calls for further research to understand the molecular mechanisms behind such an event. Further, considering the close similarity in clinical presentation of several tropical illnesses, meticulous history taking and a detailed physical examination needs to be emphasized.

The feasibility of determining the effectiveness and cost-effectiveness of medication organisation devices compared with usual care for older people in a community setting: systematic review, stakeholder focus groups and feasibility randomised controlled trial.

PubMed

Bhattacharya, Debi; Aldus, Clare F; Barton, Garry; Bond, Christine M; Boonyaprapa, Sathon; Charles, Ian S; Fleetcroft, Robert; Holland, Richard; Jerosch-Herold, Christina; Salter, Charlotte; Shepstone, Lee; Walton, Christine; Watson, Steve; Wright, David J

2016-07-01

Medication organisation devices (MODs) provide compartments for a patient's medication to be organised into the days of the week and the recommended times the medication should be taken. To define the optimal trial design for testing the clinical effectiveness and cost-effectiveness of MODs. The feasibility study comprised a systematic review and focus groups to inform a randomised controlled trial (RCT) design. The resulting features were tested on a small scale, using a 2 × 2 factorial design to compare MODs with usual packaging and to compare weekly with monthly supply. The study design was then evaluated. Potential participants were identified by medical practices. Aged over 75 years, prescribed at least three solid oral dosage form medications, unintentionally non-adherent and self-medicating. Participants were excluded if deemed by their health-care team to be unsuitable. One of three MODs widely used in routine clinical practice supplied either weekly or monthly. To identify the most effective method of participant recruitment, to estimate the prevalence of intentional and unintentional non-adherence in an older population, to provide a point estimate of the effect size of MODs relative to usual care and to determine the feasibility and acceptability of trial participation. The systematic review included MOD studies of any design reporting medication adherence, health and social outcomes, resource utilisation or dispensing or administration errors. Focus groups with patients, carers and health-care professionals supplemented the systematic review to inform the RCT design. The resulting design was implemented and then evaluated through questionnaires and group discussions with participants and health-care professionals involved in trial delivery. Studies on MODs are largely of poor quality. The relationship between adherence and health outcomes is unclear. Of the limited studies reporting health outcomes, some reported a positive relationship while some reported increased hospitalisations associated with MODs. The pre-trial focus groups endorsed the planned study design, but suggested a minimum recruitment age of 50-60 years. A total of 35.4% of patients completing the baseline questionnaire were excluded because they already used a MOD. Active recruitment yielded a higher consent rate, but passive recruitment was more cost-effective. The prevalence of intentional non-adherence was 24.7% [n = 71, 95% confidence interval (CI) 19.7% to 29.6%] of participants. Of the remaining 76 participants, 46.1% (95% CI 34.8% to 57.3%) were unintentionally non-adherent. There was no indication of a difference in adherence between the study arms. Participants reported a high level of satisfaction with the design. Five adverse/serious adverse events were identified in the MOD study arms and none was identified in the control arms. There was no discernible difference in health economic outcomes between the four study arms; the mean intervention cost was £20 per month greater for MOD monthly relative to usual supply monthly. MOD provision to unintentionally non-adherent older people may cause medication-related adverse events. The primary outcome for a definitive MOD trial should be health outcomes. Such a trial should recruit patients by postal invitation and recruit younger patients. A study examining the association between MOD initiation and adverse effects is necessary and a strategy to safely introduce MODs should be explored. A definitive study testing the clinical effectiveness and cost-effectiveness of MODs is also required. Current Controlled Trials ISRCTN 30626972 and UKCRN 12739. This project was funded by National Institute for Health Research (NIHR) Health Technology Assessment Programme and will be published in full in Health Technology Assessment; Vol. 20, No. 50. See the NIHR Journals Library website for further project information.

Early Detection of Junctional Adhesion Molecule-1 (JAM-1) in the Circulation after Experimental and Clinical Polytrauma

PubMed Central

Denk, Stephanie; Wiegner, Rebecca; Hönes, Felix M.; Messerer, David A. C.; Radermacher, Peter; Kalbitz, Miriam; Braumüller, Sonja; McCook, Oscar; Gebhard, Florian; Weckbach, Sebastian; Huber-Lang, Markus

2015-01-01

Severe tissue trauma-induced systemic inflammation is often accompanied by evident or occult blood-organ barrier dysfunctions, frequently leading to multiple organ dysfunction. However, it is unknown whether specific barrier molecules are shed into the circulation early after trauma as potential indicators of an initial barrier dysfunction. The release of the barrier molecule junctional adhesion molecule-1 (JAM-1) was investigated in plasma of C57BL/6 mice 2 h after experimental mono- and polytrauma as well as in polytrauma patients (ISS ≥ 18) during a 10-day period. Correlation analyses were performed to indicate a linkage between JAM-1 plasma concentrations and organ failure. JAM-1 was systemically detected after experimental trauma in mice with blunt chest trauma as a driving force. Accordingly, JAM-1 was reduced in lung tissue after pulmonary contusion and JAM-1 plasma levels significantly correlated with increased protein levels in the bronchoalveolar lavage as a sign for alveolocapillary barrier dysfunction. Furthermore, JAM-1 was markedly released into the plasma of polytrauma patients as early as 4 h after the trauma insult and significantly correlated with severity of disease and organ dysfunction (APACHE II and SOFA score). The data support an early injury- and time-dependent appearance of the barrier molecule JAM-1 in the circulation indicative of a commencing trauma-induced barrier dysfunction. PMID:26556956

Functional Turnover: An Empirical Assessment.

DTIC Science & Technology

1981-08-01

assumption that turnover is invariably dysfunctional to the organization (Dalton & Todor , 1979; Dalton & Todor , in press (a), (b); Jeswald, 1974; Muchinsky...34voluntary" turnover (Dalton, Todor & Krackhardt, in press). Dysfunctional (cell C) - The individual wants to leave the organization but the organization...criticized (Dalton & Todor , 1979; Dalton & Todor . in press (a), (b); Muchinsky & Tuttle, 1979; Muchinsky & Morrow, in press; Staw, in press; Staw

Mod-2 wind turbine project assessment and cluster test plans

NASA Technical Reports Server (NTRS)

Gordon, L. H.

1982-01-01

An assessment of the Mod-2 Wind Turbine project is presented based on initial goals and present results. Specifically, the Mod-2 background, project flow, and a chronology of events/results leading to Mod-2 acceptance is presented. After checkout/acceptance of the three operating turbines, NASA/LeRC will continue management of a two year test program performed at the DOE Goodnoe Hills test site. This test program is expected to yield data necessary for the continued development and optimization of wind energy systems. These test activities, the implementation of, and the results to date are also presented.

MOD-2 wind turbine development

NASA Technical Reports Server (NTRS)

Gordon, L. H.; Andrews, J. S.; Zimmerman, D. K.

1983-01-01

The development of the Mod-2 turbine, designed to achieve a cost of electricity for the 100th production unit that will be competitive with conventional electric power generation is discussed. The Mod-2 wind turbine system (WTS) background, project flow, and a chronology of events and problem areas leading to Mod-2 acceptance are addressed. The role of the participating utility during site preparation, turbine erection and testing, remote operation, and routine operation and maintenance activity is reviewed. The technical areas discussed pertain to system performance, loads, and controls. Research and technical development of multimegawatt turbines is summarized.

Inflammatory response and extracorporeal circulation.

PubMed

Kraft, Florian; Schmidt, Christoph; Van Aken, Hugo; Zarbock, Alexander

2015-06-01

Patients undergoing cardiac surgery with extracorporeal circulation (EC) frequently develop a systemic inflammatory response syndrome. Surgical trauma, ischaemia-reperfusion injury, endotoxaemia and blood contact to nonendothelial circuit compounds promote the activation of coagulation pathways, complement factors and a cellular immune response. This review discusses the multiple pathways leading to endothelial cell activation, neutrophil recruitment and production of reactive oxygen species and nitric oxide. All these factors may induce cellular damage and subsequent organ injury. Multiple organ dysfunction after cardiac surgery with EC is associated with an increased morbidity and mortality. In addition to the pathogenesis of organ dysfunction after EC, this review deals with different therapeutic interventions aiming to alleviate the inflammatory response and consequently multiple organ dysfunction after cardiac surgery. Copyright © 2015 Elsevier Ltd. All rights reserved.

On HMI's Mod-L Sequence: Test and Evaluation

NASA Astrophysics Data System (ADS)

Liu, Yang; Baldner, Charles; Bogart, R. S.; Bush, R.; Couvidat, S.; Duvall, Thomas L.; Hoeksema, Jon Todd; Norton, Aimee Ann; Scherrer, Philip H.; Schou, Jesper

2016-05-01

HMI Mod-L sequence can produce full Stokes parameters at a cadence of 90 seconds by combining filtergrams from both cameras, the front camera and the side camera. Within the 90-second, the front camera takes two sets of Left and Right Circular Polarizations (LCP and RCP) at 6 wavelengths; the side camera takes one set of Linear Polarizations (I+/-Q and I+/-U) at 6 wavelengths. By combining two cameras, one can obtain full Stokes parameters of [I,Q,U,V] at 6 wavelengths in 90 seconds. In norminal Mod-C sequence that HMI currently uses, the front camera takes LCP and RCP at a cadence of 45 seconds, while the side camera takes observation of the full Stokes at a cadence of 135 seconds. Mod-L should be better than Mod-C for providing vector magnetic field data because (1) Mod-L increases cadence of full Stokes observation, which leads to higher temporal resolution of vector magnetic field measurement; (2) decreases noise in vector magnetic field data because it uses more filtergrams to produce [I,Q,U,V]. There are two potential issues in Mod-L that need to be addressed: (1) scaling intensity of the two cameras’ filtergrams; and (2) if current polarization calibration model, which is built for each camera separately, works for the combined data from both cameras. This presentation will address these questions, and further place a discussion here.

The value of microscopic-observation drug susceptibility assay in the diagnosis of tuberculosis and detection of multidrug resistance.

PubMed

Sertel Şelale, Denİz; Uzun, Meltem

2018-01-01

Inexpensive, rapid, and reliable tests for detecting the presence and drug susceptibility of Mycobacterium tuberculosis complex (MTBC) are urgently needed to control the transmission of tuberculosis. In this study, we aimed to assess the accuracy and speed of the microscopic-observation drug susceptibility (MODS) assay in the identification of MTBC and detection of multidrug resistance. Sputum samples from patients suspected to have tuberculosis were simultaneously tested with MODS and conventional culture [Löwenstein-Jensen (LJ) culture, BACTEC MGIT™ 960 (MGIT) system], and drug susceptibility testing (MGIT system) methods. A total of 331 sputum samples were analyzed. Sensitivity and specificity of MODS assay for detection of MTBC strains were 96% and 98.8%, respectively. MODS assay detected multidrug resistant MTBC isolates with 92.3% sensitivity and 96.6% specificity. Median time to culture positivity was similar for MGIT (8 days) and MODS culture (8 days), but was significantly longer with LJ culture (20 days) (p < 0.0001 for both comparisons). Median time to availability of the susceptibility results was significantly (p < 0.0001) shorter with MODS assay (8 days) than MGIT system (20 days). In conclusion, MODS is an inexpensive and rapid test with good performance characteristics for direct diagnosis of tuberculosis and detection of multidrug resistance. © 2017 APMIS. Published by John Wiley & Sons Ltd.

Development of large, horizontal-axis wind turbines

NASA Technical Reports Server (NTRS)

Baldwin, D. H.; Kennard, J.

1985-01-01

A program to develop large, horizontal-axis wind turbines is discussed. The program is directed toward developing the technology for safe, reliable, environmentally acceptable large wind turbines that can generate a significant amount of electricity at costs competitive with those of conventional electricity-generating systems. In addition, these large wind turbines must be fully compatible with electric utility operations and interface requirements. Several ongoing projects in large-wind-turbine development are directed toward meeting the technology requirements for utility applications. The machines based on first-generation technology (Mod-OA and Mod-1) successfully completed their planned periods of experimental operation in June, 1982. The second-generation machines (Mod-2) are in operation at selected utility sites. A third-generation machine (Mod-5) is under contract. Erection and initial operation of the Mod-5 in Hawaii should take place in 1986. Each successive generation of technology increased reliability and energy capture while reducing the cost of electricity. These advances are being made by gaining a better understanding of the system-design drivers, improving the analytical design tools, verifying design methods with operating field data, and incorporating new technology and innovative designs. Information is given on the results from the first- and second-generation machines (Mod-OA, - 1, and -2), the status of the Department of Interior, and the status of the third-generation wind turbine (Mod-5).

Identification of Bacillus thuringiensis Cry1AbMod binding-proteins from Spodoptera frugiperda.

PubMed

Martínez de Castro, Diana L; García-Gómez, Blanca I; Gómez, Isabel; Bravo, Alejandra; Soberón, Mario

2017-12-01

Bacillus thuringiensis Cry toxins are currently used for pest control in transgenic crops but evolution of resistance by the insect pests threatens the use of this technology. The Cry1AbMod toxin was engineered to lack the alpha helix-1 of the parental Cry1Ab toxin and was shown to counter resistance to Cry1Ab and Cry1Ac toxins in different insect species including the fall armyworm Spodoptera frugiperda. In addition, Cry1AbMod showed enhanced toxicity to Cry1Ab-susceptible S. frugiperda populations. To gain insights into the mechanisms of this Cry1AbMod-enhanced toxicity, we isolated the Cry1AbMod toxin binding proteins from S. frugiperda brush border membrane vesicles (BBMV), which were identified by pull-down assay and liquid chromatography-tandem mass spectrometry (LC-MS/MS). The LC-MS/MS results indicated that Cry1AbMod toxin could bind to four classes of aminopeptidase (N1, N3, N4 y N5) and actin, with the highest amino acid sequence coverage acquired for APN 1 and APN4. In addition to these proteins, we found other proteins not previously described as Cry toxin binding proteins. This is the first report that suggests the interaction between Cry1AbMod and APN in S. frugiperda. Copyright © 2017 Elsevier Inc. All rights reserved.

Influence of experimental rat model of multiple organ dysfunction on cefepime and amikacin pharmacokinetics.

PubMed Central

Mimoz, O; Jacolot, A; Padoin, C; Quillard, J; Tod, M; Louchahi, K; Samii, K; Petitjean, O

1996-01-01

We adapted an experimental model of multiple organ dysfunction to study the alterations it induces in the pharmacology of cefepime and amikacin. The half-lives of both antibiotics were significantly prolonged because of nonsignificant enhancement of the volume of distribution and reduced renal elimination. In the presence of multiple organ dysfunction, the concentration of each antibiotic in the lungs, compared with that in the lungs of healthy controls, was significantly decreased, despite similar concentrations in plasma, indicating that the application of a standard antibiotic concentration in plasma could lead to underdosage in tissues during the initial days of therapy. PMID:8851623

Interdisciplinary investigations in support of project DI-MOD

NASA Technical Reports Server (NTRS)

Starks, Scott A.

1991-01-01

Interdisciplinary investigations in support of project DI-MOD are discussed. The following subject areas were covered: (1) potential extensions of Project DI-MOD to additional sites in Central America; (2) human migration patterns and their impact on malaria transmission; and (3) an investigation into possible computer-based approaches to the analysis of remotely sensed multispectral data.

JPRS Report, Science & Technology, USSR: Science & Technology Policy

DTIC Science & Technology

1988-04-29

spread: " clusters " of mod- ern science-intensive firms have begun to be grouped around a large university or research center. Such a symbiosis of...Cost Accounting in Scientific Research [G. Lakhtin; PRAVDA, 30 Jan 88] 1 Facilities, Manpower Candidate Members of Ukrainian Academy of Sciences...Ovezgeldyyev; TURKMENSKAYA ISKRA 17 Nov 87] 75 Conversion of Research Organizations to Cost Accounting [A. Guniya; ZARYA VOSTOKA 16 Jan 88] ... 78

High rate capability of a BaTiO3-decorated LiCoO2 cathode prepared via metal organic decomposition

NASA Astrophysics Data System (ADS)

Teranishi, Takashi; Katsuji, Naoto; Yoshikawa, Yumi; Yoneda, Mika; Hayashi, Hidetaka; Kishimoto, Akira; Yoda, Koji; Motobayashi, Hidefumi; Tasaki, Yuzo

2016-10-01

Metal organic decomposition (MOD) using octylic acid salts was applied to synthesize a BaTiO3-LiCoO2 (BT-LC) composite powder. The Ba and Ti octylates were utilized as metal precursors, in an attempt to synthesize homogeneous BT nanoparticles on the LC matrix. The BT-LC composite, having a phase-separated composite structure without any impurity phase, was successfully obtained by optimizing the MOD procedure. The composite prepared using octylate precursors exhibited a sharper distribution and better dispersibility of decorated BT particles. Additionally, the average particle size of the decorated BTs using metal octylate was reduced to 23.3 nm, compared to 44.4 nm from conventional processes using Ba acetate as well as Ti alkoxide as precursors. The composite cathode displayed better cell performance than its conventional counterpart; the discharge capacity of the metal octylate-derived specimen was 55.6 mAh/g at a 50C rate, corresponding to 173% of the capacity of the conventional specimen (32.2 mAh/g). The notable improvement in high rate capability obtained in this study, compared with the conventional route, was attributed to the higher density of the triple junction formed by the BT-LC-electrolyte interface.

Application of a MODIS Soil Moisture-Evapotranspiration (MOD-SMET) Model to Evaluate Landscape and Hydrologic Recovery after the High Park Fire in Colorado, USA

NASA Astrophysics Data System (ADS)

Blount, W. K.; Hogue, T. S.; Franz, K.; Knipper, K. R.

2017-12-01

Accurate estimation of evapotranspiration (ET) is critical for the management of water resources, especially in water-stressed regions. ET accounts for approximately 60% of terrestrial precipitation globally and approaches 100% of annual rainfall in arid ecosystems, where transpiration becomes the dominant term. ET is difficult to measure due to its spatiotemporal variation, which requires adequate data coverage. While new remote sensing-based ET products are available at a 1 km spatial resolution, including the Operational Simplified Surface Energy Balance model (SSEBop) and the MODIS Global Evapotranspiration Project (MOD16), these products are available at monthly and 8-day temporal resolutions, respectively. To better understand the changing dynamics of hydrologic fluxes and the partitioning of water after land cover disturbances and to identify statically significant trends, more frequent observations are necessary. Utilizing the recently developed MODIS Soil Moisture-Evapotranspiration (MOD-SMET) model, daily temporal resolution is achieved. This presentation outlines the methodology of the MOD-SMET model and compares SSEBop, MOD16, and MOD-SMET ET estimates over the High Park Fire burn scar in Colorado, USA. MOD-SMET estimates are used to identify changes in fluxes and partitioning of the water cycle after a wildfire and during recovery in the High Park Fire near Fort Collins, Colorado. Initial results indicate greenness and ET from all three models decrease post-fire, with higher statistical confidence in high burn areas and spatial patterns that closely align with burn severity. MOD-SMET improves the ability to resolve statistically significant changes in ET following wildfires and better understand changes in the post-fire water budget. Utilizing this knowledge, water resource managers can better plan for, and mitigate, the short- and long-term impacts of wildfire on regional water supplies.

Only minor additional metabolic health benefits of high as opposed to moderate dose physical exercise in young, moderately overweight men.

PubMed

Reichkendler, M H; Rosenkilde, M; Auerbach, P L; Agerschou, J; Nielsen, M B; Kjaer, A; Hoejgaard, L; Sjödin, A; Ploug, T; Stallknecht, B

2014-05-01

The dose-response effects of exercise training on insulin sensitivity, metabolic risk, and quality of life were examined. Sixty-one healthy, sedentary (VO₂max: 35 ± 5 ml/kg/min), moderately overweight (BMI: 27.9 ± 1.8), young (age: 29 ± 6 years) men were randomized to sedentary living (sedentary control group; n = 18), moderate (moderate dose training group [MOD]: 300 kcal/day, n = 21), or high (high dose training group [HIGH]: 600 kcal/day, n = 22) dose physical exercise for 11 weeks. The return rate for post-intervention testing was 82-94% across groups. Weekly exercise amounted to 2,004 ± 24 and 3,774 ± 68 kcal, respectively, in MOD and HIGH. Cardiorespiratory fitness increased (P < 0.001) 18 ± 3% in MOD and 17 ± 3% in HIGH, and fat percentage decreased (P < 0.001) similarly in both exercise groups (MOD: 32 ± 1 to 29 ± 1%; HIGH: 30 ± 1 to 27 ± 1%). Peripheral insulin sensitivity increased (P < 0.01) (MOD: 28 ± 7%; HIGH: 36 ± 8%) and the homeostasis model assessment of insulin resistance decreased (P < 0.05) (MOD: -17 ± 7%; HIGH: -18 ± 10%). The number of subjects meeting the criteria of the metabolic syndrome decreased by 78% in MOD (P < 0.01) and by 80% in HIGH (P < 0.05). General health assessed by questionnaire increased similarly in MOD (P < 0.05) and HIGH (P < 0.01). Only minor additional health benefits were found when exercising ∼3,800 as opposed to ∼2,000 kcal/week in young moderately overweight men. This finding may have important public health implications. Copyright © 2012 The Obesity Society.

Standardissimo. Les limitations théoriques du Modèle Standard. Quelles réponses y apporter?

NASA Astrophysics Data System (ADS)

Renard, F. M.

Nous présentons I 'état du Modèle Standard des interactions fortes, faibles et électromagnétiques. Après une description rapide de ses 3 secteurs, secteur de jauge (radiation), secteur fermionique (matière) et secteur scalaire (génération des masses), nous insistons sur le grand nombre de paramètres libres et sur les choix arbitraires qu'il a fallu faire dans l'élaboration du modèle. Nous faisons ressortir les problèmes techniques non résolus et nous dressons la liste des questions fondamentales restées sans réponses. Nous passons ensuite en revue les idées et méthodes proposées pour répondre à ces questions. Elles utilisent essentiellement 3 voies différentes. La première consiste à requérir plus de symétrie (extension du modèle, symétrie Gauche-Droite, Grandes Unifications, Supersymétrie,...). La seconde contient les diverses alternatives au Modèle Standard impliquant des modifications dans certains secteurs (par exemple le secteur scalaire avec le modèle de la Technicouleur) ou de façon plus violente l'hypothèse d'une sous-structure des leptons, des quarks et des bosons W et Z eux-mêmes. Une dernière voie cherche à justifier les particularités du Modèle Standard et relier ses paramètres libres en se basant sur des principes de cohérence interne du modèle. Les conséquences observables de ces diverses approches sont dans chaque cas mentionnées.

Automotive Stirling engine development program

NASA Technical Reports Server (NTRS)

Ernst, W.; Richey, A.; Farrell, R.; Riecke, G.; Smith, G.; Howarth, R.; Cronin, M.; Simetkosky, M.; Meacher, J.

1986-01-01

The major accomplishments were the completion of the Basic Stirling Engine (BSE) and the Stirling Engine System (SES) designs on schedule, the approval and acceptance of those designs by NASA, and the initiation of manufacture of BSE components. The performance predictions indicate the Mod II engine design will meet or exceed the original program goals of 30% improvement in fuel economy over a conventional Internal Combustion (IC) powered vehicle, while providing acceptable emissions. This was accomplished while simultaneously reducing Mod II engine weight to a level comparable with IC engine power density, and packaging the Mod II in a 1985 Celebrity with no external sheet metal changes. The projected mileage of the Mod II Celebrity for the combined urban and highway CVS cycle is 40.9 mpg which is a 32% improvement over the IC Celebrity. If additional potential improvements are verified and incorporated in the Mod II, the mileage could increase to 42.7 mpg.

Meteoroid/orbital debris impact damage predictions for the Russian space station MIR

NASA Technical Reports Server (NTRS)

Christiansen, E. L.; Hyde, J. L.; Lear, D.

1997-01-01

Components of the Mir space station have been exposed to the meteoroid/orbital debris (M/OD) environment for up to 11 years. During this period, no M/OD impact perforation of the pressure shell of the manned modules were reported. The NASA standard M/OD analysis code BUMPER was used to predict the probability of M/OD impact damage to various components of Mir. The analysis indicates a 1 in 2.2 chance that a M/OD impact would have caused a penetration resulting in a pressure leak of the Mir modules since its launch up to the February 1997. For the next five years, the estimated odds become 1 in 3. On an annual basis, penetration risks are 60 percent higher, on the average, in the next five years due to the larger size of Mir and the growth in the orbital debris population.

Mod-5A wind turbine generator program design report. Volume 3: Final design and system description, book 2

NASA Technical Reports Server (NTRS)

1984-01-01

The design, development and analysis of the 7.3MW MOD-5A wind turbine generator is documented. The report is divided into four volumes: Volume 1 summarizes the entire MOD-5A program, Volume 2 discusses the conceptual and preliminary design phases, Volume 3 describes the final design of the MOD-5A, and Volume 4 contains the drawings and specifications developed for the final design. Volume 3, book 2 describes the performance and characteristics of the MOD-5A wind turbine generator in its final configuration. The subsystem for power generation, control, and instrumentation subsystems is described in detail. The manufacturing and construction plans, and the preparation of a potential site on Oahu, Hawaii, are documented. The quality assurance and safety plan, and analyses of failure modes and effects, and reliability, availability and maintainability are presented.

Sin1, a Mutation Affecting Female Fertility in Arabidopsis, Interacts with Mod1, Its Recessive Modifier

PubMed Central

Lang, J. D.; Ray, S.; Ray, A.

1994-01-01

In Arabidopsis thaliana, a mutation in the SIN1 gene causes aberrant ovule development and female-specific sterility. The effect of the sin1 mutation is polymorphic and pleiotropic in different genetic backgrounds. The polymorphism concerns morphology of the mutant ovules. The pleiotropism involves internodal distance and inflorescence initiation time. The particular ovule phenotype and the length of internodes are dependent on an interaction of sin1 with a second recessive gene, which we term mod1. The recessive mod1 allele in a homozygous sin1 mutant plant reduces internode length and ovule integument size. The mutation sin1, but not mod1, has a demonstrable effect on ovule morphology when acting idependently. In our crosses mod1 was inseparably linked to the well known mutation erecta that is known to cause a reduction in internode and pedicel lengths. PMID:7982564

Calcul numérique accéléré de mesures de performance sur les modèles Markoviens appliqués aux systèmes informatiques et de télécommunications

NASA Astrophysics Data System (ADS)

Ghaddar, A.; Sinno, N.

2005-05-01

La complexité du phénomène de files d'attente dans les systèmes informatiques et télécommunications nécessite leur simulation par des modèles Markoviens pour les mesures de performance, mesure des délais d'attente au niveau des routeurs pour le modèle informatique et l'étude de la gestion des appels téléphoniques pour le modèle des circuits téléphoniques. L'optimisation des méthodes numériques de résolution des équations relatives à ces deux modèles va permettre d' ídentifier les critères de convergence rapide vers les états stationnaires correspondant à ces mesures.

Mentoring SFRM: A New Approach to International Space Station Flight Controller Training

NASA Technical Reports Server (NTRS)

Huning, Therese; Barshi, Immanuel; Schmidt, Lacey

2008-01-01

The Mission Operations Directorate (MOD) of the Johnson Space Center is responsible for providing continuous operations support for the International Space Station (ISS). Operations support requires flight controllers who are skilled in team performance as well as the technical operations of the ISS. Space Flight Resource Management (SFRM), a NASA adapted variant of Crew Resource Management (CRM), is the competency model used in the MOD. ISS flight controller certification has evolved to include a balanced focus on development of SFRM and technical expertise. The latest challenge the MOD faces is how to certify an ISS flight controller (operator) to a basic level of effectiveness in 1 year. SFRM training uses a two-pronged approach to expediting operator certification: 1) imbed SFRM skills training into all operator technical training and 2) use senior flight controllers as mentors. This paper focuses on how the MOD uses senior flight controllers as mentors to train SFRM skills. Methods: A mentor works with an operator throughout the training flow. Inserted into the training flow are guided-discussion sessions and on-the-job observation opportunities focusing on specific SFRM skills, including: situational leadership, conflict management, stress management, cross-cultural awareness, self care and team care while on-console, communication, workload management, and situation awareness. The mentor and operator discuss the science and art behind the skills, cultural effects on skills applications, recognition of good and bad skills applications, recognition of how skills application changes subtly in different situations, and individual goals and techniques for improving skills. Discussion: This mentoring program provides an additional means of transferring SFRM knowledge compared to traditional CRM training programs. Our future endeavors in training SFRM skills (as well as other organization s) may benefit from adding team performance skills mentoring. This paper explains our mentoring approach and discusses its effectiveness and future applicability in promoting SFRM/CRM skills.

ISSLive!

NASA Technical Reports Server (NTRS)

Price, Jennifer B.; Snook, Bryan

2011-01-01

The ISSLive! project is a JSC innovation award- winning, combined MOD/Education project to publish export control and PAO-approved ISS telemetry, and simplified and scrubbed crew timelines. The publication of this data will be real-time or near real time and will include links to the crew's social media feeds and existing streaming public video/audio feeds, via public-friendly website, mobile devices and tablet applications. Additionally, the project will offer interactive virtual 3D views of an ISS model based on real-time telemetry and a 3D virtual mission control center based on existing Front Room console positions in made for public displays. The ISSLive! project is MOD-managed and includes collaborations with subject-matter expertise from the ISS flight controllers regarding daily operations and planning, education program specialists from the JSC Office of Education, instructional designers, human computer interface experts, and software/hardware experts from MOD facility organization, and senior web designers. In support of the Agency s Strategic Goal #6 with respect to using the ISS National Laboratory for education activities, ISSLive! uses the Station itself as STEM education subject matter and provides data for STEM-based lessons plans using national standards. Specifically, ISSLive! supports and enables the National Laboratory Education (NLE) project to address the Agency s Strategic Goal #6. This goal mandates, sharing NASA with the public, educators, and students to provide opportunities to participate in our Mission, foster innovation .. ISSLive! satisfies the Agency s outcomes of Strategic Goal; that is, engages the public in NASA's missions by providing new pathways for participation (Outcome 6.3) and it informs, engages, and inspires the public by sharing NASA s missions, challenges, and results (Outcome 6.4). Additionally, ISSLive! enables MOD s support of JSC Outreach and NASA's Open Data and Open Government Initiatives. The audience for the ISSLive! website and its application(s) are: teachers, students, citizen scientists, and the general public who will be given new and interactive insights on how the ISS Operates.

Atom-replaced pins in a Y-based superconductor—single-crystalline perovskite structure including both PrBa2Cu3O7‑x and YBa2Cu3O7‑y

NASA Astrophysics Data System (ADS)

Hayashi, Mariko; Araki, Takeshi; Ishii, Hirotaka; Nishijima, Gen; Matsumoto, Akiyoshi

2018-05-01

Metal organic deposition using trifluoroacetates (TFA-MOD) provides many uniform superconductors on long metal tapes. The large numbers of long wires have been applied for power grids or superconducting fault current limiters. The related applications worked for a long time without fatal trouble. The quasi-liquid produced during the firing process assisted the perfectly uniform structure in TFA-MOD. On the other hand, when it was desired to introduce artificial pinning centers, the quasi-liquid also enlarged the diameter of the artificial pinning centers to several tens of nanometers. In other words, due to the nature of TFA-MOD, there is very little chance of using TFA-MOD to prepare several nm-sized artificial pinning centers. By proposing atom-replaced pins (ARPs), we aim to overcome the impasse. ARPs are realized by replacing yttrium (Y) with praseodymium (Pr) whose valence number changes from 3+ to approximately 4+. Analytical results suggested that Pr makes pinning centers on a PrBa2Cu3O7‑x (PrBCO) unit cell, and the weak-linked superconductivity derived from PrBCO extends to the adjacent unit cells in the a/b-plane. J c decrease by Pr is five times as large as the volume fraction of Pr in the Y-site of the perovskite structure. On the other hand, T c does not show large degradation in YBCO including 10% PrBCO. These results suggest that PrBCO unit cells are fully dispersed in YBa2Cu3O7‑y matrix. With regard to J c in the magnetic field, (Y0.98, Pr0.02)BCO has been slightly improved compared with pure YBCO only in the region of high temperature and low magnetic field of less than 1 T.

