Dorsal free graft urethroplasty for urethral stricture by ventral sagittal urethrotomy approach.

PubMed

Asopa, H S; Garg, M; Singhal, G G; Singh, L; Asopa, J; Nischal, A

2001-11-01

To explore the feasibility of applying a dorsal free graft to treat urethral stricture by the ventral sagittal urethrotomy approach without mobilizing the urethra. Twelve patients with long or multiple strictures of the anterior urethra were treated by a dorsal free full-thickness preputial or buccal mucosa graft. The urethra was not separated from the corporal bodies and was opened in the midline over the stricture. The floor of the urethra was incised, and an elliptical raw area was created over the tunica on which a free full-thickness graft of preputial or buccal mucosa was secured. The urethra was retubularized in one stage. After a follow-up of 8 to 40 months, one recurrence developed and required dilation. The ventral sagittal urethrotomy approach for dorsal free graft urethroplasty is not only feasible and successful, but is easy to perform.

Detection of atypical porcine pestivirus in semen from commercial boar studs in the United States.

PubMed

Gatto, I R H; Arruda, P H; Visek, C A; Victoria, J G; Patterson, A R; Krull, A C; Schwartz, K J; de Oliveira, L G; Arruda, B L

2018-04-01

Atypical porcine pestivirus (APPV) has recently been identified as a cause of congenital tremor (CT) in pigs and has been detected in semen and preputial swabs from boars that were known to be clinically affected with CT. Accordingly, the objectives of this study were to 1) detect the presence of APPV in semen, preputial fluids and preputial swabs from adult boars by quantitative reverse transcription PCR (qRT-PCR) and 2) genetically characterize a subset of positive samples to better understand the ecology of APPV in commercial boar studs and the potential risk of transmission of APPV via semen. A total of 597 samples of semen, preputial fluid and preputial swabs each representing a different boar were obtained from four commercial boar studs located in three different states in the United States. Viral RNA was detected by qRT-PCR in 90 samples (15.08%; 90/597), with the greatest per cent positive from preputial swabs (23.81%; 5/21) followed by preputial fluid (22.81%; 26/114) and semen (12.91%; 59/457). The mean cycle quantification (Cq) between sample types was similar while eleven semen samples had Cq values lower than 27.0 corresponding to approximately 2 × 10 6  copies/ml. Based on phylogenetic analysis of the Npro gene, different viral strains can be on the same farm at the same and different times. This is the first report of detection of APPV in semen from commercial boar studs. Studies investigating the role of semen in the transmission of APPV and production of CT are needed. © 2017 Blackwell Verlag GmbH.

Dual role of preputial gland secretion and its major components in sex recognition of mice.

PubMed

Zhang, Jian-Xu; Liu, Ying-Juan; Zhang, Jin-Hua; Sun, Lixing

2008-10-20

This study was aimed at validating the sexual attractiveness of hexadecanol and hexadecyl acetate, two putative pheromone compounds, from preputial gland secretion of mice. These two compounds have been reported to be among the major components of preputial gland secretion in both sexes but higher in quantity in males than females. In this study, we show that castration suppressed the production of the two compounds, further suggesting their association with maleness. Adding preputial gland secretion and the synthetic analogs of the two compounds to castrated male urine at their physiological levels in intact males increased the attractiveness of castrated male urine to female mice, showing that the two compounds were indeed male pheromones. Furthermore, their sexual attractiveness disappeared upon removing the vomeronasal organs (VNOs) from female recipients. Replenishing castrated male urine with preputial gland secretion and the two compounds at their physiological levels in females increased the attractiveness of castrated male urine to males. Such a reversal of sexual attractiveness for hexadecanol and hexadecyl acetate suggests that they had opposing dual effects in sexual attractiveness in a dosage-dependent manner.

Odor of the muskox : A preliminary investigation.

PubMed

Flood, P F; Abrams, S R; Muir, G D; Rowell, J E

1989-08-01

The behavior of captive male muskoxen was observed closely during their characteristic superiority display, the anatomy of the preputial region was studied in two adults and three calves, and preputial washings and preorbital gland secretion were subjected to gas chromatography and mass spectroscopy. During the superiority display, the prepuce was everted to form a pendulous tube tipped with a fringe of matted hair. Owing to the movement of the animal, the urine that dribbled from the preputial opening was liberally applied to the long guard hairs of the belly. The superiority display was almost exclusively confined to dominant males and apparently accounted for their odor. In the quiescent state, the hair seen around the preputial opening was drawn inside and formed an 8 cm-wide band on the lining of the prepuce. The preputial washings contained large amounts of benzoic acid andp-cresol. The infraorbital gland secretion contained cholesterol, benzaldehyde, and a homologous series of saturated γ-lactones ranging from 8 to 12 carbons. The latter compounds and the natural secretion smell similar to the human nose.

Preputial Demodex species in big brown bats (Eptesicus fuscus) in eastern Tennessee.

PubMed

Lankton, Julia S; Chapman, Alycia; Ramsay, Edward C; Kania, Stephen A; Newkirk, Kimberly M

2013-03-01

The presence of preputial Demodex species in four captive, wild-caught big brown bats (Eptesicus fuscus) in eastern Tennessee, USA, examined between 2008 and 2010 is reported. In three of four cases, there was associated folliculitis, dermatitis, or preputial adenitis. There were no clinical signs directly attributable to the mites, although penile prolapse was present in one case. Mites were retrieved from preputial skin samples of other archival big brown bats by potassium hydroxide digestion and analyzed by polymerase chain reaction (PCR). DNA sequencing of the 16S rRNA gene revealed 99.6% homology to Demodex canis, although morphologic differences distinguish the two species. Mites of this report differ in anatomic location from Demodex spp. previously reported in bats and represent a species unreported to public databases.

Femtosecond Polarization Phase Selective (PPS) High Magnetic Field Studies of Electron-Spin-Hole (ESH) Dynamics: New Tools for Ultrafast Imaging Fe-centered ESH Transfer Mechanisms Steps

NASA Astrophysics Data System (ADS)

Rupnik, Kresimir; Cooper, Benjamin; Dunne, Taylor; Gerosa, Katherine; Mercer, Kaitlyn; McGill, Stephen

In previous work, new Nanoparticle-enzyme Based Hybrids (NEBH) synthesis methods were investigated for nanoparticles of different shapes and electron energies. These hybrids can provide electromagnetic-field-driven ESH separations and transfers to desired molecular locations. Of paramount biomedical interest are the activity centers (including Fe-clusters) in proteins that perform their intended function and help synthesize other molecules. In this work we discuss results of our recent in situ ESH dynamics measurements: we use <15fs (Vitara) PPS broad band pulses and ultrahigh, 25T, magnetic fields from Split-helix magnet at NHMFL. Work included multi-spectral domain PPS harmonic generations and PPS sum frequency generations. Model compounds, including cytochromes, were used for testing and calibrations and previously studied Fe-S enzymes were prepared for measurements. While PPS opto-magnetic methods are known for their insight into electronic structure, our femtosecond measurements can provide ultrafast dynamic imaging of ESH mechanisms decision making steps. UF-PPS Project, performed in part at NHMFL, supported by NSF CA No. DMR-1157490, and 0654118 and U.S. DOE.

Measuring hospital input price increases: The rebased hospital market basket

PubMed Central

Freeland, Mark S.; Chulis, George S.; Brown, Aaron P.; Skellan, David; Maple, Brenda T.; Singer, Naphtale; Lemieux, Jeffrey; Arnett, Ross H.

1991-01-01

The input prices indexes used in part to set payment rates for Medicare inpatient hospital services in both prospective payment system (PPS) and PPS-excluded hospitals were rebased from 1982 to 1987 beginning with payments for fiscal year 1991. In this article, the issues and evidence used to determine the composition of the revised hospital input price indexes are discussed. One issue is the need for a separate market basket for PPS-excluded hospitals. Also, the payment implications of using hospital-industry versus economywide measures of wage rates as price proxies for the growth in hospital wage rates are addressed. PMID:10113610

Initial steps in defining the environment of the prepuce of the bull by measuring pH and temperature.

PubMed

Koziol, J H; Fraser, N S; Passler, T; Wolfe, D F

2017-12-01

To determine the baseline pH and temperature of the preputial cavity of bulls. We enrolled 55 bulls ranging in age from 15 to 84 months. The preputial temperature and pH were measured by insertion of temperature and pH probes, respectively, into the preputial orifice prior to routine breeding soundness examinations. Information was obtained from owners regarding the diet of each bull and categorised as one of three categories: forage only, grain supplemented or silage supplemented. The average temperature of the prepuce was 37.81°C ± 1.76 and the median pH of the prepuce was 8.45 (6.35-9.46). Preputial temperatures of the bull weakly correlated with ambient temperatures (r s  = -0.29, P = 0.028). The preputial pH of silage-fed bulls was significantly lower than that of bulls fed forage only (P = 0.025) or grain-supplemented diets (P = 0.002). The median preputial pH of bulls fed a silage-based diet was 7.6 (6.3-8.9) compared with a median pH 8.7 (7.8-9.1) for bulls fed forage-based diets or a median of 8.5 (7.7-9.4) for those given grain-supplemented diets. Diet and ambient temperature can, respectively, affect pH and the temperature in the prepuce. Further studies to describe and understand the microbiota of the prepuce and penis may assist in developing treatments for diseases of the genital tract in bulls. © 2017 Australian Veterinary Association.

The initial impact of Medicare's new prospective payment system for kidney dialysis.

PubMed

Hirth, Richard A; Turenne, Marc N; Wheeler, John R C; Nahra, Tammie A; Sleeman, Kathryn K; Zhang, Wei; Messana, Joseph A

2013-10-01

Medicare implemented a new prospective payment system (PPS) on January 1, 2011. This PPS covers an expanded bundle of services, including services previously paid on a fee-for-service basis. The objectives of the new PPS include more efficient decisions about treatment service combinations and modality choice. Primary data for this study are Medicare claims files for all dialysis patients for whom Medicare is the primary payer. We compare use of key injectable medications under the bundled PPS to use when those drugs were separately billable and examine variability across providers. We also compare each patient's dialysis modality before and after the PPS. Use of relatively expensive drugs, including erythropoiesis-stimulating agents, declined substantially after institution of the new PPS, whereas use of iron products, often therapeutic substitutes for erythropoiesis-stimulating agents, increased. Less expensive vitamin D products were substituted for more expensive types. Drug spending overall decreased by ∼$25 per session, or about 5 times the mandated reduction in the base payment rate of ∼$5. Use of peritoneal dialysis increased in 2011 after being nearly flat in the years prior to the PPS, with the increase concentrated in patients in their first or second year of dialysis. Home hemodialysis continued to increase as a percentage of total dialysis services, but at a rate similar to the pre-PPS trend. The expanded bundle dialysis PPS provided incentives for the use of lower cost therapies. These incentives seem to have motivated dialysis providers to move toward lower cost methods of care in both their use of drugs and choice of modalities. Copyright © 2013 National Kidney Foundation, Inc. All rights reserved.

Astrometric Telescope Facility isolation and pointing study

NASA Technical Reports Server (NTRS)

Hibble, William; Allen, Terry; Jackson, Louis; Medbery, James; Self, Richard

1988-01-01

The Astrometric Telescope Facility (ATF), an optical telescope designed to detect extrasolar planetary systems, is scheduled to be a major user of the Space Station's Payload Pointing System (PPS). However, because the ATF has such a stringent pointing stability specification and requires + or - 180 deg roll about its line of sight, mechanisms to enhance the basic PPS capability are required. The ATF pointing performance achievable by the addition of a magnetic isolation and pointing system (MIPS) between the PPS upper gimbal and the ATF, and separately, by the addition of a passive isolation system between the Space Station and the PPS base was investigated. The candidate MIPS can meet the ATF requirements in the presence of a 0.01 g disturbance. It fits within the available annular region between the PPS and the ATF while meeting power and weight limitations and providing the required roll motion, payload data and power services. By contrast, the passive base isolator system must have an unrealistically low isolation bandwidth on all axes to meet ATF pointing requirements and does not provide roll about the line of sight.

Microanalysis characterization of bioactive protein-bound polysaccharides produced by Amanita ponderosa cultures.

PubMed

Salvador, Cátia; Martins, M Rosário; Caldeira, A Teresa

2015-02-01

Different compounds of edible mushrooms are responsible for their bioactivity. The ability to synthesize polysaccharides, namely protein-polysaccharide (PPS) complexes, is related to the antioxidant capacity of these compounds and present great interest in preventing a number of diseases, including cancer, cardiovascular and auto-immune diseases, and accelerated aging. Amanita ponderosa are wild edible mushrooms that grow in Mediterranean "montado" areas [Portuguese name given to cork oak (Quercus suber) and holm oak (Quercus ilex) forests]. The aim of this study was to evaluate the production of PPS complexes obtained from A. ponderosa cultures using a new microanalytical approach to quickly and easily monitor the production process. Microanalysis using Fourier-transform infrared using attenuated total reflection and Raman spectroscopy of PPS samples showed spectra compatible with identification of this type of compound in culture extracts. PPS separated by size-exclusion chromatography showed seven main complexes. Molecular weights of the main PPS complexes isolated from cultures ranged between 1.5 and 20 kDa and did not present toxicity against Artemia salina, demonstrating the potential of A. ponderosa as a source of biologically active compounds with nutraceutical value. Application of this microanalytical approach to monitoring the production of PPS compounds can be successfully applied in biotechnological processes.

Parent-child relationship disorders. Part I. Parental overprotection and the development of the Parent Protection Scale.

PubMed

Thomasgard, M; Metz, W P; Edelbrock, C; Shonkoff, J P

1995-08-01

There is a spectrum of parental protective behaviors promoting child safety and security, ranging from neglect to overprotection. This paper describes the development and psychometric properties of a new measure of parental protective behaviors toward children age 2 to 10 years, the Parent Protection Scale (PPS). Items were selected to represent key dimensions of protective behaviors. Factor analyses suggested four subscales: Supervision, Separation Problems, Dependence, and Control. The PPS has acceptable internal consistency, test-retest reliability, and clinical validity. Norms by child age in the form of cutoff points corresponding to +1 SD were determined. Clinical and research uses for the PPS are noted.

A modified method for locating parapharyngeal space neoplasms on magnetic resonance images: implications for differential diagnosis

PubMed Central

Liu, Xue-Wen; Wang, Ling; Li, Hui; Zhang, Rong; Geng, Zhi-Jun; Wang, De-Ling; Xie, Chuan-Miao

2014-01-01

The parapharyngeal space (PPS) is an inverted pyramid-shaped deep space in the head and neck region, and a variety of tumors, such as salivary gland tumors, neurogenic tumors, nasopharyngeal carcinomas with parapharyngeal invasion, and lymphomas, can be found in this space. The differential diagnosis of PPS tumors remains challenging for radiologists. This study aimed to develop and test a modified method for locating PPS tumors on magnetic resonance (MR) images to improve preoperative differential diagnosis. The new protocol divided the PPS into three compartments: a prestyloid compartment, the carotid sheath, and the areas outside the carotid sheath. PPS tumors were located in these compartments according to the displacements of the tensor veli palatini muscle and the styloid process, with or without blood vessel separations and medial pterygoid invasion. This protocol, as well as a more conventional protocol that is based on displacements of the internal carotid artery (ICA), was used to assess MR images captured from a series of 58 PPS tumors. The consequent distributions of PPS tumor locations determined by both methods were compared. Of all 58 tumors, our new method determined that 57 could be assigned to precise PPS compartments. Nearly all (13/14; 93%) tumors that were located in the pre-styloid compartment were salivary gland tumors. All 15 tumors within the carotid sheath were neurogenic tumors. The vast majority (18/20; 90%) of trans-spatial lesions were malignancies. However, according to the ICA-based method, 28 tumors were located in the pre-styloid compartment, and 24 were located in the post-styloid compartment, leaving 6 tumors that were difficult to locate. Lesions located in both the pre-styloid and the post-styloid compartments comprised various types of tumors. Compared with the conventional ICA-based method, our new method can help radiologists to narrow the differential diagnosis of PPS tumors to specific compartments. PMID:25104280

Combined preputial advancement and phallopexy as a revision technique for treating paraphimosis in a dog.

PubMed

Wasik, S M; Wallace, A M

2014-11-01

A 7-year-old neutered male Jack Russell terrier-cross was presented for signs of recurrent paraphimosis, despite previous surgical enlargement of the preputial ostium. Revision surgery was performed using a combination of preputial advancement and phallopexy, which resulted in complete and permanent coverage of the glans penis by the prepuce, and at 1 year postoperatively, no recurrence of paraphimosis had been observed. The combined techniques allow preservation of the normal penile anatomy, are relatively simple to perform and provide a cosmetic result. We recommend this combination for the treatment of paraphimosis in the dog, particularly when other techniques have failed. © 2014 Australian Veterinary Association.

The Effect of Prospective Payment on Admission and Treatment Policy: Evidence from Inpatient Rehabilitation Facilities

PubMed Central

Sood, Neeraj; Huckfeldt, Peter J; Grabowski, David C; Newhouse, Joseph P; Escarce, José J

2013-01-01

We examine provider responses to the Medicare inpatient rehabilitation facility (IRF) prospective payment system (PPS), which simultaneously reduced marginal reimbursement and increased average reimbursement. IRFs could respond to the PPS by changing the number of patients admitted, admitting different types of patients, or changing the intensity of care. We use Medicare claims data to separately estimate each type of provider response. We also examine changes in patient outcomes and spillover effects on other post-acute care providers. We find that costs of care initially fell following the PPS, which we attribute to changes in treatment decisions rather than the characteristics of patients admitted to IRFs within the diagnostic categories we examine. However, the probability of admission to IRFs increased after the PPS due to the expanded admission policies of providers. We find modest spillover effects in other post-acute settings and negative health impacts for only one of three diagnostic groups studied. PMID:23994598

An unusual foreign body in the preputial sac.

PubMed Central

Jaiswal, A K

1992-01-01

A 28 year old Indian male presented with an unusual foreign body, a penicillin bottle containing tincture of iodine, in the preputial sac. The purpose of introducing the bottle was to tickle his glans penis as a form of masturbation. The bottle was so firmly impacted that it could be removed only under general anaesthesia. Images PMID:1427809

Full body action remapping of peripersonal space: the case of walking.

PubMed

Noel, Jean-Paul; Grivaz, Petr; Marmaroli, Patrick; Lissek, Herve; Blanke, Olaf; Serino, Andrea

2015-04-01

The space immediately surrounding the body, i.e. peripersonal space (PPS), is represented by populations of multisensory neurons, from a network of premotor and parietal areas, which integrate tactile stimuli from the body's surface with visual or auditory stimuli presented within a limited distance from the body. Here we show that PPS boundaries extend while walking. We used an audio-tactile interaction task to identify the location in space where looming sounds affect reaction time to tactile stimuli on the chest, taken as a proxy of the PPS boundary. The task was administered while participants either stood still or walked on a treadmill. In addition, in two separate experiments, subjects either received or not additional visual inputs, i.e. optic flow, implying a translation congruent with the direction of their walking. Results revealed that when participants were standing still, sounds boosted tactile processing when located within 65-100 cm from the participants' body, but not at farther distances. Instead, when participants were walking PPS expands as reflected in boosted tactile processing at ~1.66 m. This was found despite the fact the spatial relationship between the participant's body and the sound's source did not vary between the Standing and the Walking condition. This expansion effect on PPS boundaries due to walking was the same with or without optic flow, suggesting that kinematics and proprioceptive cues, rather than visual cues, are critical in triggering the effect. These results are the first to demonstrate an adaptation of the chest's PPS representation due to whole body motion and are compatible with the view that PPS constitutes a dynamic sensory-motor interface between the individual and the environment. Copyright © 2014 Elsevier Ltd. All rights reserved.

Sensitivity to binaural timing in bilateral cochlear implant users.

PubMed

van Hoesel, Richard J M

2007-04-01

Various measures of binaural timing sensitivity were made in three bilateral cochlear implant users, who had demonstrated moderate-to-good interaural time delay (ITD) sensitivity at 100 pulses-per-second (pps). Overall, ITD thresholds increased at higher pulse rates, lower levels, and shorter durations, although intersubject differences were evident. Monaural rate-discrimination thresholds, using the same stimulation parameters, showed more substantial elevation than ITDs with increased rate. ITD sensitivity with 6000 pps stimuli, amplitude-modulated at 100 Hz, was similar to that with unmodulated pulse trains at 100 pps, but at 200 and 300 Hz performance was poorer than with unmodulated signals. Measures of sensitivity to binaural beats with unmodulated pulse-trains showed that all three subjects could use time-varying ITD cues at 100 pps, but not 300 pps, even though static ITD sensitivity was relatively unaffected over that range. The difference between static and dynamic ITD thresholds is discussed in terms of relative contributions from initial and later arriving cues, which was further examined in an experiment using two-pulse stimuli as a function of interpulse separation. In agreement with the binaural-beat data, findings from that experiment showed poor discrimination of ITDs on the second pulse when the interval between pulses was reduced to a few milliseconds.

Identifying Variability in Mental Models Within and Between Disciplines Caring for the Cardiac Surgical Patient.

PubMed

Brown, Evans K H; Harder, Kathleen A; Apostolidou, Ioanna; Wahr, Joyce A; Shook, Douglas C; Farivar, R Saeid; Perry, Tjorvi E; Konia, Mojca R

2017-07-01

The cardiac operating room is a complex environment requiring efficient and effective communication between multiple disciplines. The objectives of this study were to identify and rank critical time points during the perioperative care of cardiac surgical patients, and to assess variability in responses, as a correlate of a shared mental model, regarding the importance of these time points between and within disciplines. Using Delphi technique methodology, panelists from 3 institutions were tasked with developing a list of critical time points, which were subsequently assigned to pause point (PP) categories. Panelists then rated these PPs on a 100-point visual analog scale. Descriptive statistics were expressed as percentages, medians, and interquartile ranges (IQRs). We defined low response variability between panelists as an IQR ≤ 20, moderate response variability as an IQR > 20 and ≤ 40, and high response variability as an IQR > 40. Panelists identified a total of 12 PPs. The PPs identified by the highest number of panelists were (1) before surgical incision, (2) before aortic cannulation, (3) before cardiopulmonary bypass (CPB) initiation, (4) before CPB separation, and (5) at time of transfer of care from operating room (OR) to intensive care unit (ICU) staff. There was low variability among panelists' ratings of the PP "before surgical incision," moderate response variability for the PPs "before separation from CPB," "before transfer from OR table to bed," and "at time of transfer of care from OR to ICU staff," and high response variability for the remaining 8 PPs. In addition, the perceived importance of each of these PPs varies between disciplines and between institutions. Cardiac surgical providers recognize distinct critical time points during cardiac surgery. However, there is a high degree of variability within and between disciplines as to the importance of these times, suggesting an absence of a shared mental model among disciplines caring for cardiac surgical patients during the perioperative period. A lack of a shared mental model could be one of the factors contributing to preventable errors in cardiac operating rooms.

Diversion of the urine stream by surgical modification of the preputial ostium in a dog.

PubMed

Pavletic, Michael M; Brum, Douglas E

2009-11-01

A 1.4-year-old sexually intact male Standard Poodle was evaluated with a history of urinating on its left forelimb and lower portion of the thorax. Physical examination revealed that the dog had an unusually elevated (tucked) abdominal wall and prominent dome-shaped thoracic wall. These anatomic changes altered the angle of the urine stream, resulting in the dog's soiling the xiphoid region of the thorax and left forelimb. The dorsal half of the preputial ostium was closed surgically to divert the urine stream in a ventral direction. The ventral portion of the ostium was reciprocally enlarged. Postoperatively, the dog urinated in a downward direction, eliminating urine contact with the body. The preputial orifice (ostium) plays an important role in the shape and direction of the urine stream exiting the penile urethra. Dogs with an elevated abdominal wall and prominent dome-shaped thorax may be prone to contamination of the lower portion of the thorax and forelimbs with urine during normal micturition. Partial closure of the dorsal preputial ostium, with reciprocal enlargement of the lower half of the orifice, can create a deflective barrier that effectively diverts the urine stream in a ventral direction.

Hepatotoxic microcystin removal using pumice embedded monolithic composite cryogel as an alternative water treatment method.

PubMed

Gurbuz, Fatma; Ceylan, Şeyda; Odabaşı, Mehmet; Codd, Geoffrey A

2016-03-01

Microcystins are the most commonly encountered water-borne cyanotoxins which present short- and long-term risks to human health. Guidelines at international and national level, and legislation in some countries, have been introduced for the effective health risk management of these potent hepatotoxic, tumour-promoters. The stable cyclic structure of microcystins and their common production by cyanobacteria in waterbodies at times of high total dissolved organic carbon content presents challenges to drinking water treatment facilities, with conventional, advanced and novel strategies under evaluation. Here, we have studied the removal of microcystins using three different forms of pumice particles (PPs), which are embedded into macroporous cryogel columns. Macroporous composite cryogel columns (MCCs) are a new generation of separation media designed to face this challenging task. Three different MCCs were prepared by adding plain PPs, Cu(2+)-attached PPs and Fe(3+)-attached PPs to reaction media before the cryogelation step. Column studies showed that MCCs could be successfully used as an alternative water treatment method for successful microcystin removal. Copyright © 2016 Elsevier Ltd. All rights reserved.

Pentosanpolysulfate coating of silicone reduces encrustation.

PubMed

Zupkas, P; Parsons, C L; Percival, C; Monga, M

2000-08-01

A significant problem associated with catheterization in the urinary tract is the encrustation of the catheter materials. One approach to reducing encrustation is to alter the surface properties of the catheters. We evaluated the effectiveness of coating with pentosanpolysulfate (PPS), a semisynthetic polysaccharide similar to heparin, in reducing encrustation and the foreign-body inflammatory response to silicone stents in the bladders of male New Zealand White rabbits. Sixteen rabbits were divided into three groups to receive placement in their bladders of uncoated (N = 7), PPS-coated (N = 7), or sham matrix-processed silicone rings (N = 2) via open cystotomy. After 50 days of maintenance on normal food and water, all rabbits were sacrificed, and the air-dried, unfixed silicone ring surfaces were examined by scanning electron microscopy. Bladders and remaining silicone rings were removed and preserved separately. Silicone rings, cleaned of all encrustation, were stained with toluidene blue to determine the presence or absence of PPS coating on the surface. Histologic examination revealed normal tissue in bladder sections exposed to coated silicone rings and an inflammatory response in sections from bladders having uncoated silicone rings. Coating with PPS was associated with an eightfold reduction in the amount of encrustation of silicone and a marked reduction in the inflammatory response of the bladder wall to the foreign body. A PPS coating may be useful in reducing the encrustation of long-term indwelling silicone stents or catheters in the human urinary tract.

Subgroups of advanced cancer patients clustered by their symptom profiles: quality-of-life outcomes.

PubMed

Husain, Amna; Myers, Jeff; Selby, Debbie; Thomson, Barbara; Chow, Edward

2011-11-01

Symptom cluster analysis is a new frontier of research in symptom management. This study clustered patients by their symptom profiles to identify subgroups that may be at higher risk for poor quality of life (QOL) and that may, therefore, benefit most from targeted interventions. Longitudinal study of metastatic cancer patients using the Edmonton Symptom Assessment Scale (ESAS). We generated two-, three-, and four-cluster subgroups and examined the relationship of cluster membership with patient outcomes. To address the problem of missing longitudinal data, we developed a novel outcome variable (QualTime) that measures both QOL and time in study. Two hundred and twenty-one patients with a mean Palliative Performance Scale (PPS) of 59.1 were enrolled. The three-cluster model was chosen for further analysis. The low-burden subgroup had all low severity symptom scores. The intermediate subgroup separates from the low-burden group on the "debility" profile of fatigue, drowsiness, appetite, and well-being. The high-burden group separates from the intermediate-burden group on pain, depression, and anxiety. At baseline, PPS (p=0.0003) and cluster membership (p<0.0001) contributed significantly to global QOL. In univariate analysis, cluster membership was related to the longitudinal outcome, QualTime. In a multivariate model, the relationship of PPS to QualTime was still significant (p=0.0002), but subgroup membership was no longer significant (p=0.1009). PPS is a stronger predictor of the longitudinal variable than cluster subgroups; however, cluster subgroups provide a target for clinical interventions that may improve QOL.

A magnetic isolation and pointing system for the astrometric telescope facility

NASA Technical Reports Server (NTRS)

Smith, Marcie; Hibble, William; Wolke, Patrick J.

1993-01-01

The astrometric telescope facility (ATF), a 20-meter telescope designed for long-term detection and observation of planetary systems outside of the solar system, is scheduled to be a major user of the Space Station's payload pointing system (PPS) capabilities. However, because the ATF has such a stringent pointing stability specification (as low as 0.01 arcsec error over the frequency range from 5 to 200 hertz) and requires +/- 180-degree roll rotation around the telescope's line of sight, the ATF's utilization of the PPS requires the addition of a mechanism or mechanisms to enhance the basic PPS capabilities. The results of a study conducted to investigate the ATF pointing performance achievable by the addition of a magnetic isolation and pointing (MIPS) system between the PPS upper gimbal and the ATF, and separately, by the addition of a passive isolation system between the Space Station and the PPS base are presented. In addition, the study produced requirements on magnetic force and gap motion as a function of the level of Space Station disturbance. These results were used to support the definition of a candidate MIPS. Pointing performance results from the study indicate that a MIPS can meet the ATF pointing requirements in the presence of a PPS base transitional acceleration of up to 0.018g, with reasonable restrictions placed on the isolation and pointing bandwidths. By contrast, the passive base isolator system must have an unrealistically low isolation bandwidth on all axes (less than 0.1 hertz) to meet ATF pointing requirements. The candidate MIPS is based on an assumed base translational disturbance of 0.01g. The system fits within the available annular region between the PPS and ATF while meeting power and weight limitations and providing the required payload roll motion. Payload data and power services are provided by noncontacting transfer devices.

Interaction of albumins and heparinoids investigated by affinity capillary electrophoresis and free flow electrophoresis.

PubMed

Mozafari, Mona; El Deeb, Sami; Krull, Friederike; Wildgruber, Robert; Weber, Gerhard; Reiter, Christian G; Wätzig, Hermann

2018-02-01

A fast and precise affinity capillary electrophoresis (ACE) method has been applied to investigate the interactions between two serum albumins (HSA and BSA) and heparinoids. Furthermore, different free flow electrophoresis methods were developed to separate the species which appears owing to interaction of albumins with pentosan polysulfate sodium (PPS) under different experimental conditions. For ACE experiments, the normalized mobility ratios (∆R/R f ), which provided information about the binding strength and the overall charge of the protein-ligand complex, were used to evaluate the binding affinities. ACE experiments were performed at two different temperatures (23 and 37°C). Both BSA and HSA interact more strongly with PPS than with unfractionated and low molecular weight heparins. For PPS, the interactions can already be observed at low mg/L concentrations (3 mg/L), and saturation is already obtained at approximately 20 mg/L. Unfractionated heparin showed almost no interactions with BSA at 23°C, but weak interactions at 37°C at higher heparin concentrations. The additional signals also appeared at higher concentrations at 37°C. Nevertheless, in most cases the binding data were similar at both temperatures. Furthermore, HSA showed a characteristic splitting in two peaks especially after interacting with PPS, which is probably attributable to the formation of two species or conformational change of HSA after interacting with PPS. The free flow electrophoresis methods have confirmed and completed the ACE experiments. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Association of Medicare's Bundled Payment Reform With Changes in Use of Vitamin D Among Patients Receiving Maintenance Hemodialysis: An Interrupted Time-Series Analysis.

PubMed

Spoendlin, Julia; Schneeweiss, Sebastian; Tsacogianis, Theodore; Paik, Julie M; Fischer, Michael A; Kim, Seoyoung C; Desai, Rishi J

2018-06-08

Medicare's 2011 prospective payment system (PPS) was introduced to curb overuse of separately billable injectable drugs. After epoietin, intravenous (IV) vitamin D analogues are the biggest drug cost drivers in hemodialysis (HD) patients, but the association between PPS introduction and vitamin D therapy has been scarcely investigated. Interrupted time-series analyses. Adult US HD patients represented in the US Renal Data System between 2008 and 2013. PPS implementation. The cumulative dose of IV vitamin D analogues (paricalcitol equivalents) per patient per calendar quarter in prevalent HD patients. The average starting dose of IV vitamin D analogues and quarterly rates of new vitamin D use (initiations/100 person-months) in incident HD patients within 90 days of beginning HD therapy. Segmented linear regression models of the immediate change and slope change over time of vitamin D use after PPS implementation. Among 359,600 prevalent HD patients, IV vitamin D analogues accounted for 99% of the total use, and this trend was unchanged over time. PPS resulted in an immediate 7% decline in the average dose of IV vitamin D analogues (average baseline dose = 186.5 μg per quarter; immediate change = -13.5 μg [P < 0.001]; slope change = 0.43 per quarter [P = 0.3]) and in the starting dose of IV vitamin D analogues in incident HD patients (average baseline starting dose = 5.22 μg; immediate change = -0.40 μg [P < 0.001]; slope change = -0.03 per quarter [P = 0.03]). The baseline rate of vitamin D therapy initiation among 99,970 incident HD patients was 44.9/100 person-months and decreased over time, even before PPS implementation (pre-PPS β = -0.46/100 person-months [P < 0.001]; slope change = -0.19/100 person-months [P = 0.2]). PPS implementation was associated with an immediate change in initiation levels (by -4.5/100 person-months; P < 0.001). Incident HD patients were restricted to those 65 years or older. PPS implementation was associated with a 7% reduction in the average dose and starting dose of IV vitamin D analogues and a 10% reduction in the rate of vitamin D therapy initiation. Copyright © 2018 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Modulation of male mouse genital sniff, attack, and mount behaviors by urogenital substances from estrous females.

PubMed

Weinhold, L L; Ingersoll, D W

1988-09-01

The modulation of attacks, genital sniffs, and mounts in male SJL/J mice by ovarian-dependent urogenital substances in the urine voided by estrous females was examined. Urogenital substances were applied onto the external urogenital areas of ovariectomized mice. When compared with urine voided by estrous females, which stimulated genital sniffing, mounting, and reduced aggression, bladder urine was ineffective. Genital sniffing and mounting was stimulated by estradiol-17 beta, vaginal fluids, and preputial extract. Aggression was reduced by estradiol-17 beta, urethral catheterized urine, and vaginal fluids. Preputialectomy reduced, but did not eliminate, urinary stimulation of genital sniffing and mounting. Preputial extract stimulated aggression. Urogenital substances from ovariectomized females were ineffective in reducing attacks and stimulating genital sniffs and mounts. It was concluded that the ovarian-dependent chemosignals in the urine voided by estrous females are contributed by the urethra, vagina, and preputial gland, perhaps in part through the excretion of unconjugated estrogens.

Intravenous immunoglobulin treatment of the post-polio syndrome: sustained effects on quality of life variables and cytokine expression after one year follow up

PubMed Central

2012-01-01

Background Expression of inflammatory cytokines in cerebrospinal fluid (CSF) has led to the hypothesis of intrathecal chronic inflammation to explain the denervation observed in post-polio syndrome (PPS). It has been shown that therapy with intravenous immunoglobulin (IVIG) improves physical performance and dampens down the inflammatory process at 6 months in PPS patients. We here examined the effects of IVIG on cytokine expression and clinical outcome one year after IVIG treatment. Methods From a previous study with 135 PPS patients included, 41 patients were further evaluated before un-blinding for one year (21 placebo and 20 treated with IVIG, Xepol® 50 mg/ml), and were assessed for clinical variables by performing the Short Form-36 survey (SF-36) questionnaire assessment, the 6 minute walk distance test (6MWT) and registering pain level by Visual Analogue Scale (VAS) after IVIG treatment. A separate cohort of 37 PPS patients went through lumbar puncture (LP) at baseline and 20 patients, treated with IVIG, repeated the LP one year later. Thirty patients affected with other neurological diseases (OND) were used as control group. Inflammatory cytokines TNF, TGFβ, IFNγ, IL-23, IL-13 and IL-10 were measured in blood cells and CSF cells with RT-PCR. Results Scores of the physical components of SF-36 were significantly higher at the one year follow up time-point in the IVIG-treated patients when compared to baseline as well as to the control subjects. Pain VAS score and 6MWT improved significantly in the IVIG-treated patients when compared with baseline Relative expression of TNF and IFN-γ in both PBMCs and CSF from PPS patients were increased compared to OND subjects at baseline (p < 0.05). One year after IVIG-treatment a decreased expression of IFN-γ and IL23 was found in CSF of PPS patients, while anti-inflammatory IL-13 was increased (p < 0.05). Conclusions IVIG has effects on relevant QoL variables and inflammatory cytokines up to one year in patients with PPS. This gives a basis for scheduling IVIG in upcoming trials with this therapy. PMID:22776106

The performance and long-term stability of low-cost separators in single-chamber bottle-type microbial fuel cells.

PubMed

Kondaveeti, Sanath; Kakarla, Ramesh; Kim, Hong Suck; Kim, Byung-Goon; Min, Booki

2018-02-01

This study evaluates long-term stability of low-cost separators in single-chamber bottle-type microbial fuel cells with domestic wastewater. Low-cost separators tested in this study were nonwoven fabrics (NWF) of polypropylene (PP80, PP100), textile fabrics of polyphenylene sulfide (PPS), sulfonated polyphenylene sulfide (SPPS), and cellulose esters. NWF PP80 separator generated the highest power density of 280 mW/m 2 , which was higher than with ion-exchange membranes (cation exchange membrane; CEM = 271 mW/m 2 , cation exchange membrane; CMI = 196 mW/m 2 , Nafion = 260 mW/m 2 ). MFC operations with other size-selective separators such as SPPS, PPS, and cellulose esters exhibited power densities of 261, 231, and 250 mW/m 2 , respectively. During a 280-day operation, initial power density of PP80 (278 mW/m 2 ) was decreased to 257 mW/m 2 , but this decrease was smaller than with others (Nafion: 265-230 mW/m 2 ; PP100: 220-126 mW/m 2 ). The anode potential of around -430 mV did not change much with all separators in the long-term operation, but the initial cathode potential gradually decreased. Fouling analysis suggested that the presence of carbonaceous substance on Nafion and PP80 after 280 days of operation and Nafion was subject to be more biofouling.

The effect of atrazine on puberty in male wistar rats: an evaluation in the protocol for the assessment of pubertal development and thyroid function.

PubMed

Stoker, T E; Laws, S C; Guidici, D L; Cooper, R L

2000-11-01

Since atrazine (ATR), a chlorotriazine herbicide, has been shown previously to alter the secretion of luteinizing hormone (LH) and prolactin (PRL) through a direct effect on the central nervous system (CNS), we hypothesized that exposure to ATR in the EDSTAC male pubertal protocol (juvenile to peripubertal) would alter the development of the male rat reproductive system. We dosed intact male Wistar rats from postnatal day (PND) 23 to 53 and examined several reproductive endpoints. ATR (0, 12.5, 25, 50, 100, 150, or 200 mg/kg) was administered by gavage and an additional pair-fed group was added to compare the effects of any decreased food consumption in the high dose group. Preputial separation (PPS) was significantly delayed in the 12.5, 50, 100, 150, and 200 mg/kg ATR dose groups. PPS was also delayed in the pair-fed group, although significantly less than in the high dose-ATR group. The males were killed on PND 53 or 54, and pituitary, thyroid, testes, epididymides, seminal vesicles, and ventral and lateral prostates were removed. ATR (50 to 200 mg/kg) treatment resulted in a significant reduction in ventral prostate weights, as did the reduced food consumption of the pair-fed group. Testes weights were unaffected by atrazine treatment. Seminal vesicle and epididymal weights were decreased in the high dose-ATR group and the control pair-fed group. However, the difference in epididymal weights was no longer significantly different when body weight was entered as a covariable. Intratesticular testosterone was significantly decreased in the high dose-ATR group on PND 45, but apparent decreases in serum testosterone were not statistically significantly on PND 53. There was a trend for a decrease in luteinizing hormone (LH) as the dose of ATR increased; however, dose group mean LH was not different from controls. Due to the variability of serum prolactin concentrations on PND 53, no significant difference was identified. Although prolactin is involved in the maintenance of LH receptors prior to puberty, we observed no difference in LH receptor number at PND 45 or 53. Serum estrone and estradiol showed dose-related increases that were significant only in the 200 mg/kg-ATR group. No differences were observed in thyroid stimulating hormone (TSH) and thyroxine (T4) between the ATR groups and the control; however triiodothyronine (T3) was elevated in the high dose-ATR group. No differences in hormone levels were observed in the pair-fed animals. These results indicate that ATR delays puberty in the male rat and its mode of action appears to be altering the secretion of steroids and having subsequent effects on the development of the reproductive tract, which appear to be due to ATR's effects on the CNS. Thus, ATR tested positive in the pubertal male screen that the Endocrine-Disrupter Screening and Testing Advisory Committee (EDSTAC) is considering as an optional screen for endocrine disrupters.

[Longitudinal preputial pedicled flap urethroplasty for chordee of Donnahoo type IV].

PubMed

Zeng, Li; Shan, Wei; Yuan, Miao; Huang, Guizhen; Huang, Lugang

2012-11-01

To investigate the effectiveness of longitudinal preputial pedicled flap urethroplasty for chordee of Donnahoo IV type. Between June 1994 and October 2011, 30 patients with chordee (Donnahoo type IV) underwent longitudinal preputial pedicled flap urethroplasty. The patients' age ranged from 2 to 16 years (mean, 5.8 years). The morphology of the balanus-navicular fossa-external urethral orifice ranged normal; the penis length was 2.5-6.8 cm (mean, 4.3 cm); the penis bending angle was 35-70 degrees (mean, 40.1 degrees). Primary and secondary operation was 27 cases and 3 cases, respectively. The size of flap ranged from 1.5 cm x 1.3 cm to 4.0 cm x 2.0 cm. After correction, the penis length was 3.0-8.5 cm (mean, 6.6 cm); the penis bending angle was 0-10 degrees (mean, 1.2 degrees). All patients were followed up 6 months to 12 years (mean, 33 months). No recurrence, stabbing pain of the balanus, or foreign body sensation occurred during follow-up. Of them, 4 patients (13.33%) had urinary fistular, they had satisfactory results after the second operation; 2 patients (6.67%) had urethral stricture 1 month after operation, they also had satisfactory results after arethral dilatation. The other patients showed no scattering urinary flow and good direction without complication. Six patients had satisfactory sexual function after puberty without erection disorder, pain, or dyspareunia. Longitudinal preputial pedicled flap urethroplasty can achieve maximum utilization of prepuce and aesthetic and functional improvement with less complication, so it is a relatively ideal mean for treating chordee of Donnahoo type IV.