Clues to Coral Reef Ecosystem Health: Spectral Analysis Coupled with Radiative Transfer Modeling

NASA Astrophysics Data System (ADS)

Guild, L.; Ganapol, B.; Kramer, P.; Armstrong, R.; Gleason, A.; Torres, J.; Johnson, L.; Garfield, N.

2003-12-01

Coral reefs are among the world's most productive and biologically rich ecosystems and are some of the oldest ecosystems on Earth. Coralline structures protect coastlines from storms, maintain high diversity of marine life, and provide nurseries for marine species. Coral reefs play a role in carbon cycling through high rates of organic carbon metabolism and calcification. Coral reefs provide fisheries habitat that are the sole protein source for humans on remote islands. Reefs respond immediately to environmental change and therefore are considered "canaries" of the oceans. However, the world's reefs are in peril: they have shrunk 10-50% from their historical extent due to climate change and anthropogenic activity. An important contribution to coral reef research is improved spectral distinction of reef species' health where anthropogenic activity and climate change impacts are high. Relatively little is known concerning the spectral properties of coral or how coral structures reflect and transmit light. New insights into optical processes of corals under stressed conditions can lead to improved interpretation of airborne and satellite data and forecasting of immediate or long-term impacts of events such as bleaching and disease in coral. We are investigating the spatial and spectral resolution required to detect remotely changes in reef health by coupling spectral analysis of in situ spectra and airborne spectral data with a new radiative transfer model called CorMOD2. Challenges include light attenuation by the water column, atmospheric scattering, and scattering caused by the coral themselves that confound the spectral signal. In CorMOD2, input coral reflectance measurements produce modeled absorption through an inversion at each visible wavelength. The first model development phase of CorMOD2 imposes a scattering baseline that is constant regardless of coral condition, and further specifies that coral is optically thick. Evolution of CorMOD2 is towards a coral-specific radiative transfer model that includes coral biochemical concentrations, specific absorptivities of coral components, and transmission measurements from coral surfaces.

Early lactate clearance is associated with biomarkers of inflammation, coagulation, apoptosis, organ dysfunction and mortality in severe sepsis and septic shock

PubMed Central

2010-01-01

Background Lactate clearance, a surrogate for the magnitude and duration of global tissue hypoxia, is used diagnostically, therapeutically and prognostically. This study examined the association of early lactate clearance with selected inflammatory, coagulation, apoptosis response biomarkers and organ dysfunction scores in severe sepsis and septic shock. Methods Measurements of serum arterial lactate, biomarkers (interleukin-1 receptor antagonist, interleukin-6, interleukin-8, interleukin-10, tumor necrosis factor-alpha, intercellular adhesion molecule-1, high mobility group box-1, D-Dimer and caspase-3), and organ dysfunction scores (Acute Physiology and Chronic Health Evaluation II, Simplified Acute Physiology Score II, Multiple Organ Dysfunction Score, and Sequential Organ Failure Assessment) were obtained in conjunction with a prospective, randomized study examining early goal-directed therapy in severe sepsis and septic shock patients presenting to the emergency department (ED). Lactate clearance was defined as the percent change in lactate levels after six hours from a baseline measurement in the ED. Results Two-hundred and twenty patients, age 65.0 +/- 17.1 years, were examined, with an overall lactate clearance of 35.5 +/- 43.1% and in-hospital mortality rate of 35.0%. Patients were divided into four quartiles of lactate clearance, -24.3 +/- 42.3, 30.1 +/- 7.5, 53.4 +/- 6.6, and 75.1 +/- 7.1%, respectively (p < 0.01). The mean levels of all biomarkers and organ dysfunction scores over 72 hours were significantly lower with higher lactate clearance quartiles (p < 0.01). There was a significant decreased in-hospital, 28-day, and 60-day mortality in the higher lactate clearance quartiles (p < 0.01). Conclusions Early lactate clearance as a surrogate for the resolution of global tissue hypoxia is significantly associated with decreased levels of biomarkers, improvement in organ dysfunction and outcome in severe sepsis and septic shock. PMID:20181046

Validating the WHO maternal near miss tool: comparing high- and low-resource settings.

PubMed

Witteveen, Tom; Bezstarosti, Hans; de Koning, Ilona; Nelissen, Ellen; Bloemenkamp, Kitty W; van Roosmalen, Jos; van den Akker, Thomas

2017-06-19

WHO proposed the WHO Maternal Near Miss (MNM) tool, classifying women according to several (potentially) life-threatening conditions, to monitor and improve quality of obstetric care. The objective of this study is to analyse merged data of one high- and two low-resource settings where this tool was applied and test whether the tool may be suitable for comparing severe maternal outcome (SMO) between these settings. Using three cohort studies that included SMO cases, during two-year time frames in the Netherlands, Tanzania and Malawi we reassessed all SMO cases (as defined by the original studies) with the WHO MNM tool (five disease-, four intervention- and seven organ dysfunction-based criteria). Main outcome measures were prevalence of MNM criteria and case fatality rates (CFR). A total of 3172 women were studied; 2538 (80.0%) from the Netherlands, 248 (7.8%) from Tanzania and 386 (12.2%) from Malawi. Total SMO detection was 2767 (87.2%) for disease-based criteria, 2504 (78.9%) for intervention-based criteria and 1211 (38.2%) for organ dysfunction-based criteria. Including every woman who received ≥1 unit of blood in low-resource settings as life-threatening, as defined by organ dysfunction criteria, led to more equally distributed populations. In one third of all Dutch and Malawian maternal death cases, organ dysfunction criteria could not be identified from medical records. Applying solely organ dysfunction-based criteria may lead to underreporting of SMO. Therefore, a tool based on defining MNM only upon establishing organ failure is of limited use for comparing settings with varying resources. In low-resource settings, lowering the threshold of transfused units of blood leads to a higher detection rate of MNM. We recommend refined disease-based criteria, accompanied by a limited set of intervention- and organ dysfunction-based criteria to set a measure of severity.

Identifying and Extinguishing Dysfunctional and Deadly Organizational Practices

ERIC Educational Resources Information Center

Mawhinney, Thomas C.

2009-01-01

It is possible to define an organization's culture in terms of its dominant behavioral practices and their molar consequences, from the shop floor to the executive suite (Redmon & Mason, 2001). Dysfunctional and potentially deadly practices (for the organization as a whole) can be "latent." They often go undetected until their…

Mod-5A wind turbine generator program design report. Volume 3: Final design and system description, book 1

NASA Technical Reports Server (NTRS)

1984-01-01

The design, development and analysis of the 7.3 MW MOD-5A wind turbine generator is documented. Volume 3, book 1 describes the performance and characteristics of the MOD-5A wind turbine generator in its final configuration. Each subsystem - the rotor, drivetrain, nacelle, tower and foundation is described in detail.

MOD3D: a model for incorporating MODTRAN radiative transfer into 3D simulations

NASA Astrophysics Data System (ADS)

Berk, Alexander; Anderson, Gail P.; Gossage, Brett N.

2001-08-01

MOD3D, a rapid and accurate radiative transport algorithm, is being developed for application to 3D simulations. MOD3D couples to optical property databases generated by the MODTRAN4 Correlated-k (CK) band model algorithm. The Beer's Law dependence of the CK algorithm provides for proper coupling of illumination and line-of-sight paths. Full 3D spatial effects are modeled by scaling and interpolating optical data to local conditions. A C++ version of MOD3D has been integrated into JMASS for calculation of path transmittances, thermal emission and single scatter solar radiation. Results from initial validation efforts are presented.

Standing Up a Narcotic Confirmation Laboratory for the Russian Federation Ministry of Defense Nuclear Personnel Reliability Program

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

LukyanenkoMD, Victor; Eisele, Gerhard R; Coates, Cameron W

2010-01-01

Through a cooperative effort between the U. S. Department of Energy and the Russian Federation (RF) Ministry of Defense (MOD) a Personnel Reliability Program (PRP) for the nuclear handlers within the RF MOD has been implemented. A key element in the RF MOD PRP is the detection and confirmation of narcotic use in subject military and civilian personnel. This paper describes the process of narcotics screening and testing in the RF MOD and explains the confirmation process once screening has shown a positive result. Issues of laboratory certification, employee certification, employee training, sample chain-of-custody, and equipment needs will be addressed.

MODFLOW-2000, the U.S. Geological Survey modular ground-water model -- Documentation of MOD-PREDICT for predictions, prediction sensitivity analysis, and evaluation of uncertainty

USGS Publications Warehouse

Tonkin, M.J.; Hill, Mary C.; Doherty, John

2003-01-01

This document describes the MOD-PREDICT program, which helps evaluate userdefined sets of observations, prior information, and predictions, using the ground-water model MODFLOW-2000. MOD-PREDICT takes advantage of the existing Observation and Sensitivity Processes (Hill and others, 2000) by initiating runs of MODFLOW-2000 and using the output files produced. The names and formats of the MODFLOW-2000 input files are unchanged, such that full backward compatibility is maintained. A new name file and input files are required for MOD-PREDICT. The performance of MOD-PREDICT has been tested in a variety of applications. Future applications, however, might reveal errors that were not detected in the test simulations. Users are requested to notify the U.S. Geological Survey of any errors found in this document or the computer program using the email address available at the web address below. Updates might occasionally be made to this document, to the MOD-PREDICT program, and to MODFLOW- 2000. Users can check for updates on the Internet at URL http://water.usgs.gov/software/ground water.html/.

Highly Reactive Thiol-Norbornene Photo-Click Hydrogels: Toward Improved Processability.

PubMed

Van Hoorick, Jasper; Gruber, Peter; Markovic, Marica; Rollot, Mélanie; Graulus, Geert-Jan; Vagenende, Maxime; Tromayer, Maximilian; Van Erps, Jürgen; Thienpont, Hugo; Martins, José C; Baudis, Stefan; Ovsianikov, Aleksandr; Dubruel, Peter; Van Vlierberghe, Sandra

2018-06-10

In the present work, gelatin type B is modified with highly reactive norbornene functionalities (Gel-NB) following a one-pot synthesis approach to enable subsequent thiol-ene photo-click crosslinking. The modification strategy displays close control over the amount of introduced functionalities. Additionally, Gel-NB exhibits considerably improved processing capabilities in terms of two-photon polymerization when benchmarked to earlier-reported crosslinkable gelatin derivatives (e.g., gelatin-methacrylamide (Gel-MOD) and gelatin-methacrylamide-aminoethylmethacrylate (Gel-MOD-AEMA)). The improvement is especially apparent in terms of minimally required laser power (20 mW vs ≥60 mW (Gel-MOD) vs ≥40 mW (Gel-MOD-AEMA) at 100 mm s -1 scan speed) and processable concentration range (≥5 w/v% vs ≥10 w/v% (Gel-MOD/Gel-MOD-AEMA)). Furthermore, the proposed functionalization scheme maintains the excellent biocompatibility and cell interactivity of gelatin. Additionally, the norbornene functionalities have potential for straightforward postprocessing "thiol-ene" surface grafting of active molecules. As a consequence, a very promising material toward tissue engineering applications and more specifically, biofabrication, is presented. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

VarMod: modelling the functional effects of non-synonymous variants

PubMed Central

Pappalardo, Morena; Wass, Mark N.

2014-01-01

Unravelling the genotype–phenotype relationship in humans remains a challenging task in genomics studies. Recent advances in sequencing technologies mean there are now thousands of sequenced human genomes, revealing millions of single nucleotide variants (SNVs). For non-synonymous SNVs present in proteins the difficulties of the problem lie in first identifying those nsSNVs that result in a functional change in the protein among the many non-functional variants and in turn linking this functional change to phenotype. Here we present VarMod (Variant Modeller) a method that utilises both protein sequence and structural features to predict nsSNVs that alter protein function. VarMod develops recent observations that functional nsSNVs are enriched at protein–protein interfaces and protein–ligand binding sites and uses these characteristics to make predictions. In benchmarking on a set of nearly 3000 nsSNVs VarMod performance is comparable to an existing state of the art method. The VarMod web server provides extensive resources to investigate the sequence and structural features associated with the predictions including visualisation of protein models and complexes via an interactive JSmol molecular viewer. VarMod is available for use at http://www.wasslab.org/varmod. PMID:24906884

20 years of research on the Alcator C-Mod tokamaka)

NASA Astrophysics Data System (ADS)

Greenwald, M.; Bader, A.; Baek, S.; Bakhtiari, M.; Barnard, H.; Beck, W.; Bergerson, W.; Bespamyatnov, I.; Bonoli, P.; Brower, D.; Brunner, D.; Burke, W.; Candy, J.; Churchill, M.; Cziegler, I.; Diallo, A.; Dominguez, A.; Duval, B.; Edlund, E.; Ennever, P.; Ernst, D.; Faust, I.; Fiore, C.; Fredian, T.; Garcia, O.; Gao, C.; Goetz, J.; Golfinopoulos, T.; Granetz, R.; Grulke, O.; Hartwig, Z.; Horne, S.; Howard, N.; Hubbard, A.; Hughes, J.; Hutchinson, I.; Irby, J.; Izzo, V.; Kessel, C.; LaBombard, B.; Lau, C.; Li, C.; Lin, Y.; Lipschultz, B.; Loarte, A.; Marmar, E.; Mazurenko, A.; McCracken, G.; McDermott, R.; Meneghini, O.; Mikkelsen, D.; Mossessian, D.; Mumgaard, R.; Myra, J.; Nelson-Melby, E.; Ochoukov, R.; Olynyk, G.; Parker, R.; Pitcher, S.; Podpaly, Y.; Porkolab, M.; Reinke, M.; Rice, J.; Rowan, W.; Schmidt, A.; Scott, S.; Shiraiwa, S.; Sierchio, J.; Smick, N.; Snipes, J. A.; Snyder, P.; Sorbom, B.; Stillerman, J.; Sung, C.; Takase, Y.; Tang, V.; Terry, J.; Terry, D.; Theiler, C.; Tronchin-James, A.; Tsujii, N.; Vieira, R.; Walk, J.; Wallace, G.; White, A.; Whyte, D.; Wilson, J.; Wolfe, S.; Wright, G.; Wright, J.; Wukitch, S.; Zweben, S.

2014-11-01

The object of this review is to summarize the achievements of research on the Alcator C-Mod tokamak [Hutchinson et al., Phys. Plasmas 1, 1511 (1994) and Marmar, Fusion Sci. Technol. 51, 261 (2007)] and to place that research in the context of the quest for practical fusion energy. C-Mod is a compact, high-field tokamak, whose unique design and operating parameters have produced a wealth of new and important results since it began operation in 1993, contributing data that extends tests of critical physical models into new parameter ranges and into new regimes. Using only high-power radio frequency (RF) waves for heating and current drive with innovative launching structures, C-Mod operates routinely at reactor level power densities and achieves plasma pressures higher than any other toroidal confinement device. C-Mod spearheaded the development of the vertical-target divertor and has always operated with high-Z metal plasma facing components—approaches subsequently adopted for ITER. C-Mod has made ground-breaking discoveries in divertor physics and plasma-material interactions at reactor-like power and particle fluxes and elucidated the critical role of cross-field transport in divertor operation, edge flows and the tokamak density limit. C-Mod developed the I-mode and the Enhanced Dα H-mode regimes, which have high performance without large edge localized modes and with pedestal transport self-regulated by short-wavelength electromagnetic waves. C-Mod has carried out pioneering studies of intrinsic rotation and demonstrated that self-generated flow shear can be strong enough in some cases to significantly modify transport. C-Mod made the first quantitative link between the pedestal temperature and the H-mode's performance, showing that the observed self-similar temperature profiles were consistent with critical-gradient-length theories and followed up with quantitative tests of nonlinear gyrokinetic models. RF research highlights include direct experimental observation of ion cyclotron range of frequency (ICRF) mode-conversion, ICRF flow drive, demonstration of lower-hybrid current drive at ITER-like densities and fields and, using a set of novel diagnostics, extensive validation of advanced RF codes. Disruption studies on C-Mod provided the first observation of non-axisymmetric halo currents and non-axisymmetric radiation in mitigated disruptions. A summary of important achievements and discoveries are included.

Mod5 protein binds to tRNA gene complexes and affects local transcriptional silencing

PubMed Central

Pratt-Hyatt, Matthew; Pai, Dave A.; Haeusler, Rebecca A.; Wozniak, Glenn G.; Good, Paul D.; Miller, Erin L.; McLeod, Ian X.; Yates, John R.; Hopper, Anita K.; Engelke, David R.

2013-01-01

The tRNA gene-mediated (tgm) silencing of RNA polymerase II promoters is dependent on subnuclear clustering of the tRNA genes, but genetic analysis shows that the silencing requires additional mechanisms. We have identified proteins that bind tRNA gene transcription complexes and are required for tgm silencing but not required for gene clustering. One of the proteins, Mod5, is a tRNA modifying enzyme that adds an N6-isopentenyl adenosine modification at position 37 on a small number of tRNAs in the cytoplasm, although a subpopulation of Mod5 is also found in the nucleus. Recent publications have also shown that Mod5 has tumor suppressor characteristics in humans as well as confers drug resistance through prion-like misfolding in yeast. Here, we show that a subpopulation of Mod5 associates with tRNA gene complexes in the nucleolus. This association occurs and is required for tgm silencing regardless of whether the pre-tRNA transcripts are substrates for Mod5 modification. In addition, Mod5 is bound to nuclear pre-tRNA transcripts, although they are not substrates for the A37 modification. Lastly, we show that truncation of the tRNA transcript to remove the normal tRNA structure also alleviates silencing, suggesting that synthesis of intact pre-tRNAs is required for the silencing mechanism. These results are discussed in light of recent results showing that silencing near tRNA genes also requires chromatin modification. PMID:23898186

Fracture strength of endodontically treated molars transfixed horizontally by a fiber glass post.

PubMed

Beltrão, Maria Cecilia Gomes; Spohr, Ana Maria; Oshima, Hugo Mitsuo Silva; Mota, Eduardo Gonçalves; Burnett, Luiz Henrique

2009-02-01

To assess the effect of a horizontally transfixed fiber glass post placed between buccal and palatal surfaces, on the fracture strength of endodontically treated molar teeth with MOD cavities, either restored with resin-based composite, or not. 75 sound maxillary human third molars were extracted, embedded in acrylic resin blocks and randomly assigned to five groups (n=15). Group A (sound teeth), (control) and Groups B, C, D and E, which were subjected to the following procedures after endodontic treatment: GB--(MOD+Endo), GC--(MOD+Endo+Post), GD--MOD and composite restoration (MOD+Endo+CR), GE--(MOD+Endo+Post+CR). The specimens were stored in distilled water at 37 degrees C for 24 hours. Later, a compressive force was applied by means of a universal testing machine at 1 mm/minute speed, parallel to the long axis of the teeth until fracture occurred. The means of the results (N) followed by the same letter represent no statistical difference by ANOVA and Tukey (P<0.05): GA = 4289.8 (+/- 1128.9)a, GB = 549.6 (+/- 120.7)b, GC = 1474.8 (+/- 338.1)c, GD = 1224.7 (+/- 236.0)c, GE = 2645.4 (+/- 675.1)d. In the analysis of qualitative variables, there was a tendency to cusp fracture in all groups except for Group C. The fiber glass post transfixed horizontally in a MOD cavity significantly increased the fracture resistance of the teeth restored with resin composite.

The prognostic and risk-stratified value of heart-type fatty acid-binding protein in septic patients in the emergency department.

PubMed

Chen, Yun-Xia; Li, Chun-Sheng

2014-08-01

To evaluate the prognostic and risk-stratified ability of heart-type fatty acid-binding protein (H-FABP) in septic patients in the emergency department (ED). From August to November 2012, 295 consecutive septic patients were enrolled. Circulating H-FABP was measured. The predictive value of H-FABP for 28-day mortality, organ dysfunction on ED arrival, and requirement for mechanical ventilation or a vasopressor within 6 hours after ED arrival was assessed by the receiver operating characteristic curve and logistic regression and was compared with Acute Physiology and Chronic Health Evaluation (APACHE) II score, Mortality in Emergency Department Sepsis (MEDS) score, and Sequential Organ Failure Assessment score. The 28-day mortality, APACHE II, MEDS, and Sequential Organ Failure Assessment scores were much higher in H-FABP-positive patients. The incidence of organ dysfunction at ED arrival and requirement for mechanical ventilation or a vasopressor within 6 hours after ED arrival was higher in H-FABP-positive patients. Heart-type fatty acid-binding protein was an independent predictor of 28-day mortality and organ dysfunction. The area under the receiver operating characteristic curve for H-FABP predicting 28-day mortality and organ dysfunction was 0.784 and 0.755, respectively. Combination of H-FABP and MEDS improved the performance of MEDS in predicting organ dysfunction, and the difference of AUC was statistically significant (P<.05). The combinations of H-FABP and MEDS or H-FABP and APACHE II also improved the prognostic value of MEDS and APACHE II, but the areas under the curve were not statistically different. Heart-type fatty acid-binding protein was helpful for prognosis and risk stratification of septic patients in the ED. Copyright © 2014 Elsevier Inc. All rights reserved.

Estimating Per-Pixel GPP of the Contiguous USA Directly from MODIS EVI Data

NASA Astrophysics Data System (ADS)

Rahman, A. F.; Sims, D. A.; El-Masri, B. Z.; Cordova, V. D.

2005-12-01

We estimated gross primary production (GPP) of the contiguous USA using enhanced vegetation index (EVI) data from NASA's moderate resolution imaging spectroradiometer (MODIS). Based on recently published values of correlation coefficients between EVI and GPP of North American vegetations, we derived GPP maps of the contiguous USA for 2001-2004, which included one La Nina year and three moderately El Nino years. The product was a truly per-pixel GPP estimate (named E-GPP), in contrast to the pseudo-continuous MOD17, the standard MODIS GPP product. We compared E-GPP with fine-scale experimental GPP data and MOD17 estimates from three Bigfoot experimental sites, and also with MOD17 estimates from the whole contiguous USA for the above-mentioned four years. For each of the '7 by 7' km Bigfoot experimental sites, E-GPP was able to track the primary production activity during the green-up period while MOD17 failed to do so. The E-GPP estimates during peak production season were similar to those from Bigfoot and MOD17 for most vegetation types except for the deciduous types, where it was lower. Annual E-GPP of the Bigfoot sites compared well with Bigfoot experimental GPP (r = 0.71) and MOD17 (r = 0.78). But for the contiguous USA for 2001-2004, annual E-GPP showed disagreement with MOD17 in both magnitude and seasonal trends for deciduous forests and grass lands. In this study we explored the reasons for this mismatch between E-GPP and MOD17 and also analyzed the uncertainties in E-GPP across multiple spatial scales. Our results show that the E-GPP, based on a simple regression model, can work as a robust alternative to MOD17 for large-area annual GPP estimation. The relative advantages of E-GPP are that it is truly per-pixel, solely dependent on remotely sensed data that is routinely available from NASA, easy to compute and has the potential of being used as an operational product.

Metallization with generic metallo-organic inks

NASA Technical Reports Server (NTRS)

Vest, G. M.

1983-01-01

The use and fabrication of metallo-organic films are discussed. Metallo-organic compounds are ones in which a metal is linked to a long chain carbon ligand through a hetero atom such as O, S, N, P or As. Films formed by the thermal decomposition of these metallo-organics are called MOD films. In order that the products of decomposition contain only CO2, H2O, and in rare cases nitrogen compounds, and to avoid S containing products, the use of a set of metallo-organic compounds for ink fabrication where the linking hetero atom was oxygen was pioneered. These links were made from commercially available carboxylates, or synthesized from commonly available reagents. The processing is described and the molecular design criteria are given. The particular carboxylates or amine carboxylates selected were the octoates or neodecanoates, and they are described.

Antioxidants that protect mitochondria reduce interleukin-6 and oxidative stress, improve mitochondrial function, and reduce biochemical markers of organ dysfunction in a rat model of acute sepsis

PubMed Central

Lowes, D. A.; Webster, N. R.; Murphy, M. P.; Galley, H. F.

2013-01-01

Background Sepsis-induced organ failure is the major cause of death in critical care units, and is characterized by a massive dysregulated inflammatory response and oxidative stress. We investigated the effects of treatment with antioxidants that protect mitochondria (MitoQ, MitoE, or melatonin) in a rat model of lipopolysaccharide (LPS) plus peptidoglycan (PepG)-induced acute sepsis, characterized by inflammation, mitochondrial dysfunction and early organ damage. Methods Anaesthetized and ventilated rats received an i.v. bolus of LPS and PepG followed by an i.v. infusion of MitoQ, MitoE, melatonin, or saline for 5 h. Organs and blood were then removed for determination of mitochondrial and organ function, oxidative stress, and key cytokines. Results MitoQ, MitoE, or melatonin had broadly similar protective effects with improved mitochondrial respiration (P<0.002), reduced oxidative stress (P<0.02), and decreased interleukin-6 levels (P=0.0001). Compared with control rats, antioxidant-treated rats had lower levels of biochemical markers of organ dysfunction, including plasma alanine amino-transferase activity (P=0.02) and creatinine concentrations (P<0.0001). Conclusions Antioxidants that act preferentially in mitochondria reduce mitochondrial damage and organ dysfunction and decrease inflammatory responses in a rat model of acute sepsis. PMID:23381720

Scotland’s Potential Independence: Defense Implications for Britain, NATO, and the United States

DTIC Science & Technology

2018-03-01

EEZ Exclusive Economic Zone EU European Union GDP Gross Domestic Product MoD Ministry of Defence NATO North Atlantic Treaty Organization NPT...Lowlanders focused more on the economic grievances they were facing as businessmen and entrepreneurs whereas the Highlanders found their grievances in...embark on improving the economic performance of Scotland compared to that of England through “enlightenment” and “de-nationalization.”8 Internal

No Substitute for Experience: Chinese Antipiracy Operations in the Gulf of Aden

DTIC Science & Technology

2013-11-01

sharing information with foreign navies, and improving advance patrols and warning.37 Broadcasting in English over very-high- frequency (VHF) radio ...Warships Covered in Day-to-Day Communications ,” Liberation Army Daily, 4 November 2009, eng .mod.gov.cn/DefenseNews/2009- 11 /04/ content_4101031.htm...ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10. SPONSOR/MONITOR’S ACRONYM(S) 11 . SPONSOR/MONITOR’S REPORT

Viewpoints, Formalisms, Languages, and Tools for Cyber-Physical Systems

DTIC Science & Technology

2014-05-16

Organization]: Special-Purpose and Application-Based Systems —real-time and embedded sys- tems; F.1.2 [Computation by Abstract Devices]: Mod- els of...domain CPS is not new. For example, early automotive embedded systems in the 1970s already combined closed-loop control of the brake and engine subsystems...Consider for example the development of an embedded control system such as an advanced driver assistance system (ADAS) (e.g., adaptive cruise control

Automotive Stirling engine systems development

NASA Technical Reports Server (NTRS)

Richey, A. E.

1984-01-01

The objective of the Automotive Stirling Engine (ASE) program is to develop a Stirling engine for automotive use that provides a 30 percent improvement in fuel economy relative to a comparable internal-combustion engine while meeting emissions goals. This paper traces the engine systems' development efforts focusing on: (1) a summary of engine system performance for all Mod I engines; (2) the development, program conducted for the upgraded Mod I; and (3) vehicle systems work conducted to enhance vehicle fuel economy. Problems encountered during the upgraded Mod I test program are discussed. The importance of the EPA driving cycle cold-start penalty and the measures taken to minimize that penalty with the Mod II are also addressed.

Pretest mediction of Semiscale Test S-07-10 B. [PWR

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

Dobbe, C A

A best estimate prediction of Semiscale Test S-07-10B was performed at INEL by EG and G Idaho as part of the RELAP4/MOD6 code assessment effort and as the Nuclear Regulatory Commission pretest calculation for the Small Break Experiment. The RELAP4/MOD6 Update 4 and the RELAP4/MOD7 computer codes were used to analyze Semiscale Test S-07-10B, a 10% communicative cold leg break experiment. The Semiscale Mod-3 system utilized an electrially heated simulated core operating at a power level of 1.94 MW. The initial system pressure and temperature in the upper plenum was 2276 psia and 604/sup 0/F, respectively.

Characterization of the Hamamatsu 8" R5912-MOD Photomultiplier tube

NASA Astrophysics Data System (ADS)

Kaptanoglu, Tanner

2018-05-01

Current and future neutrino and direct detection dark matter experiments hope to take advantage of improving technologies in photon detection. Many of these detectors are large, monolithic optical detectors that use relatively low-cost, large-area, and efficient photomultiplier tubes (PMTs). A candidate PMT for future experiments is a newly developed prototype Hamamatsu PMT, the R5912-MOD. In this paper we describe measurements made of the single photoelectron time and charge response of the R5912-MOD, as well as detail some direct comparisons to similar PMTs. Most of these measurements were performed on three R5912-MOD PMTs operating at gains close to 1 × 107. The transit time spread (σ) and the charge peak-to-valley were measured to be on average 680ps and 4.2 respectively. The results of this paper show the R5912-MOD is an excellent candidate for future experiments in several regards, particularly due to its narrow spread in timing.

Comparison of three methods for determination of N-nitrosopyrrolidine in fried dry-cured bacon.

PubMed

Gates, R A; Pensabene, J W; Fiddler, W

1984-01-01

The recently developed Eastern Regional Research Center ( ERRC ) dry column chromatographic procedure for determining N-nitrosopyrrolidine (NPYR) in fried cure-pumped bacon was evaluated for its applicability to fried dry-cured bacon. The method was then compared with 2 established procedures for volatile nitrosamine analysis in cured meat products: the multidetection thermal energy analyzer (MD) method and the mineral oil distillation (MOD) screening procedure. No significant difference (P less than 0.05) in NPYR values was found between the ERRC and MD procedures, but significant differences were found between the ERRC and MOD procedures and between the MOD and MD procedures. No artifactual nitrosamine formation was found in the ERRC procedure, but significant amounts were found in samples analyzed by the MOD procedure. The ERRC method was demonstrated to be rugged and very rapid. It is proposed that the ERRC method replace the MOD method as the official screening procedure for NPYR in fried bacon.

Mod-2 wind turbine system cluster research test program. Volume 1: Initial plan E-1290

NASA Technical Reports Server (NTRS)

Gordon, L. H.

1982-01-01

Upon completion of the design and development of three Mod-2 wind turbines, a series of research experiments are planned to gather data on and evaluate the performance, environmental effects, and operation of a cluster as well as a single, large multimegawatt wind turbine. Information on the program objectives, a Mod-2 system description, a planned schedule, organizational roles, and responsibilities, is included.

Mod-5A wind turbine generator program design report. Volume 4: Drawings and specifications, book 5

NASA Technical Reports Server (NTRS)

1984-01-01

The design, development and analysis of the 7.3 MW MOD-5A wind turbine generator is documented. There are four volumes. This volume contains the drawings and specifications that were developed in preparation for building the MOD-5A wind turbine generator. Detail drawings of several assemblies and subassemblies are given. This is the fifth book of volume 4.