Cost-effectiveness analysis of treatment alternatives for beef bulls with preputial prolapse.

PubMed

Kasari, T R; McGrann, J M; Hooper, R N

1997-10-01

To develop an economic model for comparing cost-effectiveness of medical and surgical treatment versus replacement of beef bulls with preputial prolapse. Economic analysis. Estimates determined from medical records of bulls treated for preputial prolapse at our hospital and from information about treatment of bulls published elsewhere. Annual depreciation cost for treatment (ADC(T)) and replacement (ADC(R)) were calculated. Total investment for an injured bull equaled the sum of salvage value, maintenance cost, and expected cost of the treatment option under consideration. Total investment for a replacement bull was purchase price. Net present value of cost was calculated for each year of bull use. Sensitivity analyses were constructed to determine the value that would warrant treatment of an injured bull. The decision to treat was indicated when ADC(T) was less than ADC(R). In our example, it was more cost-effective for owners to cull an injured bull. The ADC(R) was $97 less than ADC(T) for medical treatment ($365 vs $462) and $280 less than ADC(T) for surgical treatment ($365 vs $645). Likewise, net present value of cost values indicated that it was more cost-effective for owners to cull an injured bull. Sensitivity analysis indicated treatment decisions were justified on the basis of replacement value or planned number of breeding seasons remaining for the bull. The model described here can be used by practitioners to provide an objective basis to guide decision making of owners who seek advice on whether to treat or replace bulls with preputial prolapse.

Preputial skin free graft as dorsal onlay urethroplasty: Our experience of 73 patients.

PubMed

Bapat, Shivadeo S; Padhye, Abhijit S; Yadav, Pushkaraj B; Bhave, Ashish A

2007-10-01

To present the outcome of dorsal onlay urethroplasty in 73 patients for stricture urethra over a period of eight years. Seventy-three patients of stricture urethra have undergone dorsal onlay urethroplasty from July 1998 to February 2006. Age distribution: 14-58 years. Trauma 20/73 (27.39%), Balanitis Xerotica Obliterans 2/73 (2.73%), Iatrogenic 26/73(35.61%), Infection 3/73 (4.10%), Idiopathic 22/73 (30.13%). Site: Penobulbar-25/73, bulbar-38/73, membranous-8/73 and long length-2/73. Suprapubic catheter was inserted preoperatively: 21/73 patients. Preputial / distal penile skin was used in all patients. Buccal mucosa was not used in any patient. Hospitalization was for four to five days. Catheter was removed after 21 days. All patients had their first endoscopic checkup after three months. Subsequently they were followed up by uroflometry. Routine imaging of urethra for follow-up was not carried out. 63/73 (86.30%) patients had satisfactory outcome not requiring any further treatment, 8/73 (10.95%) developed anastomotic stricture (3/8-optical internal urethrotomy, 5/8 dilatation alone). 2/73 (2.75%) developed external meatal stenosis. None had urinary fistula and required repeat urethroplasty. Follow-up ranged from three months to eight years. Dorsal onlay urethroplasty using preputial/distal penile skin is a satisfactory procedure. Preputial/distal penile skin is devoid of hair and fat and hence an ideal graft material. Even in circumscribed patients distal penile skin can be harvested. Long-term follow-up is required in judging results of patients with stricture urethra.

A case-control study of self-reported health, quality-of-life and general functioning among recent immigrants and age- and sex-matched Swedish-born controls.

PubMed

Löfvander, Monica; Rosenblad, Andreas; Wiklund, Tony; Bennström, Halina; Leppert, Jerzy

2014-12-01

To examine whether new immigrants had inferior quality-of-life, well-being and general functioning compared with Swedish age- and sex-matched controls. A prospective case-control study was designed including immigrants from non-European countries, 18-65 years of age, with recent Permanent Permits to Stay (PPS) in Sweden, and age- and sex-matched Swedish-born (SB) persons from the general population in Västmanland County, Sweden. The General Health Questionnaire (GHQ-12), the brief version of the World Health Organization Quality-of-Life (WHOQOL-BREF) Scale and the General Activity Functioning Assessment Scale (GAF) from DSM-IV were posted (SB), or applied in personal interviews (PPS) with interpreters. Differences between the PPS and SB groups were measured using McNemar's test and Wilcoxon signed-rank test conducted separately for observations at baseline, 6- and 12-month follow-up. There were 93 pairs (mean age 36 years). Persons from Somalia (67%) and Iraq (27%) dominated the PPS group. The differences between the groups were statistically significant for all time points for the Psychological health and Social relationship domains of WHOQOL-BREF, and for the baseline and 6-month follow-up time points of GHQ-12 where the PPS-group had a higher degree of well-being, health and quality-of-life than the SB. This tendency applied for both sexes in the immigrant group. These new immigrants did not have inferior physical or psychological health, quality-of-life, well-being or social functioning compared with their age- and sex-matched Swedish born pairs during a 1-year follow-up. Thus, there is reason to advocate immigrants' fast integration into society. © 2014 the Nordic Societies of Public Health.

Pneumococcal vaccination in patients with systemic lupus erythematosus: A multicenter placebo-controlled randomized double-blind study.

PubMed

Grabar, Sophie; Groh, Matthieu; Bahuaud, Mathilde; Le Guern, Véronique; Costedoat-Chalumeau, Nathalie; Mathian, Alexis; Hanslik, Thomas; Guillevin, Loïc; Batteux, Frédéric; Launay, Odile

2017-09-05

Invasive pneumococcal disease and respiratory tract infections are both frequent and severe in patients with systemic lupus erythematosus (SLE). This study aimed to compare the immunological efficacy and safety of pneumococcal vaccination with the 23-valent polysaccharide (PPS) vaccine alone to a sequential immunization with the 7-valent pneumococcal conjugate (PnCj) vaccine followed by PPS in patients with SLE and stable diseaase. Multicenter randomized placebo-controlled double-blind trial: PPS vaccine alone (placebo-PPS group) or PnCj vaccine followed by PPS vaccine (PnCj-PPS group) 24weeks later. The primary endpoint was the rate of responders at week 28 to at least 5 of the 7 serotypes (4, 6B, 9V, 14, 18C, 19F and 23F) shared by both PPS and PnCj. Pneumococcal IgG antibodies' opsonophagocytic activity (OPA) were also assessed. Twenty-five patients in the placebo-PPS group and 17 in the PnCj-PPS group were included in a modified intention-to-treat analysis. The primary endpoint was reached in 72% (18/25) in the placebo-PPS and 76% (13/17) in the PnCj-PPS group (p=0.75). There was no difference in the rates of responders with OPA. At week 52, 13/18 (72%) patients in the placebo-PPS group and 10/13 (77%) patients in the PnCj-PPS group (p=0.77) that met the primary endpoint at week 28 were still responders to ≥5/7 serotypes shared by both PPS and PnCj vaccines. Nine SLE flares were reported in 6 patients (4 in the placebo-PPS and 2 in the PnCj-PPS groups respectively, p=0.70). Sequential administration of PnCj vaccine followed by PPS vaccine is safe and shows short-term immunological efficacy in patients with SLE but was not superior to the PPS vaccine alone. www.clinicaltrials.gov, NCT NCT00611663. Copyright © 2017 Elsevier Ltd. All rights reserved.

Metalloporphyrin-based porous polymers prepared via click chemistry for size-selective adsorption of protein.

PubMed

Zhu, Dailian; Qin, Cunqi; Ao, Shanshi; Su, Qiuping; Sun, Xiying; Jiang, Tengfei; Pei, Kemei; Ni, Huagang; Ye, Peng

2018-08-01

Zinc porphyrin-based porous polymers (PPs-Zn) with different pore sizes were prepared by controlling the reaction condition of click chemistry, and the protein adsorption in PPs-Zn and the catalytic activity of immobilized enzyme were investigated. PPs-Zn-1 with 18 nm and PPS-Zn-2 with 90 nm of pore size were characterized by FTIR, NMR and nitrogen absorption experiments. The amount of adsorbed protein in PPs-Zn-1 was more than that in PPs-Zn-2 for small size proteins, such as lysozyme, lipase and bovine serum albumin (BSA). And for large size proteins including myosin and human fibrinogen (HFg), the amount of adsorbed protein in PPs-Zn-1 was less than that in PPs-Zn-2. The result indicates that the protein adsorption is size-selective in PPs-Zn. Both the protein size and the pore size have a significant effect on the amount of adsorbed protein in the PPs-Zn. Lipase and lysozyme immobilized in PPs-Zn exhibited excellent reuse stability.

Pneumococcal Polysaccharide Abrogates Conjugate-Induced Germinal Center Reaction and Depletes Antibody Secreting Cell Pool, Causing Hyporesponsiveness

PubMed Central

Bjarnarson, Stefania P.; Benonisson, Hreinn; Del Giudice, Giuseppe; Jonsdottir, Ingileif

2013-01-01

Background Plain pneumococcal polysaccharide (PPS) booster administered during second year of life has been shown to cause hyporesponsiveness. We assessed the effects of PPS booster on splenic memory B cell responses and persistence of PPS-specific long-lived plasma cells in the bone marrow (BM). Methods Neonatal mice were primed subcutanously (s.c.) or intranasally (i.n.) with pneumococcal conjugate (Pnc1-TT) and the adjuvant LT-K63, and boosted with PPS+LT-K63 or saline 1, 2 or 3 times with 16 day intervals. Seven days after each booster, spleens were removed, germinal centers (GC), IgM+, IgG+ follicles and PPS-specific antibody secreting cells (AbSC) in spleen and BM enumerated. Results PPS booster s.c., but not i.n., compromised the Pnc1-TT-induced PPS-specific Abs by abrogating the Pnc1-TT-induced GC reaction and depleting PPS-specific AbSCs in spleen and limiting their homing to the BM. There was no difference in the frequency of PPS-specific AbSCs in spleen and BM between mice that received 1, 2 or 3 PPS boosters s.c.. Repeated PPS+LT-K63 booster i.n. reduced the frequency of PPS-specific IgG+ AbSCs in BM. Conclusions PPS booster-induced hyporesponsiveness is caused by abrogation of conjugate-induced GC reaction and depletion of PPS-specific IgG+ AbSCs resulting in no homing of new PPS-specific long-lived plasma cells to the BM or survival. These results should be taken into account in design of vaccination schedules where polysaccharides are being considered. PMID:24069152

Targeted deletion of Atg5 reveals differential roles of autophagy in keratin K5-expressing epithelia

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

Sukseree, Supawadee; Department of Biochemistry, Faculty of Medicine, Srinakharinwirot University, Bangkok; Rossiter, Heidemarie

2013-01-11

Highlights: Black-Right-Pointing-Pointer We generated mice lacking Atg5 and autophagy in keratin K5-positive epithelia. Black-Right-Pointing-Pointer Suppression of autophagy in thymic epithelium was not associated with signs of autoimmunity. Black-Right-Pointing-Pointer Autophagy was required for normal terminal differentiation of preputial gland cells. Black-Right-Pointing-Pointer Autophagy-deficient cells of the preputial glands degraded nuclear DNA prematurely. -- Abstract: Autophagy contributes to the homeostasis of many tissues, yet its role in epithelia is incompletely understood. A recent report proposed that Atg5-dependent autophagy in thymic epithelial cells is essential for their function in the negative selection of self-reactive T-cells and, thus, for the suppression of tissue inflammation. Heremore » we crossed mice carrying floxed alleles of the Atg5 gene with mice expressing the Cre recombinase under the control of the keratin K5 promoter to suppress autophagy in all K5-positive epithelia. The efficiency of autophagy abrogation was confirmed by immunoanalyses of LC3, which was converted to the autophagy-associated LC3-II form in normal but not Atg5-deficient cells, and of p62, which accumulated in Atg5-deficient cells. Mice carrying the epithelium-specific deletion of Atg5 showed normal weight gain, absence of tissue inflammation, and a normal morphology of the thymic epithelium. By contrast, autophagy-deficient epithelial cells of the preputial gland showed aberrant eosinophilic staining in histology and premature degradation of nuclear DNA during terminal differentiation. Taken together, the results of this study suggest that autophagy is dispensable for the suppression of autoimmunity by thymic epithelial cells but essential for normal differentiation of the preputial gland in mice.« less

[PREPUTIAL PEDICLED FLAP PHALLOPLASTY FOR REPAIR OF SEVERE WEBBED PENIS].

PubMed

Huang, Yidong; Zeng, Li; Huang, Guizhen; Kang, Lei; Huang, Lugang

2016-11-08

To evaluate the effectiveness of preputial pedicled flap phalloplasty for repair of severe webbed penis. Between May 2011 and May 2015, 23 boys with severe webbed penis were treated. The age ranged from 2 years and 8 months to 8 years and 3 months (mean, 4 years and 8 months). According to El-Koutby & El Gohary classification, 14 cases were rated as grade 3 simple webbed penis and 9 cases as compound webbed penis (2 cases of type 1, 2 cases of type 2, and 5 cases of type 3). The penis length was 2.1-5.4 cm (mean, 3.4 cm), and the penoscrotal angle was 130-160° (mean, 144°). All the glans could not be exposed. No other urinary system diseases and no history of penile surgery were found in children. All cases underwent one stage preputial pedicled flap phalloplasty. After successful correction, the penis length was 3.6-6.4 cm (mean, 4.7 cm); the penoscrotal angle was 90-110° (mean, 97°). Clear skin boundaries were observed at penile and scrotal parts. No web skin or scrotal skin was left on the penis. Primary healing of incision was obtained, with no necrosis of the flap or infection. All cases were followed up 12 to 41 months (mean, 25 months). No penile curvature, abnormal sensation of glans, or recurrence of the penoscrotal angle occurred, and the patients had normal urination. Preputial pedicled flap phalloplasty can be used as one stage repair for severe webbed penis. The penis is close to natural state and had satisfactory appearance, avoiding the possibility of long-term edema and penile curvature.

Results of a Two-stage Technique for Treatment of Proximal Hypospadias with Severe Curvature: Creation of a Urethral Plate Using a Vascularized Preputial Island Flap.

PubMed

Ozcan, Rahsan; Emre, Senol; Kendigelen, Pinar; Elicevik, Mehmet; Emir, Haluk; Soylet, Yunus; Buyukunal, S N Cenk

2016-04-16

To present the results of a two-stage technique used for the treatment of proximal hypospadias with severe curvature. The medical records of children with proximal hypospadias and severe curvature were retrospectively analyzed. A 2-stage procedure was performed in 30 children. In the first stage, the release of chordee was performed, and a well-vascularized preputial island flap was created. The vascularized island flap was brought anteriorly and sutured over the ventral surface of the glans and degloved penile shaft. The second stage was performed 6-8 months later. A neourethra was reconstructed by the tubularization of the preputial-urethral plate utilizing the principles of Duplay technique. All surgical procedures were performed between 2005 and 2011. The mean age of the patients was 4.4 years (1-17 years). The mean duration of urethral catheterization was 6 days after the first stage and 10 days following the second stage. The flaps were viable in all of the children. There was no residual chordee. Following the second stage (n = 30), complications developed in 11 children (36%), namely, a fistula in 7, a pinpoint fistula in 3, and a diverticulum formation in 1. The cosmetic outcome was satisfactory. Uroflowmetry measurements were evaluated, and only one patient had a diverticulum formation at the late follow-up. Vascularized preputial island flap is an alternative to free grafts for the reconstruction of the urethra. The main advantage of this flap technique is the creation of a thick, healthy and well-vascularized urethral plate. The advantages of this technique include better aesthetic appearance, an acceptable complication rate, and a very low rate of diverticula formation.

Pine polyphenols from Pinus koraiensis prevent injuries induced by gamma radiation in mice

PubMed Central

Li, Hui; Xu, Yier; Sun, Guicai

2016-01-01

Pine polyphenols (PPs) are bioactive dietary constituents that enhance health and help prevent diseases through antioxidants. Antioxidants reduce the level of oxidative damages caused by ionizing radiation (IR). The main purpose of this paper is to study the protective effect of PPs on peripheral blood, liver and spleen injuries in mice induced by IR. ICR (Institute of Cancer Research) male mice were administered orally with PPs (200 mg/kg b.wt.) once daily for 14 consecutive days prior to 7 Gy γ-radiations. PPs showed strong antioxidant activities. PPs significantly increased white blood cells, red blood cells and platelets counts. PPs also significantly reduced lipid peroxidation and increased the activities of superoxide dismutase, catalase and glutathione peroxidases, and the level of glutathione. PPs reduced the spleen morphologic injury. In addition, PPs inhibited mitochondria-dependent apoptosis pathways in splenocytes induced by IR. These results indicate that PPs are radioprotective promising reagents. PMID:27069807

Restless legs syndrome and post polio syndrome: a case-control study.

PubMed

Romigi, A; Pierantozzi, M; Placidi, F; Evangelista, E; Albanese, M; Liguori, C; Nazzaro, M; Risina, B U; Simonelli, V; Izzi, F; Mercuri, N B; Desiato, M T

2015-03-01

The aim was to investigate the prevalence of restless legs syndrome (RLS), fatigue and daytime sleepiness in a large cohort of patients affected by post polio syndrome (PPS) and their impact on patient health-related quality of life (HRQoL) compared with healthy subjects. PPS patients were evaluated by means of the Stanford Sleepiness Scale and the Fatigue Severity Scale (FSS). The Short Form Health Survey (SF-36) questionnaire was utilized to assess HRQoL in PPS. RLS was diagnosed when standard criteria were met. Age and sex matched healthy controls were recruited amongst spouses or friends of PPS subjects. A total of 66 PPS patients and 80 healthy controls were enrolled in the study. A significantly higher prevalence of RLS (P < 0.0005; odds ratio 21.5; 95% confidence interval 8.17-57) was found in PPS patients (PPS/RLS+ 63.6%) than in healthy controls (7.5%). The FSS score was higher in PPS/RLS+ than in PPS/RLS- patients (P = 0.03). A significant decrease of SF-36 scores, including the physical function (P = 0.001), physical role (P = 0.0001) and bodily pain (P = 0.03) domains, was found in PPS/RLS+ versus PPS/RLS- patients. Finally, it was found that PPS/RLS+ showed a significant correlation between International Restless Legs Scale score and FSS (P < 0.0001), as well as between International Restless Legs Scale score and most of the SF-36 items (physical role P = 0.0018, general health P = 0.0009, vitality P = 0.0022, social functioning P = 0.002, role emotional P = 0.0019, and mental health P = 0.0003). Our findings demonstrate a high prevalence of RLS in PPS, and that RLS occurrence may significantly influence the HRQoL and fatigue of PPS patients. A hypothetical link between neuroanatomical and inflammatory mechanisms in RLS and PPS is suggested. © 2014 EAN.

Evidence that Altered Cis Element Spacing Affects PpsR Mediated Redox Control of Photosynthesis Gene Expression in Rubrivivax gelatinosus.

PubMed

Shimizu, Takayuki; Cheng, Zhuo; Matsuura, Katsumi; Masuda, Shinji; Bauer, Carl E

2015-01-01

PpsR is a major regulator of photosynthesis gene expression among all characterized purple photosynthetic bacteria. This transcription regulator has been extensively characterized in Rhodobacter (Rba.) capsulatus and Rba. sphaeroides which are members of the α-proteobacteria lineage. In this study, we have investigated the biochemical properties and mutational effects of a ppsR deletion strain in the β-proteobacterium Rubrivivax (Rvi.) gelatinosus in order to reveal phylogenetically conserved mechanisms and species-specific characteristics. A deletion of the ppsR gene resulted in de-repression of photosystem synthesis showing that PpsR functions as a repressor of photosynthesis genes in this species. We also constructed a Rvi. gelatinosus PpsR mutant in which a conserved cysteine at position 436 was changed to an alanine to examine whether or not this residue is important for sensing redox, as reported in Rhodobacter species. Surprisingly, the Cys436 Ala mutant retained the ability to repress photosynthesis gene expression under aerobic conditions, suggesting that PpsR from Rvi. gelatinosus has different redox-responding characteristics. Furthermore, biochemical analyses demonstrated that Rvi. gelatinosus PpsR only shows redox-dependent binding to promoters with 9-bp spacing, but not 8-bp spacing, between two PpsR-recognition sequences. These results indicate that redox-dependent binding of PpsR requires appropriate cis configuration of PpsR target sequences in Rvi. gelatinosus. These results also indicate that PpsR homologs from different species regulate photosynthesis genes with altered biochemical properties.

Impact of the Penalty Points System on Road Traffic Injuries in Spain: A Time–Series Study

PubMed Central

Novoa, Ana M.; Santamariña-Rubio, Elena; Marí-Dell'Olmo, Marc; Ferrando, Josep; Peiró, Rosana; Tobías, Aurelio; Zori, Pilar; Borrell, Carme

2010-01-01

Objectives. We assessed the effectiveness of the penalty points system (PPS) introduced in Spain in July 2006 in reducing traffic injuries. Methods. We performed an evaluation study with an interrupted time–series design. We stratified dependent variables—numbers of drivers involved in injury collisions and people injured in traffic collisions in Spain from 2000 to 2007 (police data)—by age, injury severity, type of road user, road type, and time of collision, and analyzed variables separately by gender. The explanatory variable (the PPS) compared the postintervention period (July 2006 to December 2007) with the preintervention period (January 2000 to June 2006). We used quasi-Poisson regression, controlling for time trend and seasonality. Results. Among men, we observed a significant risk reduction in the postintervention period for seriously injured drivers (relative risk [RR] = 0.89) and seriously injured people (RR = 0.89). The RRs among women were 0.91 (P = .095) and 0.88 (P < .05), respectively. Risk reduction was greater among male drivers, moped riders, and on urban roads. Conclusions. The PPS was associated with reduced numbers of drivers involved in injury collisions and people injured by traffic collisions in Spain. PMID:20864703

Association between painful physical symptoms and clinical outcomes in East Asian patients with major depressive disorder: a 3-month prospective observational study.