Culture and Creativity: World of Warcraft Modding in China and the US

NASA Astrophysics Data System (ADS)

Kow, Yong Ming; Nardi, Bonnie

Modding - end-user modification of commercial hardware and software - can be traced back at least to 1961 when Spacewar! was developed by a group of MIT students on a DEC PDP-1. Spacewar! evolved into arcade games including Space Wars produced in 1977 by Cinematronics (Sotamaa 2003). In 1992, players altering Wolfenstein 3-D (1992), a first person shooter game made by id Software, overwrote the graphics and sounds by editing the game files. Learning from this experience, id Software released Doom in 1993 with isolated media files and open source code for players to develop custom maps, images, sounds, and other utilities. Players were able to pass on their modifications to others. By 1996, with the release of Quake, end-user modifications had come to be known as "mods," and modding was an accepted part of the gaming community (Kucklich 2005; Postigo 2008a, b). Since late-2005, we have been studying World of Warcraft (WoW) in which the use of mods is an important aspect of player practice (Nardi and Harris 2006; Nardi et al. 2007). Technically minded players with an interest in extending the game write mods and make them available to players for free download on distribution sites. Most modders work for free, but the distribution sites are commercial enterprises with advertising.

VarMod: modelling the functional effects of non-synonymous variants.

PubMed

Pappalardo, Morena; Wass, Mark N

2014-07-01

Unravelling the genotype-phenotype relationship in humans remains a challenging task in genomics studies. Recent advances in sequencing technologies mean there are now thousands of sequenced human genomes, revealing millions of single nucleotide variants (SNVs). For non-synonymous SNVs present in proteins the difficulties of the problem lie in first identifying those nsSNVs that result in a functional change in the protein among the many non-functional variants and in turn linking this functional change to phenotype. Here we present VarMod (Variant Modeller) a method that utilises both protein sequence and structural features to predict nsSNVs that alter protein function. VarMod develops recent observations that functional nsSNVs are enriched at protein-protein interfaces and protein-ligand binding sites and uses these characteristics to make predictions. In benchmarking on a set of nearly 3000 nsSNVs VarMod performance is comparable to an existing state of the art method. The VarMod web server provides extensive resources to investigate the sequence and structural features associated with the predictions including visualisation of protein models and complexes via an interactive JSmol molecular viewer. VarMod is available for use at http://www.wasslab.org/varmod. © The Author(s) 2014. Published by Oxford University Press on behalf of Nucleic Acids Research.

Metabolic and hormonal responses to isoenergetic high-intensity interval exercise and continuous moderate-intensity exercise.

PubMed

Peake, Jonathan M; Tan, Sok Joo; Markworth, James F; Broadbent, James A; Skinner, Tina L; Cameron-Smith, David

2014-10-01

This study investigated the effects of high-intensity interval training (HIIT) vs. work-matched moderate-intensity continuous exercise (MOD) on metabolism and counterregulatory stress hormones. In a randomized and counterbalanced order, 10 well-trained male cyclists and triathletes completed a HIIT session [81.6 ± 3.7% maximum oxygen consumption (V̇o2 max); 72.0 ± 3.2% peak power output; 792 ± 95 kJ] and a MOD session (66.7 ± 3.5% V̇o2 max; 48.5 ± 3.1% peak power output; 797 ± 95 kJ). Blood samples were collected before, immediately after, and 1 and 2 h postexercise. Carbohydrate oxidation was higher (P = 0.037; 20%), whereas fat oxidation was lower (P = 0.037; -47%) during HIIT vs. MOD. Immediately after exercise, plasma glucose (P = 0.024; 20%) and lactate (P < 0.01; 5.4×) were higher in HIIT vs. MOD, whereas total serum free fatty acid concentration was not significantly different (P = 0.33). Targeted gas chromatography-mass spectromtery metabolomics analysis identified and quantified 49 metabolites in plasma, among which 11 changed after both HIIT and MOD, 13 changed only after HIIT, and 5 changed only after MOD. Notable changes included substantial increases in tricarboxylic acid intermediates and monounsaturated fatty acids after HIIT and marked decreases in amino acids during recovery from both trials. Plasma adrenocorticotrophic hormone (P = 0.019), cortisol (P < 0.01), and growth hormone (P < 0.01) were all higher immediately after HIIT. Plasma norepinephrine (P = 0.11) and interleukin-6 (P = 0.20) immediately after exercise were not significantly different between trials. Plasma insulin decreased during recovery from both HIIT and MOD (P < 0.01). These data indicate distinct differences in specific metabolites and counterregulatory hormones following HIIT vs. MOD and highlight the value of targeted metabolomic analysis to provide more detailed insights into the metabolic demands of exercise. Copyright © 2014 the American Physiological Society.

Cardiovascular alterations and multi organ dysfunction after birth asphyxia

PubMed Central

Polglase, Graeme R.; Ong, Tracey; Hillman, Noah H

2016-01-01

Synopsis The cardiovascular response to asphyxia involves redistribution of cardiac output to maintain oxygen delivery to critical organs such as the adrenal gland, heart and brain, at the expense of other organs such as the gut, kidneys and skin. This results in reduced perfusion and localized hypoxia/ischemia in these organs, which if severe, can result in multi-organ failure. Liver injury, coagulopathy, bleeding, thrombocytopenia, renal dysfunction, pulmonary and gastrointestinal injury all result from hypoxia, under-perfusion or both. Current clinical therapies need to be considered together with therapeutic hypothermia and cardiovascular recovery. PMID:27524448

Risk Factors for Sexual Dysfunction Among Women and Men: A Consensus Statement From the Fourth International Consultation on Sexual Medicine 2015.

PubMed

McCabe, Marita P; Sharlip, Ira D; Lewis, Ron; Atalla, Elham; Balon, Richard; Fisher, Alessandra D; Laumann, Edward; Lee, Sun Won; Segraves, Robert T

2016-02-01

This article presents a review of previous research concerning risk factors for sexual dysfunction in women and men. The aim is to evaluate past research studies to determine the contribution of all risk factors to the development and maintenance of sexual dysfunction among women and men. Studies were organized under a biopsychosocial framework, with the bulk of studies of women and men having investigated the role of biological factors. The outcome measures were the data on factors for sexual dysfunction. Many more studies investigated risk factors for sexual dysfunction in men than in women. For women and men, diabetes, heart disease, urinary tract disorders, and chronic illness were significant risk factors for sexual dysfunction. Depression and anxiety and the medications used to treat these disorders also were risk factors for sexual dysfunction in women and men. In addition, substance abuse was associated with sexual dysfunction. Many other social and cultural factors were related to sexual dysfunction in women and men. Psychosocial factors are clearly risk factors for sexual dysfunction. Women and men with sexual dysfunction should be offered psychosocial evaluation and treatment, if available, in addition to medical evaluation and treatment. The impact of social and cultural factors on sexual function requires substantially more research. The evidence that erectile dysfunction is a harbinger of other forms of cardiovascular disease is strong enough to recommend that clinical evaluation for occult cardiovascular disease should be undertaken in men who do not have known cardiovascular disease but who develop organic erectile dysfunction, especially in men younger than 70 years. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Manned Certification Tests of the Modernized MK 16 MOD 1

DTIC Science & Technology

2013-11-01

CERTIFICATION TESTS OF THE MODERNIZED MK 16 MOD 1 Authors: D. E . Warkander, Ph.D. D. J. Doolette, Ph.D...PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Dan E . Warkander; David J. Doolette; Paul C. Algra 5d. PROJECT NUMBER 5e. TASK NUMBER 10-08 5f. WORK UNIT...electronics must be turned on when calibrating the secondary display. 11 REFERENCES 1. R. P. Layton , Unmanned Evaluation of the Modernized MK 16 MOD

Mod silver metallization: Screen printing and ink-jet printing

NASA Technical Reports Server (NTRS)

Vest, R. W.; Vest, G. M.

1985-01-01

Basic material efforts have proven to be very successful. Adherent and conductive films were achieved. A silver neodecanoate/bismuth 2-ethylhexanoate mixture has given the best results in both single and double layer applications. Another effort is continuing to examine the feasibility of applying metallo-organic deposition films by use of an ink jet printer. Direct line writing would result in a saving of process time and materials. So far, some well defined lines have been printed.

Evaluation of Microscopic Observation Drug Susceptibility (MODS) and the string test for rapid diagnosis of pulmonary tuberculosis in HIV/AIDS patients in Bolivia.

PubMed

Lora, Meredith H; Reimer-McAtee, Melissa J; Gilman, Robert H; Lozano, Daniel; Saravia, Ruth; Pajuelo, Monica; Bern, Caryn; Castro, Rosario; Espinoza, Magaly; Vallejo, Maya; Solano, Marco; Challapa, Roxana; Torrico, Faustino

2015-06-06

Tuberculosis (TB) is the most common opportunistic infection and the leading cause of death in HIV-positive people worldwide. Diagnosing TB is difficult, and is more challenging in resource-scarce settings where culture-based diagnostic methods rely on poorly sensitive smear microscopy by Ziehl-Neelsen stain (ZN). We performed a cross-sectional study examining the diagnostic utility of Microscopic Observation Drug Susceptibility liquid culture (MODS) versus traditional Ziehl-Neelsen staining (ZN) and Lowenstein Jensen culture (LJ) of pulmonary tuberculosis (TB) and multidrug-resistant tuberculosis (MDRTB) in HIV-infected patients in Bolivia. For sputum scarce individuals we assessed the value of the string test and induced sputum for TB diagnosis. The presence of Mycobacterium tuberculosis (Mtb) in the sputum of 107 HIV-positive patients was evaluated by ZN, LJ, and MODS. Gastric secretion samples obtained by the string test were evaluated by MODS in 102 patients. The TB-HIV co-infection rate of HIV patients with respiratory symptoms by sputum sample was 45 % (48/107); 46/48 (96 %) were positive by MODS, 38/48 (79 %) by LJ, and 30/48 (63 %) by ZN. The rate of MDRTB was 9 % (4/48). Median time to positive culture was 10 days by MODS versus 34 days by LJ (p < 0.0001). In smear-negative patients, MODS detected TB in 17/18 patients, compared to 11/18 by LJ (94.4 % vs 61.0 %, p = 0.03 %). In patients unable to produce a sputum sample without induction, the string test cultured by MODS yielded Mtb in of 9/11 (82 %) TB positive patients compared to 11/11 (100 %) with induced sputum. Of the 10 patients unable to produce a sputum sample, 4 were TB-positive by string test. MODS was faster and had a higher Mtb detection yield compared to LJ, with a greater difference in yield between the two in smear-negative patients. The string test is a valuable diagnostic technique for HIV sputum-scarce or sputum-absent patients, and should be considered as an alternative test to induced sputum to obtain sample for Mtb in resource-limited settings. Nine percent of our TB+ patients had MDRTB, which reinforces the need for rapid detection with direct drug susceptibility testing in HIV patients in Bolivia.

Sensitivity of MODIS evapotranspiration algorithm (MOD16) to the acuracy of meteorological data and land use and land cover parameterization

NASA Astrophysics Data System (ADS)

Ruhoff, Anderson; Santini Adamatti, Daniela

2017-04-01

MODIS evapotranspiration (MOD16) is currently available with 1 km of spatial resolution over 109.03 Million km2 of vegetated land surface areas and this information is widely used to evaluate the linkages between hydrological, energy and carbon cycles. The algorithm is driven by meteorological reanalysis data and MODIS remotely-sensed data, which include land use and land cover classification (MCD12Q1), leaf area index (LAI) and fraction of absorbed photosynthetically active radiation (FPAR) (MOD15A2) and albedo (MOD43b3). For calibration and parameterization, the algorithm uses a Biome Property Look-up Table (BPLUT) based on MCD12Q1 land cover classification. Several studies evaluated MOD16 accuracy using evapotranspiration measurements and water balance analysis, showing that this product can reproduce global evapotranspiration effectively under a variety climate condition, from local to wide-basin scale, with uncertainties up to 25%. In this study, we evaluated the sensitivity of MOD16 algorithm to land use and land cover parameterization and to meteorological data. Considering that MCD12Q1 has an accuracy between 70 and 85% at continental scale, we changed land cover parametererization to understand the influence of land use and land cover classification on MOD16 evapotranspiration estimations. Knowing that meteorological reanalysis data also have uncertainties (mostly related to the coarse spatial resolution), we compared MOD16 evapotranspiration driven by observed meteorological data to those driven by the reanalysis data. Our analysis were carried in South America, with evapotranspiration and meteorological measurements from the Large-Scale Biosphere-Atmosphere Experiment in Amazonia (LBA) at 8 different sites, including tropical rainforest, tropical dry forest, selective logged forest, seasonal flooded forest and pasture/agriculture. Our results indicate that land use and land cover classification has a strong influence on MOD16 algorithm. The use of incorrect parametererization due to land use and land cover misclassification can introduce large erros in estimates of evapotranspiration. We also found that the biases in meteorological reanalysis data can introduce considerable errors into the estimations. Overall, there is a significant potential for mapping and monitoring global evapotranspiration using MODIS remotely-sensed images combined to meteorological reanalysis data.

Snow fraction products evaluation with Landsat-8/OLI data and its spatial scale effects over the Tibetan Plateau

NASA Astrophysics Data System (ADS)

Jiang, L.

2016-12-01

Snow cover is one of important elements in the water supply of large populations, especially in those downstream from mountainous watershed. The cryosphere process in the Tibetan Plateau is paid much attention due to rapid change of snow amount and cover extent. Snow mapping from MODIS has been increased attention in the study of climate change and hydrology. But the lack of intensive validation of different snow mapping methods especially at Tibetan Plateau hinders its application. In this work, we examined three MODIS snow products, including standard MODIS fractional snow product (MOD10A1) (Kaufman et al., 2002; Salomonson & Appel, 2004, 2006), two other fractional snow product, MODSCAG (Painter et al., 2009) and MOD_MESMA (Shi, 2012). Both these two methods are based on spectral mixture analysis. The difference between MODISCAG and MOD_MESMA was the endmember selection. For MODSCAG product, snow spectral endmembers of varying grain size was obtained both from a radiative transfer model and spectra of vegetation, rock and soil collected in the field and laboratory. MOD_MESMA was obtained from automated endmember extraction method using linear spectral mixture analysis. Its endmembers are selected in each image to enhance the computational efficiency of MESMA (Multiple Endmember Spectral Analysis). Landsat-8 Operatinal Land Imager (OLI) data from 2013-2015 was used to evaluate the performance of these three snow fraction products in Tibetan Plateau. The effect of land cover types including forest, grass and bare soil was analyzed to evaluate three products. In addition, the effects of relatively flat surface in internal plateau and high mountain areas of Himalaya were also evaluated on the impact of these snow fraction products. From our comparison, MODSCAG and MOD10A1 overestimated snow cover, while MOD_MESMA underestimated snow cover. And RMSE of MOD_MESMA at each land cover type including forest, grass and mountain area decreased with the spatial resolution increasing from 500m, 1km, 2km to 5km. The RMSE of MODSCAG and MOD10A1 is very similar. In Himalaya area, these two RMSEs of MODSCAG and MOD10A1 increased with the spatial resolution increasing from 500m to 5km. For forest, grass and bare soil, RMSE decreased from 500m to 1km, then increased from 1km to 2km.

Utility of behavioral versus cognitive measures in differentiating between subtypes of frontotemporal lobar degeneration and Alzheimer's disease.

PubMed

Heidler-Gary, Jennifer; Gottesman, Rebecca; Newhart, Melissa; Chang, Shannon; Ken, Lynda; Hillis, Argye E

2007-01-01

We hypothesized that a modified version of the Frontal Behavioral Inventory (FBI-mod), along with a few cognitive tests, would be clinically useful in distinguishing between clinically defined Alzheimer's disease (AD) and subtypes of frontotemporal lobar degeneration (FTLD): frontotemporal dementia (dysexecutive type), progressive nonfluent aphasia, and semantic dementia. We studied 80 patients who were diagnosed with AD (n = 30) or FTLD (n = 50), on the basis of a comprehensive neuropsychological battery, imaging, neurological examination, and history. We found significant between-group differences on the FBI-mod, two subtests of the Rey Auditory Verbal Learning Test (verbal learning and delayed recall), and the Trail Making Test Part B (one measure of 'executive functioning'). AD was characterized by relatively severe impairment in verbal learning, delayed recall, and executive functioning, with relatively normal scores on the FBI-mod. Frontotemporal dementia was characterized by relatively severe impairment on the FBI-mod and executive functioning in the absence of severe impairment in verbal learning and recall. Progressive nonfluent aphasia was characterized by severe impairment in executive functioning with relatively normal scores on verbal learning and recall and FBI-mod. Finally, semantic dementia was characterized by relatively severe deficits in delayed recall, but relatively normal performance on new learning, executive functioning, and on FBI-mod. Discriminant function analysis confirmed that the FBI-mod, in conjunction with the Rey Auditory Verbal Learning Test, and the Trail Making Test Part B categorized the majority of patients as subtypes of FTLD or AD in the same way as a full neuropsychological battery, neurological examination, complete history, and imaging. These tests may be useful for efficient clinical diagnosis, although progressive nonfluent aphasia and semantic dementia are likely to be best distinguished by language tests not included in standard neuropsychological test batteries.

Perceived vulnerability moderates the relations between the use of protective behavioral strategies and alcohol use and consequences among high-risk young adults.

PubMed

Garcia, Tracey A; Fairlie, Anne M; Litt, Dana M; Waldron, Katja A; Lewis, Melissa A

2018-06-01

Drinking protective behavioral strategies (PBS) have been associated with reductions in alcohol use and alcohol-related consequences in young adults. PBS subscales, Limiting/Stopping (LS), Manner of Drinking (MOD), and Serious Harm Reduction (SHR), have been examined in the literature; LS, MOD, and SHR have mixed support as protective factors. Understanding moderators between PBS and alcohol use and related consequences is an important development in PBS research in order to delineate when and for whom PBS use is effective in reducing harm from alcohol use. Perceptions of vulnerability to negative consequences, included in health-risk models, may be one such moderator. The current study examined whether two types of perceived vulnerability (perceived vulnerability when drinking; perceived vulnerability in uncomfortable/unfamiliar situations) moderated the relations between LS, MOD, SHR strategies and alcohol use and related negative consequences. High-risk young adults (N = 400; 53.75% female) recruited nationally completed measures of PBS, alcohol use and related consequences, and measures of perceived vulnerability. Findings demonstrated that perceived vulnerability when drinking moderated the relations between MOD strategies and alcohol use. The interactions between perceived vulnerability when drinking and PBS did not predict alcohol-related consequences. Perceived vulnerability in unfamiliar/uncomfortable social situations moderated relations between MOD strategies and both alcohol use and related negative consequences; no other significant interactions emerged. Across both perceived vulnerability types and MOD strategies, those with the highest levels of perceived vulnerability and who used MOD strategies the most had the greatest decrements in alcohol use and related negative consequences. Prevention and intervention implications are discussed. Copyright © 2018. Published by Elsevier Ltd.

R-HyMOD: an R-package for the hydrological model HyMOD

NASA Astrophysics Data System (ADS)

Baratti, Emanuele; Montanari, Alberto

2015-04-01

A software code for the implementation of the HyMOD hydrological model [1] is presented. HyMOD is a conceptual lumped rainfall-runoff model that is based on the probability-distributed soil storage capacity principle introduced by R. J. Moore 1985 [2]. The general idea behind this model is to describe the spatial variability of some process parameters as, for instance, the soil structure or the water storage capacities, through probability distribution functions. In HyMOD, the rainfall-runoff process is represented through a nonlinear tank connected with three identical linear tanks in parallel representing the surface flow and a slow-flow tank representing groundwater flow. The model requires the optimization of five parameters: Cmax (the maximum storage capacity within the watershed), β (the degree of spatial variability of the soil moisture capacity within the watershed), α (a factor for partitioning the flow between two series of tanks) and the two residence time parameters of quick-flow and slow-flow tanks, kquick and kslow respectively. Given its relatively simplicity but robustness, the model is widely used in the literature. The input data consist of precipitation and potential evapotranspiration at the given time scale. The R-HyMOD package is composed by a 'canonical' R-function of HyMOD and a fast FORTRAN implementation. The first one can be easily modified and can be used, for instance, for educational purposes; the second part combines the R user friendly interface with a fast processing unit. [1] Boyle D.P. (2000), Multicriteria calibration of hydrological models, Ph.D. dissertation, Dep. of Hydrol. and Water Resour., Univ of Arizona, Tucson. [2] Moore, R.J., (1985), The probability-distributed principle and runoff production at point and basin scale, Hydrol. Sci. J., 30(2), 273-297.

Analysis of risk factors for and the prognosis of postoperative acute respiratory distress syndrome in patients with Stanford type A aortic dissection.

PubMed

Chen, Mei-Fang; Chen, Liang-Wan; Cao, Hua; Lin, Yong

2016-10-01

To explore the risk factors for and the prognosis of postoperative acute respiratory distress syndrome (ARDS) in patients with Stanford type A aortic dissection (AD). This retrospective nested case-control study included 527 Stanford type A AD patients who were divided into ARDS groups and non-ARDS groups. The clinical features of the groups were examined. The fifty-nine patients in the ARDS group exhibited extended durations of cardiopulmonary bypass (CPB) (P=0.004), deep hypothermic circulatory arrest (DHCA) (P=0.000), ventilator support (P=0.013) and intensive care unit (ICU) stay (P=0.045), higher hospital costs (P=0.000), larger perioperative transfusions volumes [red blood cells (RBC): P=0.002, platelets (PLT): P=0.040, fresh frozen plasma (FFP): P=0.001], more frequent pulmonary infection (P=0.018) and multiple organ dysfunction syndrome (MODS) (P=0.040) and a higher rate of in-hospital mortality (P=0.020). The ARDS group exhibited worse statuses in terms of oxygenation index (OI) values (P=0.000) and Apache II scores (P=0.000). DHCA [P=0.000, odds ratio (OR) =2.589] and perioperative transfusion (RBC: P=0.000, OR =2.573; PLT: P=0.027, OR =1.571; FFP: P=0.002, OR =1.929) were independent risk factors for postoperative ARDS. The survival rates and median survival times after discharge were similar between the two groups (P=0.843). DHCA duration and perioperative transfusion volume were independent risk factors for postoperative ARDS which warrants greater attention by the cardiac surgeons.

Dynamic Network Security Control Using Software Defined Networking

DTIC Science & Technology

2016-03-24

Most importantly I thank my family for understanding, loving , and thriving in the hectic world of military spouse and children. Michael C. Todd v...RBAC poses access to objects as a user to member-of group relationship . This construct results in a set of rules to govern access to objects based...API. Agent Agent.py Event.py Message.py ModSysStatus.py Event Message ModSysStatus Event - Message - ModSysStatus Relationship Figure 12. Agent Design

A New Ferroelectric Varactor from Water Based Inorganic Precursors

DTIC Science & Technology

2003-04-03

See Equation 2). 0 0 4 OH +-)4T H13< Equation 2. Idealized Reaction of Titanium Isopropoxide with 2-ethylhexanoic acid. Inconsistent results with the...Equation 3). Equation 3. Reaction of 2-ethylhexanoic anhydride with Titanium Isopropoxide We have made over one hundred batches of both BST and SBTN MOD...aliphatic acids used in the more common MOD precursors. Equation 4 shows a comparison of the decomposition products of Titanium MOD precursors made from 2

Air Force Intercontinental Ballistic Missile Fuze Modernization (ICBM Fuze Mod)

DTIC Science & Technology

2015-12-01

Selected Acquisition Report ( SAR ) RCS: DD-A&T(Q&A)823-498 Air Force Intercontinental Ballistic Missile Fuze Modernization (ICBM Fuze Mod) As of FY...2015 SAR March 17, 2016 09:03:03 UNCLASSIFIED 2 Table of Contents Common Acronyms and Abbreviations for MDAP Programs 3 Program Information...Acquisition Unit Cost ICBM Fuze Mod December 2015 SAR March 17, 2016 09:03:03 UNCLASSIFIED 3 PB - President’s Budget PE - Program Element PEO - Program

The MOD-1 steel blade

NASA Technical Reports Server (NTRS)

Vanbronkhorst, J.

1979-01-01

The design, development, fabrication, testing, and transport of two 100 foot metal blades for the MOD-1 WTS are summarized. Because the metal blade design was started late in the MOD-1 system development, many of the design requirements (allocations) were restrictive for the metal blade concept, particularly the maximum weight requirement. The design solutions required to achieve the weight goal resulted in a labor intensive (expensive) fabrication, particularly for a quantity of only two blades manufactured using minimal tooling.

Comparison of Measurements and FluorMOD Simulations for Solar Induced Chlorophyll Fluorescence and Reflectance of a Corn Crop under Nitrogen Treatments [SIF and Reflectance for Corn

NASA Technical Reports Server (NTRS)

Middleton, Elizabeth M.; Corp, Lawrence A.; Campbell, Petya K. E.

2007-01-01

The FLuorescence Explorer (FLEX) satellite concept is one of six semifinalist mission proposals selected in 2006 for pre-Phase studies by the European Space Agency (ESA). The FLEX concept proposes to measure passive solar induced chlorophyll fluorescence (SIF) of terrestrial ecosystems. A new spectral vegetation Fluorescence Model (FluorMOD) was developed to include the effects of steady state SIF on canopy reflectance. We used our laboratory and field measurements previously acquired from foliage and canopies of corn (Zea mays L.) under controlled nitrogen (N) fertilization to parameterize and evaluate FluorMOD. Our data included biophysical properties, fluorescence (F) and reflectance spectra for leaves; reflectance spectra of canopies and soil; solar irradiance; plot-level leaf area index; and canopy SIF emissions determined using the Fraunhofer Line Depth principal for the atmospheric telluric oxygen absorption features at 688 nm (O2-beta) and 760 nm (O2-alpha). FluorMOD simulations implemented in the default "look-up-table" mode did not reproduce the observed magnitudes of leaf F, canopy SIF, or canopy reflectance. However, simulations for all of these parameters agreed with observations when the default FluorMOD information was replaced with measurements, although N treatment responses were underestimated. Recommendations were provided to enhance FluorMOD's potential utility in support of SIF field experiments and studies of agriculture and ecosystems.

Experience and assessment of the DOE-NASA Mod-1 2000-Kilowatt wind turbine generator at Boone, North Carolina

NASA Technical Reports Server (NTRS)

Collins, J. L.; Shaltenc, R. K.; Poor, R. H.; Barton, R. S.

1982-01-01

The Mod 1 program objectives are defined. The Mod 1 wind turbine is described. In addition to the steel blade operated on the wind turbine, a composite blade was designed and manufactured. During the early phase of the manufacturing cycle of Mod 1A configuration was designed that identified concepts such as partial span control, a soft tower, and upwind teetered rotors that were incorporated in second and third generation industry designs. The Mod 1 electrical system performed as designed, with voltage flicker characteristics within acceptable utility limits. Power output versus wind speed equaled or exceeded design predictions. The wind turbine control system was operated successfully at the site and remotely from the utility dispatcher's office. During wind turbine operations, television interference was experienced by the local residents. As a consequence, operations were restricted. Although not implemented, two potential solutions were identified. In addition to television interference, a few local residents complained bout objectionable sound, particularly the 'thump' as the blade passed behind the tower. To eliminate objections, the sound generation level was reduced by 10 dB by reducing the rotor speed from 35 rpm to 23 rpm. Bolts in the drive train fractured. A solution was identified but not implemented. The public reaction toward the Mod 1 wind turbine program was overwhelmingly favorable.

MODIS Collection 6 Clear Sky Restoral (CSR): Filtering Cloud Mast 'Not Clear' Pixels

NASA Technical Reports Server (NTRS)

Meyer, Kerry G.; Platnick, Steven Edward; Wind, Galina; Riedi, Jerome

2014-01-01

Correctly identifying cloudy pixels appropriate for the MOD06 cloud optical and microphysical property retrievals is accomplished in large part using results from the MOD35 1km cloud mask tests (note there are also two 250m subpixel cloud mask tests that can convert the 1km cloudy designations to clear sky). However, because MOD35 is by design clear sky conservative (i.e., it identifies "not clear" pixels), certain situations exist in which pixels identified by MOD35 as "cloudy" are nevertheless likely to be poor retrieval candidates. For instance, near the edge of clouds or within broken cloud fields, a given 1km MODIS field of view (FOV) may in fact only be partially cloudy. This can be problematic for the MOD06 retrievals because in these cases the assumptions of a completely overcast homogenous cloudy FOV and 1-dimensional plane-parallel radiative transfer no longer hold, and subsequent retrievals will be of low confidence. Furthermore, some pixels may be identified by MOD35 as "cloudy" for reasons other than the presence of clouds, such as scenes with thick smoke or lofted dust, and should therefore not be retrieved as clouds. With such situations in mind, a Clear Sky Restoral (CSR) algorithm was introduced in C5 that attempts to identify pixels expected to be poor retrieval candidates. Table 1 provides SDS locations for CSR and partly cloudy (PCL) pixels.

Sur la modélisation des supraconducteurs : le ``modèle de l'état critique'' de Bean, en trois dimensions

NASA Astrophysics Data System (ADS)

Bossavit, A.

1993-03-01

Macroscopic modelling of superconductors demands a substitution of some nonlinear behavior law for Ohm's law. For this, a version of Bean's “critical state” model, derived from the setting of a convex functional of the current density field, valid in dimension 3 without any previous assumption about the direction of currents, is proposed. It is shown how two standard three-dimensional finite element methods (“h-formulation” and “e-formulation”), once fitted with this model, can deal with situations were superconductors are present. La modélisation macroscopique des supraconducteurs suppose le remplacement de la loi d'Ohm par une loi de comportement non linéaire adéquate. On présente à cet effet une version du “modèle de Bean”, ou modèle de l'état critique, basée sur la construction d'une certaine fonctionnelle convexe du champ des densités de courant, qui est valable en dimension 3 sans hypothèses préalables sur la direction des courants. On montre comment adapter deux méthodes standards de calcul de courants de Foucault par élérnents finis en trois dimensions (“en h” et “en e”) à la présence de supraconducteurs, en incorporant ce modèle.

Disruption Warning Database Development and Exploratory Machine Learning Studies on Alcator C-Mod

NASA Astrophysics Data System (ADS)

Montes, Kevin; Rea, Cristina; Granetz, Robert

2017-10-01

A database of about 1800 shots from the 2015 campaign on the Alcator C-Mod tokamak is assembled, including disruptive and non-disruptive discharges. The database consists of 40 relevant plasma parameters with data taken from 160k time slices. In order to investigate the possibility of developing a robust disruption prediction algorithm that is tokamak-independent, we focused machine learning studies on a subset of dimensionless parameters such as βp, n /nG , etc. The Random Forests machine learning algorithm provides insight on the available data set by ranking the relative importance of the input features. Its application on the C-Mod database, however, reveals that virtually no one parameter has more importance than any other, and that its classification algorithm has a low rate of successfully predicted samples, as well as poor false positive and false negative rates. Comparing the analysis of this algorithm on the C-Mod database with its application to a similar database on DIII-D, we conclude that disruption prediction may not be feasible on C-Mod. This conclusion is supported by empirical observations that most C-Mod disruptions are caused by radiative collapse due to molybdenum from the first wall, which happens on just a 1-2ms timescale. Supported by the US Dept. of Energy under DE-FC02-99ER54512 and DE-FC02-04ER54698.

Targeting Extracellular Histones with Novel RNA Biodrugs for the Treatment of Acute Lung Injury

DTIC Science & Technology

2017-10-01

inactivate) circulating histones and prevent the morbidity and mortality associated with multiple organ dysfunction/ acute respiratory distress syndrome ...patients. 15. SUBJECT TERMS Acute lung injury (ALI), acute respiratory distress syndrome (ARDS), multiple organ dysfunction syndrome , extracellular...are acute lung injury (ALI) from smoke/chlorine gas inhalation, burns, radiation , influenza and severe infection. Only recently have investigators

Investigation of the critical edge ion heat flux for L-H transitions in Alcator C-Mod and its dependence on B T

NASA Astrophysics Data System (ADS)

Schmidtmayr, M.; Hughes, J. W.; Ryter, F.; Wolfrum, E.; Cao, N.; Creely, A. J.; Howard, N.; Hubbard, A. E.; Lin, Y.; Reinke, M. L.; Rice, J. E.; Tolman, E. A.; Wukitch, S.; Ma, Y.; ASDEX Upgrade Team; Alcator C-Mod Team

2018-05-01

This paper presents investigations on the role of the edge ion heat flux for transitions from L-mode to H-mode in Alcator C-Mod. Previous results from the ASDEX Upgrade tokamak indicated that a critical value of edge ion heat flux per particle is needed for the transition. Analysis of C-Mod data confirms this result. The edge ion heat flux is indeed found to increase linearly with density at given magnetic field and plasma current. Furthermore, the Alcator C-Mod data indicate that the edge ion heat flux at the L-H transition also increases with magnetic field. Combining the data from Alcator C-Mod and ASDEX Upgrade yields a general expression for the edge ion heat flux at the L-H transition. These results are discussed from the point of view of the possible physics mechanism of the L-H transition. They are also compared to the L-H power threshold scaling and an extrapolation for ITER is given.