PubMed

Ang, Q Q; Wing, Y K; He, Y; Sulaiman, A H; Chiu, N-Y; Shen, Y-C; Wang, G; Zhang, C; Lee, K-H; Singh, P; Granger, R E; Raskin, J; Dossenbach, M

2009-07-01

Reports from non-Asian populations indicate that painful physical symptoms (PPS) are associated with poorer clinical and functional outcomes in major depressive disorder (MDD). The purpose of this study is to report comparative changes in disease severity, treatment patterns and quality of life observed in East Asian patients with MDD, with and without PPS, as assessed prospectively over a 3-month observation period. This observational study enrolled 909 patients with MDD in psychiatric care settings in China, Hong Kong, Korea, Malaysia, Singapore and Taiwan. Patients were classified as PPS positive (PPS+) or negative (PPS-) based on mean modified Somatic Symptom Inventory scores of >or= 2 or < 2 respectively. The Clinical Global Impression of Severity (CGI-S) and 17-item Hamilton Depression Rating Scale (HAMD(17)) determined depression severity; a visual analogue scale (VAS) determined pain severity; and the EuroQoL (EQ-5D) assessed well-being after 3 months observation. Of the 909 enrollees, 355/471 (75.4%) of PPS+ patients and 363/438 (82.9%) of PPS- patients completed the study (p = 0.006). PPS+ patients improved less than PPS- patients on depression, pain and quality of life measures during the study (HAMD(17) p < 0.001, CGI-S p < 0.001, VAS p = 0.008 and EQ-5D p = 0.004). Fewer PPS+ patients (46.5%) achieved remission compared with PPS- patients (69.4%, p < 0.001). As the presence of PPS is associated with poorer outcomes in East Asian MDD patients, clinical management should aim to address both the mental and PPS associated with MDD.

Folic acid conjugated mPEG-PEI600 as an efficient non-viral vector for targeted nucleic acid delivery.

PubMed

Xu, Zhenhua; Jin, Jiefu; Siu, Leo K S; Yao, Hong; Sze, Johnny; Sun, Hongzhe; Kung, Hsiang-Fu; Poon, Wai Sang; Ng, Samuel S M; Lin, Marie C

2012-04-15

In this study we describe a novel polymer, mPPS-FA, synthesized as a potential gene transfer vector. To complete mPPS-FA, folic acid was conjugated to a backbone (named mPPS) consisting of a copolymer of methyl PEG-2000, PEI-600, and sebacoyl chloride. (1)H NMR, FT-IR, and UV spectroscopy were used to characterize the structure of mPPS-FA. It was revealed that mPPS-FA holds the ability to bind plasmid DNA yielding positively charged particles (polyplexes). Dynamic light scattering (DLS) and TEM techniques were used to study the size and morphology of the formed mPPS-FA/DNA nanocomplexes. The mPPS-FA/DNA nanoparticles exhibited low cytotoxicity as transfection of B16-F0, U87MG, CHO-1, and Ho-8910 cells produced >80% viability indicating low cytotoxicity of the polymer. The ability of mPPS-FA to deliver EGFP plasmid to melanoma B16-F0, U87, CHO-1, Ho-8910, and A549 cells was investigated in vitro as compared to the lipid-based transfection agent Lipofectamine2000 and Linear PEI 22 kDa (L-PEI 22 kDa). We found that mPPS-FA/DNA complexes yielded the highest GFP transfection efficiency in B16-F0, U87, CHO-1, and Ho-8910 cells, which all highly express folate receptors (FR), at an mPPS-FA/DNA ratio (w/w) of 15. Furthermore, the transfection of mPPS-FA/DNA complexes in CHO-1 cells could be competitively blocked by free folic acid molecules. In contrast, in low FR expressing A549 cells, mPPS-FA showed similar low transfection efficiency as mPPS. Taken together, mPPS-FA showed the highest efficiency in vitro and the potential to be developed as a nonviral gene carrier. Copyright © 2012 Elsevier B.V. All rights reserved.

A reliability and validity study of the Palliative Performance Scale

PubMed Central

Ho, Francis; Lau, Francis; Downing, Michael G; Lesperance, Mary

2008-01-01

Background The Palliative Performance Scale (PPS) was first introduced in1996 as a new tool for measurement of performance status in palliative care. PPS has been used in many countries and has been translated into other languages. Methods This study evaluated the reliability and validity of PPS. A web-based, case scenarios study with a test-retest format was used to determine reliability. Fifty-three participants were recruited and randomly divided into two groups, each evaluating 11 cases at two time points. The validity study was based on the content validation of 15 palliative care experts conducted over telephone interviews, with discussion on five themes: PPS as clinical assessment tool, the usefulness of PPS, PPS scores affecting decision making, the problems in using PPS, and the adequacy of PPS instruction. Results The intraclass correlation coefficients for absolute agreement were 0.959 and 0.964 for Group 1, at Time-1 and Time-2; 0.951 and 0.931 for Group 2, at Time-1 and Time-2 respectively. Results showed that the participants were consistent in their scoring over the two times, with a mean Cohen's kappa of 0.67 for Group 1 and 0.71 for Group 2. In the validity study, all experts agreed that PPS is a valuable clinical assessment tool in palliative care. Many of them have already incorporated PPS as part of their practice standard. Conclusion The results of the reliability study demonstrated that PPS is a reliable tool. The validity study found that most experts did not feel a need to further modify PPS and, only two experts requested that some performance status measures be defined more clearly. Areas of PPS use include prognostication, disease monitoring, care planning, hospital resource allocation, clinical teaching and research. PPS is also a good communication tool between palliative care workers. PMID:18680590

Effects of Medicare payment changes on nursing home staffing and deficiencies.

PubMed

Konetzka, R Tamara; Yi, Deokhee; Norton, Edward C; Kilpatrick, Kerry E

2004-06-01

To investigate the effects of Medicare's Prospective Payment System (PPS) for skilled nursing facilities (SNFs) and associated rate changes on quality of care as represented by staffing ratios and regulatory deficiencies. Online Survey, Certification and Reporting (OSCAR) data from 1996-2000 were linked with Area Resource File (ARF) and Medicare Cost Report data to form a panel dataset. A difference-in-differences model was used to assess effects of the PPS and the BBRA (Balanced Budget Refinement Act) on staffing and deficiencies, a design that allows the separation of the effects of the policies from general trends. Ordinary least squares and negative binomial models were used. The OSCAR and Medicare Cost Report data are self-reported by nursing facilities; ARF data are publicly available. Data were linked by provider ID and county. We find that professional staffing decreased and regulatory deficiencies increased with PPS, and that both effects were mitigated with the BBRA rate increases. The effects appear to increase with the percent of Medicare residents in the facility except, in some cases, at the highest percentage of Medicare. The findings on staffing are statistically significant. The effects on deficiencies, though exhibiting consistent signs and magnitudes with the staffing results, are largely insignificant. Medicare's PPS system and associated rate cuts for SNFs have had a negative effect on staffing and regulatory compliance. Further research is necessary to determine whether these changes are associated with worse outcomes. Findings from this investigation could help guide policy modifications that support the provision of quality nursing home care.

Effects of Medicare Payment Changes on Nursing Home Staffing and Deficiencies

PubMed Central

Konetzka, R Tamara; Yi, Deokhee; Norton, Edward C; Kilpatrick, Kerry E

2004-01-01

Objective To investigate the effects of Medicare's Prospective Payment System (PPS) for skilled nursing facilities (SNFs) and associated rate changes on quality of care as represented by staffing ratios and regulatory deficiencies. Data Sources Online Survey, Certification and Reporting (OSCAR) data from 1996–2000 were linked with Area Resource File (ARF) and Medicare Cost Report data to form a panel dataset. Study Design A difference-in-differences model was used to assess effects of the PPS and the BBRA (Balanced Budget Refinement Act) on staffing and deficiencies, a design that allows the separation of the effects of the policies from general trends. Ordinary least squares and negative binomial models were used. Data Collection Methods The OSCAR and Medicare Cost Report data are self-reported by nursing facilities; ARF data are publicly available. Data were linked by provider ID and county. Principal Findings We find that professional staffing decreased and regulatory deficiencies increased with PPS, and that both effects were mitigated with the BBRA rate increases. The effects appear to increase with the percent of Medicare residents in the facility except, in some cases, at the highest percentage of Medicare. The findings on staffing are statistically significant. The effects on deficiencies, though exhibiting consistent signs and magnitudes with the staffing results, are largely insignificant. Conclusions Medicare's PPS system and associated rate cuts for SNFs have had a negative effect on staffing and regulatory compliance. Further research is necessary to determine whether these changes are associated with worse outcomes. Findings from this investigation could help guide policy modifications that support the provision of quality nursing home care. PMID:15149474

Mission Operations Center (MOC) - Precipitation Processing System (PPS) Interface Software System (MPISS)

NASA Technical Reports Server (NTRS)

Ferrara, Jeffrey; Calk, William; Atwell, William; Tsui, Tina

2013-01-01

MPISS is an automatic file transfer system that implements a combination of standard and mission-unique transfer protocols required by the Global Precipitation Measurement Mission (GPM) Precipitation Processing System (PPS) to control the flow of data between the MOC and the PPS. The primary features of MPISS are file transfers (both with and without PPS specific protocols), logging of file transfer and system events to local files and a standard messaging bus, short term storage of data files to facilitate retransmissions, and generation of file transfer accounting reports. The system includes a graphical user interface (GUI) to control the system, allow manual operations, and to display events in real time. The PPS specific protocols are an enhanced version of those that were developed for the Tropical Rainfall Measuring Mission (TRMM). All file transfers between the MOC and the PPS use the SSH File Transfer Protocol (SFTP). For reports and data files generated within the MOC, no additional protocols are used when transferring files to the PPS. For observatory data files, an additional handshaking protocol of data notices and data receipts is used. MPISS generates and sends to the PPS data notices containing data start and stop times along with a checksum for the file for each observatory data file transmitted. MPISS retrieves the PPS generated data receipts that indicate the success or failure of the PPS to ingest the data file and/or notice. MPISS retransmits the appropriate files as indicated in the receipt when required. MPISS also automatically retrieves files from the PPS. The unique feature of this software is the use of both standard and PPS specific protocols in parallel. The advantage of this capability is that it supports users that require the PPS protocol as well as those that do not require it. The system is highly configurable to accommodate the needs of future users.

Rural Hospital Wages and the Area Wage Index

PubMed Central

Dalton, Kathleen; Slifkin, Rebecca T.; Howard, Hilda A.

2002-01-01

We examined data on hospital hourly wages and the prospective payment system (PPS) wage index from 1990 to 1997, to determine if incremental changes to the index have improved its precision and equity as a regional cost adjuster. The differential between average rural and urban PPS hourly wages has declined by almost one-fourth over the 8-year study period. Nearly one-half of the decrease is attributable to regulatory and reporting changes in the annual hospital wage survey. Patterns of within-market wage variation across rural-urban continuum codes identify three separate sub-markets within the State-level aggregates defining rural labor markets. Geographic reclassification decisions appear to eliminate one of the three. Remaining systematic within-market rural wage differences work to the reimbursement advantage of hospitals in the smaller and more isolated communities. PMID:12545604

Initial home health outcomes under prospective payment.

PubMed

Schlenker, Robert E; Powell, Martha C; Goodrich, Glenn K

2005-02-01

To assess initial changes in home health patient outcomes under Medicare's home health Prospective Payment System (PPS), implemented by the Centers for Medicare and Medicaid Services (CMS) in October 2000. Pre-PPS and early PPS data were obtained from CMS Outcome and Assessment Information Set (OASIS) and Medicare claims files. Regression analysis was applied to national random samples (n=164,810) to estimate pre-PPS/PPS outcome and visit-per-episode changes. Outcome episodes were constructed from OASIS data and linked with Medicare claims data on visits. Outcome changes (risk adjusted) were mixed and generally modest. Favorable changes included higher improvement rates under PPS for functioning and dyspnea, higher community discharge rates, and lower hospitalization and emergent care rates. Most stabilization (nonworsening) outcome rates also increased. However, improvement rates were lower under PPS for wounds, incontinence, and cognitive and emotional/behavioral outcomes. Total visits per episode (case-mix adjusted) declined 16.6 percent although therapy visits increased by 8.4 percent. The outcome and visit results suggest improved system efficiency under PPS (fewer visits, similar outcomes). However, declines in several improvement rates merit ongoing monitoring, as do subsequent (posthome health) hospitalization and emergent care use. Since only the early PPS period was examined, longer-term analyses are needed.

Identification of lipid-phosphatidylserine (PS) as the target of unbiasedly selected cancer specific peptide-peptoid hybrid PPS1.

PubMed

Desai, Tanvi J; Toombs, Jason E; Minna, John D; Brekken, Rolf A; Udugamasooriya, Damith Gomika

2016-05-24

Phosphatidylserine (PS) is an anionic phospholipid maintained on the inner-leaflet of the cell membrane and is externalized in malignant cells. We previously launched a careful unbiased selection targeting biomolecules (e.g. protein, lipid or carbohydrate) distinct to cancer cells by exploiting HCC4017 lung cancer and HBEC30KT normal epithelial cells derived from the same patient, identifying HCC4017 specific peptide-peptoid hybrid PPS1. In this current study, we identified PS as the target of PPS1. We validated direct PPS1 binding to PS using ELISA-like assays, lipid dot blot and liposome based binding assays. In addition, PPS1 recognized other negatively charged and cancer specific lipids such as phosphatidic acid, phosphatidylinositol and phosphatidylglycerol. PPS1 did not bind to neutral lipids such as phosphatidylethanolamine found in cancer and phosphatidylcholine and sphingomyelin found in normal cells. Further we found that the dimeric version of PPS1 (PPS1D1) displayed strong cytotoxicity towards lung cancer cell lines that externalize PS, but not normal cells. PPS1D1 showed potent single agent anti-tumor activity and enhanced the efficacy of docetaxel in mice bearing H460 lung cancer xenografts. Since PS and anionic phospholipid externalization is common across many cancer types, PPS1 may be an alternative to overcome limitations of protein targeted agents.

Microbiota-derived butyrate suppresses group 3 innate lymphoid cells in terminal ileal Peyer's patches.

PubMed

Kim, Sae-Hae; Cho, Byeol-Hee; Kiyono, Hiroshi; Jang, Yong-Suk

2017-06-21

The regional specialization of intestinal immune cells is affected by the longitudinal heterogeneity of environmental factors. Although the distribution of group 3 innate lymphoid cells (ILC3s) is well characterized in the lamina propria, it is poorly defined in Peyer's patches (PPs) along the intestine. Given that PP ILC3s are closely associated with mucosal immune regulation, it is important to characterize the regulatory mechanism of ILC3s. Here, we found that terminal ileal PPs of specific pathogen-free (SPF) mice have fewer NKp46 + ILC3s than jejunal PPs, while there was no difference in NKp46 + ILC3 numbers between terminal ileal and jejunal PPs in antibiotics (ABX)-treated mice. We also found that butyrate levels in the terminal ileal PPs of SPF mice were higher than those in the jejunal PPs of SPF mice and terminal ileal PPs of ABX-treated mice. The reduced number of NKp46 + ILC3s in terminal ileal PPs resulted in a decrease in Csf2 expression and, in turn, resulted in reduced regulatory T cells and enhanced antigen-specific T-cell proliferation. Thus, we suggest that NKp46 + ILC3s are negatively regulated by microbiota-derived butyrate in terminal ileal PPs and the reduced ILC3 frequency is closely associated with antigen-specific immune induction in terminal ileal PPs.

A novel technique for repair of mid-penile hypospadias using a preputial skin flap: results of 110 patients.

PubMed

Elmoghazy, Hazem; Hussein, Mohamed M; Mohamed, Elnisr; Badawy, Abdelbasset; Alsagheer, Gamal; Abd Elhamed, Ahmed Mamdouh

2016-12-01

Several techniques have been used to repair mid-penile hypospadias; however, high failure rates and major complications have been reported. In this study, we describe a novel technique using a well-vascularized flap of the inner and outer preputial skin. A total of 110 male children with hypospadias underwent repair by our technique between 2008 and 2015. The inclusion criteria were children with mid-penile or slightly more proximal hypospadias, with or without ventral chordae, and an intact prepuce of the cobra eyes variety. Recurrent cases, patients with other preputial types, and circumcised children were excluded from this study. The prepared flap was sutured in its natural longitudinal orientation to the created urethral plate strip to form a neo-urethra over a urethral catheter. Outcome measures included surgical success without the formation of a urethra-cutaneous fistula, no ischaemia of the flaps, glans dehiscence or infection and functional outcome and cosmetic appearance. The median follow-up duration was 3.3 years. There were 63 cases of mid-penile hypospadias (57.3 %), and in 47 cases (42.7 %), the meatus was slightly more proximal. The age of the patients ranged from 1.1 to 8.0 years, with a mean age of 4.6 ± 1.2 years. Surgery was successful in 106 (96.4 %) cases. Minor complications occurred in 11 patients (10 %) and included oedema of glans in ten patients and bluish discoloration on the ventral aspect of the glans close to the suture line in three patients. All patients improved within 2 weeks after surgery. Long-term follow-up revealed a properly functioning urethra with a forward, projectile, single, compact, and rifled urinary stream of adequate calibre and cosmetically acceptable repair. No cases of meatal retraction, meatal stenosis, urethral stricture, or acquired urethral diverticulum occurred. Our technique is different from the split prepuce in situ technique. We create a narrow strip of the urethral plate that facilitates glanular closure, and we use the inner and adjacent outer skin in a vertical manner to preserve excess skin for penile coverage. Prepuce is split at midline to preserve more preputial skin with favourable dartos tissue for penile skin coverage. The glans is closed using a stitch-by-stitch method that has not been described previously. This study presents a novel technique for mid-penile hypospadias repair using a preputial skin flap with excellent results in terms of short- and long-term outcomes.

Quantitation of blood lymphocytes secreting antibodies to pneumococcal polysaccharides after in vivo antigenic stimulation.

PubMed

Heilmann, C; Pedersen, F K

1986-02-01

An indirect plaque-forming cell assay detecting B cells secreting IgM, IgG and IgA antibodies against pneumococcal polysaccharides (PPS) is described. The numbers of anti-PPS-secreting cells (SC) and Ig-SC in the blood of normal persons immunized with a polyvalent PPS vaccine were quantitated. Anti-PPS-SC were recorded from the fourth to the twelfth post-vaccination day, and the maximum number was found between days 6 and 9. Quantitatively IgA anti-PPS-SC outnumbered the IgM and IgG anti-PPS-SC. Concomitant with the increase in the numbers of antibody-SC an increase in polyclonally activated IgM-, IgG- and IgA-SC was recorded. The specific anti-PPS-antibody-SC constituted 20-80% of the total numbers of Ig-SC from the sixth to the ninth post-vaccination day.

Ureaplasma serotypes associated with the bovine urogenital tract.

PubMed Central

Truscott, R B

1983-01-01

One hundred and thirty-one ureaplasma isolates were tested using the immunoperoxidase system. Thirty-four were from semen, 34 from preputial washes of normal bulls and 63 were from vaginal swabs from herds experiencing infertility problems and/or vulvovaginitis. The serotypes from semen were T44 (12.1%), Bu2 (11.2%), D48 (2.8%), T315 (0.9%) and T288 (0.9%). Those from preputial washes were T44 (9.3%), Bu2 (8.4%), T288 (7.5%), D48 (0.9%) and T95 (0.9%). From vaginal swabs the serotypes were D48 (22.4%), Bu2 (10.3%), T45 (4.7%), T288 (3.8%) and T315 (1.9%). PMID:6365295

Feasibility study of strengthening the public-private partnership for tuberculosis case detection in Bandung City, Indonesia.

PubMed

Lestari, Bony Wiem; Arisanti, Nita; Siregar, Adiatma Y M; Sihaloho, Estro Dariatno; Budiman, Gelar; Hill, Philip C; Alisjahbana, Bachti; McAllister, Susan

2017-08-14

Private practitioner's (PPs) collaboration for detection, diagnosis and treatment of tuberculosis (TB) is recommended by the World Health Organization and encouraged by the Indonesian National TB control programme. TB case management by PPs, however, are mostly not in line with current guidelines. Therefore, we developed an intervention package for PPs comprising of TB training, implementation of a mobile phone application for notification of TB cases and a 6-month regular follow-up with PPs. This study aimed to evaluate the feasibility of the intervention package to increase TB case detection and notification rates among PPs in five community health centre areas in Bandung City, Indonesia. A total of 87 PPs were registered within the study area of whom 17 attended the training and 12 had the mobile phone application successfully installed. The remaining five PPs had phones that did not support the application. During the follow-up period, five PPs registered patients with TB symptoms and cases into the application. A total of 36 patients with TB symptoms were identified and 17 were confirmed TB positive.

Spinal cord lesions shrink peripersonal space around the feet, passive mobilization of paraplegic limbs restores it.

PubMed

Scandola, Michele; Aglioti, Salvatore Maria; Bonente, Claudio; Avesani, Renato; Moro, Valentina

2016-04-06

Peripersonal space (PPS) is the space surrounding us within which we interact with objects. PPS may be modulated by actions (e.g. when using tools) or sense of ownership (e.g. over a rubber hand). Indeed, intense and/or prolonged use of a tool may induce a sense of ownership over it. Conversely, inducing ownership over a rubber hand may activate brain regions involved in motor control. However, the extent to which PPS is modulated by action-dependent or ownership-dependent mechanisms remains unclear. Here, we explored the PPS around the feet and the sense of ownership over lower limbs in people with Paraplegia following Complete spinal cord Lesions (PCL) and in healthy subjects. PCL people can move their upper body but have lost all sensory-motor functions in their lower body (e.g. lower limbs). We tested whether PPS alterations reflect the topographical representations of various body parts. We found that the PPS around the feet was impaired in PCL who however had a normal representation of the PPS around the hands. Significantly, passive mobilization of paraplegic limbs restored the PPS around the feet suggesting that activating action representations in PCL brings about short-term changes of PPS that may thus be more plastic than previously believed.

Spinal cord lesions shrink peripersonal space around the feet, passive mobilization of paraplegic limbs restores it

PubMed Central

Scandola, Michele; Aglioti, Salvatore Maria; Bonente, Claudio; Avesani, Renato; Moro, Valentina

2016-01-01

Peripersonal space (PPS) is the space surrounding us within which we interact with objects. PPS may be modulated by actions (e.g. when using tools) or sense of ownership (e.g. over a rubber hand). Indeed, intense and/or prolonged use of a tool may induce a sense of ownership over it. Conversely, inducing ownership over a rubber hand may activate brain regions involved in motor control. However, the extent to which PPS is modulated by action-dependent or ownership-dependent mechanisms remains unclear. Here, we explored the PPS around the feet and the sense of ownership over lower limbs in people with Paraplegia following Complete spinal cord Lesions (PCL) and in healthy subjects. PCL people can move their upper body but have lost all sensory-motor functions in their lower body (e.g. lower limbs). We tested whether PPS alterations reflect the topographical representations of various body parts. We found that the PPS around the feet was impaired in PCL who however had a normal representation of the PPS around the hands. Significantly, passive mobilization of paraplegic limbs restored the PPS around the feet suggesting that activating action representations in PCL brings about short-term changes of PPS that may thus be more plastic than previously believed. PMID:27049439

Frequency and outcomes of painful physical symptoms in a naturalistic population with major depressive disorder: an analysis of pooled observational studies focusing on subjects aged 65 years and over.

PubMed

Brnabic, A; Raskin, J; Alev, L; Serap Monkul, E; Lowry, A

2012-12-01

To estimate the frequency of painful physical symptoms (PPS) in elderly subjects (≥ 65 years) with major depressive disorder (MDD) in real-world clinical conditions and to establish whether PPS are associated with poor depression outcomes, including more severe depression and worse health-related quality of life (HRQoL). Observational studies of MDD that included assessment of PPS and elderly subjects were screened. Measures of PPS were based on the Somatic Symptom Inventory (SSI) or Visual Analogue Scale (VAS). Data from a variety of depressive symptom severity and HRQoL scales were used. Analysis cohorts were based on age [aged ≥ 65 years (elderly) or < 65 years (younger)] and/or PPS status (presence or absence); five subsets were used to examine specific outcomes in matched elderly subjects. Data from seven studies (representing 26 countries) were collated. Of the 11,477 subjects, 14% were aged ≥ 65 years and 71% were classified as having PPS (PPS+). PPS were more frequent in elderly subjects (74% vs. 70% of younger subjects) and were positively associated with being female and Hispanic, and negatively associated with being East Asian in the elderly. The presence of PPS was associated with more severe clinical symptomatology and comparatively poorer HRQoL in elderly subjects. PPS, although frequent in younger MDD patients, were slightly more frequent in elderly MDD patients and associated with comparatively poorer clinical and functional outcomes. As elderly patients report somatic symptoms more readily than emotional symptoms, physicians should consider depression in addition to physical causes when PPS are present. © 2012 Blackwell Publishing Ltd.

Extending peripersonal space representation without tool-use: evidence from a combined behavioral-computational approach

PubMed Central

Serino, Andrea; Canzoneri, Elisa; Marzolla, Marilena; di Pellegrino, Giuseppe; Magosso, Elisa

2015-01-01

Stimuli from different sensory modalities occurring on or close to the body are integrated in a multisensory representation of the space surrounding the body, i.e., peripersonal space (PPS). PPS dynamically modifies depending on experience, e.g., it extends after using a tool to reach far objects. However, the neural mechanism underlying PPS plasticity after tool use is largely unknown. Here we use a combined computational-behavioral approach to propose and test a possible mechanism accounting for PPS extension. We first present a neural network model simulating audio-tactile representation in the PPS around one hand. Simulation experiments showed that our model reproduced the main property of PPS neurons, i.e., selective multisensory response for stimuli occurring close to the hand. We used the neural network model to simulate the effects of a tool-use training. In terms of sensory inputs, tool use was conceptualized as a concurrent tactile stimulation from the hand, due to holding the tool, and an auditory stimulation from the far space, due to tool-mediated action. Results showed that after exposure to those inputs, PPS neurons responded also to multisensory stimuli far from the hand. The model thus suggests that synchronous pairing of tactile hand stimulation and auditory stimulation from the far space is sufficient to extend PPS, such as after tool-use. Such prediction was confirmed by a behavioral experiment, where we used an audio-tactile interaction paradigm to measure the boundaries of PPS representation. We found that PPS extended after synchronous tactile-hand stimulation and auditory-far stimulation in a group of healthy volunteers. Control experiments both in simulation and behavioral settings showed that the same amount of tactile and auditory inputs administered out of synchrony did not change PPS representation. We conclude by proposing a simple, biological-plausible model to explain plasticity in PPS representation after tool-use, which is supported by computational and behavioral data. PMID:25698947

Extending peripersonal space representation without tool-use: evidence from a combined behavioral-computational approach.

PubMed

Serino, Andrea; Canzoneri, Elisa; Marzolla, Marilena; di Pellegrino, Giuseppe; Magosso, Elisa

2015-01-01

Stimuli from different sensory modalities occurring on or close to the body are integrated in a multisensory representation of the space surrounding the body, i.e., peripersonal space (PPS). PPS dynamically modifies depending on experience, e.g., it extends after using a tool to reach far objects. However, the neural mechanism underlying PPS plasticity after tool use is largely unknown. Here we use a combined computational-behavioral approach to propose and test a possible mechanism accounting for PPS extension. We first present a neural network model simulating audio-tactile representation in the PPS around one hand. Simulation experiments showed that our model reproduced the main property of PPS neurons, i.e., selective multisensory response for stimuli occurring close to the hand. We used the neural network model to simulate the effects of a tool-use training. In terms of sensory inputs, tool use was conceptualized as a concurrent tactile stimulation from the hand, due to holding the tool, and an auditory stimulation from the far space, due to tool-mediated action. Results showed that after exposure to those inputs, PPS neurons responded also to multisensory stimuli far from the hand. The model thus suggests that synchronous pairing of tactile hand stimulation and auditory stimulation from the far space is sufficient to extend PPS, such as after tool-use. Such prediction was confirmed by a behavioral experiment, where we used an audio-tactile interaction paradigm to measure the boundaries of PPS representation. We found that PPS extended after synchronous tactile-hand stimulation and auditory-far stimulation in a group of healthy volunteers. Control experiments both in simulation and behavioral settings showed that the same amount of tactile and auditory inputs administered out of synchrony did not change PPS representation. We conclude by proposing a simple, biological-plausible model to explain plasticity in PPS representation after tool-use, which is supported by computational and behavioral data.

Neural adaptation accounts for the dynamic resizing of peripersonal space: evidence from a psychophysical-computational approach.

PubMed

Noel, Jean-Paul; Blanke, Olaf; Magosso, Elisa; Serino, Andrea

2018-06-01

Interactions between the body and the environment occur within the peripersonal space (PPS), the space immediately surrounding the body. The PPS is encoded by multisensory (audio-tactile, visual-tactile) neurons that possess receptive fields (RFs) anchored on the body and restricted in depth. The extension in depth of PPS neurons' RFs has been documented to change dynamically as a function of the velocity of incoming stimuli, but the underlying neural mechanisms are still unknown. Here, by integrating a psychophysical approach with neural network modeling, we propose a mechanistic explanation behind this inherent dynamic property of PPS. We psychophysically mapped the size of participant's peri-face and peri-trunk space as a function of the velocity of task-irrelevant approaching auditory stimuli. Findings indicated that the peri-trunk space was larger than the peri-face space, and, importantly, as for the neurophysiological delineation of RFs, both of these representations enlarged as the velocity of incoming sound increased. We propose a neural network model to mechanistically interpret these findings: the network includes reciprocal connections between unisensory areas and higher order multisensory neurons, and it implements neural adaptation to persistent stimulation as a mechanism sensitive to stimulus velocity. The network was capable of replicating the behavioral observations of PPS size remapping and relates behavioral proxies of PPS size to neurophysiological measures of multisensory neurons' RF size. We propose that a biologically plausible neural adaptation mechanism embedded within the network encoding for PPS can be responsible for the dynamic alterations in PPS size as a function of the velocity of incoming stimuli. NEW & NOTEWORTHY Interactions between body and environment occur within the peripersonal space (PPS). PPS neurons are highly dynamic, adapting online as a function of body-object interactions. The mechanistic underpinning PPS dynamic properties are unexplained. We demonstrate with a psychophysical approach that PPS enlarges as incoming stimulus velocity increases, efficiently preventing contacts with faster approaching objects. We present a neurocomputational model of multisensory PPS implementing neural adaptation to persistent stimulation to propose a neurophysiological mechanism underlying this effect.

Simultaneous detection of ultraviolet B-induced DNA damage using capillary electrophoresis with laser-induced fluorescence.

PubMed

Guthrie, Jeffrey W; Limmer, Robert T; Brooks, Eric A; Wisnewski, Chelsea C; Loggins-Davis, Nnekia D; Bouzid, Abderraouf

2015-01-01

An immunoassay based on CE-LIF was developed for the simultaneous detection of cyclobutane pyrimidine dimers (CPDs) and pyrimidine 6-4 pyrimidone photoproducts (6-4PPs) in genomic DNA irradiated with UVB or natural sunlight. Human cells were first exposed to varying amounts of UVB or natural sunlight to induce DNA damage. Genomic DNA was extracted and incubated with anti-CPD and anti-6-4PP primary antibodies attached to secondary antibodies with a fluorescent quantum dot (QD) reporter that emitted either red or yellow fluorescence. CE was used to separate the unbound antibodies from those bound to the photoproducts, and LIF with appropriate optical filters was used to separate the fluorescence signals from each QD to individual photomultiplier tubes for simultaneous photoproduct detection. Using this strategy, photoproducts were detected from ∼6 ng (200 ng μL(-1)) of DNA under a low UVB fluence of 65 J m(-2) for CPDs or 195 J m(-2) for 6-4PPs. This assay was also the first to demonstrate the detection of CPDs in human cells after only 15 min of irradiation under natural sunlight. Copyright © 2014 Elsevier B.V. All rights reserved.

Benefits and costs of low thrust propulsion systems

NASA Technical Reports Server (NTRS)

Robertson, R. I.; Rose, L. J.; Maloy, J. E.

1983-01-01

The results of costs/benefits analyses of three chemical propulsion systems that are candidates for transferring high density, low volume STS payloads from LEO to GEO are reported. Separate algorithms were developed for benefits and costs of primary propulsion systems (PPS) as functions of the required thrust levels. The life cycle costs of each system were computed based on the developmental, production, and deployment costs. A weighted criteria rating approach was taken for the benefits, with each benefit assigned a value commensurate to its relative worth to the overall system. Support costs were included in the costs modeling. Reference missions from NASA, commercial, and DoD catalog payloads were examined. The program was concluded reliable and flexible for evaluating benefits and costs of launch and orbit transfer for any catalog mission, with the most beneficial PPS being a dedicated low thrust configuration using the RL-10 system.

Pressure pain sensitivity as a marker for stress and pressure pain sensitivity-guided stress management in women with primary breast cancer.

PubMed

Axelsson, Christen K; Ballegaard, Søren; Karpatschof, Benny; Schousen, Peer

2014-08-01

To validate (1) Pressure Pain Sensitivity (PPS) as a marker for stress and (2) a PPS-guided intervention in women with primary Breast Cancer (BC). (1) A total of 58 women with BC were examined before and after 6 months of intervention. A control group of 165 women office employees was divided in a High Stress Group (HSG, n = 37) and a Low Stress Group (LSG, n = 128) to evaluate the association between PPS, questionnaire-related Quality of Life (QOL) and self-evaluated stress. (2) A PPS-guided stress management program (n = 40) was compared to a Psychosocial Group Intervention (PGI, n = 91) and no treatment (n = 86) with respect to a European Organization for Research and Treatment of Cancer (EORTC) questionnaire measured QOL. (1) Resting PPS and changes in PPS during the intervention period correlated significantly to EORTC and Short Form 36 (SF 36) main scores: (all p < 0.05). Between BC, HSG and LSG there was a significant and positive correlation with respect to PPS, SF 36 main scores, depression, and clinical stress scores (all p < 0.05). However, the BC group scored significantly lower than both HSG and LSG (both p < 0.05) with respect to self-evaluated stress. (2) The PPS-guided intervention group improved EORTC main score, pain and nausea, when compared to the control groups (all p < 0.05). PPS was positively associated with QOL, which was in contrast to self-evaluated stress. PPS-guided intervention improved QOL in women with breast cancer.

Rehabilitation services after the implementation of the nursing home prospective payment system: differences related to patient and nursing home characteristics.

PubMed

Murray, Patrick K; Love, Thomas E; Dawson, Neal V; Thomas, Charles L; Cebul, Randall D

2005-11-01

The prospective payment system (PPS) for nursing homes was designed to curtail the rapid expansion of Medicare costs for skilled nursing care. This study examines the changes that occurred in nursing home patients and rehabilitation services following the PPS. Free-standing Medicare and/or Medicaid certified nursing homes in Ohio. The percent of new admissions receiving therapy and the amount of rehabilitation therapy provided. A total of 7006 first admissions in 1994-6 (pre-PPS) and 61,569 first admissions in 2000-1 (post-PPS). A logistic model predicting likelihood of rehabilitation was developed and validated in pre-PPS admissions and applied to the post-PPS patients. Rehabilitation services were compared in the pre-PPS and post-PPS cohorts overall, stratified by quintile of predicted score, diagnosis group, and by nursing home profit status. Post-PPS patients had less cognitive impairment, more depression, and more family support. The amount of rehabilitation services declined the most in the higher quintiles of predicted likelihood of rehabilitation and among patients with stroke. The percent of patients receiving rehabilitation services increased the most in the lowest quintile and among patients with medical conditions. These changes were greater in for-profit nursing homes. The implementation of the PPS in nursing homes has been associated with a decrease in the amount of rehabilitation services, targeted at those predicted to receive higher amounts and an increased frequency of providing services targeted at those predicted to be less likely to receive them. The outcomes of the changes deserve further study.

Phosphorylation of psyllium seed polysaccharide and its characterization.

PubMed

Rao, Monica R P; Warrier, Deepa U; Gaikwad, Snehal R; Shevate, Prachi M

2016-04-01

Psyllium is widely used as a medicinally active natural polysaccharide for treating conditions like constipation, diarrhea, and irritable bowel syndrome, inflammatory bowel disease, ulcerative colitis and colon cancer. Studies have been performed to characterize and modify the polysaccharide obtained from psyllium seed husk and to evaluate its use as a pharmaceutical excipient, but no studies have been performed to evaluate the properties of the polysaccharide present in psyllium seeds. The present study focuses on phosphorylation of psyllium seed polysaccharide (PPS) using sodium tri-meta phosphate as the cross-linking agent. The modified phosphorylated psyllium seed polysaccharide was then evaluated for physicochemical properties, rheological properties, spectral analysis, thermal analysis, crosslinking density and acute oral toxicity studies. The modified polysaccharide (PhPPS) has a high swelling index due to which it can be categorized as a hydrogel. The percent increase in swelling of PhPPS as compared to PPS was found to be 90.26%. The PPS & PhPPS mucilages of all strengths were found to have shear thinning properties. These findings are suggestive of the potential use of PhPPS as gelling & suspending agent. PhPPS was found to have a mucoadhesive property which was comparable with carbopol. Copyright © 2015 Elsevier B.V. All rights reserved.

Transverse preputial onlay island flap urethroplasty for single-stage correction of proximal hypospadias.

PubMed

Singal, Arbinder Kumar; Dubey, Manish; Jain, Viral

2016-07-01

Transverse preputial onlay island flap urethroplasty (TPOIF) was described initially for distal hypospadias, but has seen extended application for proximal hypospadias. We describe a set of modifications in the technique and results in a large series of proximal hypospadias. All children who underwent TPOIF repair for proximal hypospadias (proximal penile, penoscrotal and scrotal) from June 2006 to June 2013 by a single surgeon were prospectively followed till June, 2014. A standard technique and postoperative protocol were followed. Salient points to be emphasized in the technique: (1) dissection of the dartos pedicle till penopubic junction to prevent penile torsion, (2) incorporation of the spongiosum in the urethroplasty, (3) midline urethral plate incision in glans (hinging the plate), (4) Dartos blanket cover on whole urethroplasty. Out of 136 children with proximal hypospadias, 92 children who underwent TPOIF formed the study group. Out of 92 children, 48 (52 %) children required a tunica albuginea plication for chordee correction. In total, 16 (17 %) patients developed 24 complications and 11 children (12 %) required second surgeries: fistula closure in 7 (with meatoplasty in 5), glansplasty for glans dehiscence in 2 and excision of diverticulum in 2. Two children required a third surgery. Only 5 children had a noticeable penile torsion (less than 30 degree), and 7 had a patulous meatus. Transverse preputial onlay island flap urethroplasty can deliver reliable cosmetic and functional outcomes in proximal hypospadias.

Single-Staged Improved Tubularized Preputial/Penile Skin Flap Urethroplasty for Obliterated Anterior Urethral Stricture: Long-Term Results.

PubMed

Xue, Jing-Dong; Xie, Hong; Fu, Qiang; Feng, Chao; Guo, Hui; Xu, Yue-Min

2016-01-01

To present an improved tubularized flap (ITF) technique and report the outcome of single-stage urethroplasty using preputial/penile skin flaps (PSFs) for the treatment of obliterative anterior urethral strictures (AUSs). From January 2000 to June 2012, 42 cases of obliterative AUS (3-14 cm, mean 6.38 cm) with urethral plate unsalvageable were treated using PSF-ITF urethroplasty including longitudinal skin flap, circular island flap, L-flap, Q-flap. Patients were divided into 3 groups: pendulous urethral stricture (Group A), bulbar urethral stricture (Group B) and panurethral strictures (Group C). Patients were followed up by uroflowmetry, urethrography and ureteroscope when necessary. The mean follow-up in these patients was 65 months (range 36 months-15 years). The primary success rates at 3-year follow-up were 75, 75 and 60% for Groups A, B and C, respectively. The overall success rates were 85, 83 and 70% with the remedial measure of a single visual internal urethrotomy at 3-year follow-up. A total 60% of the patients in the study completed more than 5 years of follow-up with no additional recurrence. Improved tubularized preputial/PSF urethroplasty with relatively high overall satisfaction is a novel technique for treatment of AUS when there is inadequate urethral plate or obliterative defects. © 2016 S. Karger AG, Basel.

Role of parenteral testosterone in hypospadias: A study from a teaching hospital in India

PubMed Central

Ahmad, Reyaz; Chana, Rajendra Singh; Ali, Syed Manazir; Khan, Shehtaj

2011-01-01

Objectives: To evaluate the effect of parenteral testosterone on penile length, preputial skin and side effects in patients with hypospadias. Materials and Methods: 23 patients with hypospadias were included in this study. An oily solution, each ml of which contained testosterone propionate 25 mg, and testosterone enanthate 110 mg, equivalent to 100 mg of testosterone was given deep intramuscularly 4, 3 and 2 weeks before reconstructive surgery at the dose of 2 mg/kg body weight. Increase in penile length, transverse preputial diameter, and diameter at the base of penis were noted. Basal testosterone levels were obtained before the institution of therapy and on the day of operation. In addition, side effect such as development of pubic hair and delay in bone age was noted. Results: Following parenteral testosterone administration, the mean increase in penile length, transverse preputial diameter and diameter at the base of penis was 1.35±0.40 cm (P<0.001), 1.40±0.47 cm (P<0.001), and 0.72±0.47 cm (P<0.001), respectively. Serum testosterone level after injection was well within normal range for that age. Minimal side effects were noted in form of development of fine pubic hair. Conclusion: We conclude that parenteral testosterone can be safely used to improve the surgical outcome of hypospadias repair. PMID:21976926

Balanitis xerotica obliterans in children and its incidence under the age of 5 years.