Conceptual design of the 6 MW Mod-5A wind turbine generator

NASA Technical Reports Server (NTRS)

Barton, R. S.; Lucas, W. C.

1982-01-01

The General Electric Company, Advanced Energy Programs Department, is designing under DOE/NASA sponsorship the MOD-5A wind turbine system which must generate electricity for 3.75 cent/KWH (1980) or less. During the Conceptual Design Phase, completed in March, 1981, the MOD-5A WTG system size and features were established as a result of tradeoff and optimization studies driven by minimizing the system cost of energy (COE). This led to a 400' rotor diameter size. The MOD-5A system which resulted is defined in this paper along with the operational and environmental factors that drive various portions of the design. Development of weight and cost estimating relationships (WCER's) and their use in optimizing the MOD-5A are discussed. The results of major tradeoff studies are also presented. Subsystem COE contributions for the 100th unit are shown along with the method of computation. Detailed descriptions of the major subsystems are given, in order that the results of the various trade and optimization studies can be more readily visualized.

Oral Disease Profiles in Chronic Graft versus Host Disease

PubMed Central

Fassil, H.; Mays, J.W.; Edwards, D.; Baird, K.; Steinberg, S.M.; Cowen, E.W.; Naik, H.; Datiles, M.; Stratton, P.; Gress, R.E.; Pavletic, S.Z.

2015-01-01

At least half of patients with chronic graft-versus-host-disease (cGVHD), the leading cause of morbidity and non-relapse mortality after allogeneic stem cell transplantation, have oral manifestations: mucosal lesions, salivary dysfunction, and limited mouth-opening. cGVHD may manifest in a single organ or affect multiple organ systems, including the mouth, eyes, and the skin. The interrelationship of the 3 oral manifestations of cGVHD with each other and with the specific manifestations of extraoral cGVHD has not been studied. In this analysis, we explored, in a large group of patients with cGVHD, the potential associations between: (1) oral mucosal disease and erythematous skin disease, (2) salivary gland dysfunction and lacrimal gland dysfunction, and (3) limited mouth-opening and sclerotic skin cGVHD. Study participants, enrolled in a cGVHD Natural History Protocol (NCT00331968, n = 212), underwent an oral examination evaluating: (1) mucosal cGVHD [NIH Oral Mucosal Score (OMS)], (2) salivary dysfunction (saliva flow and xerostomia), and (3) maximum mouth-opening measurement. Parameters for dysfunction (OMS > 2, saliva flow ≤ 1 mL/5 min, mouth-opening ≤ 35 mm) were analyzed for association with skin cGVHD involvement (erythema and sclerosis, skin symptoms), lacrimal dysfunction (Schirmer’s tear test, xerophthalmia), Lee cGVHD Symptom Scores, and NIH organ scores. Oral mucosal disease (31% prevalence) was associated with skin erythema (P < 0.001); salivary dysfunction (11% prevalence) was associated with lacrimal dysfunction (P = 0.010) and xerostomia with xerophthalmia (r = 0.32, P = 0.001); and limited mouth-opening (17% prevalence) was associated with skin sclerosis (P = 0.008) and skin symptoms (P = 0.001). There was no association found among these 3 oral cGVHD manifestations. This analysis supports the understanding of oral cGVHD as 3 distinct diseases: mucosal lesions, salivary gland dysfunction, and mouth sclerosis. Clear classification of oral cGVHD as 3 separate manifestations will improve clinical diagnosis, observational research data collection, and the definitions of outcome measures in clinical trials. PMID:25740857

In Silico Modeling: Methods and Applications toTrauma and Sepsis

PubMed Central

Vodovotz, Yoram; Billiar, Timothy R.

2013-01-01

Objective To familiarize clinicians with advances in computational disease modeling applied to trauma and sepsis. Data Sources PubMed search and review of relevant medical literature. Summary Definitions, key methods, and applications of computational modeling to trauma and sepsis are reviewed. Conclusions Computational modeling of inflammation and organ dysfunction at the cellular, organ, whole-organism, and population levels has suggested a positive feedback cycle of inflammation → damage → inflammation that manifests via organ-specific inflammatory switching networks. This structure may manifest as multi-compartment “tipping points” that drive multiple organ dysfunction. This process may be amenable to rational inflammation reprogramming. PMID:23863232

Regional cardiac function analysis from tagged MRI images. Comparison of techniques: Harmonic-Phase (HARP) versus Sinusoidal-Modeling (SinMod) analysis.

PubMed

Ibrahim, El-Sayed H; Stojanovska, Jadranka; Hassanein, Azza; Duvernoy, Claire; Croisille, Pierre; Pop-Busui, Rodica; Swanson, Scott D

2018-05-16

Cardiac MRI tagging is a valuable technique for evaluating regional heart function. Currently, there are a number of different techniques for analyzing the tagged images. Specifically, k-space-based analysis techniques showed to be much faster than image-based techniques, where harmonic-phase (HARP) and sine-wave modeling (SinMod) stand as two famous techniques of the former group, which are frequently used in clinical studies. In this study, we compared HARP and SinMod and studied inter-observer variability between the two techniques for evaluating myocardial strain and apical-to-base torsion in numerical phantom, nine healthy controls, and thirty diabetic patients. Based on the ground-truth numerical phantom measurements (strain = -20% and rotation angle = -4.4°), HARP and SinMod resulted in overestimation (in absolute value terms) of strain by 1% and 5% (strain values), and of rotation angle by 0.4° and 2.0°, respectively. For the in-vivo results, global strain and torsion ranges were -10.6 to -35.3% and 1.8-12.7°/cm in patients, and -17.8 to -32.7% and 1.8-12.3°/cm in volunteers. On average, SinMod overestimated strain measurements by 5.7% and 5.9% (strain values) in the patients and volunteers, respectively, compared to HARP, and overestimated torsion measurements by 2.9°/cm and 2.5°/cm in the patients and volunteers, respectively, compared to HARP. Location-wise, the ranges for basal, mid-ventricular, and apical strain in patients (volunteers) were -8.4 to -31.5% (-11.6 to -33.3%), -6.3 to -37.2% (-17.8 to -33.3%), and -5.2 to -38.4% (-20.0 to -33.2%), respectively. SinMod overestimated strain in the basal, mid-ventricular, and apical slices by 4.7% (5.7%), 5.9% (5.5%), and 8.9% (6.8%), respectively, compared to HARP in the patients (volunteers). Nevertheless, there existed good correlation between the HARP and SinMod measurements. Finally, there were no significant strain or torsion measurement differences between patients and volunteers. There existed good inter-observer agreement, as all measurement differences lied within the Bland-Altman ± 2 standard-deviation (SD) difference limits. In conclusion, despite the consistency of the results by either HARP or SinMod and acceptable agreement of the generated strain and torsion patterns by both techniques, SinMod systematically overestimated the measurements compared to HARP. Under current operating conditions, the measurements from HARP and SinMod cannot be used interchangeably. Copyright © 2017. Published by Elsevier Inc.

Computer Assisted Exercise Environment for Terrorist Attack Consequence Management

DTIC Science & Technology

2006-09-01

security and crisis management. Fig. 3. Third Generation SSR for Integrated Security Sector MoD MoI MoEM MoFA Special Services Integrated Security...Ministries: MoEM , MoI, MoD, MH, MoEW, MoE, MoAF National Media, NGOs, other agencies District EOC / LEMA MHS/IDS/WIS Field EOC MHS/IDS/WIS MHS IDS...SRA EDA DG Environment ... EU SR Fund MoD MoI MoE&S MoEM ... National USA Great Britain Netherlands Germany ... Bilateral BSEC Stab. Pact ... Regional

An Apple II Implementation of Man-Mod Manpower Planning Model.

DTIC Science & Technology

1982-03-01

next page. It is highly recommended, to prevent the loss of data, that the user save the data at this point. If Choice (1 ), yes, is selected, the...approximately 30 seconds, but will clear and reload memory preventing any inadvertent memory changes which might cause program interruptions or erroneous cal... prgram . 70 MAN-MOD/PROGRAM (PROGRAM LISTING) 1000 REM MAN-MOD/PROGRAM PROGRAM: "FOR" IS IN QUOTES IN LINES 1004,10518,10520,10524,10526,10528,1072

Directly e-mailing authors of newly published papers encourages community curation

PubMed Central

Bunt, Stephanie M.; Grumbling, Gary B.; Field, Helen I.; Marygold, Steven J.; Brown, Nicholas H.; Millburn, Gillian H.

2012-01-01

Much of the data within Model Organism Databases (MODs) comes from manual curation of the primary research literature. Given limited funding and an increasing density of published material, a significant challenge facing all MODs is how to efficiently and effectively prioritize the most relevant research papers for detailed curation. Here, we report recent improvements to the triaging process used by FlyBase. We describe an automated method to directly e-mail corresponding authors of new papers, requesting that they list the genes studied and indicate (‘flag’) the types of data described in the paper using an online tool. Based on the author-assigned flags, papers are then prioritized for detailed curation and channelled to appropriate curator teams for full data extraction. The overall response rate has been 44% and the flagging of data types by authors is sufficiently accurate for effective prioritization of papers. In summary, we have established a sustainable community curation program, with the result that FlyBase curators now spend less time triaging and can devote more effort to the specialized task of detailed data extraction. Database URL: http://flybase.org/ PMID:22554788

Nuclear location of a chromatin insulator in Drosophila melanogaster.

PubMed

Xu, Qinghao; Li, Mo; Adams, Jessica; Cai, Haini N

2004-03-01

Chromatin-related functions are associated with spatial organization in the nucleus. We have investigated the relationship between the enhancer-blocking activity and subnuclear localization of the Drosophila melanogaster suHw insulator. Using fluorescent in situ hybridization, we observed that genomic loci containing the gypsy retrotransposon were distributed closer to the nuclear periphery than regions without the gypsy retrotransposon. However, transgenes containing a functional 340 bp suHw insulator did not exhibit such biased distribution towards the nuclear periphery, which suggests that the suHw insulator sequence is not responsible for the peripheral localization of the gypsy retrotransposon. Antibody stains showed that the two proteins essential for the suHw insulator activity, SUHW and MOD(MDG4), are not restricted to the nuclear periphery. The enhancer-blocking activity of suHw remained intact under the heat shock conditions, which was shown to disrupt the association of gypsy, SUHW and MOD(MDG4) with the nuclear periphery. Our results indicate that the suHw insulator can function in the nuclear interior, possibly through local interactions with chromatin components or other nuclear structures.

The roles and potential therapeutic implications of CXCL4 and its variant CXCL4L1 in the pathogenesis of chronic liver allograft dysfunction.

PubMed

Li, Jing; Liu, Bin; Yan, Lu-nan; Lau, Wan-yee

2015-02-01

Chronic liver allograft dysfunction is the leading cause of patient morbidity and late allograft loss after liver transplantation. The pathogenesis of chronic liver allograft dysfunction remains unknown. Recent studies have demonstrated that CXCL4 and its variant CXCL4L1 are involved in organ damage induced through inflammatory and immune responses throughout all stages of liver transplantation. CXCL4 and CXCL4L1 are low-molecular-weight proteins that have been implicated in hematopoiesis, angiostasis, organ fibrogenesis, mitogenesis, tumor growth and metastasis. The purpose of this review is to discuss the current status and future developments of research into the roles of CXCL4 and CXCL4L1 in the pathogenesis of chronic liver allograft dysfunction. The potential utilization of CXCL4 and CXCL4L1 as therapeutic targets for chronic liver allograft dysfunction will also be discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

Mitochondrial dysfunction in alveolar and white matter developmental failure in premature infants

PubMed Central

Ten, Vadim S.

2017-01-01

At birth, some organs in premature infants are not developed enough to meet challenges of the extra-uterine life. Although growth and maturation continues after premature birth, postnatal organ development may become sluggish or even arrested, leading to organ dysfunction. There is no clear mechanistic concept of this postnatal organ developmental failure in premature neonates. This review introduces a concept-forming hypothesis: Mitochondrial bioenergetic dysfunction is a fundamental mechanism of organs maturation failure in premature infants. Data collected in support of this hypothesis are relevant to two major diseases of prematurity: white matter injury and broncho-pulmonary dysplasia. In these diseases, totally different clinical manifestations are defined by the same biological process, developmental failure of the main functional units—alveoli in the lungs and axonal myelination in the brain. Although molecular pathways regulating alveolar and white matter maturation differ, proper bioenergetic support of growth and maturation remains critical biological requirement for any actively developing organ. Literature analysis suggests that successful postnatal pulmonary and white matter development highly depends on mitochondrial function which can be inhibited by sublethal postnatal stress. In premature infants, sublethal stress results mostly in organ maturation failure without excessive cellular demise. PMID:27901512

Mitochondrial dysfunction in alveolar and white matter developmental failure in premature infants.

PubMed

Ten, Vadim S

2017-02-01

At birth, some organs in premature infants are not developed enough to meet challenges of the extra-uterine life. Although growth and maturation continues after premature birth, postnatal organ development may become sluggish or even arrested, leading to organ dysfunction. There is no clear mechanistic concept of this postnatal organ developmental failure in premature neonates. This review introduces a concept-forming hypothesis: Mitochondrial bioenergetic dysfunction is a fundamental mechanism of organs maturation failure in premature infants. Data collected in support of this hypothesis are relevant to two major diseases of prematurity: white matter injury and broncho-pulmonary dysplasia. In these diseases, totally different clinical manifestations are defined by the same biological process, developmental failure of the main functional units-alveoli in the lungs and axonal myelination in the brain. Although molecular pathways regulating alveolar and white matter maturation differ, proper bioenergetic support of growth and maturation remains critical biological requirement for any actively developing organ. Literature analysis suggests that successful postnatal pulmonary and white matter development highly depends on mitochondrial function which can be inhibited by sublethal postnatal stress. In premature infants, sublethal stress results mostly in organ maturation failure without excessive cellular demise.

The Meta-Organization: A Research and Conceptual Landscape

DTIC Science & Technology

2011-06-01

la Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale...une approche globale en nous intéressant plus particulièrement aux problèmes pernicieux, à la convergence et à l’association, et à la gestion des ...rédigé dans le cadre du projet de modélisation de la collaboration et de la prise de décisions méta-organisationnelles financé par le

French MALE UAV Program

DTIC Science & Technology

2003-09-02

ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) MoD- France 8...1French Air Force MINISTÈRE DE LA DÉFENSE 1 SIDM CONOPS 2 FAF IMAGERY ARCHITECTURE 3 FUTURE FRENCH MALE UAV PROGRAM FRENCH MALE UAV PROGRAM Report...2. REPORT TYPE N/A 3. DATES COVERED - 4. TITLE AND SUBTITLE French Male UAV Program 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM

40 CFR 85.2115 - Notification of intent to certify.

Code of Federal Regulations, 2013 CFR

2013-07-01

... testing and durability demonstration represent worst case with respect to emissions of all those... submitted by the aftermarket manufacturer to: Mod Director, MOD (EN-340F), Attention: Aftermarket Parts, 401...

40 CFR 85.2115 - Notification of intent to certify.

Code of Federal Regulations, 2012 CFR

2012-07-01

... testing and durability demonstration represent worst case with respect to emissions of all those... submitted by the aftermarket manufacturer to: Mod Director, MOD (EN-340F), Attention: Aftermarket Parts, 401...

40 CFR 85.2115 - Notification of intent to certify.

Code of Federal Regulations, 2014 CFR

2014-07-01

... testing and durability demonstration represent worst case with respect to emissions of all those... submitted by the aftermarket manufacturer to: Mod Director, MOD (EN-340F), Attention: Aftermarket Parts, 401...

Serotonergic signalling suppresses ataxin 3 aggregation and neurotoxicity in animal models of Machado-Joseph disease

PubMed Central

Teixeira-Castro, Andreia; Kang, Soosung; da Silva Santos, Liliana; Silva-Fernandes, Anabela; Neto, Mário F.; Brielmann, Renée M.; Bessa, Carlos; Duarte-Silva, Sara; Miranda, Adriana; Oliveira, Stéphanie; Neves-Carvalho, Andreia; Bessa, João; Summavielle, Teresa; Silverman, Richard B.; Oliveira, Pedro; Morimoto, Richard I.

2015-01-01

Polyglutamine diseases are a class of dominantly inherited neurodegenerative disorders for which there is no effective treatment. Here we provide evidence that activation of serotonergic signalling is beneficial in animal models of Machado-Joseph disease. We identified citalopram, a selective serotonin reuptake inhibitor, in a small molecule screen of FDA-approved drugs that rescued neuronal dysfunction and reduced aggregation using a Caenorhabditis elegans model of mutant ataxin 3-induced neurotoxicity. MOD-5, the C. elegans orthologue of the serotonin transporter and cellular target of citalopram, and the serotonin receptors SER-1 and SER-4 were strong genetic modifiers of ataxin 3 neurotoxicity and necessary for therapeutic efficacy. Moreover, chronic treatment of CMVMJD135 mice with citalopram significantly reduced ataxin 3 neuronal inclusions and astrogliosis, rescued diminished body weight and strikingly ameliorated motor symptoms. These results suggest that small molecule modulation of serotonergic signalling represents a promising therapeutic target for Machado-Joseph disease. PMID:26373603

[Epithelial dysfunction associated with pyo-inflammatory diseases of the ENT organs].

PubMed

Petukhova, N A

The modern concept of epithelial-endothelial dysfunction and epithelial-endothelial distress-syndrome associated with pyo-inflammatory ENT diseases is presented. It has provided a basis for the analysis of the initial stages of etiopathogenesis of acute and chronic inflammation in the ENT system including the mucous and associated lymphoid tissues as well as the Pirogov-Waldeyer limphopharyngeal ring making up the first protective barrier. The leading role of dysbiosis of synanthropic microflora and endotoxins of the Gram-negative bacteria in the mechanisms of regional responsiveness of the organism to the infection and chronic endotoxic aggression is demonstrated. The regional and synthetic mechanisms underlying the interaction between the external and internal media of the organism are subjected to the analysis with special reference to those operating in epithelium. The possible variants of the outcome of these processes are considered including both the recovery and the development of chronic inflammation. It has been proved that the exhaustion of the internal reserves for the stabilization of the epithelium-associated lymphoid tissue system including the Pirogov-Waldeyer limphopharyngeal ring leads to the formation of epithelial dysfunction as the initial stage of epithelial-endothelial dysfunction and epithelial-endothelial distress-syndrome. It is concluded that the modern concept of epithelial-endothelial dysfunction and epithelial-endothelial distress-syndrome is a fundamental interdisciplinary phenomenon.

Brain structural network topological alterations of the left prefrontal and limbic cortex in psychogenic erectile dysfunction.

PubMed

Chen, Jianhuai; Chen, Yun; Gao, Qingqiang; Chen, Guotao; Dai, Yutian; Yao, Zhijian; Lu, Qing

2018-05-01

Despite increasing understanding of the cerebral functional changes and structural abnormalities in erectile dysfunction, alterations in the topological organization of brain networks underlying psychogenic erectile dysfunction remain unclear. Here, based on the diffusion tensor image data of 25 patients and 26 healthy controls, we investigated the topological organization of brain structural networks and its correlations with the clinical variables using the graph theoretical analysis. Patients displayed a preserved overall small-world organization and exhibited a less connectivity strength in the left inferior frontal gyrus, amygdale and the right inferior temporal gyrus. Moreover, an abnormal hub pattern was observed in patients, which might disturb the information interactions of the remaining brain network. Additionally, the clustering coefficient of the left hippocampus was positively correlated with the duration of patients and the normalized betweenness centrality of the right anterior cingulate gyrus and the left calcarine fissure were negatively correlated with the sum scores of the 17-item Hamilton Depression Rating Scale. These findings suggested that the damaged white matter and the abnormal hub distribution of the left prefrontal and limbic cortex might contribute to the pathogenesis of psychogenic erectile dysfunction and provided new insights into the understanding of the pathophysiological mechanisms of psychogenic erectile dysfunction.

Non-Exertional Heatstroke: A Case Report and Review of the Literature

PubMed Central

Mozzini, Chiara; Xotta, Giovanni; Garbin, Ulisse; Pasini, Anna Maria Fratta; Cominacini, Luciano

2017-01-01

Patient: Female, 41 Final Diagnosis: Heatstroke Symptoms: Coma Medication: — Clinical Procedure: Intensive Care Unit-Internal Medicine Specialty: Critical Care Medicine Objective: Rare co-existance of disease or pathology Background: Heatstroke (HS) is a life-threatening condition characterized by an elevation of the core body temperature above 40°C, central nervous system dysfunction, and possible multi-organ failure. HS can trigger systemic inflammation, disseminated intravascular coagulation (DIC), rhabdomyolysis, cerebral edema and seizures, pulmonary edema, heart dysfunctions, and renal and hepatic failure. Case Report: We report the case of a 41-year-old Romanian woman with a history of alcoholism who developed HS after arriving by bus in Verona, Italy in June 2016. The patient developed consecutive multi-organ dysfunction, including liver and renal failure, rhabdomyolysis, DIC, and arrhythmia. The patient was successfully treated with conservative measures. After 17 days, she recovered completely. Conclusions: The exact mechanism of HS-related multiple organ dysfunction is not completely understood and its pathogenesis is complex. It involves inflammation, oxidative stress, endoplasmic reticulum (ER) stress, and mitochondrial dysfunction. Development of a model in which chronic alcohol abuse alters oxidative, inflammatory, and ER stress response could also be a conceivable solution to the positive prognosis of severe HS patients, in which liver failure has a prominent role. PMID:28974669

Decreased Autophagy Contributes to Myocardial Dysfunction in Rats Subjected to Nonlethal Mechanical Trauma

PubMed Central

Liang, Feng; Li, Xiaoyu; Wang, Li; Yang, Caihong; Yan, Zi; Zhang, Suli; Liu, Huirong

2013-01-01

Autophagy is important in cells for removing damaged organelles, such as mitochondria. Insufficient autophagy plays a critical role in tissue injury and organ dysfunction under a variety of pathological conditions. However, the role of autophagy in nonlethal traumatic cardiac damage remains unclear. The aims of the present study were to investigate whether nonlethal mechanical trauma may result in the change of cardiomyocyte autophagy, and if so, to determine whether the changed myocardial autophagy may contribute to delayed cardiac dysfunction. Male adult rats were subjected to nonlethal traumatic injury, and cardiomyocyte autophagy, cardiac mitochondrial function, and cardiac function in isolated perfused hearts were detected. Direct mechanical traumatic injury was not observed in the heart within 24 h after trauma. However, cardiomyocyte autophagy gradually decreased and reached a minimal level 6 h after trauma. Cardiac mitochondrial dysfunction was observed by cardiac radionuclide imaging 6 h after trauma, and cardiac dysfunction was observed 24 h after trauma in the isolated perfused heart. These were reversed when autophagy was induced by administration of the autophagy inducer rapamycin 30 min before trauma. Our present study demonstrated for the first time that nonlethal traumatic injury caused decreased autophagy, and decreased autophagy may contribute to post-traumatic organ dysfunction. Though our study has some limitations, it strongly suggests that cardiac damage induced by nonlethal mechanical trauma can be detected by noninvasive radionuclide imaging, and induction of autophagy may be a novel strategy for reducing posttrauma multiple organ failure. PMID:23977036

Experiment data report for Semiscale Mod-1 Test S-05-1 (alternate ECC injection test)

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

Feldman, E. M.; Patton, Jr., M. L.; Sackett, K. E.

Recorded test data are presented for Test S-05-1 of the Semiscale Mod-1 alternate ECC injection test series. These tests are among several Semiscale Mod-1 experiments conducted to investigate the thermal and hydraulic phenomena accompanying a hypothesized loss-of-coolant accident in a pressurized water reactor (PWR) system. Test S-05-1 was conducted from initial conditions of 2263 psia and 544/sup 0/F to investigate the response of the Semiscale Mod-1 system to a depressurization and reflood transient following a simulated double-ended offset shear of the cold leg broken loop piping. During the test, cooling water was injected into the vessel lower plenum to simulatemore » emergency core coolant injection in a PWR, with the flow rate based on system volume scaling.« less

Mod II engine performance

NASA Technical Reports Server (NTRS)

Richey, Albert E.; Huang, Shyan-Cherng

1987-01-01

The testing of a prototype of an automotive Stirling engine, the Mod II, is discussed. The Mod II is a one-piece cast block with a V-4 single-crankshaft configuration and an annular regenerator/cooler design. The initial testing of Mod II concentrated on the basic engine, with auxiliaries driven by power sources external to the engine. The performance of the engine was tested at 720 C set temperature and 820 C tube temperature. At 720 C, it is observed that the power deficiency is speed dependent and linear, with a weak pressure dependency, and at 820 C, the power deficiency is speed and pressure dependent. The effects of buoyancy and nozzle spray pattern on the heater temperature spread are investigated. The characterization of the oil pump and the operating cycle and temperature spread tests are proposed for further evaluation of the engine.

Deciphering Suicide and Other Manners of Death Associated with Drug Intoxication: A Centers for Disease Control and Prevention Consultation Meeting Summary.

PubMed

Stone, Deborah M; Holland, Kristin M; Bartholow, Brad; E Logan, Joseph; LiKamWa McIntosh, Wendy; Trudeau, Aimee; Rockett, Ian R H

2017-08-01

Manner of death (MOD) classification (i.e., natural, accident, suicide, homicide, or undetermined cause) affects mortality surveillance and public health research, policy, and practice. Determination of MOD in deaths caused by drug intoxication is challenging, with marked variability across states. The Centers for Disease Control and Prevention hosted a multidisciplinary meeting to discuss drug intoxication deaths as they relate to suicide and other MOD. The meeting objectives were to identify individual-level, system-level, and place-based factors affecting MOD classification and identify potential solutions to classification barriers. Suggested strategies included improved standardization in death scene investigation, toxicology, and autopsy practice; greater accountability; and creation of job aids for investigators. Continued collaboration and coordination of activities are needed among stakeholders to affect prevention efforts.

Removal of phosphate from eutrophic lakes through adsorption by in situ formation of magnesium hydroxide from diatomite.

PubMed

Xie, Fazhi; Wu, Fengchang; Liu, Guijian; Mu, Yunsong; Feng, Chenglian; Wang, Huanhua; Giesy, John P

2014-01-01

Since in situ formation of Mg(OH)2 can efficiently sorb phosphate (PO4) from low concentrations in the environment, a novel dispersed magnesium oxide nanoflake-modified diatomite adsorbent (MOD) was developed for use in restoration of eutrophic lakes by removal of excess PO4. Various adsorption conditions, such as pH, temperature and contact time were investigated. Overall, sorption capacities increased with increasing temperature and contact time, and decreased with increasing pH. Adsorption of PO4 was well described by both the Langmuir isotherm and pseudo second-order models. Theoretical maximum sorption capacity of MOD for PO4 was 44.44-52.08 mg/g at experimental conditions. Characterization of PO4 adsorbed to MOD by use of X-ray powder diffraction (XRD), X-ray photoelectron spectroscopy (XPS) and solid state (31)P nuclear magnetic resonance revealed that electrostatic attraction, surface complexation and chemical conversion in situ were the major forces in adsorption of PO4. Mg(OH)2 formed in situ had a net positive charge on the surface of the MOD that could adsorb PO4(3-) and HPO4(2-) anion to form surface complex and gradually convert to Mg3(PO4)2 and MgHPO4. Efficiency of removal of PO4 was 90% when 300 mg MOD/L was added to eutrophic lake water. Results presented here demonstrated the potential use of the MOD for restoration of eutrophic lakes by removal of excess PO4.

Pretest analysis of Semiscale Mod-3 baseline test S-07-8 and S-07-9

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

Fineman, C.P.; Steiner, J.L.; Snider, D.M.

This document contains a pretest analysis of the Semiscale Mod-3 system thermal-hydraulic response for the second and third integral tests in Test Series 7 (Tests S-07-8 and S-07-9). Test Series 7 is the first test series to be conducted with the Semiscale Mod-3 system. The design of the Mod-3 system includes an improved representation of certain portions of a pressurized water reactor (PWR) when compared to the previously operated Semiscale Mod-1 system. The improvements include a new vessel which contains a full length (3.66 m) core, a full length upper plenum and upper head, and an external downcomer. An activemore » pump and active steam generator scaled to their pressurized water reactor (PWR) counterparts have been added to the broken loop. The upper head design includes the capability to simulate emergency core coolant (ECC) injection into this region. Test Series 7 is divided into three groups of tests that emphasize the evaluation of the Mod-3 system performance during different phases of the loss-of-coolant experiment (LOCE) transient. The last test group, which includes Tests S-07-8 and S-07-9, will be used to evaluate the integral behavior of the system. The previous two test groups were used to evaluate the blowdown behavior and the reflood behavior of the system. 3 refs., 35 figs., 12 tabs.« less

Maternal mortality and derivations from the WHO near-miss tool: An institutional experience over a decade in Southern India.

PubMed

Halder, Ajay; Jose, Ruby; Vijayselvi, Reeta

2014-01-01

Preceding the use of World Health Organization (WHO) near-miss approach in our institute for the surveillance of Severe Maternal Outcome (SMO), we pilot-tested the tool on maternal death cases that took place over the last 10 years in order to establish its feasibility and usefulness at the institutional level. This was a retrospective review of maternal deaths in Christian Medical College Vellore, India, over a decade. Cases were recorded and analyzed using the WHO near-miss tool. The International Classification of Diseases, 10(th) Revision was used to define and classify maternal mortality. There were 98,139 total births and 212 recorded maternal deaths. Direct causes of mortality constituted 46.96% of total maternal deaths, indirect causes constituted 51.40%, and unknown cases constituted 1.9%. Nonobstetrical cause (48.11%) is the single largest group. Infections (19.8%) other than puerperal sepsis remain an important group, with pulmonary tuberculosis, scrub typhus, and malaria being the leading ones. According to the WHO near-miss criteria, cardiovascular and respiratory dysfunctions are the most frequent organ dysfunctions. Incidence of coagulation dysfunction is seen highest in obstetrical hemorrhage (64%). All women who died had at least one organ dysfunction; 90.54% mothers had two- and 38.52% had four- or more organ involvement. The screening questions of the WHO near-miss tool are particularly instrumental in obtaining a comprehensive assessment of the problem beyond the International Classification of Diseases-Maternal Mortality and establish the need for laboratory-based identification of organ dysfunctions and prompt availability of critical care facilities. The process indicators, on the other hand, inquire about the basic interventions that are more or less widely practiced and therefore give no added information at the institutional level.