PubMed

Jayakumar, S; Antao, B; Bevington, O; Furness, P; Ninan, G K

2012-06-01

To analyse the incidence of BXO among paediatric circumcisions for preputial pathology, in particular in children under the age of 5 years. Retrospective review revealed 1769 paediatric circumcisions performed between 1997 and 2008 at our institution. Data were collected on patient's age, date when sample received by pathology department and histological findings for all the foreskin samples received and examined during the study period. Epidemiological data were obtained from the Office for National Statistics, UK. A total of 346 foreskin samples were received and BXO was found in 182 (52.6%). There were 31 children under the age of 5 years circumcised for preputial pathology. BXO was reported in 6 (19.3%) and chronic inflammation in 16 (51.6%) of these patients. The foreskin was reported normal in 2 (6.5%) and the remaining 7 (22.6%) patients had preputial cysts or other pathology. Epidemiological population data analysis revealed the incidence of BXO per year to be 3.01 cases/1000 boys under 15 years of age and 0.322 cases/1000 boys under 5 years. The incidence of BXO in boys noted in our study is higher than previously reported. BXO can result in significant complications and should be considered in children even under 5 years. Copyright © 2011 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Neuropathic pain in post-burn hypertrophic scars: a psychophysical and neurophysiological study.

PubMed

Isoardo, Gianluca; Stella, Maurizio; Cocito, Dario; Risso, Daniela; Migliaretti, Giuseppe; Cauda, Franco; Palmitessa, Angela; Faccani, Giuliano; Ciaramitaro, Palma

2012-06-01

Pain complicates hypertrophic post-burn pathologic scars (PPS) METHODS: To investigate the possible neuropathic origin of pain, 13 patients with painful PPS involving at least 1 hand underwent clinical examination, including the Douleur Neuropathique en 4 questions (DN4) questionnaire; median, ulnar, and radial nerve conduction studies (NCS); cold- (CDT) and heat-induced pain threshold evaluation by quantitative sensory testing; and cutaneous silent period (CSP) testing of the abductor pollicis brevis. Controls included 9 patients with non-painful PPS, 52 healthy subjects, and 28 patients with carpal tunnel syndrome (CTS). All patients with painful PPS had possible neuropathic pain (DN4 score ≥4). NCS signs of CTS were similarly present in PPS subjects with or without pain. Hands with painful PPS had lower CDT and CSP duration, more frequent cold- and heat-pain hypesthesia, and more thermal allodynia than controls. In PPS, possible neuropathic pain is associated with psychophysical and neurophysiological abnormalities suggestive of small-fiber damage. Copyright © 2011 Wiley Periodicals, Inc.

A receiver function investigation of the Lithosphere beneath Southern California using Wavefield Iterative Deconvolution(WID)

NASA Astrophysics Data System (ADS)

Ainiwaer, A.; Gurrola, H.

2017-12-01

In traditional Ps receiver functions (RFs) imaging, PPs and PSs phases from the shallow layers (near surface and crust) can be miss stacked as Ps phases or interfere with deeper Ps phases. To overcome interference between phases, we developed a method to produce phase specific Ps, PPs and PSs receiver functions (wavefield iterative deconvolution or WID). Rather than preforming a separate deconvolution of each seismogram recorded at a station, WID processes all the seismograms from a seismic station in a single run. Each iteration of WID identifies the most prominent phase remaining in the data set, based on the shape of its wavefield (or moveout curve), and then places this phase on the appropriate phase specific RF. As a result, we produce PsRFs that are free of PPs and PSs phase; and reverberations thereof. We also produce phase specific PPsRFs and PSsRFs but moveout curves for these phases and their higher order reverberations are not as distinct from one another. So the PPsRFs and the PSsRFs are not as clean as the PsRFs. These phase specific RFs can be stacked to image 2-D or 3-D Earth structure using common conversion point (CCP) stacking or migration. We applied WID to 524 Southern California seismic stations to construct 3-D PsRF image of lithosphere beneath southern California. These CCP images exhibit a Ps phases from the Moho and the lithosphere asthenosphere boundary (LAB) that are free of interference from the crustal reverberations. The Moho and LAB were found to be deepest beneath the Sierra Nevada, Tansverse Range and Peninsular Range. Shallow Moho and Lab is apparent beneath the Inner Borderland and Salton Trough. The LAB depth that we estimate is in close agreement to recent published results that used Sp imaging (Lekic et al., 2011). We also found complicated structure beneath Mojave Block where mid crustal features are apparent and anomalous Ps phases at 60 km depth are observed beneath Western Mojave dessert.

Development and performance of power processor system for 2-gigahertz, 200-watt amplifier for communications technology satellite

NASA Technical Reports Server (NTRS)

Siegert, C. E.; Gourash, F.; Vasicek, R. W.

1977-01-01

The electrical and environmental requirements for a power processor system (PPS) designed to supply the appropriate voltages and currents to a 200-watt traveling wave tube (TWT) for a communication technology satellite is described. A block diagram of the PPS, the interface requirements between the PPS and spacecraft, the interface requirements between the PPS and 200-watt TWT, and the environmental requirements of the PPS are presented. Also included are discussions of protection circuits, interlocking sequences, and transient requirements. Predictions of the flight performance, based on ground test data, are provided.

Performance of freestanding inpatient rehabilitation hospitals before and after the rehabilitation prospective payment system.

PubMed

Thompson, Jon M; McCue, Michael J

2010-01-01

Inpatient rehabilitation hospitals provide important services to patients to restore physical and cognitive functioning. Historically, these hospitals have been reimbursed by Medicare under a cost-based system; but in 2002, Medicare implemented a rehabilitation prospective payment system (PPS). Despite the implementation of a PPS for rehabilitation, there is limited published research that addresses the operating and financial performance of these hospitals. We examined operating and financial performance in the pre- and post-PPS periods for for-profit and nonprofit freestanding inpatient rehabilitation hospitals to test for pre- and post-PPS differences within the ownership groups. We identified freestanding inpatient rehabilitation hospitals from the Centers for Medicare and Medicaid Services Health Care Cost Report Information System database for the first two fiscal years under PPS. We excluded facilities that had fiscal years less than 270 days, facilities with missing data, and government facilities. We computed average values for performance variables for the facilities in the two consecutive fiscal years post-PPS. For the pre-PPS period, we collected data on these same facilities and, once facilities with missing data and fiscal years less than 270 days were excluded, computed average values for the two consecutive fiscal years pre-PPS. Our final sample of 140 inpatient rehabilitation facilities was composed of 44 nonprofit hospitals and 96 for-profit hospitals both pre- and post-PPS. We utilized a pairwise comparison test (t-test comparison) to measure the significance of differences on each performance variable between pre- and post-PPS periods within each ownership group. Findings show that both nonprofit and for-profit freestanding inpatient rehabilitation hospitals reduced length of stay, increased discharges, and increased profitability. Within the for-profit ownership group, the percentage of Medicare discharges increased and operating expense per adjusted discharge decreased. Findings suggest that managers of these hospitals have adapted their administrative practices to conform with the financial incentives of the rehabilitation PPS. Managers must continue to control costs, increase discharges, and reduce length of stay to remain financially viable under the rehabilitation PPS.

Pentosan polysulfate inhibits atherosclerosis in Watanabe heritable hyperlipidemic rabbits: differential modulation of metalloproteinase-2 and -9.

PubMed

Lupia, Enrico; Zheng, Feng; Grosjean, Fabrizio; Tack, Ivan; Doublier, Sophie; Elliot, Sharon J; Vlassara, Helen; Striker, Gary E

2012-02-01

Pentosan polysulfate (PPS), a heparinoid compound essentially devoid of anticoagulant activity, modulates cell growth and decreases inflammation. We investigated the effect of PPS on the progression of established atherosclerosis in Watanabe heritable hyperlipidemic (WHHL) rabbits. After severe atherosclerosis developed on an atherogenic diet, WHHL rabbits were treated with oral PPS or tap water for 1 month. The aortic intima-to-media ratio and macrophage infiltration were reduced, plaque collagen content was increased, and plaque fibrous caps were preserved by PPS treatment. Plasma lipid levels and post-heparin hepatic lipase activity remained unchanged. However, net collagenolytic activity in aortic extracts was decreased, and the levels of matrix metalloproteinase (MMP)-2 and tissue inhibitor of metalloproteinase (TIMP) activity were increased by PPS. Moreover, PPS treatment decreased tumor necrosis factor α (TNFα)-stimulated proinflammatory responses, in particular activation of nuclear factor-κB and p38, and activation of MMPs in macrophages. In conclusion, oral PPS treatment prevents progression of established atherosclerosis in WHHL rabbits. This effect may be partially mediated by increased MMP-2 and TIMP activities in the aortic wall and reduced TNFα-stimulated inflammation and MMP activation in macrophages. Thus, PPS may be a useful agent in inhibiting the progression of atherosclerosis.

Pentosan polysulfate inhibits atherosclerosis in Watanabe heritable hyperlipidemic rabbits: differential modulation of metalloproteinase-2 and -9

PubMed Central

Lupia, Enrico; Zheng, Feng; Grosjean, Fabrizio; Tack, Ivan; Doublier, Sophie; Elliot, Sharon J; Vlassara, Helen; Striker, Gary E

2013-01-01

Pentosan polysulfate (PPS), a heparinoid compound essentially devoid of anticoagulant activity, modulates cell growth and decreases inflammation. We investigated the effect of PPS on the progression of established atherosclerosis in Watanabe heritable hyperlipidemic (WHHL) rabbits. After severe atherosclerosis developed on an atherogenic diet, WHHL rabbits were treated with oral PPS or tap water for 1 month. The aortic intima-to-media ratio and macrophage infiltration were reduced, plaque collagen content was increased, and plaque fibrous caps were preserved by PPS treatment. Plasma lipid levels and post-heparin hepatic lipase activity remained unchanged. However, net collagenolytic activity in aortic extracts was decreased, and the levels of matrix metalloproteinase (MMP)-2 and tissue inhibitor of metalloproteinase (TIMP) activity were increased by PPS. Moreover, PPS treatment decreased tumor necrosis factor α (TNFα)-stimulated proinflammatory responses, in particular activation of nuclear factor-κB and p38, and activation of MMPs in macrophages. In conclusion, oral PPS treatment prevents progression of established atherosclerosis in WHHL rabbits. This effect may be partially mediated by increased MMP-2 and TIMP activities in the aortic wall and reduced TNFα-stimulated inflammation and MMP activation in macrophages. Thus, PPS may be a useful agent in inhibiting the progression of atherosclerosis. PMID:22042083

PpsA-mediated alternative pathway to complement RNase E essentiality in Escherichia coli.

PubMed

Tamura, Masaru; Honda, Naoko; Fujimoto, Hirofumi; Cohen, Stanley N; Kato, Atsushi

2016-07-01

Escherichia coli cells require RNase E, encoded by the essential gene rne, to propagate. The growth properties on different carbon sources of E. coli cells undergoing suppression of RNase E production suggested that reduction in RNase E is associated with decreased expression of phosphoenolpyruvate synthetase (PpsA), which converts pyruvate to phosphoenolpyruvate during gluconeogenesis. Western blotting and genetic complementation confirmed the role of RNase E in PpsA expression. Adventitious ppsA overexpression from a multicopy plasmid was sufficient to restore colony formation of ∆rne E. coli on minimal media containing glycerol or succinate as the sole carbon source. Complementation of ∆rne by ppsA overproduction was observed during growth on solid media but was only partial, and bacteria showed slowed cell division and grew as filamentous chains. We found that restoration of colony-forming ability by ppsA complementation occurred independent of the presence of endogenous RNase G or second-site suppressors of RNase E essentiality. Our investigations demonstrate the role of phosphoryl transfer catalyzable by PpsA as a determinant of RNase E essentiality in E. coli.

Impact of the new payment system on laparoscopic appendectomy in Korea.

PubMed

Kim, Jong Wan; Shin, Dong Woo; Chae, Jin Ju; Kim, Jeong Yeon; Park, Sung Gil

2015-12-01

Korea has a nationalized health system. The aim of this study was to evaluate the impact of the Korea diagnosis related group-based prospective payment system (K-DRG/PPS) on the use of medical resources and the rate of adverse events during laparoscopic appendectomy. We included patients who underwent laparoscopic appendectomy at Dongtan Sacred Heart Hospital, Korea, between November 2012 and February 2014. The patients were divided into two groups: before-DRG/PPS or after-DRG/PPS groups. The length of the postoperative hospital stay (LOS) and medical costs were indicators of the medical resources. Medical costs included those of the initial hospital stay, outpatient clinic, readmission, and the sum of these charges. Complication and readmission rates were indicators of the rates of adverse events. After the implementation of the DRG/PPS, length of the hospital stay decreased by 10% (4.9 d before versus 4.4 d after DRG/PPS; P < 0.001). The initial hospital stay and total cost were significantly lower in the after-DRG/PPS group (both P < 0.001). The complication rates during the initial hospital stay (3.5% before versus 2.3% after DRG/PPS; P = 0.225) and the readmission rates (4.3% versus 2.5%, respectively; P = 0.227) were statistically similar. This study shows that the K-DRG/PPS for laparoscopic appendectomy had no negative effect on the rate of adverse events and reduced the use of medical resources. Further evaluation of other procedures is required to determine the overall effects of the K-DRG/PPS. Copyright © 2015 Elsevier Inc. All rights reserved.

Identification of the minimum pharmacophore of lipid-phosphatidylserine (PS) binding peptide-peptoid hybrid PPS1D1.

PubMed

Singh, Jaspal; Shukla, Satya Prakash; Desai, Tanvi J; Udugamasooriya, D Gomika

2016-09-15

We previously reported a unique peptide-peptoid hybrid, PPS1 that specifically recognizes lipid-phosphatidylserine (PS) and a few other negatively charged phospholipids, but not neutral phospholipids, on the cell membrane. The dimeric version of PPS1, i.e., PPS1D1 triggers strong cancer cell cytotoxicity and has been validated in lung cancer models both in vitro and in vivo. Given that PS and other negatively charged phospholipids are abundant in almost all tumor microenvironments, PPS1D1 is an attractive drug lead that can be developed into a globally applicable anti-cancer agent. Therefore, it is extremely important to identify the minimum pharmacophore of PPS1D1. In this study, we have synthesized alanine/sarcosine derivatives as well as truncated derivatives of PPS1D1. We performed ELISA-like competitive binding assay to evaluate the PS-recognition potential and standard MTS cell viability assay on HCC4017 lung cancer cells to validate the cell cytotoxicity effects of these derivatives. Our studies indicate that positively charged residues at the second and third positions, as well as four hydrophobic residues at the fifth through eighth positions, are imperative for the binding and activity of PPS1D1. Methionine at the first position was not essential, whereas the positively charged Nlys at the fourth position was minimally needed, as two derivatives that were synthesized replacing this residue were almost as active as PPS1D1. Copyright © 2016 Elsevier Ltd. All rights reserved.

GM1 antibodies in post-polio syndrome and previous paralytic polio.

PubMed

Farbu, E; Rekand, T; Tysnes, O-B; Aarli, J A; Gilhus, N E; Vedeler, C A

2003-06-01

We studied the relationship between post-polio syndrome (PPS) and GM1 antibodies, since such antibodies have been associated with PPS and motor neuron disorders. Sera from 144 patients with previous poliomyelitis (105 paralytic, 22 nonparalytic and 17 PPS), 60 with previous Guillain-Barré syndrome, 44 with amyotrophic lateral sclerosis (ALS) and 22 healthy blood donors were analyzed with ELISA for GM1 IgM, IgG and IgA antibodies. GM1 antibodies were present in 14% of the PPS patients, but the prevalence did not differ significantly from that of the other groups. Our study does not support the hypothesis that GM1 antibodies are involved in the pathogenesis of PPS.

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

Gong, Yan-Xiang, E-mail: yxgong@sina.com

A hydrodynamical simulation shows that a circumbinary planet will migrate inward to the edge of the disk cavity. If multiple planets form in a circumbinary disk, successive migration will lead to planet–planet scattering (PPS). PPS of Kepler -like circumbinary planets is discussed in this paper. The aim of this paper is to answer how PPS affects the formation of these planets. We find that a close binary has a significant influence on the scattering process. If PPS occurs near the unstable boundary of a binary, about 10% of the systems can be completely destroyed after PPS. In more than 90%more » of the systems, there is only one planet left. Unlike the eccentricity distribution produced by PPS in a single star system, the surviving planets generally have low eccentricities if PPS take place near the location of the currently found circumbinary planets. In addition, the ejected planets are generally the innermost of two initial planets. The above results depend on the initial positions of the two planets. If the initial positions of the planets are moved away from the binary, the evolution tends toward statistics similar to those around single stars. In this process, the competition between the planet–planet force and the planet-binary force makes the eccentricity distribution of surviving planets diverse. These new features of P-type PPS will deepen our understanding of the formation of these circumbinary planets.« less

Exploring the role of organizational policies and procedures in promoting research utilization in registered nurses

PubMed Central

Squires, Janet E; Moralejo, Donna; LeFort, Sandra M

2007-01-01

Background Policies and procedures (P&Ps) have been suggested as one possible strategy for moving research evidence into practice among nursing staff in hospitals. Research in the area of P&Ps is limited, however. This paper explores: 1) nurses' use of eight specific research-based practices (RBPs) and RBP overall, 2) nurses' use and understanding of P&Ps, and 3) the role of P&Ps in promoting research utilization. Methods Staff nurses from the eight health regions governing acute care services across the Canadian province of Newfoundland and Labrador completed an anonymous questionnaire regarding their use of eight RBPs and associated P&Ps. Data were also obtained from authorities in six of the eight regions about existing relevant P&Ps. We used descriptive statistics and multivariate regression analysis to assess the relationship between key independent variables and self-reported use of RBP. Results Use of the eight RBPs ranged from 7.8% to 88.6%, depending on the practice. Nurses ranked P&P manuals as their number one source of practice knowledge. Most respondents (84.8%) reported that the main reason they consult the P&P manual is to confirm they are practicing according to agency rules. Multivariate regression analysis identified three significant predictors of being a user versus non-user of RBP overall: awareness, awareness by regular use, and persuasion. Six significant predictors of being a consistent versus less consistent user of RBP overall were also identified: perception of P&P existence, unit, nursing experience, personal experience as a source of practice knowledge, number of existing research-based P&Ps, and lack of time as a barrier to consulting P&P manuals. Conclusion Findings suggest that nurses use P&Ps to guide their practice. However, the mere existence of P&Ps is not sufficient to translate research into nursing practice. Individual and organizational factors related to nurses' understanding and use of P&Ps also play key roles. Thus, moving research evidence into practice will require careful interplay between the organization and the individual. P&Ps may be the interface through which this occurs. PMID:17550597

Gait characteristics of post-poliomyelitis patients: standardization of quantitative data reporting.

PubMed

Portnoy, S; Schwartz, I

2013-10-01

To evaluate the differences in gait characteristics and gait symmetry of post-polio syndrome (PPS) patients ambulating with or without shoes and between subgroups walking with different walking aids and orthoses, study the correlation of these data with personal data, illness condition, physical health, frequency of using aids and orthotics and frequency of falls, and derive recommendations for standardization of reporting these data. Twenty-six PPS subjects ambulated with their own walking devices. We calculated spatio-temporal parameters and symmetry indices (SI) of gait using a data acquired by a motion capture system. We compared inter-subject differences in gait pattern for PPS groups that differed by questionnaire-obtained data of demographics, physical activity, polio history, falls and walking aids. Additional inter-subject comparisons were performed between normal subjects (n=16), PPS patients walking with shoes with/without an ankle-foot-orthosis (n=11), PPS patients walking with knee-ankle-foot-orthosis (n=5), and PPS patients walking with a walker/crutches (n=10). We also compared intra-subject variability in PPS subjects who were able to repeat the trials barefoot. Our main results show that subjects who reported participating in physical activity twice a week or more had significantly better step time and double support symmetry. Subjects who use walking aids on a daily basis had significantly higher gait cadence and shorter stride time. Also, subjects that do not require knee-ankle-foot orthoses and/or walking aids walked with a smaller base width and better symmetry in stance and swing durations than PPS subjects who require these aids. The gait pattern of PPS patients is related to numerous intrinsic and extrinsic factors. Standardization of the reporting protocol of gait-related data of PPS patients is crucial for patient evaluation and treatment design. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Private Practitioners’ Perspectives on Their Involvement With the Tuberculosis Control Programme in a Southern Indian State

PubMed Central

Salve, Solomon; Sheikh, Kabir; Porter, John DH

2016-01-01

Background: Public and private health sectors both play a crucial role in the health systems of low- and middle-income countries (LMICs). The tuberculosis (TB) control strategy in India encourages the public sector to actively partner with private practitioners (PPs) to improve the quality of front line service delivery. However, ensuring effective and sustainable involvement of PPs constitutes a major challenge. This paper reports the findings from an empirical study focusing on the perspectives and experiences of PPs towards their involvement in TB control programme in India. Methods: The study was carried out between November 2010 and December 2011 in a district of a Southern Indian State and utilised qualitative methodologies, combining observations and in-depth interviews with 21 PPs from different medical systems. The collected data was coded and analysed using thematic analysis. Results: PPs perceived themselves to be crucial healthcare providers, with different roles within the public-private mix (PPM) TB policy. Despite this, PPs felt neglected and undervalued in the actual process of implementation of the PPM-TB policy. The entire process was considered to be government driven and their professional skills and knowledge of different medical systems remained unrecognised at the policy level, and weakened their relationship and bond with the policy and with the programme. PPs had contrasting perceptions about the different components of the TB programme that demonstrated the public sector’s dominance in the overall implementation of the DOTS strategy. Although PPs felt responsible for their TB patients, they found it difficult to perceive themselves as ‘partners with the TB programme.’ Conclusion: Public-private partnerships (PPPs) are increasingly utilized as a public health strategy to strengthen health systems. These policies will fail if the concerns of the PPs are neglected. To ensure their long-term involvement in the programme the abilities of PPs and the important perspectives from other Indian medical systems need to be recognised and supported. PMID:27801358

EKPD: a hierarchical database of eukaryotic protein kinases and protein phosphatases.