A Nonerythropoietic Peptide that Mimics the 3D Structure of Erythropoietin Reduces Organ Injury/Dysfunction and Inflammation in Experimental Hemorrhagic Shock

PubMed Central

Patel, Nimesh SA; Nandra, Kiran K; Brines, Michael; Collino, Massimo; Wong, WS Fred; Kapoor, Amar; Benetti, Elisa; Goh, Fera Y; Fantozzi, Roberto; Cerami, Anthony; Thiemermann, Christoph

2011-01-01

Recent studies have shown that erythropoietin, critical for the differentiation and survival of erythrocytes, has cytoprotective effects in a wide variety of tissues, including the kidney and lung. However, erythropoietin has been shown to have a serious side effect—an increase in thrombovascular effects. We investigated whether pyroglutamate helix B-surface peptide (pHBSP), a nonerythropoietic tissue-protective peptide mimicking the 3D structure of erythropoietin, protects against the organ injury/ dysfunction and inflammation in rats subjected to severe hemorrhagic shock (HS). Mean arterial blood pressure was reduced to 35 ± 5 mmHg for 90 min followed by resuscitation with 20 mL/kg Ringer Lactate for 10 min and 50% of the shed blood for 50 min. Rats were euthanized 4 h after the onset of resuscitation. pHBSP was administered 30 min or 60 min into resuscitation. HS resulted in significant organ injury/dysfunction (renal, hepatic, pancreas, neuromuscular, lung) and inflammation (lung). In rats subjected to HS, pHBSP significantly attenuated (i) organ injury/dysfunction (renal, hepatic, pancreas, neuromuscular, lung) and inflammation (lung), (ii) increased the phosphorylation of Akt, glycogen synthase kinase-3β and endothelial nitric oxide synthase, (iii) attenuated the activation of nuclear factor (NF)-κB and (iv) attenuated the increase in p38 and extracellular signal-regulated kinase (ERK)1/2 phosphorylation. pHBSP protects against multiple organ injury/dysfunction and inflammation caused by severe hemorrhagic shock by a mechanism that may involve activation of Akt and endothelial nitric oxide synthase, and inhibition of glycogen synthase kinase-3β and NF-κB. PMID:21607291

Multi-organ dysfunction due to bath salts: are we aware of this entity?

PubMed

Valsalan, Rohith; Varghese, Benoj; Soman, Diya; Buckmaster, Jonathan; Yew, Steven; Cooper, David

2017-01-01

Methylenedioxypyrovalerone (MDPV) is a synthetic, cathinone-derivative, central nervous system stimulant taken to produce a cocaine- or methamphetamine-like high. Physical manifestations include tachycardia, hypertension, arrhythmias, hyperthermia, sweating, rhabdomyolysis, hyperkalaemia, disseminated intravascular coagulation, oliguria and seizures. We report a patient who presented with severe metabolic acidosis, multi-organ dysfunction, rhabdomyolysis, hyperkalaemia and seizures. This case highlights that even though a urine drug screen for routine psychostimulant drugs is negative, clinicians need to be vigilant about the adverse effects of MDPV as a possible cause of multi-organ dysfunction. Substances such as this can only be detected by special tests, such as gas/liquid chromatography mass spectrometry. This is the first reported case of MDPV toxicity successfully treated in Australia to the best of our knowledge. © 2017 Royal Australasian College of Physicians.

NetMOD Version 2.0 Mathematical Framework

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

Merchant, Bion J.; Young, Christopher J.; Chael, Eric P.

2015-08-01

NetMOD ( Net work M onitoring for O ptimal D etection) is a Java-based software package for conducting simulation of seismic, hydroacoustic and infrasonic networks. Network simulations have long been used to study network resilience to station outages and to determine where additional stations are needed to reduce monitoring thresholds. NetMOD makes use of geophysical models to determine the source characteristics, signal attenuation along the path between the source and station, and the performance and noise properties of the station. These geophysical models are combined to simulate the relative amplitudes of signal and noise that are observed at each ofmore » the stations. From these signal-to-noise ratios (SNR), the probabilities of signal detection at each station and event detection across the network of stations can be computed given a detection threshold. The purpose of this document is to clearly and comprehensively present the mathematical framework used by NetMOD, the software package developed by Sandia National Laboratories to assess the monitoring capability of ground-based sensor networks. Many of the NetMOD equations used for simulations are inherited from the NetSim network capability assessment package developed in the late 1980s by SAIC (Sereno et al., 1990).« less

WEST-3 wind turbine simulator development. Volume 2: Verification

NASA Technical Reports Server (NTRS)

Sridhar, S.

1985-01-01

The details of a study to validate WEST-3, a new time wind turbine simulator developed by Paragib Pacific Inc., are presented in this report. For the validation, the MOD-0 wind turbine was simulated on WEST-3. The simulation results were compared with those obtained from previous MOD-0 simulations, and with test data measured during MOD-0 operations. The study was successful in achieving the major objective of proving that WEST-3 yields results which can be used to support a wind turbine development process. The blade bending moments, peak and cyclic, from the WEST-3 simulation correlated reasonably well with the available MOD-0 data. The simulation was also able to predict the resonance phenomena observed during MOD-0 operations. Also presented in the report is a description and solution of a serious numerical instability problem encountered during the study. The problem was caused by the coupling of the rotor and the power train models. The results of the study indicate that some parts of the existing WEST-3 simulation model may have to be refined for future work; specifically, the aerodynamics and procedure used to couple the rotor model with the tower and the power train models.

A robust and accurate center-frequency estimation (RACE) algorithm for improving motion estimation performance of SinMod on tagged cardiac MR images without known tagging parameters.

PubMed

Liu, Hong; Wang, Jie; Xu, Xiangyang; Song, Enmin; Wang, Qian; Jin, Renchao; Hung, Chih-Cheng; Fei, Baowei

2014-11-01

A robust and accurate center-frequency (CF) estimation (RACE) algorithm for improving the performance of the local sine-wave modeling (SinMod) method, which is a good motion estimation method for tagged cardiac magnetic resonance (MR) images, is proposed in this study. The RACE algorithm can automatically, effectively and efficiently produce a very appropriate CF estimate for the SinMod method, under the circumstance that the specified tagging parameters are unknown, on account of the following two key techniques: (1) the well-known mean-shift algorithm, which can provide accurate and rapid CF estimation; and (2) an original two-direction-combination strategy, which can further enhance the accuracy and robustness of CF estimation. Some other available CF estimation algorithms are brought out for comparison. Several validation approaches that can work on the real data without ground truths are specially designed. Experimental results on human body in vivo cardiac data demonstrate the significance of accurate CF estimation for SinMod, and validate the effectiveness of RACE in facilitating the motion estimation performance of SinMod. Copyright © 2014 Elsevier Inc. All rights reserved.

MODi: a powerful and convenient web server for identifying multiple post-translational peptide modifications from tandem mass spectra.

PubMed

Kim, Sangtae; Na, Seungjin; Sim, Ji Woong; Park, Heejin; Jeong, Jaeho; Kim, Hokeun; Seo, Younghwan; Seo, Jawon; Lee, Kong-Joo; Paek, Eunok

2006-07-01

MOD(i) (http://modi.uos.ac.kr/modi/) is a powerful and convenient web service that facilitates the interpretation of tandem mass spectra for identifying post-translational modifications (PTMs) in a peptide. It is powerful in that it can interpret a tandem mass spectrum even when hundreds of modification types are considered and the number of potential PTMs in a peptide is large, in contrast to most of the methods currently available for spectra interpretation that limit the number of PTM sites and types being used for PTM analysis. For example, using MOD(i), one can consider for analysis both the entire PTM list published on the unimod webpage (http://www.unimod.org) and user-defined PTMs simultaneously, and one can also identify multiple PTM sites in a spectrum. MOD(i) is convenient in that it can take various input file formats such as .mzXML, .dta, .pkl and .mgf files, and it is equipped with a graphical tool called MassPective developed to display MOD(i)'s output in a user-friendly manner and helps users understand MOD(i)'s output quickly. In addition, one can perform manual de novo sequencing using MassPective.

Identification of functional elements and regulatory circuits by Drosophila modENCODE

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

Roy, Sushmita; Ernst, Jason; Kharchenko, Peter V.

2010-12-22

To gain insight into how genomic information is translated into cellular and developmental programs, the Drosophila model organism Encyclopedia of DNA Elements (modENCODE) project is comprehensively mapping transcripts, histone modifications, chromosomal proteins, transcription factors, replication proteins and intermediates, and nucleosome properties across a developmental time course and in multiple cell lines. We have generated more than 700 data sets and discovered protein-coding, noncoding, RNA regulatory, replication, and chromatin elements, more than tripling the annotated portion of the Drosophila genome. Correlated activity patterns of these elements reveal a functional regulatory network, which predicts putative new functions for genes, reveals stage- andmore » tissue-specific regulators, and enables gene-expression prediction. Our results provide a foundation for directed experimental and computational studies in Drosophila and related species and also a model for systematic data integration toward comprehensive genomic and functional annotation. Several years after the complete genetic sequencing of many species, it is still unclear how to translate genomic information into a functional map of cellular and developmental programs. The Encyclopedia of DNA Elements (ENCODE) (1) and model organism ENCODE (modENCODE) (2) projects use diverse genomic assays to comprehensively annotate the Homo sapiens (human), Drosophila melanogaster (fruit fly), and Caenorhabditis elegans (worm) genomes, through systematic generation and computational integration of functional genomic data sets. Previous genomic studies in flies have made seminal contributions to our understanding of basic biological mechanisms and genome functions, facilitated by genetic, experimental, computational, and manual annotation of the euchromatic and heterochromatic genome (3), small genome size, short life cycle, and a deep knowledge of development, gene function, and chromosome biology. The functions of {approx}40% of the protein and nonprotein-coding genes [FlyBase 5.12 (4)] have been determined from cDNA collections (5, 6), manual curation of gene models (7), gene mutations and comprehensive genome-wide RNA interference screens (8-10), and comparative genomic analyses (11, 12). The Drosophila modENCODE project has generated more than 700 data sets that profile transcripts, histone modifications and physical nucleosome properties, general and specific transcription factors (TFs), and replication programs in cell lines, isolated tissues, and whole organisms across several developmental stages (Fig. 1). Here, we computationally integrate these data sets and report (i) improved and additional genome annotations, including full-length proteincoding genes and peptides as short as 21 amino acids; (ii) noncoding transcripts, including 132 candidate structural RNAs and 1608 nonstructural transcripts; (iii) additional Argonaute (Ago)-associated small RNA genes and pathways, including new microRNAs (miRNAs) encoded within protein-coding exons and endogenous small interfering RNAs (siRNAs) from 3-inch untranslated regions; (iv) chromatin 'states' defined by combinatorial patterns of 18 chromatin marks that are associated with distinct functions and properties; (v) regions of high TF occupancy and replication activity with likely epigenetic regulation; (vi)mixed TF and miRNA regulatory networks with hierarchical structure and enriched feed-forward loops; (vii) coexpression- and co-regulation-based functional annotations for nearly 3000 genes; (viii) stage- and tissue-specific regulators; and (ix) predictive models of gene expression levels and regulator function.« less

Optical properties of amorphous Ba0.7Sr0.3TiO3 thin films obtained by metal organic decomposition technique

NASA Astrophysics Data System (ADS)

Qiu, Fei; Xu, Zhimou

2009-08-01

In this study, the amorphous Ba0.7Sr0.3TiO3 (BST0.7) thin films were grown onto fused quartz and silicon substrates at low temperature by using a metal organic decomposition (MOD)-spin-coating procedure. The optical transmittance spectrum of amorphous BST0.7 thin films on fused quartz substrates has been recorded in the wavelength range 190~900 nm. The films were highly transparent for wavelengths longer than 330 nm; the transmission drops rapidly at 330 nm, and the cutoff wavelength occurs at about 260 nm. In addition, we also report the amorphous BST0.7 thin film groove-buried type waveguides with 90° bent structure fabricated on Si substrates with 1.65 μm thick SiO2 thermal oxide layer. The design, fabrication and optical losses of amorphous BST0.7 optical waveguides were presented. The amorphous BST0.7 thin films were grown onto the SiO2/Si substrates by using a metal organic decomposition (MOD)-spin-coating procedure. The optical propagation losses were about 12.8 and 9.4 dB/cm respectively for the 5 and 10 μm wide waveguides at the wavelength of 632.8 nm. The 90° bent structures with a small curvature of micrometers were designed on the basis of a double corner mirror structure. The bend losses were about 1.2 and 0.9 dB respectively for 5 and 10 μm wide waveguides at the wavelength of 632.8 nm. It is expected for amorphous BST0.7 thin films to be used not only in the passive optical interconnection in monolithic OEICs but also in active waveguide devices on the Si chip.

Effect of decomposition and organic residues on resistivity of copper films fabricated via low-temperature sintering of complex particle mixed dispersions

NASA Astrophysics Data System (ADS)

Yong, Yingqiong; Nguyen, Mai Thanh; Tsukamoto, Hiroki; Matsubara, Masaki; Liao, Ying-Chih; Yonezawa, Tetsu

2017-03-01

Mixtures of a copper complex and copper fine particles as copper-based metal-organic decomposition (MOD) dispersions have been demonstrated to be effective for low-temperature sintering of conductive copper film. However, the copper particle size effect on decomposition process of the dispersion during heating and the effect of organic residues on the resistivity have not been studied. In this study, the decomposition process of dispersions containing mixtures of a copper complex and copper particles with various sizes was studied. The effect of organic residues on the resistivity was also studied using thermogravimetric analysis. In addition, the choice of copper salts in the copper complex was also discussed. In this work, a low-resistivity sintered copper film (7 × 10-6 Ω·m) at a temperature as low as 100 °C was achieved without using any reductive gas.

Posttest RELAP5 simulations of the Semiscale S-UT series experiments. [PWR

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

Leonard, M.T.

The RELAP5/MOD1 computer code was used to perform posttest calculations, simulating six experiments, run in the Semiscale Mod-2A facility, investigating the effects of upper head injection on small break transient behavior. The results of these calculations and corresponding test data are presented in this report. An evaluation is made of the capability of RELAP5 to calculate the thermal-hydraulic response of the Mod-2A system over a spectrum of break sizes, with and without the use of upper head injection.

mod_bio: Apache modules for Next-Generation sequencing data.

PubMed

Lindenbaum, Pierre; Redon, Richard

2015-01-01

We describe mod_bio, a set of modules for the Apache HTTP server that allows the users to access and query fastq, tabix, fasta and bam files through a Web browser. Those data are made available in plain text, HTML, XML, JSON and JSON-P. A javascript-based genome browser using the JSON-P communication technique is provided as an example of cross-domain Web service. https://github.com/lindenb/mod_bio. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Use of blade pitch control to provide power train damping for the Mod-2, 2.5-mW wind turbine

NASA Technical Reports Server (NTRS)

Blissell, W. A., Jr.

1995-01-01

The Control System for the Mod-2 wind turbine system is required to provide not only for startup, RPM regulation, maximizing or regulating power, and stopping the rotor, but also for load limiting, especially in the power train. Early operations with above-rated winds revealed an instability which was caused primarily by coupling between the quill shaft and the rotor air loads. This instability caused the first of several major Mod-2 Control System changes which are reviewed in the paper.

Harpoon Employment in Naval Antisurface Warfare (ASUW)

DTIC Science & Technology

1988-04-01

7 KASHIN MOD ...... 6 KILDEN MOD ...... 3 UDALOY .......... 8 KASHIN ......... 13 KANIN ........... 6 KOTLIN .......... 6 SKORY ........... 5 KILDIN...1 SVERDLOV CLCP 17,200 1 SVERDLOV CCL 17,200 DESTROYER I SOVREMENNY DDG 7,850 1 UDALOY DDG 8,300 4 KASHIN DDG 4,900 3 KANIN DDG 4,.150 2 SAM- KOTLIN ...DDG 3,850 4 MOD- KOTLIN DDG 3,750 FRIGATES 2 KRIVAK 3 FFG 3,800 5 KRIVAK 2 FFG 3,800 6 KRIVAK I FFG 3,800 SUBMARINE FORCES 26 SSGN/SSG 50 SSN/SS Source

Metal-water reaction and cladding deformation models for RELAP5/MOD3

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

Caraher, D.L.; Shumway, R.W.

1989-06-01

A model for calculating the reaction of zirconium with steam according to the Cathcart-Pawel correlation has been incorporated into RELAP5/MOD3. A cladding deformation model which computes swelling and rupture of the cladding according to the empirical correlations for Powers and Meyer has also been incorporated into RELAP5/MOD3. This report gives the background of the models, documents their implantation into the RELAP5 subroutines, and reports the developmental assessment done on the models. 4 refs., 9 figs., 9 tabs.

Mod-5A wind turbine generator program design report. Volume 4: Drawings and specifications, book 1

NASA Astrophysics Data System (ADS)

1984-08-01

The design, development and analysis of the 7.3 MW MOD-5A wind turbine generator is documented. Volume 4 contains the drawings and specifications that were developed in preparation for building the MOD-5A wind turbine generator. This is the first of five books of volume four. It contains structural design criteria, generator step-up transformer specs, specs for design, fabrication and testing of the system, specs for the ground control enclosure, systems specs, slip ring specs, and control system specs.

Mod-5A Wind Turbine Generator Program Design Report. Volume 4: Drawings and Specifications, Book 1

NASA Technical Reports Server (NTRS)

1984-01-01

The design, development and analysis of the 7.3 MW MOD-5A wind turbine generator is documented. Volume 4 contains the drawings and specifications that were developed in preparation for building the MOD-5A wind turbine generator. This is the first of five books of volume four. It contains structural design criteria, generator step-up transformer specs, specs for design, fabrication and testing of the system, specs for the ground control enclosure, systems specs, slip ring specs, and control system specs.

Integrating Occupational Characteristics into Human Performance Models: IPME Versus ISMAT Approach

DTIC Science & Technology

2009-08-01

modélisation générique de la performance humaine appelé Integrated Performance Modelling Environment (IPME). Ce projet a permis d’explorer l’utilisation de la...groupes professionnels dans des modèles de performance humaine : l’approche IPME et l’approche ISMAT Par Christy Lorenzen; RDDC RC 2009-059; R & D...application de simulation d’événements discrets disponible sur le marché et servant à développer des modèles qui simulent la performance humaine et de

An Introduction to the IP/PCT Model Implementation in IPME

DTIC Science & Technology

2011-03-01

perceptuel (TCP) mis en œuvre dans le logiciel Environnement intégré de modélisation des performances (EIMP) par Micro Analysis and Design. Ce...de la théorie du contrôle perceptuel (TCP) mis en œuvre dans le logiciel Environnement intégré de modélisation des performances (EIMP) par Micro...modèles de traitement de l’information (TI) et de la théorie du contrôle perceptuel (TCP) mis en œuvre dans le logiciel Environnement intégré de

Economic Analysis Model Evaluation for Technology Modernization Programs.

DTIC Science & Technology

1983-09-01

program and ’ expost - facto ’ utilized the ASD model to evaluate the accuracy of the ASD model. The following chapter reviews the literature on Tech Mod and...was applied to the CAR 80 Tech Mod project ’ expost - facto ’ in order to develop an ASD model estimated rate o . return. The ASD model was applied in...ASD estimate to achieve a range for the actual IRR. The ASD model was applied expost - facto to the CAR 80 Tech Mod program to derive an IRR. Initial data

Pavement-Transportation Computer Assisted Structural Engineering (PCASE) Implementation of the Modified Berggren (ModBerg) Equation for Computing the Frost Penetration Depth within Pavement Structures

DTIC Science & Technology

2012-04-01

ER D C/ G SL T R -1 2 -1 5 Pavement -Transportation Computer Assisted Structural Engineering (PCASE) Implementation of the Modified...Berggren (ModBerg) Equation for Computing the Frost Penetration Depth within Pavement Structures G eo te ch n ic al a n d S tr u ct u re s La b or at...April 2012 Pavement -Transportation Computer Assisted Structural Engineering (PCASE) Implementation of the Modified Berggren (ModBerg) Equation for

modPDZpep: a web resource for structure based analysis of human PDZ-mediated interaction networks.

PubMed

Sain, Neetu; Mohanty, Debasisa

2016-09-21

PDZ domains recognize short sequence stretches usually present in C-terminal of their interaction partners. Because of the involvement of PDZ domains in many important biological processes, several attempts have been made for developing bioinformatics tools for genome-wide identification of PDZ interaction networks. Currently available tools for prediction of interaction partners of PDZ domains utilize machine learning approach. Since, they have been trained using experimental substrate specificity data for specific PDZ families, their applicability is limited to PDZ families closely related to the training set. These tools also do not allow analysis of PDZ-peptide interaction interfaces. We have used a structure based approach to develop modPDZpep, a program to predict the interaction partners of human PDZ domains and analyze structural details of PDZ interaction interfaces. modPDZpep predicts interaction partners by using structural models of PDZ-peptide complexes and evaluating binding energy scores using residue based statistical pair potentials. Since, it does not require training using experimental data on peptide binding affinity, it can predict substrates for diverse PDZ families. Because of the use of simple scoring function for binding energy, it is also fast enough for genome scale structure based analysis of PDZ interaction networks. Benchmarking using artificial as well as real negative datasets indicates good predictive power with ROC-AUC values in the range of 0.7 to 0.9 for a large number of human PDZ domains. Another novel feature of modPDZpep is its ability to map novel PDZ mediated interactions in human protein-protein interaction networks, either by utilizing available experimental phage display data or by structure based predictions. In summary, we have developed modPDZpep, a web-server for structure based analysis of human PDZ domains. It is freely available at http://www.nii.ac.in/modPDZpep.html or http://202.54.226.235/modPDZpep.html . This article was reviewed by Michael Gromiha and Zoltán Gáspári.

Chemical composition of groundwater/drinking water and oncological disease mortality in Slovak Republic.

PubMed

Rapant, S; Cvečková, V; Fajčíková, K; Dietzová, Z; Stehlíková, B

2017-02-01

This study deals with the analysis of relationship between chemical composition of the groundwater/drinking water and the data on mortality from oncological diseases (MOD) in the Slovak Republic. Primary data consist of the Slovak national database of groundwater analyses (20,339 chemical analyses, 34 chemical elements/compounds) and data on MOD (17 health indicators) collected for the 10-year period (1994-2003). The chemical and health data were unified in the same form and expressed as the mean values for each of 2883 municipalities within the Slovak Republic. Pearson and Spearman correlation as well as artificial neural network (ANN) methods were used for analysis of the relationship between chemical composition of groundwater/drinking water and MOD. The most significant chemical elements having influence on MOD were identified together with their limit values (limit and optimal contents). Based on the results of calculations, made through the neural networks, the following eight chemical elements/parameters in the groundwater were defined as the most significant for MOD: Ca + Mg (mmol l -1 ), Ca, Mg, TDS, Cl, HCO 3 , SO 4 and NO 3 . The results document the highest relationship between MOD and groundwater contents of Ca + Mg (mmol l -1 ), Ca and Mg. We observe increased MOD with low (deficit) contents of these three parameters of groundwater/drinking water. The following limit values were set for the most significant groundwater chemicals/parameters: Ca + Mg 1.73-5.85 mmol l -1 , Ca 60.5-196.8 mg l -1 and Mg 25.6-35.8 mg l -1 . At these concentration ranges, the mortality for oncological diseases in the Slovak Republic is at the lowest levels. These limit values are about twice higher in comparison with the current Slovak valid guideline values for the drinking water.

Comparison of biophysical factors influencing on emphysema quantification with low-dose CT

NASA Astrophysics Data System (ADS)

Heo, Chang Yong; Kim, Jong Hyo

2014-03-01

Emphysema Index(EI) measurements in MDCT is known to be influenced by various biophysical factors such as total lung volume, and body size. We investigated the association of the four biophysical factors with emphysema index in low-dose MDCT. In particular, we attempted to identify a potentially stronger biophysical factor than total lung volume. A total of 400 low-dose MDCT volumes taken at 120kVp, 40mAs, 1mm thickness, and B30f reconstruction kernel were used. The lungs, airways, and pulmonary vessels were automatically segmented, and two Emphysema Indices, relative area below -950HU(RA950) and 15th percentile(Perc15), were extracted from the segmented lungs. The biophysical factors such as total lung volume(TLV), mode of lung attenuation(ModLA), effective body diameter(EBD), and the water equivalent body diameter(WBD) were estimated from the segmented lung and body area. The association of biophysical factors with emphysema indices were evaluated by correlation coefficients. The mean emphysema indices were 8.3±5.5(%) in RA950, and -930±18(HU) in Perc15. The estimates of biophysical factors were 4.7±1.0(L) in TLV, -901±21(HU) in ModLA, 26.9±2.2(cm) in EBD, and 25.9±2.6(cm) in WBD. The correlation coefficients of biophysical factors with RA950 were 0.73 in TLV, 0.94 in ModLA, 0.31 in EBD, and 0.18 WBD, the ones with Perc15 were 0.74 in TLV, 0.98 in ModLA, 0.29 in EBD, and 0.15 WBD. Study results revealed that two biophysical factors, TLV and ModLA, mostly affects the emphysema indices. In particular, the ModLA exhibited strongest correlation of 0.98 with Perc15, which indicating the ModLA is the most significant confounding biophysical factor in emphysema indices measurement.

The modA10 phasevarion of nontypeable Haemophilus influenzae R2866 regulates multiple virulence-associated traits.

PubMed

VanWagoner, Timothy M; Atack, John M; Nelson, Kevin L; Smith, Hannah K; Fox, Kate L; Jennings, Michael P; Stull, Terrence L; Smith, Arnold L

2016-03-01

Non-typeable Haemophilus influenzae (NTHi) is a human restricted commensal and pathogen that elicits inflammation by adhering to and invading airway epithelia cells: transcytosis across these cells can result in systemic infection. NTHi strain R2866 was isolated from the blood of a normal 30-month old infant with meningitis, and is unusual for NTHi in that it is able to cause systemic infection. Strain R2866 is able to replicate in normal human serum due to expression of lgtC which mimics human blood group p(k). R2866 contains a phase-variable DNA methyltransferase, modA10 which switches ON and OFF randomly and reversibly due to polymerase slippage over a long tetrameric repeat tract located in its open reading frame. Random gain or loss of repeats during replication can results in expressed (ON), or not expressed (OFF) states, the latter due to a frameshift or transcriptional termination at a premature stop codon. We sought to determine if the unusual virulence of R2866 was modified by modA10 phase-variation. A modA10 knockout mutant was found to have increased adherence to, and invasion of, human ear and airway monolayers in culture, and increased invasion and transcytosis of polarized human bronchial epithelial cells. Intriguingly, the rate of bacteremia was lower in the infant rat model of infection than a wild-type R2866 strain, but the fatality rate was greater. Transcriptional analysis comparing the modA10 knockout to the R2866 wild-type parent strain showed increased expression of genes in the modA10 knockout whose products mediate cellular adherence. We conclude that loss of ModA10 function in strain R2866 enhances colonization and invasion by increasing expression of genes that allow for increased adherence, which can contribute to the increased virulence of this strain. Copyright © 2015 Elsevier Ltd. All rights reserved.

Solid organ transplantation following end-organ failure in recipients of hematopoietic stem cell transplantation in children.

PubMed

Upadhyay, Kiran; Fine, Richard N

2014-08-01

Hematopoietic stem cell transplantation (HSCT) is an accepted treatment modality for various malignant and non-malignant disorders of the lympho-hematopoietic system. Patient survival rate has increased significantly with the use of this procedure. However, with the increase in disease-free patient survival rates, complications including various organ toxicities are also common. Kidney, liver, lung, heart, and skin are among those solid organs that are commonly affected and frequently lead to organ dysfunction and eventually end-organ disease. Conservative measures may or may not be successful in managing the organ failure in these patients. Solid organ transplantation has been shown to be promising in those patients who fail conservative management. This review will summarize the causes of solid organ (kidney, liver, and lung) dysfunction and the available data on transplantation of these solid organs in post-HSCT recipients.

Operating experience with four 200 kW Mod-0A wind turbine generators

NASA Technical Reports Server (NTRS)

Birchenough, A. G.; Saunders, A. L.; Nyland, T. W.; Shaltens, R. K.

1982-01-01

The windpowered generator, Mod-0A, and its advantages and disadvantages, particularly as it affects reliability, are discussed. The machine performance with regard to power availability and power output is discussed.

Airport Noise Prediction Model -- MOD 7

DOT National Transportation Integrated Search

1978-07-01

The MOD 7 Airport Noise Prediction Model is fully operational. The language used is Fortran, and it has been run on several different computer systems. Its capabilities include prediction of noise levels for single parameter changes, for multiple cha...

40 CFR 85.2115 - Notification of intent to certify.

Code of Federal Regulations, 2010 CFR

2010-07-01

... which the part is being certified including make(s), model(s), year(s), engine size(s) and all other... submitted by the aftermarket manufacturer to: Mod Director, MOD (EN-340F), Attention: Aftermarket Parts, 401...

NetMOD Version 2.0 Parameters

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

Merchant, Bion J.

2015-08-01

NetMOD ( Net work M onitoring for O ptimal D etection) is a Java-based software package for conducting simulation of seismic, hydroacoustic and infrasonic networks. Network simulations have long been used to study network resilience to station outages and to determine where additional stations are needed to reduce monitoring thresholds. NetMOD makes use of geophysical models to determine the source characteristics, signal attenuation along the path between the source and station, and the performance and noise properties of the station. These geophysical models are combined to simulate the relative amplitudes of signal and noise that are observed at each ofmore » the stations. From these signal-to-noise ratios (SNR), the probability of detection can be computed given a detection threshold. This document describes the parameters that are used to configure the NetMOD tool and the input and output parameters that make up the simulation definitions.« less

Initial utility experience with cluster of three Mod-2 wind turbine systems

NASA Technical Reports Server (NTRS)

Seely, D. B.; Warchol, E. J.; Butler, N. G.; Ciranny, S.

1982-01-01

This paper describes the initial utility experiences of operating three MOD-2s during the Engineering Acceptance Testing. Electrical quantities of bus voltage, phase currents and power are initially being recorded to evaluate impacts to customers on the 69-kV subtransmission line during synchronization and operation of one or more WTSs. To date, effects on the system have been essentially undetectable. Measurements of television signal strengths were taken at an existing television remote pickup and relay station at the WTS site. Potential TV signal interference problems from the WTSs have been avoided by replacing the remote pickups with microwave repeater links for the four TV channels received from Portland, Oregon. Preliminary measurements of audible and sub-audible noise levels indicate that the upwind rotor, tubular tower design of the MOD-2 does not have the pulsing high intensity infrasound problems experienced by the MOD-1 machine at Boone, North Carolina.

Mentoring SFRM: A New Approach to International Space Station Flight Control Training

NASA Technical Reports Server (NTRS)

Huning, Therese; Barshi, Immanuel; Schmidt, Lacey

2009-01-01

The Mission Operations Directorate (MOD) of the Johnson Space Center is responsible for providing continuous operations support for the International Space Station (ISS). Operations support requires flight controllers who are skilled in team performance as well as the technical operations of the ISS. Space Flight Resource Management (SFRM), a NASA adapted variant of Crew Resource Management (CRM), is the competency model used in the MOD. ISS flight controller certification has evolved to include a balanced focus on development of SFRM and technical expertise. The latest challenge the MOD faces is how to certify an ISS flight controller (Operator) to a basic level of effectiveness in 1 year. SFRM training uses a twopronged approach to expediting operator certification: 1) imbed SFRM skills training into all Operator technical training and 2) use senior flight controllers as mentors. This paper focuses on how the MOD uses senior flight controllers as mentors to train SFRM skills.

Wind - Prototypes on the landscape

NASA Astrophysics Data System (ADS)

Smith, M. L.

1981-12-01

Large wind turbines are shown to be attractive to utilities because of the potential for decreasing gas and oil consumption, the relatively low costs for entry into the field, and the wide distribution of wind energy. The total generating capacity can be increased in incremental steps, experience in construction and operation of large turbines have been gained from the NASA Mod O, OA, 1, and 2 models, and advances in manufacturing processes will make the large turbines competitive as replacement power for oil and gas burning utility generators. The 300 ft rotor Mod 2 machines are described, along with designs for the Mod 5A and Mod 5B wind turbines, with 400 and 422 ft, 6.2 and 7.2 MW rotors and outputs, respectively. Current plans for multi-MW windfarms are reviewed, and the option of using the land around large wind turbines for other purposes is stressed.

Mission Operations Directorate - Success Legacy of the Space Shuttle Program

NASA Technical Reports Server (NTRS)

Azbell, Jim

2010-01-01

In support of the Space Shuttle Program, as well as NASA's other human space flight programs, the Mission Operations Directorate (MOD) at the Johnson Space Center has become the world leader in human spaceflight operations. From the earliest programs - Mercury, Gemini, Apollo - through Skylab, Shuttle, ISS, and our Exploration initiatives, MOD and its predecessors have pioneered ops concepts and emphasized a history of mission leadership which has added value, maximized mission success, and built on continual improvement of the capabilities to become more efficient and effective. MOD's focus on building and contributing value with diverse teams has been key to their successes both with the US space industry and the broader international community. Since their beginning, MOD has consistently demonstrated their ability to evolve and respond to an ever changing environment, effectively prepare for the expected and successfully respond to the unexpected, and develop leaders, expertise, and a culture that has led to mission and Program success.

Development of Low-Cost Inverted Microscope to Detect Early Growth of Mycobacterium tuberculosis in MODS Culture

PubMed Central

Zimic, Mirko; Velazco, Abner; Comina, Germán; Coronel, Jorge; Fuentes, Patricia; Luna, Carmen G.; Sheen, Patricia; Gilman, Robert H.; Moore, David A. J.

2010-01-01

Background The microscopic observation drug susceptibility (MODS) assay for rapid, low-cost detection of tuberculosis and multidrug resistant tuberculosis depends upon visualization of the characteristic cording colonies of Mycobacterium tuberculosis in liquid media. This has conventionally required an inverted light microscope in order to inspect the MODS culture plates from below. Few tuberculosis laboratories have this item and the capital cost of $5,000 for a high-end microscope could be a significant obstacle to MODS roll-out. Methodology We hypothesized that the precise definition provided by costly high-specification inverted light microscopes might not be necessary for pattern recognition. Significance In this work we describe the development of a low-cost artesenal inverted microscope that can operate in both a standard or digital mode to effectively replace the expensive commercial inverted light microscope, and an integrated system that could permit a local and remote diagnosis of tuberculosis. PMID:20351778

Analyses of 1/15 scale Creare bypass transient experiments. [PWR

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

Kmetyk, L.N.; Buxton, L.D.; Cole, R.K. Jr.

1982-09-01

RELAP4 analyses of several 1/15 scale Creare H-series bypass transient experiments have been done to investigate the effect of using different downcomer nodalizations, physical scales, slip models, and vapor fraction donoring methods. Most of the analyses were thermal equilibrium calculations performed with RELAP4/MOD5, but a few such calculations were done with RELAP4/MOD6 and RELAP4/MOD7, which contain improved slip models. In order to estimate the importance of nonequilibrium effects, additional analyses were performed with TRAC-PD2, RELAP5 and the nonequilibrium option of RELAP4/MOD7. The purpose of these studies was to determine whether results from Westinghouse's calculation of the Creare experiments, which weremore » done with a UHI-modified version of SATAN, were sufficient to guarantee SATAN would be conservative with respect to ECC bypass in full-scale plant analyses.« less

The NASA-LeRC wind turbine sound prediction code

NASA Technical Reports Server (NTRS)

Viterna, L. A.

1981-01-01

Since regular operation of the DOE/NASA MOD-1 wind turbine began in October 1979 about 10 nearby households have complained of noise from the machine. Development of the NASA-LeRC with turbine sound prediction code began in May 1980 as part of an effort to understand and reduce the noise generated by MOD-1. Tone sound levels predicted with this code are in generally good agreement with measured data taken in the vicinity MOD-1 wind turbine (less than 2 rotor diameters). Comparison in the far field indicates that propagation effects due to terrain and atmospheric conditions may be amplifying the actual sound levels by about 6 dB. Parametric analysis using the code has shown that the predominant contributions to MOD-1 rotor noise are: (1) the velocity deficit in the wake of the support tower; (2) the high rotor speed; and (3) off column operation.

Simulation of German PKL refill/reflood experiment K9A using RELAP4/MOD7. [PWR

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

Hsu, M.T.; Davis, C.B.; Behling, S.R.

This paper describes a RELAP4/MOD7 simulation of West Germany's Kraftwerk Union (KWU) Primary Coolant Loop (PKL) refill/reflood experiment K9A. RELAP4/MOD7, a best-estimate computer program for the calculation of thermal and hydraulic phenomena in a nuclear reactor or related system, is the latest version in the RELAP4 code development series. This study was the first major simulation using RELAP4/MOD7 since its release by the Idaho National Engineering Laboratory (INEL). The PKL facility is a reduced scale (1:134) representation of a typical West German four-loop 1300 MW pressurized water reactor (PWR). A prototypical scale of the total volume to power ratio wasmore » maintained. The test facility was designed specifically for an experiment simulating the refill/reflood phase of a Loss-of-Coolant Accident (LOCA).« less

Lithium wall conditioning by high frequency pellet injection in RFX-mod

NASA Astrophysics Data System (ADS)

Innocente, P.; Mansfield, D. K.; Roquemore, A. L.; Agostini, M.; Barison, S.; Canton, A.; Carraro, L.; Cavazzana, R.; De Masi, G.; Fassina, A.; Fiameni, S.; Grando, L.; Rais, B.; Rossetto, F.; Scarin, P.

2015-08-01

In the RFX-mod reversed field pinch experiment, lithium wall conditioning has been tested with multiple scopes: to improve density control, to reduce impurities and to increase energy and particle confinement time. Large single lithium pellet injection, lithium capillary-pore system and lithium evaporation has been used for lithiumization. The last two methods, which presently provide the best results in tokamak devices, have limited applicability in the RFX-mod device due to the magnetic field characteristics and geometrical constraints. On the other side, the first mentioned technique did not allow injecting large amount of lithium. To improve the deposition, recently in RFX-mod small lithium multi-pellets injection has been tested. In this paper we compare lithium multi-pellets injection to the other techniques. Multi-pellets gave more uniform Li deposition than evaporator, but provided similar effects on plasma parameters, showing that further optimizations are required.

The Dysfunctions of Bureaucratic Structure.

ERIC Educational Resources Information Center

Duttweiler, Patricia Cloud

1988-01-01

Numerous dysfunctions result from bureaucratic school organization, including an overemphasis on specialized tasks, routine operating rules, and formal procedures for managing teaching and learning. Such schools are characterized by numerous regulations; formal communications; centralized decision making; and sharp distinctions among…

[Channels: a new way to revisit pathology].

PubMed

Fournier, Emmanuel

2014-02-01

Many "essential" diseases that manifest themselves in the form of crises or fits (epilepsies, episodic ataxia, periodic paralyses, myotonia, heart rhythm disorders, etc.) are due to ionic channel dysfunction and are thus referred to as "channelopathies". Some of these disorders are congenital, due to mutations of genes encoding channel subunits, while others result from toxic, immune or hormonal disturbances affecting channelfunction. Channelopathies take on a wide variety of clinical forms, depending on the type of channel (sodium, potassium, calcium, chloride...) and the type of dysfunction (loss or gain of function). Some apparently unrelated diseases affecting distinct organs are due to a similar dysfunction of the same channel, revealing unsuspected relationships between organs and between medical specialties. In addition, a given syndrome can be caused by distinct channel dysfunctions. This provides new opportunities for diferential diagnosis and specific correction of the causal defects, although some treatments find applications across multiple medical specialties.

The perils of dimensionalization: challenges in distinguishing negative traits from personality disorders.

PubMed

Wakefield, Jerome C

2008-09-01

The harmful dysfunction analysis of mental disorder is used to assess whether traits are indicative of personality disorder, and the ways such an inference can go wrong. Personality is an overall organization that allows the organism to accomplish basic goals within the constraints of its basic traits and specific intentional states. Extreme traits can be negative or "dysfunctional" in the sense that they interfere with the achievement of socially or personally valued goals; however, they are not necessarily dysfunctions or disorders in the biological or medical sense. Thus, no sheer assessment of a set of traits can offer sufficient information for a diagnosis of personality disorder. Nor do criteria such as maladaptiveness, impairment, or clinical significance necessarily transform a trait into a personality disorder. The DSM's most plausible suggestion for judging when traits are dysfunctions, inflexibility, is also problematic because many nondisordered traits are inflexible as well.

Speciations and Extinctions in a Self-Organizing Critical Model of Tree-Like Evolution

NASA Astrophysics Data System (ADS)

Kramer, M.; Vandewalle, N.; Ausloos, M.

1996-04-01

We study analytically a simple model of a self-organized critical evolution. The model considers both extinction and speciation events leading to the growth of phylogenetic-like trees. Through a mean-field like theory, we study the evolution of the local configurations for the tree leaves. The fitness threshold, below which life activity takes place through avalanches of all sizes is calculated. The transition between speciating (evolving) and dead trees is obtained and is in agreement with numerical simulations. Moreover, this theoretical work suggests that the structure of the tree is strongly dependent on the extinction strength. Nous étudions analytiquement un modèle simple d'évolution auto-organisée critique. Le modèle considère des extinctions et des spéciations conduisant à une croissance d'arbre phylogénétiques. Nous étudions ici par une théorie de champ moyen l'évolution des configurations des extrémités de l'arbre. Le seuil critique de “fitness” en-dessous duquel des explosions d'activité biologique de toutes tailles se produisent est calculé. La transition entre arbres croissants et arbres éteints est également obtenue en accord avec les simulations. En outre, ce travail théorique suggère que la structure des arbres générés dépend fortement du paramètre d'extinctions.

Evaluation of decontamination process of heart valve and artery tissues in European Homograft Bank (EHB): a retrospective study of 1,055 cases.

PubMed

Fan, Ye-Dong; Van Hoeck, Beatrice; Holovska, Vanda; Jashari, Ramadan

2012-06-01

To evaluate the efficiency of decontamination practice in European Homograft Bank (EHB), the data of the cardiovascular tissues received during recent 2 years were retrospectively analysed in this study. After initial assessment, the tissues were incubated in a 3-antibiotics' cocktail at 4°C for 20-48 h. The states of contamination were evaluated before and after incubation with the focus on the differences in donor type, tissue type, germ type and incubation time. Amongst 1,055 eligible tissues, 77.2% were hearts and 22.8% were arteries. 82.2% of the tissues were retrieved from the multi-organ donors (MOD), 15.4% from the recipients of heart transplantation (RHT) and 2.4% from the non-heart beating donors (NHBD). The initial contamination rate was 27.4% with a significantly higher incidence in arteries. The RHT tissues had the lowest contamination rate comparing to that of MOD and NHBD. Staphylococcus species was the major source of contamination. After antibiotic incubation, 76.8% of the contaminated tissues were disinfected, which was significantly higher for the hearts than the arteries. The RHT tissues had the highest decontamination rate than that of MOD and NHBD tissues. Propionibacterium acnes was detected in 48.1% of the remaining contaminated cases. The average incubation time of the Propionibacterium-positive tissues was significantly shorter than that of decontaminated tissues. In conclusion, the current decontamination protocol of EHB is sufficient for most of the initially contaminated bacteria, whereas it is inadequate for Propionibacterium acnes. This may be related to the slow-growing nature of this bacterium and thereby the relative shorter antibiotic incubation time.

Transport performance of a HTS current lead prepared by the TFA-MOD processed YBCO tapes

NASA Astrophysics Data System (ADS)

Shiohara, K.; Sakai, S.; Ohki, S.; Yamada, Y.; Tachikawa, K.; Koizumi, T.; Aoki, Y.; Hikichi, Y.; Nishioka, J.; Hasegawa, T.

2009-10-01

A superconducting current lead has been prepared using 12 tapes of the trifluoroacetates - metal organic deposition (TFA-MOD) processed Y 1Ba 2Cu 3O 7-δ (YBCO) coated conductors with critical current ( I c) of about 100 A at 77 K in self-field. The tapes are 4.5 mm in width, 220 mm in length and about 120 μm in overall thickness. The 1 μm thick superconducting YBCO layer was formed through the TFA-MOD process on Hastelloy TM substrate tapes with two buffer oxide layers of Gd 2Zr 2O 7 (GZO) and CeO 2. The 12 YBCO tapes were arrayed on the both sides (six tapes on each side) of a stainless steel board with 3 mm in thickness for a board type shape. They were similarly soldered to copper caps at the both ends. The transport current of 1000 A was stably applied for 10 min in the liquid nitrogen temperature without any voltage generation in all tapes. Although some voltage in some YBCO tapes generated at the applied currents of about 1100 A, the transport current of 1200 A was successfully applied without quenching. The voltage between both copper caps linearly increased with increasing the transport current, and it was about 300 μV at an applied current of 1000 A. A low joint resistance between the YBCO tapes and the copper caps resulted in small amounts of the Joule heating at the joints when 1000 A was applied. The overall (effective) thermal conductivity of the current leads composed of YBCO tapes and the stainless steel board was much lower than that of Non-superconducting current leads. Therefore, the present current leads with small heat leakage seemed to be practically promising for superconducting magnets.

Extension of the lod score: the mod score.

PubMed

Clerget-Darpoux, F

2001-01-01

In 1955 Morton proposed the lod score method both for testing linkage between loci and for estimating the recombination fraction between them. If a disease is controlled by a gene at one of these loci, the lod score computation requires the prior specification of an underlying model that assigns the probabilities of genotypes from the observed phenotypes. To address the case of linkage studies for diseases with unknown mode of inheritance, we suggested (Clerget-Darpoux et al., 1986) extending the lod score function to a so-called mod score function. In this function, the variables are both the recombination fraction and the disease model parameters. Maximizing the mod score function over all these parameters amounts to maximizing the probability of marker data conditional on the disease status. Under the absence of linkage, the mod score conforms to a chi-square distribution, with extra degrees of freedom in comparison to the lod score function (MacLean et al., 1993). The mod score is asymptotically maximum for the true disease model (Clerget-Darpoux and Bonaïti-Pellié, 1992; Hodge and Elston, 1994). Consequently, the power to detect linkage through mod score will be highest when the space of models where the maximization is performed includes the true model. On the other hand, one must avoid overparametrization of the model space. For example, when the approach is applied to affected sibpairs, only two constrained disease model parameters should be used (Knapp et al., 1994) for the mod score maximization. It is also important to emphasize the existence of a strong correlation between the disease gene location and the disease model. Consequently, there is poor resolution of the location of the susceptibility locus when the disease model at this locus is unknown. Of course, this is true regardless of the statistics used. The mod score may also be applied in a candidate gene strategy to model the potential effect of this gene in the disease. Since, however, it ignores the information provided both by disease segregation and by linkage disequilibrium between the marker alleles and the functional disease alleles, its power of discrimination between genetic models is weak. The MASC method (Clerget-Darpoux et al., 1988) has been designed to address more efficiently the objectives of a candidate gene approach.

A comparison of normal versus low dietary carbohydrate intake on substrate oxidation during and after moderate intensity exercise in women.

PubMed

Patterson, Rachel; Potteiger, Jeffrey A

2011-12-01

We compared the effects of consuming a 2-day low-carbohydrate (CHO) diet (low-CHO; 20% CHO, 40% protein, 40% fat) versus an isocaloric 2-day moderate-CHO diet (mod-CHO; 55% CHO, 15% protein, 30% fat) on substrate oxidation during and after exercise in ten active, young women. Subjects were 24.9 ± 6.2% body fat with a VO(2max) of 68.8 ± 13.8 ml/kg FFM/min. For 2 days prior to exercise, subjects consumed either the mod-CHO or the low-CHO diet and then completed treadmill exercise at 55% of VO(2max) until 350 kcal of energy was expended. During exercise and for 2 h post-exercise, expired gases were analyzed to determine oxidation rates for CHO (CHO-OX) and fat (FAT-OX). Significant differences (p < 0.05) were found between diets for CHO-OX and FAT-OX (mg/kg FFM/min) during exercise, 1 h post-ex, and 2 h post-ex. During exercise, FAT-OX was higher (low-CHO 8.7 ± 2.2 vs. mod-CHO 6.2 ± 2.2) and CHO-OX was lower (low-CHO 25.1 ± 5.6 vs. mod-CHO 31.1 ± 6.2) following the low-CHO diet. A similar trend was observed during 1 h post-ex for FAT-OX (low-CHO 2.2 ± 0.5 vs. mod-CHO 1.6 ± 0.5) and CHO-OX (low-CHO 2.5 ± 1.2 vs. mod-CHO 4.1 ± 1.9), as well as 2 h post-ex for FAT-OX (low-CHO vs. 1.9 ± 0.5 mod-CHO 1.7 ± 0.4) and CHO-OX (low-CHO 2.5 ± 0.9 vs. mod-CHO 3.1 ± 1.1). Significant positive correlations were observed between VO(2max) and CHO-OX during exercise and post-exercise, as well as significant negative correlations between VO(2max) and FAT-OX post-exercise in the low-CHO condition. Waist circumference and FAT-OX exhibited a significant negative correlation during exercise in the low-CHO condition. Dietary macronutrient intake influenced substrate oxidation in active young women during and after moderate intensity exercise.

Comparison and Evaluation of Annual NDVI Time Series in China Derived from the NOAA AVHRR LTDR and Terra MODIS MOD13C1 Products

PubMed Central

Guo, Xiaoyi; Zhang, Hongyan; Wu, Zhengfang; Zhao, Jianjun; Zhang, Zhengxiang

2017-01-01

Time series of Normalized Difference Vegetation Index (NDVI) derived from multiple satellite sensors are crucial data to study vegetation dynamics. The Land Long Term Data Record Version 4 (LTDR V4) NDVI dataset was recently released at a 0.05 × 0.05° spatial resolution and daily temporal resolution. In this study, annual NDVI time series that are composited by the LTDR V4 and Moderate Resolution Imaging Spectroradiometer (MODIS) NDVI datasets (MOD13C1) are compared and evaluated for the period from 2001 to 2014 in China. The spatial patterns of the NDVI generally match between the LTDR V4 and MOD13C1 datasets. The transitional zone between high and low NDVI values generally matches the boundary of semi-arid and sub-humid regions. A significant and high coefficient of determination is found between the two datasets according to a pixel-based correlation analysis. The spatially averaged NDVI of LTDR V4 is characterized by a much weaker positive regression slope relative to that of the spatially averaged NDVI of the MOD13C1 dataset because of changes in NOAA AVHRR sensors between 2005 and 2006. The measured NDVI values of LTDR V4 were always higher than that of MOD13C1 in western China due to the relatively lower atmospheric water vapor content in western China, and opposite observation appeared in eastern China. In total, 18.54% of the LTDR V4 NDVI pixels exhibit significant trends, whereas 35.79% of the MOD13C1 NDVI pixels show significant trends. Good agreement is observed between the significant trends of the two datasets in the Northeast Plain, Bohai Economic Rim, Loess Plateau, and Yangtze River Delta. By contrast, the datasets contrasted in northwestern desert regions and southern China. A trend analysis of the regression slope values according to the vegetation type shows good agreement between the LTDR V4 and MOD13C1 datasets. This study demonstrates the spatial and temporal consistencies and discrepancies between the AVHRR LTDR and MODIS MOD13C1 NDVI products in China, which could provide useful information for the choice of NDVI products in subsequent studies of vegetation dynamics. PMID:28587266

Comparison and Evaluation of Annual NDVI Time Series in China Derived from the NOAA AVHRR LTDR and Terra MODIS MOD13C1 Products.

PubMed

Guo, Xiaoyi; Zhang, Hongyan; Wu, Zhengfang; Zhao, Jianjun; Zhang, Zhengxiang

2017-06-06

Time series of Normalized Difference Vegetation Index (NDVI) derived from multiple satellite sensors are crucial data to study vegetation dynamics. The Land Long Term Data Record Version 4 (LTDR V4) NDVI dataset was recently released at a 0.05 × 0.05° spatial resolution and daily temporal resolution. In this study, annual NDVI time series that are composited by the LTDR V4 and Moderate Resolution Imaging Spectroradiometer (MODIS) NDVI datasets (MOD13C1) are compared and evaluated for the period from 2001 to 2014 in China. The spatial patterns of the NDVI generally match between the LTDR V4 and MOD13C1 datasets. The transitional zone between high and low NDVI values generally matches the boundary of semi-arid and sub-humid regions. A significant and high coefficient of determination is found between the two datasets according to a pixel-based correlation analysis. The spatially averaged NDVI of LTDR V4 is characterized by a much weaker positive regression slope relative to that of the spatially averaged NDVI of the MOD13C1 dataset because of changes in NOAA AVHRR sensors between 2005 and 2006. The measured NDVI values of LTDR V4 were always higher than that of MOD13C1 in western China due to the relatively lower atmospheric water vapor content in western China, and opposite observation appeared in eastern China. In total, 18.54% of the LTDR V4 NDVI pixels exhibit significant trends, whereas 35.79% of the MOD13C1 NDVI pixels show significant trends. Good agreement is observed between the significant trends of the two datasets in the Northeast Plain, Bohai Economic Rim, Loess Plateau, and Yangtze River Delta. By contrast, the datasets contrasted in northwestern desert regions and southern China. A trend analysis of the regression slope values according to the vegetation type shows good agreement between the LTDR V4 and MOD13C1 datasets. This study demonstrates the spatial and temporal consistencies and discrepancies between the AVHRR LTDR and MODIS MOD13C1 NDVI products in China, which could provide useful information for the choice of NDVI products in subsequent studies of vegetation dynamics.

Oral disease profiles in chronic graft versus host disease.

PubMed

Bassim, C W; Fassil, H; Mays, J W; Edwards, D; Baird, K; Steinberg, S M; Cowen, E W; Naik, H; Datiles, M; Stratton, P; Gress, R E; Pavletic, S Z

2015-04-01

At least half of patients with chronic graft-versus-host-disease (cGVHD), the leading cause of morbidity and non-relapse mortality after allogeneic stem cell transplantation, have oral manifestations: mucosal lesions, salivary dysfunction, and limited mouth-opening. cGVHD may manifest in a single organ or affect multiple organ systems, including the mouth, eyes, and the skin. The interrelationship of the 3 oral manifestations of cGVHD with each other and with the specific manifestations of extraoral cGVHD has not been studied. In this analysis, we explored, in a large group of patients with cGVHD, the potential associations between: (1) oral mucosal disease and erythematous skin disease, (2) salivary gland dysfunction and lacrimal gland dysfunction, and (3) limited mouth-opening and sclerotic skin cGVHD. Study participants, enrolled in a cGVHD Natural History Protocol (NCT00331968, n = 212), underwent an oral examination evaluating: (1) mucosal cGVHD [NIH Oral Mucosal Score (OMS)], (2) salivary dysfunction (saliva flow and xerostomia), and (3) maximum mouth-opening measurement. Parameters for dysfunction (OMS > 2, saliva flow ≤ 1 mL/5 min, mouth-opening ≤ 35 mm) were analyzed for association with skin cGVHD involvement (erythema and sclerosis, skin symptoms), lacrimal dysfunction (Schirmer's tear test, xerophthalmia), Lee cGVHD Symptom Scores, and NIH organ scores. Oral mucosal disease (31% prevalence) was associated with skin erythema (P < 0.001); salivary dysfunction (11% prevalence) was associated with lacrimal dysfunction (P = 0.010) and xerostomia with xerophthalmia (r = 0.32, P = 0.001); and limited mouth-opening (17% prevalence) was associated with skin sclerosis (P = 0.008) and skin symptoms (P = 0.001). There was no association found among these 3 oral cGVHD manifestations. This analysis supports the understanding of oral cGVHD as 3 distinct diseases: mucosal lesions, salivary gland dysfunction, and mouth sclerosis. Clear classification of oral cGVHD as 3 separate manifestations will improve clinical diagnosis, observational research data collection, and the definitions of outcome measures in clinical trials. © International & American Associations for Dental Research 2015.

Multi-organ dysfunction in bodybuilding possibly caused by prolonged hypercalcemia due to multi-substance abuse: case report and review of literature.

PubMed

Schäfer, C N; Guldager, H; Jørgensen, H L

2011-01-01

A 26-year-old male bodybuilder was admitted to the surgical department of a Danish community hospital for hematemesis. During the clinical interview, he revealed that he had recently finished a course of anabolic steroids and erythropoietin. The patient also had a previous history of infections and chronic ulcers due to paraffin-oil injections in both upper arms one year before. Over the course of the next few hours, the patient developed signs of multi-organ dysfunction, including pancreatitis, hemorrhagic gastritis, nephropathy with temporary anuria, and respiratory insufficiency, and was transferred to the ICU. After manometric monitoring on the patient's upper arms proved difficult, invasive blood pressure monitoring was used and revealed that the patient was in a state of hypertensive crisis. This case of multi-organ dysfunction was possibly caused by multi-substance-induced hypercalcemia. © Georg Thieme Verlag KG Stuttgart · New York.

Infection Rate and Acute Organ Dysfunction Risk as Explanations for Racial Differences in Severe Sepsis

PubMed Central

Mayr, Florian B.; Yende, Sachin; Linde-Zwirble, Walter T.; Peck-Palmer, Octavia M.; Barnato, Amber E.; Weissfeld, Lisa A.; Angus, Derek C.

2013-01-01

Context Severe sepsis, defined as infection complicated by acute organ dysfunction, occurs more frequently and leads to more deaths in black than in white individuals. The optimal approach to minimize these disparities is unclear. Objective To determine the extent to which higher severe sepsis rates in black than in white patients are due to higher infection rates or to a higher risk of acute organ dysfunction. Design, Setting, and Participants Analysis of infection-related hospitalizations from the 2005 hospital discharge data of 7 US states and infection-related emergency department visits from the 2003-2007 National Hospital Ambulatory Care Survey. Main Outcome Measure Age- and sex-standardized severe sepsis and infection hospitalization rates and the risk of acute organ dysfunction. Results Of 8 661 227 non–childbirth-related discharges, 2 261 857 were associated with an infection, and of these, 381 787 (16.8%) had severe sepsis. Black patients had a 67% higher age- and sex-standardized severe sepsis rate than did white patients (9.4; 95% confidence interval [CI], 9.3-9.5 vs 5.6; 95% CI, 5.6-5.6 per 1000 population; P<.001) and 80% higher standardized mortality (1.8, 95% CI, 1.8-1.9 vs 1.0, 95% CI, 1.0-1.1 per 1000 population; P<.001). The higher severe sepsis rate was explained by both a higher infection rate in black patients (47.3; 95% CI, 47.1-47.4 vs 34.0; 95% CI, 33.9-34.0 per 1000 population; incidence rate ratio, 1.39; P<.001) and a higher risk of developing acute organ dysfunction (age- and sex-adjusted odds ratio [OR],1.29; 95% CI, 1.27-1.30; P<.001). Differences in infection presented broadly across different sites and etiology of infection and for community- and hospital-acquired infections and occurred despite a lower likelihood of being admitted for infection from the emergency department (adjusted OR, 0.70; 95% CI, 0.64-0.76; P<.001). The higher risk of organ dysfunction persisted but was attenuated after adjusting for age, sex, comorbid conditions, poverty, and hospital effect (OR, 1.14; 95% CI, 1.13-1.16; P<.001). Racial disparities in infection and severe sepsis incidence and mortality rates were largest among younger adults (eg, the proportion of invasive pneumococcal disease occurring in adults <65 years was 73.9% among black patients vs 44.5% among white patients, P<.001). Conclusion Racial differences in severe sepsis are explained by both a higher infection rate and a higher risk of acute organ dysfunction in black than in white individuals. PMID:20571016

Toxic hepatitis in occupational exposure to solvents

PubMed Central

Malaguarnera, Giulia; Cataudella, Emanuela; Giordano, Maria; Nunnari, Giuseppe; Chisari, Giuseppe; Malaguarnera, Mariano

2012-01-01

The liver is the main organ responsible for the metabolism of drugs and toxic chemicals, and so is the primary target organ for many organic solvents. Work activities with hepatotoxins exposures are numerous and, moreover, organic solvents are used in various industrial processes. Organic solvents used in different industrial processes may be associated with hepatotoxicity. Several factors contribute to liver toxicity; among these are: species differences, nutritional condition, genetic factors, interaction with medications in use, alcohol abuse and interaction, and age. This review addresses the mechanisms of hepatotoxicity. The main pathogenic mechanisms responsible for functional and organic damage caused by solvents are: inflammation, dysfunction of cytochrome P450, mitochondrial dysfunction and oxidative stress. The health impact of exposure to solvents in the workplace remains an interesting and worrying question for professional health work. PMID:22719183

Sylow p-groups of polynomial permutations on the integers mod pn☆

PubMed Central

Frisch, Sophie; Krenn, Daniel

2013-01-01

We enumerate and describe the Sylow p-groups of the groups of polynomial permutations of the integers mod pn for n⩾1 and of the pro-finite group which is the projective limit of these groups. PMID:26869732

Mod-2 wind turbine system development. Volume 1: Executive summary

NASA Technical Reports Server (NTRS)

1982-01-01

The development of the MOD-2 wind turbine through acceptance testing and initial operational evaluation is documented. Pitch control hydraulic system, yaw control system, drive train, electrical power station, control system, operations and maintenance experience, and availability are discussed.

Noise Exposure Model (MOD 4)

DOT National Transportation Integrated Search

1971-08-01

The purpose of this report is threefold: : 1. To record the results of efforts at the Transportaiton Systems Center to refine and expand the Noise Exposure Model, which have specifically resulted in the MOD 4 ver described herein; : 2. To serve as an...

Noise Exposure Model MOD-5 : Volume 1

DOT National Transportation Integrated Search

1971-06-01

The report contains three sections. The first two sections are contained in Volume 1. It contains an airport analysis which describes the noise exposure model MOD-5 from the perspective of analysing an airport in order to develop the program input mo...

Advanced multi-megawatt wind turbine design for utility application

NASA Technical Reports Server (NTRS)

Pijawka, W. C.

1984-01-01

A NASA/DOE program to develop a utility class multimegawatt wind turbine, the MOD-5A, is described. The MOD-5A features a 400 foot diameter rotor which is teetered and positioned upwind of the tower; a 7.3 megawatt power rating with a variable speed electric generating system; and a redundant rotor support and torque transmission structure. The rotor blades were fabricated from an epoxy-bonded wood laminate material which was a successful outgrowth of the MOD-OA airfoil design. Preliminary data from operational tests carried out at the NASA Plumbrook test facility are presented.

Advanced multi-megawatt wind turbine design for utility application

NASA Astrophysics Data System (ADS)

Pijawka, W. C.

1984-08-01

A NASA/DOE program to develop a utility class multimegawatt wind turbine, the MOD-5A, is described. The MOD-5A features a 400 foot diameter rotor which is teetered and positioned upwind of the tower; a 7.3 megawatt power rating with a variable speed electric generating system; and a redundant rotor support and torque transmission structure. The rotor blades were fabricated from an epoxy-bonded wood laminate material which was a successful outgrowth of the MOD-OA airfoil design. Preliminary data from operational tests carried out at the NASA Plumbrook test facility are presented.

Utility operational experience on the NASA/DOE MOD-0A 200-kW wind turbine

NASA Technical Reports Server (NTRS)

Glasgow, J. C.; Robbins, W. H.

1979-01-01

The Mod-0A 200 wind turbine was designed and fabricated as part of the Federal Wind Energy Program. Early wind turbine operation and performance data were obtained while gaining initial experience in the operation of large, horizontal axis wind turbines in typical utility environments. The Mod-0A wind turbine was turned over to the Town of Clayton Light and Water Plant, Clayton, NM, for utility operation and on December 31, 1978, the machine had completed ten months of utility operation. The machine is described and the recent operational experience at Clayton, NMis documented.

An evaluation of TRAC-PF1/MOD1 computer code performance during posttest simulations of Semiscale MOD-2C feedwater line break transients

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

Hall, D.G.: Watkins, J.C.