PubMed

Wang, Yongbo; Liu, Zexian; Cheng, Han; Gao, Tianshun; Pan, Zhicheng; Yang, Qing; Guo, Anyuan; Xue, Yu

2014-01-01

We present here EKPD (http://ekpd.biocuckoo.org), a hierarchical database of eukaryotic protein kinases (PKs) and protein phosphatases (PPs), the key molecules responsible for the reversible phosphorylation of proteins that are involved in almost all aspects of biological processes. As extensive experimental and computational efforts have been carried out to identify PKs and PPs, an integrative resource with detailed classification and annotation information would be of great value for both experimentalists and computational biologists. In this work, we first collected 1855 PKs and 347 PPs from the scientific literature and various public databases. Based on previously established rationales, we classified all of the known PKs and PPs into a hierarchical structure with three levels, i.e. group, family and individual PK/PP. There are 10 groups with 149 families for the PKs and 10 groups with 33 families for the PPs. We constructed 139 and 27 Hidden Markov Model profiles for PK and PP families, respectively. Then we systematically characterized ∼50,000 PKs and >10,000 PPs in eukaryotes. In addition, >500 PKs and >400 PPs were computationally identified by ortholog search. Finally, the online service of the EKPD database was implemented in PHP + MySQL + JavaScript.

Your place or mine: shared sensory experiences elicit a remapping of peripersonal space.

PubMed

Maister, Lara; Cardini, Flavia; Zamariola, Giorgia; Serino, Andrea; Tsakiris, Manos

2015-04-01

Our perceptual systems integrate multisensory information about objects that are close to our bodies, which allow us to respond quickly and appropriately to potential threats, as well as act upon and manipulate useful tools. Intriguingly, the representation of this area close to our body, known as the multisensory 'peripersonal space' (PPS), can expand or contract during social interactions. However, it is not yet known how different social interactions can alter the representation of PPS. In particular, shared sensory experiences, such as those elicited by bodily illusions such as the enfacement illusion, can induce feelings of ownership over the other's body which has also been shown to increase the remapping of the other's sensory experiences onto our own bodies. The current study investigated whether such shared sensory experiences between two people induced by the enfacement illusion could alter the way PPS was represented, and whether this alteration could be best described as an expansion of one's own PPS towards the other or a remapping of the other's PPS onto one's own. An audio-tactile integration task allowed us to measure the extent of the PPS before and after a shared sensory experience with a confederate. Our results showed a clear increase in audio-tactile integration in the space close to the confederate's body after the shared experience. Importantly, this increase did not extend across the space between participant and confederate, as would be expected if the participant's PPS had expanded. Thus, the pattern of results is more consistent with a partial remapping of the confederate's PPS onto the participant's own PPS. These results have important consequences for our understanding of interpersonal space during different kinds of social interactions. Copyright © 2014 Elsevier Ltd. All rights reserved.

Did the introduction of a prospective payment system for nursing home stays reduce the likelihood of pharmacological management of secondary ischaemic stroke?

PubMed

Lapane, Kate L; Hughes, Carmel M

2006-01-01

Since 1998, a prospective payment system (PPS) for Medicare services provided by nursing homes in the US has been in operation. Concerns have been expressed that the PPS may affect the quality of care delivered to residents. This study evaluates the impact of the PPS on pharmacological secondary ischaemic stroke prevention in nursing homes. The nationally mandated Minimum Data Set and Online Survey Certification and Automated Record data system from 1997 and 2000 for four states were used. We conducted a quasi-experimental study comparing the pharmacological treatment rates for secondary stroke prevention in the pre-PPS period (1997) with those in the post-PPS period (2000) in residents who experienced an ischaemic stroke within 6 months (n1997 = 5008; n2000 = 5243) of living in nursing facilities (n1997 = 1226; n2000 = 1092) in Kansas, Maine, Mississippi or Ohio. The sample was stratified according to recommendations for use of warfarin. Logistic regression models adjusting for clustering effects of residents residing in homes using generalised estimating equations provided estimates of the PPS effect on use of antiplatelets and the use of warfarin. The unadjusted proportion of use of pharmacological agents for the secondary prevention of stroke was similar for warfarin in both time periods and increased for antiplatelets in 2000. Relative to the pre-PPS era, the likelihood of use of antiplatelets increased in the post-PPS era (adjusted odds ratio 1.26; 95% CI 1.15, 1.38); there was no effect on the use of warfarin. Although the lack of a PPS effect on pharmacological management of secondary ischaemic stroke is encouraging, there is still room for improvement in overall stroke management.

Physicochemical properties, immunomodulation and antitumor activities of polysaccharide from Pavlova viridis.

PubMed

Sun, Liqin; Chu, Jinling; Sun, Zhongliang; Chen, Lihong

2016-01-01

Polysaccharides synthesized by microalgae can be used as the functional ingredients of food or drugs. Here, we investigated the physicochemical properties and bioactivities of the polysaccharide from microalgae Pavlova viridis, and indicated the structure-activity relationship. The polysaccharides (PPS0) were degraded with H2O2-vitamin C assisted by ultrasonic waves. The functional group content, monosaccharide composition, and average molecular weight (avg-MW) were detected by chemical or chromatographic method. The immunomodulatory activities were evaluated in vitro by detecting nitric oxide (NO) emission, neutral red uptake and macrophage proliferation. Antitumor activities of degraded fragments were detected using S180-tumor-bearing mouse model by intragastric administration. Degraded polysaccharides PPS1 and PPS2 were obtained at avg-MW of 386.96 and 54.99 kDa. The sulfate group content of polysaccharide was 16%, and the uronic acid content was 5.88 and 8.48%. PPS mainly consisted of fructose, glucose and mannose. All the degraded PPSs could increase phagocytosis and proliferation of macrophages, and stimulated NO emission in a dose-dependently way. PPS2 in Low-MW fragments had the strongest immunoenhancing activities. Different doses of PPS all could inhibit the growth of implanted S180 tumor. At dose of 200 mg/kg/day, the tumor inhibition rate of PPS2 was 57.06%, about 23.6% less than that of CTX-treated group. Different-MW PPS significantly increased lymphocyte proliferation. At 200 mg/L, the proliferation index of PPS2 was 1.37, 2.03 times higher than that of CTX-treated group. The polysaccharides of Pavlova viridis had potential antitumor activities by improving immune response. Moreover, the bioactivities depend on their molecular weight. Copyright © 2015 Elsevier Inc. All rights reserved.

An extended model for the repression of photosynthesis genes by the AppA/PpsR system in Rhodobacter sphaeroides.

PubMed

Pandey, Rakesh; Flockerzi, Dietrich; Hauser, Marcus J B; Straube, Ronny

2012-09-01

Purple bacteria derive energy from aerobic respiration or photosynthesis depending on the availability of oxygen and light. Under aerobic conditions, photosynthesis genes are specifically repressed by the PpsR protein. In Rhodobacter sphaeroides, the repressive action of PpsR is antagonized by the blue-light and redox-sensitive flavoprotein AppA, which sequesters PpsR under anaerobic conditions into transcriptionally inactive complexes. However, under semi-aerobic conditions, blue-light excitation of AppA causes the AppA-PpsR complexes to dissociate, again leading to a repression of photosynthesis genes. We have recently developed a simple mathematical model suggesting that this phenotype arises from the formation of a maximum in the response curve of reduced PpsR at intermediate oxygen concentrations. However, this model focused mainly on the oxygen-dependent interactions whereas light regulation was only implemented in a simplified manner. In the present study, we incorporate a more detailed mechanism for the light-dependent interaction between AppA and PpsR, which now allows for a direct comparison with experiments. Specifically, we take into account that, upon blue-light excitation, AppA undergoes a conformational change, creating a long-lived signalling state causing the dissociation of the AppA-PpsR complexes. The predictions of the extended model are found to be in good agreement with experimental results on the light-dependent repression of photosynthesis genes under semi-aerobic conditions. We also identify the potential kinetic and stoichiometric constraints that the interplay between light and redox regulation imposes on the functionality of the AppA/PpsR system, especially with respect to a possible bistable response. © 2012 The Authors Journal compilation © 2012 FEBS.

The impacts of migraine and anxiety disorders on painful physical symptoms among patients with major depressive disorder.

PubMed

Hung, Ching-I; Liu, Chia-Yih; Chen, Ching-Yen; Yang, Ching-Hui; Wang, Shuu-Jiun

2014-11-10

No study has simultaneously investigated the impacts of migraine and anxiety disorders on painful physical symptoms (PPS) among patients with major depressive disorder (MDD). The study aimed to investigate this issue. This open-label study enrolled 155 outpatients with MDD, who were then treated with venlafaxine 75 mg per day for four weeks. Eighty-five participants with good compliance completed the treatment. Migraine was diagnosed according to the International Classification of Headache Disorders. MDD and anxiety disorders were diagnosed using the Structured Clinical Interview for DSM-IV-TR. The visual analog scale (VAS) was used to evaluate the severity of eight PPS. Multiple linear and logistic regressions were used to investigate the impacts of migraine and anxiety disorders on PPS. Compared with patients without migraine, patients with migraine had a greater severity of PPS at baseline and post-treatment. After controlling for demographic variables and depressive severity, migraine independently predicted the intensities of eight PPS at baseline and four PPS post-treatment. Moreover, migraine independently predicted poorer treatment responses of chest pain and full remission of pains in the head, chest, neck and/or shoulder. Anxiety disorders predicted less full remission of pains in the abdomen and limbs. Migraine and anxiety disorders have negative impacts on PPS among patients with MDD. Integrating the treatment of migraine and anxiety disorders into the management of depression might help to improve PPS and the prognosis of MDD.

Maximizing MST's inductive capability with a Bp programmable power supply

NASA Astrophysics Data System (ADS)

Chapman, B. E.; Holly, D. J.; Jacobson, C. M.; McCollam, K. J.; Morin, J. C.; Sarff, J. S.; Squitieri, A.

2016-10-01

A major goal of the MST program is the advancement of inductive control for the development of both the RFP's fusion potential and, synergistically, the predictive capability of fusion science. This entails programmable power supplies (PPS's) for the Bt and Bp circuits. A Bt PPS is already in place, allowing advanced RFP operation and the production of tokamak plasmas, and a Bp PPS prototype is under construction. To explore some of the new capabilities to be provided by the Bp PPS, the existing Bt PPS has been temporarily connected to the Bp circuit. One key result is new-found access to very low Ip (20 kA) and very low Lundquist number, S (104). At this low S, simulation of RFP plasmas with the MHD code NIMROD is readily achievable, and work toward validation of extended MHD models using NIMROD is underway with direct comparisons to these MST plasmas. The full Bp PPS will also provide higher Ip and S than presently possible, allowing MST to produce plasmas with S spanning as much as five orders of magnitude, a dramatic extension of MST's capability. In these initial tests, the PPS has also increased five-fold MST's Ip flattop duration, to about 100 ms. This, coupled with the recently demonstrated PPS ability to drive large-amplitude sinusoidal oscillations in Ip, will allow tests of extended-duration oscillating field current drive, the goal of which is ac sustainment of a quasi-dc plasma current. Work supported by US DOE.

Nanofiltration for concentration of roasted coffee extract: From bench to pilot

NASA Astrophysics Data System (ADS)

Dat, Lai Quoc; Quyen, Nguyen Thi Ngoc

2017-09-01

This paper focused on the application of nanofiltration (NF) for concentration of the roasted coffee extract in instant coffee processing. Three kinds of NF membranes were screened for separation capacity of total dry solid (TDS), polyphenols (PPs) and caffeine in roasted coffee extract and NF99 membrane showed the good performance for the NF of the extract. The crossflow NF with NF99 membrane at pilot scale was investigated for technical assessment of concentration of roasted coffee extract. Maximum theoretical concentration was estimated as 6.06. Recovery yields of TDS, PPs and caffeine were higher than 70% at 4.4 of concentration factor. The content of TDS in accumulative permeate was lower than 2.0 g/L. The fouling of NF was also solved by the suitable cleaning procedure with recovery index being 97.7%. Results of research indicate that it is feasible to apply NF for concentration of the roasted coffee extract in instant coffee production.

Multidimensional fatigue inventory and post-polio syndrome - a Rasch analysis.

PubMed

Dencker, Anna; Sunnerhagen, Katharina S; Taft, Charles; Lundgren-Nilsson, Åsa

2015-02-12

Fatigue is a common symptom in post-polio syndrome (PPS) and can have a substantial impact on patients. There is a need for validated questionnaires to assess fatigue in PPS for use in clinical practice and research. The aim with this study was to assess the validity and reliability of the Swedish version of Multidimensional Fatigue Inventory (MFI-20) in patients with PPS using the Rasch model. A total of 231 patients diagnosed with PPS completed the Swedish MFI-20 questionnaire at post-polio out-patient clinics in Sweden. The mean age of participants was 62 years and 61% were females. Data were tested against assumptions of the Rasch measurement model (i.e. unidimensionality of the scale, good item fit, independency of items and absence of differential item functioning). Reliability was tested with the person separation index (PSI). A transformation of the ordinal total scale scores into an interval scale for use in parametric analysis was performed. Dummy cases with minimum and maximum scoring were used for the transformation table to achieve interval scores between 20 and 100, which are comprehensive limits for the MFI-20 scale. An initial Rasch analysis of the full scale with 20 items showed misfit to the Rasch model (p < 0.001). Seven items showed slightly disordered thresholds and person estimates were not significantly improved by rescoring items. Analysis of MFI-20 scale with the 5 MFI-20 subscales as testlets showed good fit with a non-significant x (2) value (p = 0.089). PSI for the testlet solution was 0.86. Local dependency was present in all subscales and fit to the Rasch model was solved with testlets within each subscale. PSI ranged from 0.52 to 0.82 in the subscales. This study shows that the Swedish MFI-20 total scale and subscale scores yield valid and reliable measures of fatigue in persons with post-polio syndrome. The Rasch transformed total scores can be used for parametric statistical analyses in future clinical studies.

METAS New Time Scale Generation System - A Progress Report

DTIC Science & Technology

2007-01-01

and a TWSTFT station are used for remote T&F comparisons. The GPS TAI link is driven by one of the atomic clocks defined as the REF clock...UTC(CH.P) paper clock TA(CH.P) paper clock TWSTFT link GPS link CH00 WAB1 H-maser 1-PPS H-maser 1-PPS REF 1-PPS 5-MHz from all clocks UTC(CH.R) 1-PPS...lost, the only consequence would be a transient of UTC (CH.P), which can be corrected by a subsequent steering. The GPS and TWSTFT links can be

Incidental and Underreported Pleural Plaques at Chest CT: Do Not Miss Them—Asbestos Exposure Still Exists

PubMed Central

Contorni, Francesco; Gentili, Francesco; Pinto, Antonio; Sisinni, Antonietta Gerardina; Paolucci, Valentina; Romeo, Riccardo; Sartorelli, Pietro

2017-01-01

Pleural plaques (PPs) may be a risk factor for mortality from lung cancer in asbestos-exposed workers and are considered to be a marker of exposure. Diagnosing PPs is also important because asbestos-exposed patients should be offered a health surveillance that is mandatory in many countries. On the other hand PPs are useful for compensation purposes. In this study we aimed to evaluate the prevalence, as incidental findings, and the underreporting rate of PPs in chest CT scans (CTs) performed in a cohort of patients (1512) who underwent chest CT with a slice thickness no more than 1.25 mm. PPs were found in 76 out of 1482 patients (5.1%); in 13 out of 76 (17,1%) CTs were performed because of clinical suspicion of asbestos exposure and 5 of them (38%) were underreported by radiologist. In the remaining 63 cases (82.9%) there was no clinical suspicion of asbestos exposure at the time of CTs (incidental findings) and in 38 of these 63 patients (60.3%) PPs were underreported. Reaching a correct diagnosis of PPs requires a good knowledge of normal locoregional anatomy and rigorous technical approach in chest CT execution. However the job history of the patient should always be kept in mind. PMID:28656146

Fly Caught in Foreskin: An Usual Case of Preputial Myiasis

PubMed Central

Parkinson, Richard J; Robinson, Simon; Lessells, Richard; Lemberger, John

2008-01-01

Cutaneous bot fly infestation is common in travellers to Mexico and Central America. Myiasis affecting the genitalia is rare, however, with few previous reports. We document an unusual case in Nottingham, UK PMID:18492386

Long-term stability of the Leksell Gamma Knife{sup ®} Perfexion™ patient positioning system (PPS)

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

Novotny, J., E-mail: josef.novotnyml@homolka.cz; Department of Medical Physics, Na Homolce Hospital, Prague 150 30; Institute of Biophysics and Informatics, First Faculty of Medicine, Charles University in Prague, Prague 120 00

2014-03-15

Purpose: To assess the long-term mechanical stability and accuracy of the patient positioning system (PPS) of the Leksell Gamma Knife{sup ®} Perfexion™ (LGK PFX). Methods: The mechanical stability of the PPS of the LGK PFX was evaluated using measurements obtained between September 2007 and June 2011. Three methods were employed to measure the deviation of the coincidence of the radiological focus point (RFP) and the PPS calibration center point (CCP). In the first method, the onsite diode test tool with single diode detector was used together with the 4 mm collimator on a daily basis. In the second method, amore » service diode test tool with three diode detectors was used biannually at the time of the routine preventive maintenance. The test performed with the service diode test tool measured the deviations for all three collimators 4, 8, and 16 mm and also for three different positions of the PPS. The third method employed the conventional film pin-prick method. This test was performed annually for the 4 mm collimator at the time of the routine annual QA. To estimate the effect of the patient weight on the performance of the PPS, the focus precision tests were also conducted with varying weights on the PPS using a set of lead bricks. Results: The average deviations measured from the 641 daily focus precision tests were 0.1 ± 0.1, 0.0 ± 0.0, and 0.0 ± 0.0 mm, respectively, for the 4 mm collimator in the X (left/right of the patient), Y (anterior/posterior of the patient), and Z (superior/inferior of the patient) directions. The average of the total radial deviations as measured during ten semiannual measurements with the service diode test tool were 0.070 ± 0.029, 0.060 ± 0.022, and 0.103 ± 0.028 mm, respectively for the central, long, and short diodes for the 4 mm collimator. Similarly, the average total radial deviations measured during the semiannual measurements for the 4, 8, and 16 mm collimators and using the central diode were 0.070 ± 0.029, 0.097 ± 0.025, 0.159 ± 0.028 mm, respectively. The average values of the deviations as obtained from the five annual film pin-prick tests for the 4 mm collimator were 0.10 ± 0.06, 0.06 ± 0.09, and 0.03 ± 0.03 mm for the X, Y, Z stereotactic directions, respectively. Only a minor change was observed in the total radial deviations of the PPS as a function of the simulated patient weight up to 202 kg on the PPS. Conclusions: Excellent long-term mechanical stability and high accuracy was observed for the PPS of the LGK PFX. No PPS recalibration or any adjustment in the PPS was needed during the monitored period of time. Similarly, the weight on the PPS did not cause any significant disturbance in the performance of the PPS for up to 202 kg simulated patient weight.« less

Pleural plaques and their effect on lung function in Libby vermiculite miners.

PubMed

Clark, Kathleen A; Flynn, J Jay; Goodman, Julie E; Zu, Ke; Karmaus, Wilfried J J; Mohr, Lawrence C

2014-09-01

Multiple studies have investigated the relationship between asbestos-related pleural plaques (PPs) and lung function, with disparate and inconsistent results. Most use chest radiographs to identify PPs and simple spirometry to measure lung function. High-resolution CT (HRCT) scanning improves the accuracy of PP identification. Complete pulmonary function tests (PFTs), including spirometry, lung volumes, and diffusing capacity of the lung for carbon monoxide, provide a more definitive assessment of lung function. The goal of this study was to determine, using HRCT scanning and complete PFTs, the effect of PPs on lung function in Libby vermiculite miners. The results of HRCT scanning and complete PFTs performed between January 2000 and August 2012 were obtained from the medical records of 166 Libby vermiculite miners. Multivariate regression analyses with Tukey multivariate adjustment were used to assess statistical associations between the presence of PPs and lung function. Adjustments were made for age, BMI, smoking history, duration of employment, and years since last occupational asbestos exposure. Nearly 90% of miners (n = 149) had evidence of PPs on HRCT scan. No significant differences in spirometry results, lung volumes, or diffusing capacity of the lung for carbon monoxide were found between miners with PPs alone and miners with normal HRCT scans. Miners with both interstitial fibrosis and the presence of PPs had a significantly decreased total lung capacity in comparison with miners with normal HRCT scans (P = .02). Age, cumulative smoking history, and BMI were significant covariates that contributed to abnormal lung function. Asbestos-related PPs alone have no significant effect on lung function in Libby vermiculite miners.

Psychophysiological Approach To Support Of Cosmonauts Performance Reliability

NASA Astrophysics Data System (ADS)

Nechaev, A. P.