This report documents an evaluation of the TRAC-PF1/MOD1 reactor safety analysis computer code during computer simulations of feedwater line break transients. The experimental data base for the evaluation included the results of three bottom feedwater line break tests performed in the Semiscale Mod-2C test facility. The tests modeled 14.3% (S-FS-7), 50% (S-FS-11), and 100% (S-FS-6B) breaks. The test facility and the TRAC-PF1/MOD1 model used in the calculations are described. Evaluations of the accuracy of the calculations are presented in the form of comparisons of measured and calculated histories of selected parameters associated with the primary and secondary systems. In additionmore » to evaluating the accuracy of the code calculations, the computational performance of the code during the simulations was assessed. A conclusion was reached that the code is capable of making feedwater line break transient calculations efficiently, but there is room for significant improvements in the simulations that were performed. Recommendations are made for follow-on investigations to determine how to improve future feedwater line break calculations and for code improvements to make the code easier to use.« less

Osteogenic response of human MSCs and osteoblasts to hydrophilic and hydrophobic nanostructured titanium implant surfaces.

PubMed

Lotz, Ethan M; Olivares-Navarrete, Rene; Berner, Simon; Boyan, Barbara D; Schwartz, Zvi

2016-12-01

Microstructured implant surfaces created by grit blasting and acid etching titanium (Ti) support osseointegration. This effect is further enhanced by storing in aqueous solution to retain hydrophilicity, but this also leads to surface nanostructure formation. The purpose of this study was to assess the contributions of nanostructures on the improved osteogenic response of osteoblast lineage cells to hydrophilic microstructured Ti. Human mesenchymal stem cells (MSCs) and normal human osteoblasts (NHOsts) were cultured separately on non-nanostructured/hydrophobic (SLA), nanostructured/hydrophilic (modSLA), or nanostructured/hydrophobic (SLAnano) Ti surfaces. XPS showed elevated carbon levels on SLA and SLAnano compared to modSLA. Contact angle measurements indicated only modSLA was hydrophilic. Confocal laser microscopy revealed minor differences in mean surface roughness. SEM showed the presence of nanostructures on modSLA and SLAnano. MSCs and NHOst cells exhibited similar morphology on the substrates and osteoblastic differentiation and maturation were greatest on modSLA. These results suggest that when the appropriate microstructure is present, hydrophilicity may play a greater role in stimulating MSC and NHOst osteoblastic differentiation and maturation than the presence of nanostructures generated during storage in an aqueous environment. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 104A: 3137-3148, 2016. © 2016 Wiley Periodicals, Inc.

Flight controller alertness and performance during MOD shiftwork operations

NASA Technical Reports Server (NTRS)

Kelly, Sean M.; Rosekind, Mark R.; Dinges, David F.; Miller, Donna L.; Gillen, Kelly A.; Gregory, Kevin B.; Aguilar, Ronald D.; Smith, Roy M.

1994-01-01

Decreased alertness and performance associated with fatigue, sleep loss, and circadian disruption are issues faced by a diverse range of shiftwork operations. During STS operations, MOD personnel provide 24 hr. coverage of critical tasks. A joint JSC and ARC project was undertaken to examine these issues in flight controllers during MOD shiftwork operations. An initial operational test of procedures and measures was conducted during STS-53 in Dec. 1992. The study measures included a background questionnaire, a subjective daily logbook completed on a 24 hr. basis (to report sleep patterns, work periods, etc.), and an 8 minute performance and mood test battery administered at the beginning, middle, and end of each shift period. Seventeen Flight controllers representing the 3 Orbit shifts participated. The initial results clearly support further data collection during other STS missions to document baseline levels of alertness and performance during MOD shiftwork operations. These issues are especially pertinent for the night shift operations and the acute phase advance required for the transition of day shift personnel into the night for shuttle launch. Implementation and evaluation of the countermeasure strategies to maximize alertness and performance is planned. As STS missions extend to further extended duration orbiters, timelines and planning for 24 circadian disruption will remain highly relevant in the MOD environment.

Incipient evolution of Wolbachia compatibility types.

PubMed

Charlat, Sylvain; Riegler, Markus; Baures, Isabelle; Poinsot, Denis; Stauffer, Christian; Merçot, Hervé

2004-09-01

Cytoplasmic incompatibility (CI) is induced in arthropods by the maternally inherited bacterium Wolbachia. When infected males mate with uninfected females or with females bearing a different Wolbachia variant, paternal chromosomes behave abnormally and embryos die. This pattern can be interpreted as resulting from two bacterial effects: One (usually termed mod, for modification) would affect sperm and induce embryo death, unless Wolbachia is also present in the egg, which implies the existence of a second effect, usually termed resc, for rescue. The fact that CI can occur in crosses between males and females infected by different Wolbachia shows that mod and resc interact in a specific manner. In other words, different compatibility types, or mod/resc pairs seem to have diverged from one (or a few) common ancestor(s). We are interested in the process allowing the evolution of mod/resc pairs. Here this question is addressed experimentally after cytoplasmic injection into a single host species (Drosophila simulans) by investigating compatibility relationships between closely related Wolbachia variants naturally evolving in different dipteran hosts: D. simulans, Drosophila melanogaster, and Rhagoletis cerasi. Our results suggest that closely related bacteria can be totally or partially incompatible. The compatibility relationships observed can be explained using a formal description of the mod and resc functions, implying both qualitative and quantitative variations.

GPCR-ModSim: A comprehensive web based solution for modeling G-protein coupled receptors

PubMed Central

Esguerra, Mauricio; Siretskiy, Alexey; Bello, Xabier; Sallander, Jessica; Gutiérrez-de-Terán, Hugo

2016-01-01

GPCR-ModSim (http://open.gpcr-modsim.org) is a centralized and easy to use service dedicated to the structural modeling of G-protein Coupled Receptors (GPCRs). 3D molecular models can be generated from amino acid sequence by homology-modeling techniques, considering different receptor conformations. GPCR-ModSim includes a membrane insertion and molecular dynamics (MD) equilibration protocol, which can be used to refine the generated model or any GPCR structure uploaded to the server, including if desired non-protein elements such as orthosteric or allosteric ligands, structural waters or ions. We herein revise the main characteristics of GPCR-ModSim and present new functionalities. The templates used for homology modeling have been updated considering the latest structural data, with separate profile structural alignments built for inactive, partially-active and active groups of templates. We have also added the possibility to perform multiple-template homology modeling in a unique and flexible way. Finally, our new MD protocol considers a series of distance restraints derived from a recently identified conserved network of helical contacts, allowing for a smoother refinement of the generated models which is particularly advised when there is low homology to the available templates. GPCR- ModSim has been tested on the GPCR Dock 2013 competition with satisfactory results. PMID:27166369

Magnetic resonance imaging of pelvic floor dysfunction.

PubMed

Lalwani, Neeraj; Moshiri, Mariam; Lee, Jean H; Bhargava, Puneet; Dighe, Manjiri K

2013-11-01

Pelvic floor dysfunction is largely a complex problem of multiparous and postmenopausal women and is associated with pelvic floor or organ descent. Physical examination can underestimate the extent of the dysfunction and misdiagnose the disorders. Functional magnetic resonance (MR) imaging is emerging as a promising tool to evaluate the dynamics of the pelvic floor and use for surgical triage and operative planning. This article reviews the anatomy and pathology of pelvic floor dysfunction, typical imaging findings, and the current role of functional MR imaging. Copyright © 2013 Elsevier Inc. All rights reserved.

Hepatic dysfunction.

PubMed

McCord, Kelly W; Webb, Craig B

2011-07-01

This article reviews the common pathophysiology that constitutes hepatic dysfunction, regardless of the inciting cause. The systemic consequences of liver failure and the impact of this condition on other organ systems are highlighted. The diagnostic tests available for determining the cause and extent of liver dysfunction are outlined, treatment strategies aimed at supporting hepatic health and recovery are discussed, and prognosis is briefly covered. The article emphasizes the fact that because of the central role of the liver in maintaining normal systemic homeostasis, hepatic dysfunction cannot be effectively addressed as an isolated entity. Copyright © 2011 Elsevier Inc. All rights reserved.

Effect of milk replacer program on calf performance and digestion of nutrients with age of the dairy calf.

PubMed

Chapman, C E; Erickson, P S; Quigley, J D; Hill, T M; Bateman, H G; Suarez-Mena, F X; Schlotterbeck, R L

2016-04-01

Calves fed large amounts of milk replacer (MR) gain more body weight preweaning than calves fed less-aggressive programs; however, postweaning growth may be reduced. Limited research suggests that less than optimal digestion of the postweaned diet due to large amounts of MR with reduced dry feed intake preweaning may contribute to growth impairment postweaning. Current research was conducted to compare growth and postweaning digestion in 3-d-old male Holstein calves fed various MR programs. The MR programs were a conventional [CON; 0.44 kg of dry matter (DM) 21% crude protein (CP), 21% fat powder fed for 42d], moderate (MOD; 0.66 kg of DM 27% CP, 17% fat powder fed for 42d), and aggressive program (AGG; up to 0.87 kg of DM 27% CP, 17% fat powder fed for 49d). All calves were fed a 20% CP textured starter and water ad libitum for 56d. The trial used 96 calves (initially 41 ± 1.9 kg of body weight) received 5 wk apart in 2 groups of 48 calves. During d 51 to 56, fecal samples were collected from 5 calves per treatment randomly selected from calves in the first group. Selected nutrients and acid-insoluble ash (used as an internal flow marker) were analyzed in the starter and feces to estimate digestibility. Data were analyzed as a randomized complete block design with starting time of each group of calves as a block. Repeated measure analysis was performed on overall (0 to 56d) data. Means were separated with a protected least significant difference test. Pen was the experimental unit. Calves fed CON had the least average daily gain [CON=0.35, MOD=0.51, and AGG=0.55 kg/d; standard error of the mean (SEM)=0.018], feed efficiency (CON=0.35, MOD=0.49, and AGG=0.48 gain/feed, SEM=0.016), and change in hip width (CON=3.3, MOD=4.1, and AGG=4.1cm, SEM=0.20) compared with calves fed other programs. Calves fed AGG had the greatest change in BCS and least starter intake compared with calves fed the other programs. Digestibility of organic matter was 79, 78, and 68% and neutral detergent fiber was 54, 51, and 26% for calves fed programs CON, MOD, and AGG, respectively, and were least for calves fed AGG. These results indicate that postweaning digestion is lower than optimal and contributes to lower postweaning growth in calves fed aggressive compared with conventional or moderate MR programs. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

[Successful continuous renal replacement therapy in a neonate with early-onset group B streptococcal sepsis and multi-organ dysfunction syndrome].

PubMed

von Schnakenburg, C; Hufnagel, M; Superti-Furga, A; Rieger-Fackeldey, E; Berner, R

2009-01-01

Group B streptococcal early-onset sepsis (GBS EOS) in neonates has a mortality rate of approximately 5%, particularly in the presence of multi-organ dysfunction. Fluid management is crucial in these patients, and continuous venovenous haemofiltration (CVVH) should be considered a therapeutic option even in newborn babies. After an uneventful pregnancy within hours after birth, a female term infant presented with dyspnoea, irritability and cyanosis. The systemic inflammatory response syndrome (SIRS) progressed to multi-organ dysfunction with acute respiratory distress syndrome (ARDS), impaired myocardial contractility, pulmonary hypertension and fluid overload. The maximum PRISM score was 51. The child required maximal respiratory and inotropic support with high volume intravenous fluid administration. However, only by using of CVVH from day 5 to 14, we successfully resolved progressive pulmonary and cardiovascular dysfunction. The child improved directly after initiation of fluid removal, was extubated on day 17 and discharged without obvious sequelae on day 57. All microbiology studies revealed GBS. Perinatal GBS-infections remain a major life-threatening event for newborn babies. CVVH should be considered an option for reversing fluid overload even in neonates with overwhelming SIRS. Alternatively, extracorporeal membrane oxygenation (ECMO) is discussed.

Potential of VIIRS Data for Regional Monitoring of Gypsy Moth Defoliation: Implications for Forest Threat Early Warning System

NASA Technical Reports Server (NTRS)

Spruce, Joseph P.; Ryan, Robert E.; Smoot, James C.; Prados, Donald; McKellip, Rodney; Sader. Steven A.; Gasser, Jerry; May, George; Hargrove, William

2007-01-01

A NASA RPC (Rapid Prototyping Capability) experiment was conducted to assess the potential of VIIRS (Visible/Infrared Imager/Radiometer Suite) data for monitoring non-native gypsy moth (Lymantria dispar) defoliation of forests. This experiment compares defoliation detection products computed from simulated VIIRS and from MODIS (Moderate Resolution Imaging Spectroradiometer) time series products as potential inputs to a forest threat EWS (Early Warning System) being developed for the USFS (USDA Forest Service). Gypsy moth causes extensive defoliation of broadleaved forests in the United States and is specifically identified in the Healthy Forest Restoration Act (HFRA) of 2003. The HFRA mandates development of a national forest threat EWS. This system is being built by the USFS and NASA is aiding integration of needed satellite data products into this system, including MODIS products. This RPC experiment enabled the MODIS follow-on, VIIRS, to be evaluated as a data source for EWS forest monitoring products. The experiment included 1) assessment of MODIS-simulated VIIRS NDVI products, and 2) evaluation of gypsy moth defoliation mapping products from MODIS-simulated VIIRS and from MODIS NDVI time series data. This experiment employed MODIS data collected over the approximately 15 million acre mid-Appalachian Highlands during the annual peak defoliation time frame (approximately June 10 through July 27) during 2000-2006. NASA Stennis Application Research Toolbox software was used to produce MODIS-simulated VIIRS data and NASA Stennis Time Series Product Tool software was employed to process MODIS and MODIS-simulated VIIRS time series data scaled to planetary reflectance. MODIS-simulated VIIRS data was assessed through comparison to Hyperion-simulated VIIRS data using data collected during gypsy moth defoliation. Hyperion-simulated MODIS data showed a high correlation with actual MODIS data (NDVI R2 of 0.877 and RMSE of 0.023). MODIS-simulated VIIRS data for the same date showed moderately high correlation with Hyperion-simulated VIIRS data (NDVI R2 of 0.62 and RMSE of 0.035), even though the datasets were collected about a half an hour apart during changing weather conditions. MODIS products (MOD02, MOD09, and MOD13) and MOD02-simulated VIIRS time series data were used to generate defoliation mapping products based on image classification and image differencing change detection techniques. Accuracy of final defoliation mapping products was assessed by image interpreting over 170 randomly sampled locations found on Landsat and ASTER data in conjunction with defoliation map data from the USFS. The MOD02-simulated VIIRS 400-meter NDVI classification produced a similar overall accuracy (87.28 percent with 0.72 Kappa) to the MOD02 250-meter NDVI classification (86.71 percent with 0.71 Kappa). In addition, the VIIRS 400-meter NDVI, MOD02 250-meter NDVI, and MOD02 500-meter NDVI showed good user and producer accuracies for the defoliated forest class (70 percent) and acceptable Kappa values (0.66). MOD02 and MOD02-simulated VIIRS data both showed promise as data sources for regional monitoring of forest disturbance due to insect defoliation.

85. Command HQ. SAC control center (MOD) new work cross ...

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

85. Command HQ. SAC control center (MOD) new work cross section, drawing number AW-30-02-07, dated 7 February, 1962 - Offutt Air Force Base, Strategic Air Command Headquarters & Command Center, Headquarters Building, 901 SAC Boulevard, Bellevue, Sarpy County, NE

Automotive Stirling Engine Development Program

NASA Technical Reports Server (NTRS)

Nightingale, N.; Ernst, W.; Richey, A.; Simetkosky, M.; Smith, G.; Rohdenburg, C.; Antonelli, M. (Editor)

1983-01-01

Program status and plans are discussed for component and technology development; reference engine system design, the upgraded Mod 1 engine; industry test and evaluation; and product assurance. Four current Mod 1 engines reached a total of 2523 operational hours, while two upgraded engines accumulated 166 hours.

Recombinant human brain natriuretic peptide attenuates trauma-/haemorrhagic shock-induced acute lung injury through inhibiting oxidative stress and the NF-κB-dependent inflammatory/MMP-9 pathway.

PubMed

Song, Zhi; Zhao, Xiu; Liu, Martin; Jin, Hongxu; Wang, Ling; Hou, Mingxiao; Gao, Yan

2015-12-01

Acute lung injury (ALI) is one of the most serious complications in traumatic patients and is an important part of multiple organ dysfunction syndrome (MODS). Recombinant human brain natriuretic peptide (rhBNP) is a peptide with a wide range of biological activity. In this study, we investigated local changes in oxidative stress and the NF-κB-dependent matrix metalloproteinase-9 (MMP-9) pathway in rats with trauma/haemorrhagic shock (TH/S)-induced ALI and evaluated the effects of pretreatment with rhBNP. Forty-eight rats were randomly divided into four groups: sham operation group, model group, low-dosage rhBNP group and high-dosage rhBNP group (n = 12 for each group). Oxidative stress and MPO activity were measured by ELISA kits. MMP-9 activity was detected by zymography analysis. NF-κB activity was determined using Western blot assay. With rhBNP pretreatment, TH/S-induced protein leakage, increased MPO activity, lipid peroxidation and metalloproteinase (MMP)-9 activity were inhibited. Activation of antioxidative enzymes was reversed. The phosphorylation of NF-κB and the degradation of its inhibitor IκB were suppressed. The results suggested that the protection mechanism of rhBNP is possibly mediated through upregulation of anti-oxidative enzymes and inhibition of NF-κB activation. More studies are needed to further evaluate whether rhBNP is a suitable candidate as an effective inhaling drug to reduce the incidence of TH/S-induced ALI. © 2016 The Authors. International Journal of Experimental Pathology © 2016 International Journal of Experimental Pathology.

A non-synonymous SNP in the NOS2 associated with septic shock in patients with sepsis in Chinese populations.

PubMed

Wang, Zhifu; Feng, Kai; Yue, Maoxing; Lu, Xiaoguang; Zheng, Qihan; Zhang, Hongxing; Zhai, Yun; Li, Peiyao; Yu, Lixia; Cai, Mi; Zhang, Xiumei; Kang, Xin; Shi, Weihai; Xia, Xia; Chen, Xi; Cao, Pengbo; Li, Yuanfeng; Chen, Huipeng; Ling, Yan; Li, Yuxia; He, Fuchu; Zhou, Gangqiao

2013-03-01

Sepsis represents a systemic inflammatory response to infection and its sequelae include severe sepsis, septic shock, multiple organ dysfunction syndrome (MODS) and death. Studies in mice and humans indicate that the inducible nitric oxide synthase (iNOS, NOS2) plays an important role in the development of sepsis and its sequelae. It was reported that several single nucleotide polymorphisms (SNPs) within NOS2 could influence the production or activity of NOS2. In this study, we assessed whether SNPs within NOS2 gene were associated with severity of sepsis in Chinese populations. A case-control study was conducted, which included 299 and 280 unrelated patients with sepsis recruited from Liaoning and Jiangsu provinces in China, respectively. Six SNPs within NOS2 were genotyped using Sequenom MassARRAY system. The associations between the SNPs and risk of sepsis complications were estimated by a binary logistic regression model adjusted for confounding factors. Functional assay was performed to assess the biological significance. The GA + AA genotype of a non-synonymous SNP in the exon 16 of NOS2 (rs2297518: G>A) was significantly associated with increased susceptibility to septic shock compared with GG genotype in Liaoning population (OR = 3.29, 95% CI = 1.40-7.72, P = 0.0047). This association was confirmed in the Jiangsu population (OR = 3.49, 95% CI = 1.57-7.79, P = 0.0019). Furthermore, the functional assay performed in the immortalized lymphocyte cell lines indicated that the at-risk GA genotype had a tendency of higher NOS2 activity than the GG genotype (P = 0.32). Our findings suggest that the NOS2 rs2297518 may play a role in mediating the susceptibility to septic shock in patients with sepsis in Chinese populations.

Bone Marrow Mesenchymal Stem Cells Suppress Acute Lung Injury Induced by Lipopolysaccharide Through Inhibiting the TLR2, 4/NF-κB Pathway in Rats with Multiple Trauma.

PubMed

Li, Dequan; Pan, Xuebo; Zhao, Jing; Chi, Chuang; Wu, Guangyu; Wang, Yuanyuan; Liao, Shiyao; Wang, Cong; Ma, Jihong; Pan, Jingye

2016-06-01

Multiple trauma normally leads to acute lung injury (ALI) and other multiple organ dysfunction syndrome (MODS). Finding effective treatments for ALI remains a medical as well as socioeconomic challenge. Several studies show that bone marrow mesenchymal stem cells (BMSCs) have the potent anti-inflammation activity and transfusion of BMSCs can effectively inhibit inflammatory and autoimmune diseases. In this study, we investigated the TLR2, 4/NF-κB signaling pathway to determine the therapeutic value of BMSCs on lipopolysaccharide (LPS)-induced ALI. To investigate the immunosuppression effects of BMSCs, rats subjected to multiple trauma were administrated with LPS to induce ALI and then treated with BMSCs. The histology of the lung was examined. Serum levels of the pro-inflammatory factors TNFα, interleukin (IL)-6, and IL-1β, as well as anti-inflammatory factor IL-10 were measured at 3, 6, 12, and 24 h after the treatment. Moreover, expressions of TLR2 and TLR4 at the mRNA and protein levels, as well as phosphorylation of p65 in the lungs, were assessed at these time points. We found that BMSCs reduced inflammatory injury, inhibited LPS-induced upregulation of TLR2 and TLR4 expression at the mRNA and protein levels, and compromised p65 phosphorylation. In addition, infusion of BMSCs also downregulated the abundance of pro-inflammatory TNFα, IL-6, and IL-1β and upregulated the abundance of anti-inflammatory IL-10 levels in the serum. Our results suggest that BMSCs suppress the inflammatory reactions through inhibition of the TLR2, 4 mediated NF-κB signal pathway, which hints that BMSCs can potentially be used to treat ALI in multiple trauma.

Case report: severe heat stroke with multiple organ dysfunction – a novel intravascular treatment approach

PubMed Central

Broessner, Gregor; Beer, Ronny; Franz, Gerhard; Lackner, Peter; Engelhardt, Klaus; Brenneis, Christian; Pfausler, Bettina; Schmutzhard, Erich

2005-01-01

Introduction We report the case of a patient who developed a severe post-exertional heat stroke with consecutive multiple organ dysfunction resistant to conventional antipyretic treatment, necessitating the use of a novel endovascular device to combat hyperthermia and maintain normothermia. Methods A 38-year-old male suffering from severe heat stroke with predominant signs and symptoms of encephalopathy requiring acute admission to an intensive care unit, was admitted to a ten-bed neurological intensive care unit of a tertiary care hospital. The patient developed consecutive multiple organ dysfunction with rhabdomyolysis, and hepatic and respiratory failure. Temperature elevation was resistant to conventional treatment measures. Aggressive intensive care treatment included forced diuresis and endovascular cooling to combat hyperthermia and maintain normothermia. Results Analyses of serum revealed elevation of proinflammatory cytokines (TNF alpha, IL-6), cytokines (IL-2R), anti-inflammatory cytokines (IL-4) and chemokines (IL-8) as well as signs of rhabdomyolysis and hepatic failure. Aggressive intensive care treatment as forced diuresis and endovascular cooling (CoolGard® and CoolLine®) to combat hyperthermia and maintain normothermia were used successfully to treat this severe heat stroke. Conclusion In this case of severe heat stroke, presenting with multiple organ dysfunction and elevation of cytokines and chemokines, which was resistant to conventional cooling therapies, endovascular cooling may have contributed significantly to the reduction of body temperature and, possibly, avoided a fatal result. PMID:16285034

[Prediction of mortality in patients with acute hepatic failure].

PubMed

Eremeeva, L F; Berdnikov, A P; Musaeva, T S; Zabolotskikh, I B

2013-01-01

The article deals with a study of 243 patients (from 18 to 65 years old) with acute hepatic failure. Purpose of the study was to evaluate the predictive capability of severity scales APACHE III, SOFA, MODS, Child-Pugh and to identify mortality predictors in patients with acute hepatic failure. Results; The best predictive ability in patients with acute hepatic failure and multiple organ failure had APACHE III and SOFA scales. The strongest mortality predictors were: serum creatinine > 132 mmol/L, fibrinogen < 1.4 g/L, Na < 129 mmol/L.

A Modularity-Based Method Reveals Mixed Modules from Chemical-Gene Heterogeneous Network

PubMed Central

Song, Jianglong; Tang, Shihuan; Liu, Xi; Gao, Yibo; Yang, Hongjun; Lu, Peng

2015-01-01

For a multicomponent therapy, molecular network is essential to uncover its specific mode of action from a holistic perspective. The molecular system of a Traditional Chinese Medicine (TCM) formula can be represented by a 2-class heterogeneous network (2-HN), which typically includes chemical similarities, chemical-target interactions and gene interactions. An important premise of uncovering the molecular mechanism is to identify mixed modules from complex chemical-gene heterogeneous network of a TCM formula. We thus proposed a novel method (MixMod) based on mixed modularity to detect accurate mixed modules from 2-HNs. At first, we compared MixMod with Clauset-Newman-Moore algorithm (CNM), Markov Cluster algorithm (MCL), Infomap and Louvain on benchmark 2-HNs with known module structure. Results showed that MixMod was superior to other methods when 2-HNs had promiscuous module structure. Then these methods were tested on a real drug-target network, in which 88 disease clusters were regarded as real modules. MixMod could identify the most accurate mixed modules from the drug-target 2-HN (normalized mutual information 0.62 and classification accuracy 0.4524). In the end, MixMod was applied to the 2-HN of Buchang naoxintong capsule (BNC) and detected 49 mixed modules. By using enrichment analysis, we investigated five mixed modules that contained primary constituents of BNC intestinal absorption liquid. As a matter of fact, the findings of in vitro experiments using BNC intestinal absorption liquid were found to highly accord with previous analysis. Therefore, MixMod is an effective method to detect accurate mixed modules from chemical-gene heterogeneous networks and further uncover the molecular mechanism of multicomponent therapies, especially TCM formulae. PMID:25927435

The Addition of SPECT/CT Lymphoscintigraphy to Breast Cancer Radiation Planning Spares Lymph Nodes Critical for Arm Drainage

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

Cheville, Andrea L., E-mail: Cheville.andrea@mayo.edu; Brinkmann, Debra H.; Ward, Shelly B.

2013-03-15

Background: This prospective cohort study was designed to determine whether the amount of radiation delivered to the nonpathological lymph nodes (LNs) that drain the arm can be significantly reduced by integrating single-photon emission computed tomography (SPECT)/computed tomography (CT) scans into radiation treatment planning. Methods: SPECT-CT scans were acquired for the 28 patients with stage I or II breast cancer and fused with the routinely obtained radiation oncology planning CT scans. Arm-draining LNs were contoured with 0.5-cm margins automatically using a threshold of 50% maximum intensity. Two treatment plans were generated: 1 per routine clinical practice (standard; STD) and the secondmore » (modified; MOD) with treatment fields modified to minimize dose to the arm-draining LNs visible on SPECT/CT images without interfering with the dosage delivered to target tissues. Participants were treated per the MOD plans. Arm volumes were measured prior to radiation and thereafter at least three subsequent 6-month intervals. Results: Sixty-eight level I-III arm-draining LNs were identified, 57% of which were inside the STD plan fields but could be blocked in the MOD plan fields. Sixty-five percent of arm-draining LNs in the STD versus 16% in the MOD plans received a mean of ≥10 Gy, and 26% in the STD versus 4% in the MOD plans received a mean of ≥40 Gy. Mean LN radiation exposure was 23.6 Gy (standard deviation 18.2) with the STD and 7.7 Gy (standard deviation 11.3) with the MOD plans (P<.001). No participant developed lymphedema. Conclusions: The integration of SPECT/CT scans into breast cancer radiation treatment planning reduces unnecessary arm-draining LN radiation exposure and may lessen the risk of lymphedema.« less

Comparison of removal torques between laser-etched and modified sandblasted acid-etched Ti implant surfaces in rabbit tibias

PubMed Central

Al Awamleh, Abdel Ghani Ibrahim

2018-01-01

PURPOSE The purpose of this study was to analyze the effects of two different implant surface treatments on initial bone connection by comparing the Removal Torque Values (RTQs) at 7 and 10 days after chemically modified, sandblasted, large-grit and acid-etched (modSLA), and Laser-etched (LE) Ti implant placements. MATERIALS AND METHODS Twenty modSLA and 20 LE implants were installed on the left and right tibias of 20 adult rabbits. RTQs were measured after 7 and 10 days in 10 rabbits each. Scanning electron microscope (SEM) photographs of the two implants were observed by using Quanta FEG 650 from the FEI company (Hillsboro, OR, USA). Analyses of surface elements and components were conducted using energy dispersive spectroscopy (EDS, Horiba, Kyoto, Japan). RESULTS The mean RTQs were 12.29 ± 0.830 and 12.19 ± 0.713 Ncm after 7 days (P=.928) and 16.47 ± 1.324 and 16.17 ± 1.165 Ncm after 10 days (P=.867) for LE and modSLA, respectively, indicating no significant inter-group differences. Pore sizes in the LE were 40 µm and consisted of numerous small pores, whereas pore sizes in the modSLA were 5 µm. In the EDS analysis, Ti, O, and C were the only three elements found in the LE surfaces. Na, Ca, Cl, and K were also observed in modSLA, in addition to Ti, O, and C. CONCLUSION The implants showed no significant difference in biomechanical bond strength to bone in early-stage osseointegration. LE implant can be considered an excellent surface treatment method in addition to the modSLA implant and can be applied to the early loading of the prosthesis clinically. PMID:29503717

Microscopic observation drug-susceptibility assay vs. Xpert® MTB/RIF for the diagnosis of tuberculosis in a rural African setting: a cost-utility analysis.

PubMed

Wikman-Jorgensen, Philip E; Llenas-García, Jara; Pérez-Porcuna, Tomàs M; Hobbins, Michael; Ehmer, Jochen; Mussa, Manuel A; Ascaso, Carlos

2017-06-01

To compare the cost-utility of microscopic observation drug-susceptibility assay (MODS) and Xpert ® MTB/RIF implementation for tuberculosis (TB) diagnosis in rural northern Mozambique. Stochastic transmission compartmental TB model from the healthcare provider perspective with parameter input from direct measurements, systematic literature reviews and expert opinion. MODS and Xpert ® MTB/RIF were evaluated as replacement test of smear microscopy (SM) or as an add-on test after a negative SM. Costs were calculated in 2013 USD, effects in disability-adjusted life years (DALY). Willingness to pay threshold (WPT) was established at once the per capita Gross National Income of Mozambique. MODS as an add-on test to negative SM produced an incremental cost-effectiveness ratio (ICER) of 5647.89USD/DALY averted. MODS as a substitute for SM yielded an ICER of 5374.58USD/DALY averted. Xpert ® MTB/RIF as an add-on test to negative SM yielded ICER of 345.71USD/DALY averted. Xpert ® MTB/RIF as a substitute for SM obtained an ICER of 122.13USD/DALY averted. TB prevalence and risk of infection were the main factors impacting MODS and Xpert ® MTB/RIF ICER in the one-way sensitivity analysis. In the probabilistic sensitivity analysis, Xpert ® MTB/RIF was most likely to have an ICER below the WPT, whereas MODS was not. Our cost-utility analysis favours the implementation of Xpert ® MTB/RIF as a replacement of SM for all TB suspects in this rural high TB/HIV prevalence African setting. © 2017 John Wiley & Sons Ltd.

The addition of SPECT/CT lymphoscintigraphy to breast cancer radiation planning spares lymph nodes critical for arm drainage.

PubMed

Cheville, Andrea L; Brinkmann, Debra H; Ward, Shelly B; Durski, Jolanta; Laack, Nadia N; Yan, Elizabeth; Schomberg, Paula J; Garces, Yolanda I; Suman, Vera J; Petersen, Ivy A

2013-03-15

This prospective cohort study was designed to determine whether the amount of radiation delivered to the nonpathological lymph nodes (LNs) that drain the arm can be significantly reduced by integrating single-photon emission computed tomography (SPECT)/computed tomography (CT) scans into radiation treatment planning. SPECT-CT scans were acquired for the 28 patients with stage I or II breast cancer and fused with the routinely obtained radiation oncology planning CT scans. Arm-draining LNs were contoured with 0.5-cm margins automatically using a threshold of 50% maximum intensity. Two treatment plans were generated: 1 per routine clinical practice (standard; STD) and the second (modified; MOD) with treatment fields modified to minimize dose to the arm-draining LNs visible on SPECT/CT images without interfering with the dosage delivered to target tissues. Participants were treated per the MOD plans. Arm volumes were measured prior to radiation and thereafter at least three subsequent 6-month intervals. Sixty-eight level I-III arm-draining LNs were identified, 57% of which were inside the STD plan fields but could be blocked in the MOD plan fields. Sixty-five percent of arm-draining LNs in the STD versus 16% in the MOD plans received a mean of ≥10 Gy, and 26% in the STD versus 4% in the MOD plans received a mean of ≥40 Gy. Mean LN radiation exposure was 23.6 Gy (standard deviation 18.2) with the STD and 7.7 Gy (standard deviation 11.3) with the MOD plans (P<.001). No participant developed lymphedema. The integration of SPECT/CT scans into breast cancer radiation treatment planning reduces unnecessary arm-draining LN radiation exposure and may lessen the risk of lymphedema. Copyright © 2013 Elsevier Inc. All rights reserved.

Diagnostic accuracy of cone-beam computed tomography in detecting secondary caries under composite fillings: an in vitro study.

PubMed

Yildizer Keris, Elif; Demirel, Oguzhan; Ozdede, Melih; Altunkaynak, Bulent; Peker, Ilkay

2017-01-01

The aim of this in vitro study was to assess the diagnostic performance of cone-beam computed tomography (CBCT) in the detection of secondary carious lesions under composite resin fillings applied to different types of cavities. Occlusal cavities (O) (n=18), occlusal cavities with mesial or distal component (MO/DO) (n=30), and mesial-occlusal-distal cavities (MOD) (n=30) were prepared in seventy eight extracted human posterior teeth. In half of the cavities in each group, artificial secondary caries lesions were simulated. All cavities were restored by using composite resin. All specimens were embedded in silicone and they were positioned to have approximal contacts. CBCT imaging was done and data were evaluated two times with two week interval by two observers, using a five-point confidence scale. Intra- and inter-observer agreements were calculated with Kappa statistics (κ). The area under (Az) the receiver operating characteristic (ROC) curve was used to evaluate the diagnostic accuracy. Intra- (κ =0.89) and inter-observer (κ = 0.79) agreements were found to be excellent. Az values were highest for the O restorations which is followed by the MOD and DO/MO restorations. Az values for MOD and DO/MO restorations were very low and no statistically significant difference was found. Sensitivity for DO/MO restorations and specificity for MOD restorations were found to be the lowest values. Diagnostic performance of CBCT was higher in O composite restorations than MOD and DO/MO restorations for secondary caries detection. The use of alternative imaging methods rather than CBCT may be useful for evaluating secondary caries under composite MOD and DO/MO restorations.

Cerebral Palsy and Growth Failure at 6 to 7 Years

PubMed Central

Stephens, Bonnie E.; McDonald, Scott A.; Ehrenkranz, Richard A.; Laptook, Abbot R.; Pappas, Athina; Hintz, Susan R.; Shankaran, Seetha; Higgins, Rosemary D.; Das, Abhik

2013-01-01

OBJECTIVE: To evaluate the association between severity of cerebral palsy (CP) and growth to 6 to 7 years of age among children with moderate to severe (Mod/Sev) hypoxic ischemic encephalopathy (HIE). It was hypothesized that children with Mod/Sev CP would have poorer growth, lower cognitive scores, and increased rehospitalization rates compared with children with no CP (No CP). METHODS: Among 115 of 122 surviving children followed in the hypothermia trial for neonatal HIE, growth parameters and neurodevelopmental status at 18 to 22 months and 6 to 7 years were available. Group comparisons (Mod/Sev CP and No CP) with unadjusted and adjusted analyses for growth <10th percentile and z scores by using Fisher’s exact tests and regression modeling were conducted. RESULTS: Children with Mod/Sev CP had high rates of slow growth and cognitive and motor impairment and rehospitalizations at 18 to 22 months and 6 to 7 years. At 6 to 7 years of age, children with Mod/Sev CP had increased rates of growth parameters <10th percentile compared with those with No CP (weight, 57% vs 3%; height, 70% vs 2%; and head circumference, 82% vs 13%; P < .0001). Increasing severity of slow growth was associated with increasing age (P < .04 for weight, P < .001 for length, and P < .0001 for head circumference). Gastrostomy feeds were associated with better growth. CONCLUSIONS: Term children with HIE who develop Mod/Sev CP have high and increasing rates of growth <10th percentile by 6 to 7 years of age. These findings support the need for close medical and nutrition management of children with HIE who develop CP. PMID:24019415

Evaluating the role of land cover and climate uncertainties in computing gross primary production in Hawaiian Island ecosystems

PubMed Central

Selmants, Paul C.; Moreno, Alvaro; Running, Steve W.; Giardina, Christian P.

2017-01-01

Gross primary production (GPP) is the Earth’s largest carbon flux into the terrestrial biosphere and plays a critical role in regulating atmospheric chemistry and global climate. The Moderate Resolution Imaging Spectrometer (MODIS)-MOD17 data product is a widely used remote sensing-based model that provides global estimates of spatiotemporal trends in GPP. When the MOD17 algorithm is applied to regional scale heterogeneous landscapes, input data from coarse resolution land cover and climate products may increase uncertainty in GPP estimates, especially in high productivity tropical ecosystems. We examined the influence of using locally specific land cover and high-resolution local climate input data on MOD17 estimates of GPP for the State of Hawaii, a heterogeneous and discontinuous tropical landscape. Replacing the global land cover data input product (MOD12Q1) with Hawaii-specific land cover data reduced statewide GPP estimates by ~8%, primarily because the Hawaii-specific land cover map had less vegetated land area compared to the global land cover product. Replacing coarse resolution GMAO climate data with Hawaii-specific high-resolution climate data also reduced statewide GPP estimates by ~8% because of the higher spatial variability of photosynthetically active radiation (PAR) in the Hawaii-specific climate data. The combined use of both Hawaii-specific land cover and high-resolution Hawaii climate data inputs reduced statewide GPP by ~16%, suggesting equal and independent influence on MOD17 GPP estimates. Our sensitivity analyses within a heterogeneous tropical landscape suggest that refined global land cover and climate data sets may contribute to an enhanced MOD17 product at a variety of spatial scales. PMID:28886187

Evaluating the role of land cover and climate uncertainties in computing gross primary production in Hawaiian Island ecosystems

USGS Publications Warehouse

Kimball, Heather L.; Selmants, Paul; Moreno, Alvaro; Running Steve W,; Giardina, Christian P.

2017-01-01

Gross primary production (GPP) is the Earth’s largest carbon flux into the terrestrial biosphere and plays a critical role in regulating atmospheric chemistry and global climate. The Moderate Resolution Imaging Spectrometer (MODIS)-MOD17 data product is a widely used remote sensing-based model that provides global estimates of spatiotemporal trends in GPP. When the MOD17 algorithm is applied to regional scale heterogeneous landscapes, input data from coarse resolution land cover and climate products may increase uncertainty in GPP estimates, especially in high productivity tropical ecosystems. We examined the influence of using locally specific land cover and high-resolution local climate input data on MOD17 estimates of GPP for the State of Hawaii, a heterogeneous and discontinuous tropical landscape. Replacing the global land cover data input product (MOD12Q1) with Hawaii-specific land cover data reduced statewide GPP estimates by ~8%, primarily because the Hawaii-specific land cover map had less vegetated land area compared to the global land cover product. Replacing coarse resolution GMAO climate data with Hawaii-specific high-resolution climate data also reduced statewide GPP estimates by ~8% because of the higher spatial variability of photosynthetically active radiation (PAR) in the Hawaii-specific climate data. The combined use of both Hawaii-specific land cover and high-resolution Hawaii climate data inputs reduced statewide GPP by ~16%, suggesting equal and independent influence on MOD17 GPP estimates. Our sensitivity analyses within a heterogeneous tropical landscape suggest that refined global land cover and climate data sets may contribute to an enhanced MOD17 product at a variety of spatial scales.

Evaluating the role of land cover and climate uncertainties in computing gross primary production in Hawaiian Island ecosystems.

PubMed

Kimball, Heather L; Selmants, Paul C; Moreno, Alvaro; Running, Steve W; Giardina, Christian P

2017-01-01

Gross primary production (GPP) is the Earth's largest carbon flux into the terrestrial biosphere and plays a critical role in regulating atmospheric chemistry and global climate. The Moderate Resolution Imaging Spectrometer (MODIS)-MOD17 data product is a widely used remote sensing-based model that provides global estimates of spatiotemporal trends in GPP. When the MOD17 algorithm is applied to regional scale heterogeneous landscapes, input data from coarse resolution land cover and climate products may increase uncertainty in GPP estimates, especially in high productivity tropical ecosystems. We examined the influence of using locally specific land cover and high-resolution local climate input data on MOD17 estimates of GPP for the State of Hawaii, a heterogeneous and discontinuous tropical landscape. Replacing the global land cover data input product (MOD12Q1) with Hawaii-specific land cover data reduced statewide GPP estimates by ~8%, primarily because the Hawaii-specific land cover map had less vegetated land area compared to the global land cover product. Replacing coarse resolution GMAO climate data with Hawaii-specific high-resolution climate data also reduced statewide GPP estimates by ~8% because of the higher spatial variability of photosynthetically active radiation (PAR) in the Hawaii-specific climate data. The combined use of both Hawaii-specific land cover and high-resolution Hawaii climate data inputs reduced statewide GPP by ~16%, suggesting equal and independent influence on MOD17 GPP estimates. Our sensitivity analyses within a heterogeneous tropical landscape suggest that refined global land cover and climate data sets may contribute to an enhanced MOD17 product at a variety of spatial scales.

Changing impact of modifiable risk factors on the incidence of major outcomes of type 1 diabetes: the Pittsburgh Epidemiology of Diabetes Complications Study.

PubMed

Miller, Rachel G; Secrest, Aaron M; Ellis, Demetrius; Becker, Dorothy J; Orchard, Trevor J

2013-12-01

The incidence of type 1 diabetes complications appears to be decreasing, but relative contributions of risk factors are unclear. We thus estimated the effect of modifiable risk factors on the incidence of a composite end point, major outcomes of diabetes (MOD). The Pittsburgh Epidemiology of Diabetes Complications (EDC) Study was used to derive two cohorts based on diabetes diagnosis year (1960-1969 and 1970-1980). Baseline exam data in the current analysis for the 1960s group were collected in 1986-1988 and for the 1970s in 1996-1998. Each group was followed for 8 years for MOD incidence (diabetes-related death, myocardial infarction, revascularization procedure/blockage ≥50%, stroke, end-stage renal disease, blindness, and amputation). Assessed risk factors include the following: HbA1c, hypertension, microalbuminuria, BMI, hypercholesterolemia, and smoking. Accelerated failure time models were used to estimate the acceleration factor. MOD incidence decreased in the 1970s cohort (15.8% [95% CI 11.6-21.4]) compared with the 1960s (22.6% [17.0-29.1]) over the 8-year follow-up (P = 0.06). Hypertension and microalbuminuria were associated with significantly accelerated MOD incidence in both cohorts (P < 0.01 for both). High HbA1c (P = 0.0005), hypercholesterolemia (P = 0.01), and current smoking (P = 0.003) significantly accelerated the incidence of MOD in the 1960s but not 1970s cohort. BMI was not associated with MOD in either cohort. These results suggest that hypertension and microalbuminuria remain important predictors of complications that are not being adequately addressed.

Effect of bulk-fill base material on fracture strength of root-filled teeth restored with laminate resin composite restorations.

PubMed

Taha, N A; Maghaireh, G A; Ghannam, A S; Palamara, J E

2017-08-01

To evaluate the effect of using a bulk-fill flowable base material on fracture strength and fracture patterns of root-filled maxillary premolars with MOD preparations restored with laminate restorations. Fifty extracted maxillary premolars were selected for the study. Standardized MOD cavities with endodontic treatment were prepared for all teeth, except for intact control. The teeth were divided randomly into five groups (n=10); (Group 1) sound teeth, (Group 2) unrestored teeth; (Group 3) MOD cavities with Vitrebond base and resin-based composite (Ceram. X One Universal); (Group 4) MOD cavities with 2mm GIC base (Fuji IX GP) and resin-based composite (Ceram. X One Universal) open laminate, (Group 5) MOD cavities were restored with 4mm of bulk-fill flowable base material (SDR) and resin-based composite (Ceram. X One Universal). All teeth were thermocycled and subjected to a 45° ramped oblique load in a universal testing machine. Fracture load and fracture patterns were recorded. Data were analyzed using one-way ANOVA and Dunnett's T3 test. Restoration in general increased the fracture strength compared to unrestored teeth. The fracture strength of group 5 (bulk-fill) was significantly higher than the fracture strength of the GIC laminate groups and not significantly different from the intact teeth (355±112N, P=0.118). The type of failure was unfavorable for most of the groups, with the majority being mixed failures. The use of a bulk-fill flowable base material significantly increased the fracture strength of extracted root-filled teeth with MOD cavities; however it did not improve fracture patterns to more favorable ones. Investigating restorative techniques that may improve the longevity of root-filled premolar teeth restored with direct resin restorations. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Cardio-Renal Interrelationship.

PubMed

Boudoulas, Konstantinos Dean; Triposkiadis, Filippos; Parissis, John; Butler, Javed; Boudoulas, Harisios

The heart and the kidney are of utmost importance for the maintenance of cardiovascular (CV) homeostasis. In healthy subjects, hemodynamic changes in either organ may affect hemodynamics of the other organ. This interaction is fine-tuned by neurohumoral activity, including atrial natriuretic peptides, renin-angiotensin aldosterone system and sympathetic activity. Dysfunction or disease of one organ may initiate, accentuate, or precipitate dysfunction or disease state in the other organ, often leading to a vicious cycle. Further, the interaction between the heart and the kidney may occur in the setting of processes and diseases that may affect both organs simultaneously, such as advanced age, hypertension, diabetes mellitus, atherosclerosis, etc. In this regard, a stiff aorta that occurs with aging due to mechanical stress may independently initiate or precipitate dysfunction and disease in the heart and the kidney. All of these factors contribute to a high prevalence of coexistent CV and kidney disease, especially in the elderly. In advanced kidney disease, hemodynamic and neurohumoral homeostasis are lost, volume and pressure overload may coexist, and the elimination of certain pharmacologic agents may be substantially impaired. Thus, coexistence of CV and kidney disease complicates diagnosis, propagates pathophysiology, adversely affects prognosis, and hinders management. Copyright © 2016 Elsevier Inc. All rights reserved.

Using gene chips to identify organ-specific, smooth muscle responses to experimental diabetes: potential applications to urological diseases.

PubMed

Hipp, Jason D; Davies, Kelvin P; Tar, Moses; Valcic, Mira; Knoll, Abraham; Melman, Arnold; Christ, George J

2007-02-01

To identify early diabetes-related alterations in gene expression in bladder and erectile tissue that would provide novel diagnostic and therapeutic treatment targets to prevent, delay or ameliorate the ensuing bladder and erectile dysfunction. The RG-U34A rat GeneChip (Affymetrix Inc., Sunnyvale, CA, USA) oligonucleotide microarray (containing approximately 8799 genes) was used to evaluate gene expression in corporal and male bladder tissue excised from rats 1 week after confirmation of a diabetic state, but before demonstrable changes in organ function in vivo. A conservative analytical approach was used to detect alterations in gene expression, and gene ontology (GO) classifications were used to identify biological themes/pathways involved in the aetiology of the organ dysfunction. In all, 320 and 313 genes were differentially expressed in bladder and corporal tissue, respectively. GO analysis in bladder tissue showed prominent increases in biological pathways involved in cell proliferation, metabolism, actin cytoskeleton and myosin, as well as decreases in cell motility, and regulation of muscle contraction. GO analysis in corpora showed increases in pathways related to ion channel transport and ion channel activity, while there were decreases in collagen I and actin genes. The changes in gene expression in these initial experiments are consistent with the pathophysiological characteristics of the bladder and erectile dysfunction seen later in the diabetic disease process. Thus, the observed changes in gene expression might be harbingers or biomarkers of impending organ dysfunction, and could provide useful diagnostic and therapeutic targets for a variety of progressive urological diseases/conditions (i.e. lower urinary tract symptoms related to benign prostatic hyperplasia, erectile dysfunction, etc.).

MOD control center automated information systems security evolution

NASA Technical Reports Server (NTRS)

Owen, Rich

1991-01-01

The role of the technology infusion process in future Control Center Automated Information Systems (AIS) is highlighted. The following subject areas are presented in the form of the viewgraphs: goals, background, threat, MOD's AISS program, TQM, SDLC integration, payback, future challenges, and bottom line.

Appendix C : the Noise Exposure Model (MOD 4)

DOT National Transportation Integrated Search

1971-08-01

The purpose of this report is threefold: 1. To record the results of efforts at the Transportaiton Systems Center to refine and expand the Noise Exposure Model, which have specifically resulted in the MOD 4 ver described herein; 2. To serve as an Use...

A methodology for assessment of wind turbine noise generation

NASA Astrophysics Data System (ADS)

Kelley, N. D.; Hemphill, R. R.; McKenna, H. E.

1982-05-01

An investigation of the sources of impulsive noise generated by the operation of the Mod 1 2 MW wind turbine was performed to establish criteria for assessing the noise-producing potential of other large wind turbines. Unsteady loading of the rotors was determined to be the cause of the sound pressure, which was generally below 100 Hz. Complaints originated from people in dwellings with a room with a window facing the machine. Indoor monitoring revealed pressure traces in the 31.5 Hz band with energy densities exceeding background by about 30 dB. It was concluded that the sound pressure was conveyed by the walls acting as a diaphragm. The induced vibration coupled with human body fundamental modes to produce a feeling of whole-body vibration. Spectral analyses were made of the vibration fields of the Mod 2, a 17 m Darrieus, and a Mod OA to allow comparison with the nuisance points of the Mod 1. Sound pressure levels were found at certain frequencies which would eliminate the occurrence of acoustic pollution.

Comparison of tungsten nano-tendrils grown in Alcator C-Mod and linear plasma devices

NASA Astrophysics Data System (ADS)

Wright, G. M.; Brunner, D.; Baldwin, M. J.; Bystrov, K.; Doerner, R. P.; Labombard, B.; Lipschultz, B.; De Temmerman, G.; Terry, J. L.; Whyte, D. G.; Woller, K. B.

2013-07-01

Growth of tungsten nano-tendrils ("fuzz") has been observed for the first time in the divertor region of a high-power density tokamak experiment. After 14 consecutive helium L-mode discharges in Alcator C-Mod, the tip of a tungsten Langmuir probe at the outer strike point was fully covered with a layer of nano-tendrils. The depth of the W fuzz layer (600 ± 150 nm) is consistent with an empirical growth formula from the PISCES experiment. Re-creating the C-Mod exposures as closely as possible in Pilot-PSI experiment can produce nearly-identical nano-tendril morphology and layer thickness at surface temperatures that agree with uncertainties with the C-Mod W probe temperature data. Helium concentrations in W fuzz layers are measured at 1-4 at.%, which is lower than expected for the observed sub-surface voids to be filled with several GPa of helium pressure. This possibly indicates that the void formation is not pressure driven.

Considerations for applying VARSKIN mod 2 to skin dose calculations averaged over 10 cm2.

PubMed

Durham, James S

2004-02-01

VARSKIN Mod 2 is a DOS-based computer program that calculates the dose to skin from beta and gamma contamination either directly on skin or on material in contact with skin. The default area for calculating the dose is 1 cm2. Recently, the U.S. Nuclear Regulatory Commission issued new guidelines for calculating shallow dose equivalent from skin contamination that requires the dose be averaged over 10 cm2. VARSKIN Mod 2 was not filly designed to calculate beta or gamma dose estimates averaged over 10 cm2, even though the program allows the user to calculate doses averaged over 10 cm2. This article explains why VARSKIN Mod 2 overestimates the beta dose when applied to 10 cm2 areas, describes a manual method for correcting the overestimate, and explains how to perform reasonable gamma dose calculations averaged over 10 cm2. The article also describes upgrades underway in Varskin 3.

Mission Operations Directorate - Success Legacy of the Space Shuttle Program

NASA Technical Reports Server (NTRS)

Azbell, James A.

2011-01-01

In support of the Space Shuttle Program, as well as NASA s other human space flight programs, the Mission Operations Directorate (MOD) at the Johnson Space Center has become the world leader in human spaceflight operations. From the earliest programs - Mercury, Gemini, Apollo - through Skylab, Shuttle, ISS, and our Exploration initiatives, MOD and its predecessors have pioneered ops concepts and emphasized a history of mission leadership which has added value, maximized mission success, and built on continual improvement of the capabilities to become more efficient and effective. MOD s focus on building and contributing value with diverse teams has been key to their successes both with the US space industry and the broader international community. Since their beginning, MOD has consistently demonstrated their ability to evolve and respond to an ever changing environment, effectively prepare for the expected and successfully respond to the unexpected, and develop leaders, expertise, and a culture that has led to mission and Program success.

Real-time sensing and gas jet mitigation of VDEs on Alcator C-Mod

NASA Astrophysics Data System (ADS)

Granetz, R. S.; Wolfe, S. M.; Izzo, V. A.; Reinke, M. L.; Terry, J. L.; Hughes, J. W.; Zhurovich, K.; Whyte, D. G.; Bakhtiari, M.; Wurden, G.

2006-10-01

Experiments have been carried out in Alcator C-Mod to test the effectiveness of gas jet disruption mitigation of VDEs with real-time detection and triggering by the C-Mod digital plasma control system (DPCS). The DPCS continuously computes the error in the plasma vertical position from the magnetics diagnostics. When this error exceeds an adjustable preset value, the DPCS triggers the gas jet valve (with a negligible latency time). The high-pressure gas (argon) only takes a few milliseconds to enter the vacuum chamber and begin affecting the plasma, but this is comparable to the VDE timescale on C-Mod. Nevertheless, gas jet injection reduced the halo current, increased the radiated power fraction, and reduced the heating of the divertor compared to unmitigated disruptions, but not quite as well as in earlier mitigation experiments with vertically stable plasmas. Presumably a faster overall response time would be beneficial, and several ways to achieve this will also be discussed.

Test prediction for the German PKL Test K5A using RELAP4/MOD6

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

Chen, Y.S.; Haigh, W.S.; Sullivan, L.H.

RELAP4/MOD6 is the most recent modification in the series of RELAP4 computer programs developed to describe the thermal-hydraulic conditions attendant to postulated transients in light water reactor systems. The major new features in RELAP4/MOD6 include best-estimate pressurized water reactor (PWR) reflood transient analytical models for core heat transfer, local entrainment, and core vapor superheat, and a new set of heat transfer correlations for PWR blowdown and reflood. These new features were used for a test prediction of the Kraftwerk Union three-loop PRIMAR KREISLAUF (PKL) Reflood Test K5A. The results of the prediction were in good agreement with the experimental thermalmore » and hydraulic system data. Comparisons include heater rod surface temperature, system pressure, mass flow rates, and core mixture level. It is concluded that RELAP4/MOD6 is capable of accurately predicting transient reflood phenomena in the 200% cold-leg break test configuration of the PKL reflood facility.« less

Plasma granulocyte colony-stimulating factor and granulocyte-macrophage colony-stimulating factor levels in critical illness including sepsis and septic shock: relation to disease severity, multiple organ dysfunction, and mortality.

PubMed

Presneill, J J; Waring, P M; Layton, J E; Maher, D W; Cebon, J; Harley, N S; Wilson, J W; Cade, J F

2000-07-01

To define the circulating levels of granulocyte colony-stimulating factor (G-CSF) and granulocyte-macrophage colony-stimulating factor (GM-CSF) during critical illness and to determine their relationship to the severity of illness as measured by the Acute Physiology and Chronic Health Evaluation (APACHE) II score, the development of multiple organ dysfunction, or mortality. Prospective cohort study. University hospital intensive care unit. A total of 82 critically ill adult patients in four clinically defined groups, namely septic shock (n = 29), sepsis without shock (n = 17), shock without sepsis (n = 22), and nonseptic, nonshock controls (n = 14). None. During day 1 of septic shock, peak plasma levels of G-CSF, interleukin (IL)-6, and leukemia inhibitory factor (LIF), but not GM-CSF, were greater than in sepsis or shock alone (p < .001), and were correlated among themselves (rs = 0.44-0.77; p < .02) and with the APACHE II score (rs = 0.25-0.40; p = .03 to .18). G-CSF, IL-6, and UF, and sepsis, shock, septic shock, and APACHE II scores were strongly associated with organ dysfunction or 5-day mortality by univariate analysis. However, multiple logistic regression analysis showed that only septic shock remained significantly associated with organ dysfunction and only APACHE II scores and shock with 5-day mortality. Similarly, peak G-CSF, IL-6, and LIF were poorly predictive of 30-day mortality. Plasma levels of G-CSF, IL-6, and LIF are greatly elevated in critical illness, including septic shock, and are correlated with one another and with the severity of illness. However, they are not independently predictive of mortality, or the development of multiple organ dysfunction. GM-CSF was rarely elevated, suggesting different roles for G-CSF and GM-CSF in human septic shock.

AccessMod 3.0: computing geographic coverage and accessibility to health care services using anisotropic movement of patients

PubMed Central

Ray, Nicolas; Ebener, Steeve

2008-01-01

Background Access to health care can be described along four dimensions: geographic accessibility, availability, financial accessibility and acceptability. Geographic accessibility measures how physically accessible resources are for the population, while availability reflects what resources are available and in what amount. Combining these two types of measure into a single index provides a measure of geographic (or spatial) coverage, which is an important measure for assessing the degree of accessibility of a health care network. Results This paper describes the latest version of AccessMod, an extension to the Geographical Information System ArcView 3.×, and provides an example of application of this tool. AccessMod 3 allows one to compute geographic coverage to health care using terrain information and population distribution. Four major types of analysis are available in AccessMod: (1) modeling the coverage of catchment areas linked to an existing health facility network based on travel time, to provide a measure of physical accessibility to health care; (2) modeling geographic coverage according to the availability of services; (3) projecting the coverage of a scaling-up of an existing network; (4) providing information for cost effectiveness analysis when little information about the existing network is available. In addition to integrating travelling time, population distribution and the population coverage capacity specific to each health facility in the network, AccessMod can incorporate the influence of landscape components (e.g. topography, river and road networks, vegetation) that impact travelling time to and from facilities. Topographical constraints can be taken into account through an anisotropic analysis that considers the direction of movement. We provide an example of the application of AccessMod in the southern part of Malawi that shows the influences of the landscape constraints and of the modes of transportation on geographic coverage. Conclusion By incorporating the demand (population) and the supply (capacities of heath care centers), AccessMod provides a unifying tool to efficiently assess the geographic coverage of a network of health care facilities. This tool should be of particular interest to developing countries that have a relatively good geographic information on population distribution, terrain, and health facility locations. PMID:19087277

The challenges associated with applying global models in heterogeneous landscapes: A case study using MOD17 GPP estimates in Hawaii

NASA Astrophysics Data System (ADS)

Kimball, H.; Selmants, P. C.; Running, S. W.; Moreno, A.; Giardina, C. P.

2016-12-01

In this study we evaluate the influence of spatial data product accuracy and resolution on the application of global models for smaller scale heterogeneous landscapes. In particular, we assess the influence of locally specific land cover and high-resolution climate data products on estimates of Gross Primary Production (GPP) for the Hawaiian Islands using the MOD17 model. The MOD17 GPP algorithm uses a measure of the fraction of absorbed photosynthetically active radiation from the National Aeronautics and Space Administration's Earth Observation System. This direct measurement is combined with global land cover (500-m resolution) and climate models ( 1/2-degree resolution) to estimate GPP. We first compared the alignment between the global land cover model used in MOD17 with a Hawaii specific land cover data product. We found that there was a 51.6% overall agreement between the two land cover products. We then compared four MOD17 GPP models: A global model that used the global land cover and low-resolution global climate data products, a model produced using the Hawaii specific land cover and low-resolution global climate data products, a model with global land cover and high-resolution climate data products, and finally, a model using both Hawaii specific land cover and high-resolution climate data products. We found that including either the Hawaii specific land cover or the high-resolution Hawaii climate data products with MOD17 reduced overall estimates of GPP by 8%. When both were used, GPP estimates were reduced by 16%. The reduction associated with land cover is explained by a reduction of the total area designated as evergreen broad leaf forest and an increase in the area designated as barren or sparsely vegetated in the Hawaii land cover product as compared to the global product. The climate based reduction is explained primarily by the spatial resolution and distribution of solar radiation in the Hawaiian Islands. This study highlights the importance of accuracy and resolution when applying global models to highly variable landscapes and provides an estimate of the influence of land cover and climate data products on estimates of GPP using MOD17.

A comprehensive evaluation of two MODIS evapotranspiration products over the conterminous United States: using point and gridded FLUXNET and water balance ET

USGS Publications Warehouse

Velpuri, Naga M.; Senay, Gabriel B.; Singh, Ramesh K.; Bohms, Stefanie; Verdin, James P.

2013-01-01

Remote sensing datasets are increasingly being used to provide spatially explicit large scale evapotranspiration (ET) estimates. Extensive evaluation of such large scale estimates is necessary before they can be used in various applications. In this study, two monthly MODIS 1 km ET products, MODIS global ET (MOD16) and Operational Simplified Surface Energy Balance (SSEBop) ET, are validated over the conterminous United States at both point and basin scales. Point scale validation was performed using eddy covariance FLUXNET ET (FLET) data (2001–2007) aggregated by year, land cover, elevation and climate zone. Basin scale validation was performed using annual gridded FLUXNET ET (GFET) and annual basin water balance ET (WBET) data aggregated by various hydrologic unit code (HUC) levels. Point scale validation using monthly data aggregated by years revealed that the MOD16 ET and SSEBop ET products showed overall comparable annual accuracies. For most land cover types, both ET products showed comparable results. However, SSEBop showed higher performance for Grassland and Forest classes; MOD16 showed improved performance in the Woody Savanna class. Accuracy of both the ET products was also found to be comparable over different climate zones. However, SSEBop data showed higher skill score across the climate zones covering the western United States. Validation results at different HUC levels over 2000–2011 using GFET as a reference indicate higher accuracies for MOD16 ET data. MOD16, SSEBop and GFET data were validated against WBET (2000–2009), and results indicate that both MOD16 and SSEBop ET matched the accuracies of the global GFET dataset at different HUC levels. Our results indicate that both MODIS ET products effectively reproduced basin scale ET response (up to 25% uncertainty) compared to CONUS-wide point-based ET response (up to 50–60% uncertainty) illustrating the reliability of MODIS ET products for basin-scale ET estimation. Results from this research would guide the additional parameter refinement required for the MOD16 and SSEBop algorithms in order to further improve their accuracy and performance for agro-hydrologic applications.

Mod-5A wind turbine generator program design report. Volume 4: Drawings and specifications, book 4

NASA Technical Reports Server (NTRS)

1984-01-01

The design, development and analysis of the 7.3 MW MOD-5A wind turbine generator are documented. There are four volumes. This volume contains the drawings and specifications that were developed in preparation for building the MOD-5A wind turbine generator. This volume contains 5 books of which this is the fourth, providing drawings 47A380128 through 47A387125. In addition to the parts listing and where-used list, the logic design of the controller software and the code listing of the controller software are provided. Also given are the aerodynamic profile coordinates.