Space flight factors may effect negatively on psychophysiological state (PPS) and work capacity of crewmembers, lead to errors in tasks performance. Such errors cannot be entirely prevented during "crew-spacecraft" system designing and/or crewmembers training as they are consequence of a human "psychophysiological troubles". In the present investigation we paid special attention to work and rest schedule (WRS) intensity due to sleep-wake rhythm disturbances and crewmembers overload may cause PPS aggravation. By methods of the correlation analysis of the data collected during 9 "Mir" missions (18 Russian cosmonauts, 226 flight weeks) the significant (p<0.05) interrelations between WRS intensity and cosmonauts PPS as well as between cosmonauts PPS and crewmembers errors (CE) frequency have been established. It allows to consider WRS intensity as "the controlling factor" in relation to crewmember's PPS. Quantitative characteristics of these interrelations have been also determined. This findings have been used for development of algorithm of crewmember's PPS management with the purpose of decrease in CE frequency. The algorithm can be briefly described in the following kind. On the basis of the analysis of crew forthcoming work experts should assess WRS intensity, possible crewmembers PPS alterations, and expected CE frequency. If CE frequency is allowable the management may be limited to recommendations that operative vigilance increase. If CE frequency is higher allowable it is necessary to carry out the measures on crewmembers PPS normalization by means of decrease in WRS intensity. The algorithm is intended for use in the on-ground expert system of psychophysiological support of cosmonauts performance.

78 FR 3031 - Amended Certification Regarding Eligibility To Apply for Worker Adjustment Assistance

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-15

... PRINTING SYSTEMS (PPS), SUPPLY CHAIN OPERATIONS (FORMERLY KNOWN AS IWS), VANCOUVER, WA. In accordance with... Services (IWS) and Supply Chain Operations (formerly known as IWS) units. The workers within PPS (both... Group, Vancouver, Washington (TA-W-81,739A), and H-P, PPS, Supply Chain Operations, Vancouver...

Optimization of Photosensitized Tryptophan Oxidation in the Presence of Dimegin-Polyvinylpyrrolidone-Chitosan Systems.

PubMed

Solovieva, Anna B; Kardumian, Valeria V; Aksenova, Nadezhda A; Belovolova, Lyudmila V; Glushkov, Mikhail V; Bezrukov, Evgeny A; Sukhanov, Roman B; Kotova, Svetlana L; Timashev, Peter S

2018-05-23

By the example of a model process of tryptophan photooxidation in the aqueous medium in the presence of a three-component photosensitizing complex (porphyrin photosensitizer-polyvinylpyrrolidone- chitosan, PPS-PVP-CT) in the temperature range of 20-40 °С, we have demonstrated a possibility of modification of such a process by selecting different molar ratios of the components in the reaction mixture. The actual objective of this selection is the formation of a certain PPS-PVP-CT composition in which PVP macromolecules would coordinate with PPS molecules and at the same time practically block the complex binding of PPS molecules with chitosan macromolecules. Such blocking allows utilization of the bactericidal properties of chitosan to a greater extent, since chitosan is known to depress the PPS photosensitizing activity in PPS-PVP-CT complexes when using those in photodynamic therapy (PDT). The optimal composition of photosensitizing complexes appears to be dependent on the temperature at which the PDT sessions are performed. We have analyzed the correlations of the effective rate constants of tryptophan photooxidation with the photophysical characteristics of the formed complexes.

Road accidents and business cycles in Spain.

PubMed

Rodríguez-López, Jesús; Marrero, Gustavo A; González, Rosa Marina; Leal-Linares, Teresa

2016-11-01

This paper explores the causes behind the downturn in road accidents in Spain across the last decade. Possible causes are grouped into three categories: Institutional factors (a Penalty Point System, PPS, dating from 2006), technological factors (active safety and passive safety of vehicles), and macroeconomic factors (the Great recession starting in 2008, and an increase in fuel prices during the spring of 2008). The PPS has been blessed by incumbent authorities as responsible for the decline of road fatalities in Spain. Using cointegration techniques, the GDP growth rate, the fuel price, the PPS, and technological items embedded in motor vehicles appear to be statistically significantly related with accidents. Importantly, PPS is found to be significant in reducing fatal accidents. However, PPS is not significant for non-fatal accidents. In view of these results, we conclude that road accidents in Spain are very sensitive to the business cycle, and that the PPS influenced the severity (fatality) rather than the quantity of accidents in Spain. Importantly, technological items help explain a sizable fraction in accidents downturn, their effects dating back from the end of the nineties. Copyright © 2016 Elsevier Ltd. All rights reserved.

Anatomy of mole external genitalia: Setting the record straight

PubMed Central

Sinclair, Adriane Watkins; Glickman, Stephen; Baskin, Lawrence; Cunha, Gerald R.

2016-01-01

Anatomy of male and female external genitalia of adult mice (Mus musculus) and broad-footed moles (Scapanus latimanus) was re-examined to provide more meaningful anatomical terminology. In the past the perineal appendage of male broad-footed moles has been called the penis, while the female perineal appendage has been given several terms (e.g. clitoris, penile clitoris, peniform clitoris and others). Histological examination demonstrates that perineal appendages of male and female broad-footed moles are the prepuce, which in both sexes are covered externally with a hair-bearing epidermis and lacks erectile bodies. The inner preputial epithelium is non-hair-bearing and defines the preputial space in both sexes. The penis of broad-footed moles lies deep within the preputial space, is an “internal organ” in the resting state and contains the penile urethra, os penis, and erectile bodies. The clitoris of broad-footed moles is defined by a U-shaped clitoral epithelial lamina. Residing within clitoral stroma encompassed by the clitoral epithelial lamina is the corpus cavernosum, blood-filled spaces and the urethra. External genitalia of male and female mice are anatomically similar to that of broad-footed moles with the exception that in female mice the clitoris contains a small os clitoridis and lacks defined erectile bodies, while male mice have an os penis and a prominent distal cartilaginous structure within the male urogenital mating protuberance (MUMP). Clitori of female broad-footed moles lack an os clitoridis but contain defined erectile bodies, while male moles have an os penis similar to the mouse but lack the distal cartilaginous structure. PMID:26694958

Visualization of GPM Standard Products at the Precipitation Processing System (PPS)

NASA Astrophysics Data System (ADS)

Kelley, O.

2010-12-01

Many of the standard data products for the Global Precipitation Measurement (GPM) constellation of satellites will be generated at and distributed by the Precipitation Processing System (PPS) at NASA Goddard. PPS will provide several means to visualize these data products. These visualization tools will be used internally by PPS analysts to investigate potential anomalies in the data files, and these tools will also be made available to researchers. Currently, a free data viewer called THOR, the Tool for High-resolution Observation Review, can be downloaded and installed on Linux, Windows, and Mac OS X systems. THOR can display swath and grid products, and to a limited degree, the low-level data packets that the satellite itself transmits to the ground system. Observations collected since the 1997 launch of the Tropical Rainfall Measuring Mission (TRMM) satellite can be downloaded from the PPS FTP archive, and in the future, many of the GPM standard products will also be available from this FTP site. To provide easy access to this 80 terabyte and growing archive, PPS currently operates an on-line ordering tool called STORM that provides geographic and time searches, browse-image display, and the ability to order user-specified subsets of standard data files. Prior to the anticipated 2013 launch of the GPM core satellite, PPS will expand its visualization tools by integrating an on-line version of THOR within STORM to provide on-the-fly image creation of any portion of an archived data file at a user-specified degree of magnification. PPS will also provide OpenDAP access to the data archive and OGC WMS image creation of both swath and gridded data products. During the GPM era, PPS will continue to provide realtime globally-gridded 3-hour rainfall estimates to the public in a compact binary format (3B42RT) and in a GIS format (2-byte TIFF images + ESRI WorldFiles).

Comparing the outcomes of two strategies for colorectal tumor detection: policy-promoted screening program versus health promotion service.

PubMed

Wu, Ping-Hsiu; Lin, Yu-Min; Liao, Chao-Sheng; Chang, Hung-Chuen; Chen, Yu-Hung; Yang, Kuo-Ching; Shih, Chia-Hui

2013-06-01

The Taiwanese government has proposed a population-based colorectal tumor detection program for the average-risk population. This study's objectives were to understand the outcomes of these screening policies and to evaluate the effectiveness of the program. We compared two databases compiled in one medical center. The "policy-promoted cancer screening" (PPS) database was built on the basis of the policy of the Taiwan Bureau of National Health Insurance for cancer screening. The "health promotion service" (HPS) database was built to provide health check-ups for self-paid volunteers. Both the PPS and HPS databases employ the immunochemical fecal occult blood test (iFOBT) and colonoscopy for colorectal tumor screening using different strategies. A comparison of outcomes between the PPS and HPS included: (1) quality indicators-compliance rate, cecum reaching rate, and tumor detection rate; and (2) validity indicators-sensitivity, specificity, positive, and negative predictive values for detecting colorectal neoplasms. A total of 10,563 and 1481 individuals were enrolled in PPS and HPS, respectively. Among quality indicators, there was no statistically significant difference in the cecum reaching rate between PPS and HPS. The compliance rates were 56.1% for PPS and 91.8% for HPS (p < 0.001). The advanced adenoma detection rates of PPS and HPS were 1.0% and 3.6%, respectively (p < 0.01). The carcinoma detection rates were 0.3% and 0.4%, respectively (p = 0.59). For validity indicators, PPS provides only a positive predictive value for colorectal tumor detection. HPS provides additional validity indicators, including sensitivity, specificity, positive predictive value, and negative predictive value, for colorectal tumor screening. In comparison with the outcomes of the HPS database, the screening efficacy of the PPS database is even for detecting colorectal carcinoma but is limited in detecting advanced adenoma. HPS may provide comprehensive validity indicators and will be helpful in adjusting current policies for improving screening performance. Copyright © 2013. Published by Elsevier B.V.

Involving private practitioners in the Indian tuberculosis programme: a randomised trial.

PubMed

Yellappa, Vijayashree; Battaglioli, Tullia; Gurum, Sanath Kumar; Narayanan, Devadasan; Van der Stuyft, Patrick

2018-05-01

To assess a multicomponent intervention to improve private practitioners (PPs) involvement in referral of presumptive pulmonary TB (PTB) cases to the Revised National TB Control Programme (RNTCP) for sputum examination. Randomised controlled trial. We randomly allocated all 189 eligible PPs in Tumkur city, South India, to intervention or control arm. The intervention, implemented between December 2014 and January 2016, included two sets of activities, one targeted at health system strengthening (building RNTCP staff capacity to collaborate with PPs, provision of feedback on referrals through SMS) and one targeted at intervention PPs (training in RNTCP, provision of referral pads and education materials and monthly visits to PPs by RNTCP staff). Crude and adjusted referral and PTB case-finding rate ratios were calculated with negative binomial regression. PPs referred 836 individuals (548 from intervention and 169 from control arm PPs) of whom 176 were diagnosed with bacteriologically confirmed PTB. The proportion (95% confidence interval) of referring PPs [0.59 (0.49, 0.68) vs. 0.42 (0.32, 0.52) in the intervention and control arm, respectively], mean referral rate per PP-year [(5.7 (3.8, 8.7) vs. 1.8 (1.2, 2.8)] and smear-positive PTB case-finding rate per PP-year [(1.5 (0.9, 2.2) vs. 0.6 (0.3, 0.9)] were significantly higher in the intervention than the control arm. Stratifying by qualification, a statistically significant difference in the above indicators remained only among GPs and internists. Overall, surgeons, paediatricians and gynaecologists referred few patients. PP referrals contributed to 20% of the sputum smear positive PTB cases detected by RNTCP in Tumkur city (14% were from intervention arm PPs). We demonstrated the effectiveness of a health system-oriented intervention to improve PP's referrals of presumptive PTB cases to RNTCP. © 2018 John Wiley & Sons Ltd.

Development of Regulatory Documents for Creation (Upgrade) of Physical Protection Systems under the Russian/American MPC&A Program

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

Izmaylov, Alexandr V.; Babkin, Vladimir; Kurov, Valeriy

2009-10-07

The development of new or the upgrade of existing physical protection systems (PPS) for nuclear facilities involves a multi-step and multidimensional process. The process consists of conceptual design, design, and commissioning stages. The activities associated with each of these stages are governed by Russian government and agency regulations. To ensure a uniform approach to development or upgrading of PPS at Russian nuclear facilities, the development of a range of regulatory and methodological documents is necessary. Some issues of PPS development are covered by the regulatory documents developed by Rosatom, as well as other Russian agencies with nuclear facilities under theirmore » control. This regulatory development has been accomplished as part of the U.S.-Russian MPC&A cooperation or independently by the Russian Federation. While regulatory coverage is extensive, there are a number of issues such as vulnerability analysis, effectiveness assessment, upgrading PPS, and protection of information systems for PPS that require additional regulations be developed. This paper reports on the status of regulatory coverage for PPS development or upgrade, and outlines a new approach to regulatory document development. It describes the evolutionary process of regulatory development through experience gained in the design, development and implementation of PPS as well as experience gained through the cooperative efforts of Russian and U.S. experts involved the development of MPC&A regulations.« less

Ripple Effects of PPS on Nursing Homes: Swimming or Drowning in the Funding Stream?

ERIC Educational Resources Information Center

Swan, James H.; And Others

1990-01-01

Of 189 nursing homes, 83 percent reported that Medicare's hospital Prospective Payment System (PPS) affected patient needs, 53 percent said it affected patients and services provided, and 25 percent said it affected referrals to hospitals. PPS effects depended on facility factors of size, Medicare certification, tax status, and on local market…

[Musculoskeletal symptoms in patients with post-polio syndrome].

PubMed

Balzien, B; Hofner, B; Harlander-Weikert, E; Frommelt, P; Bork, H; Forst, R; Fujak, A

2014-06-01

The prevalence of the post-polio syndrome (PPS) is in estimated 50 % of persons with established poliomyelitis with a subsequently stable phase of at least 15 years. The basic mechanism is a loss of motoneuron cells in the spinal cord resulting in muscle weakness and fatigue. In addition pain, cold intolerance and a loss of stamina are frequently reported. There are few studies focusing on the orthopaedic symptoms in the PPS. This study should support the health-care professionals to the address the needs of PPS patients. A questionnaire was developed to collect data on patients who have been diagnosed by a neurologist as fulfilling the criteria of a PPS. It consists of two parts. In the first part, general patient data are collected. In the second part, details of health, pain, and activities of daily living are collected at two points in time: the time of the stable phase immediately after the acute phase of the disease and the phase after the PPS diagnosis. The questionnaires were sent to patients with a diagnosis of PPS. A total of 124 questionnaires were analysed (male: 45, female: 79). Parts of the data were used to calculate a score. It was hypothesised that the score would demonstrate a higher load of orthopaedic symptoms in the PPS phase. The results show that the phase after poliomyelitis (stable phase vs. PPS phase) was associated with significantly different sum score relating to the orthopaedic impairments. The score in the stable phase is on average 18.6 units lower than that in the post-PPS diagnosis phase (p < 0.001). The hypothesis that in the PPS phase the load of orthopaedic symptoms is increased is confirmed by our data. The "loss of functioning in the upper extremity" is also significantly associated with the score (p = 0.004). At the time the survey was taken, patients reveal a high level of musculoskeletal impairments and disabilities after PPS than during the stable phase with regard to general health as well as pain status and performance of daily activities. Age has no significant impact. Many of the patients are severely limited, especially with regard to activities such as walking, climbing stairs, and performing simple household tasks. Since there is no causal therapy for the underlying degeneration of the anterior horn cell pools, treatment is focused on the compensation of the functional limitations. Georg Thieme Verlag KG Stuttgart · New York.

Effect of the cross-linking agent on performances of NaCS-CS/WSC microcapsules.

PubMed

Wu, Qing-Xi; Xu, Xin; Wang, Zu-Li; Yao, Shan-Jing; Tong, Wang-Yu; Chen, Yan

2016-11-01

Based on the properties of oppositely charged natural polysaccharides, the polyelectrolyte complexes (PECs) prepared with chitosan-related polycationic polyelectrolytes and cellulose-related polyanionic polyelectrolytes have been widely concerned for their potential applications as micro-drug-carriers for colon. However, the poor mechanical property of the PECs becomes the obstacle encountered in practical applications. This study investigated the effect of the cross-linking agent (sodium polyphosphate, PPS) on the performances of sodium cellulose sulfate -chitosan/water soluble chitosan (NaCS-CS/WSC) microcapsules. The results revealed that PPS could penetrate through the PEC film and form tighter interior structures compared with the microcapsules without the addition of cross-linking agent. The NaCS-CS microcapsules and NaCS-WSC microcapsules with or without PPS had distinct microstructures, which could be ascribed to the different physicochemical properties of CS and WSC. During the formation process, CS can be dissolved in water under acidic conditions, while WSC can be directly dissolved and protonated in acid-free aqueous providing NH3(+) groups quickly, which resulted in the microstructure's difference. Further analysis showed the NaCS-CS-PPS microcapsules and NaCS-WSC-PPS microcapsules had lower swelling ratios due to their tighter interior microstructures that formed. The cross-linking agent had important effect on the total mass of PECs that produced; moreover, the decline of zeta potential of NaCS-CS-PPS microcapsules was lower than that of NaCS-CS microcapsules, similar trend was found in the NaCS-WSC-PPS microcapsules compared with NaCS-WSC microcapsules, indicating the PPS participated in the interactions and played a role in the microcapsules' formation process. Copyright © 2016 Elsevier B.V. All rights reserved.

The impact of DRGs on the cost and quality of health care in the United States.

PubMed

Davis, C; Rhodes, D J

1988-01-01

The prospective Payment System (PPS) represents a fundamental change in the way the United States government reimburses hospitals for medical services covered under Medicare, a federal health care insurance program for the elderly and disabled. PPS replaced the retrospective cost-based system of payment for Medicare services with a prospective payment system. Under PPS, a predetermined specific rate for each discharge dictates payment according to the diagnosis related group (DRG) in which the discharge is classified. The PPS was intended to create financial incentives that encourage hospitals to restrain the use of resources while providing high-quality inpatient care. Both objectives appear to have been met under PPS. Hospital utilization has declined, average length of stay has fallen, and the locus of care has shifted from the inpatient setting to less costly outpatient settings. The growth in inpatient hospital benefits has slowed and the impending insolvency of the Medicare trust fund has been forestalled. Studies have found no deterioration in the quality of care rendered to Medicare beneficiaries. Neither the mortality rate nor the rate of re-admission (presumably related to premature discharge) increased under PPS. Indeed, PPS appears to have enhanced the quality of inpatient care by discouraging unnecessary and potentially harmful procedures, and by encouraging the concentration of complex procedures in facilities in which the high frequency of these procedures promotes efficiency. Incentive-based reimbursement also appears to have contributed to the growth in alternative delivery systems, such as HMOs and PPOs, which contain costs by maintaining a high volume of a limited range of services. The success of the PPS/DRG system in controlling costs and promoting quality in this country suggests its application in other countries, either as a method of reimbursement or as a product line management tool.

Hierarchical regulation of photosynthesis gene expression by the oxygen-responsive PrrBA and AppA-PpsR systems of Rhodobacter sphaeroides.

PubMed

Gomelsky, Larissa; Moskvin, Oleg V; Stenzel, Rachel A; Jones, Denise F; Donohue, Timothy J; Gomelsky, Mark

2008-12-01

In the facultatively phototrophic proteobacterium Rhodobacter sphaeroides, formation of the photosynthetic apparatus is oxygen dependent. When oxygen tension decreases, the response regulator PrrA of the global two-component PrrBA system is believed to directly activate transcription of the puf, puh, and puc operons, encoding structural proteins of the photosynthetic complexes, and to indirectly upregulate the photopigment biosynthesis genes bch and crt. Decreased oxygen also results in inactivation of the photosynthesis-specific repressor PpsR, bringing about derepression of the puc, bch, and crt operons. We uncovered a hierarchical relationship between these two regulatory systems, earlier thought to function independently. We also more accurately assessed the spectrum of gene targets of the PrrBA system. First, expression of the appA gene, encoding the PpsR antirepressor, is PrrA dependent, which establishes one level of hierarchical dominance of the PrrBA system over AppA-PpsR. Second, restoration of the appA transcript to the wild-type level is insufficient for rescuing phototrophic growth impairment of the prrA mutant, whereas inactivation of ppsR is sufficient. This suggests that in addition to controlling appA transcription, PrrA affects the activity of the AppA-PpsR system via an as yet unidentified mechanism(s). Third, PrrA directly activates several bch and crt genes, traditionally considered to be the PpsR targets. Therefore, in R. sphaeroides, the global PrrBA system regulates photosynthesis gene expression (i) by rigorous control over the photosynthesis-specific AppA-PpsR regulatory system and (ii) by extensive direct transcription activation of genes encoding structural proteins of photosynthetic complexes as well as genes encoding photopigment biosynthesis enzymes.

[Comparison of port needle with safety device between Huber Plus (HP) and Poly PERF Safe (PPS)].

PubMed

Shimono, Chigusa; Tanaka, Atsuko; Fujita, Ai; Ishimoto, Miki; Oura, Shoji; Yamaue, Hiroki; Sato, Morio

2010-05-01

An embedded port is frequently used for outpatients with advanced cancer in central venous chemotherapy or hepatic arterial chemoinfusion. The port needle with a safety device in an ambulatory treatment center is indispensable for medical employees and patient plus family to reduce the risk of a needle puncture accident and to prevent iatrogenic infection. The port needle with safety system has been already introduced in our chemotherapy center. There are two types of port needle with safety device; Huber Plus (HP, Medicon Co., Ltd.) and POLY PERF Safe (PPS, Pyolax Device, Co., Ltd.). The comparison of the feasibility between HP and PPS was conducted by both medical employees and patients plus family using an inquiry score method. HP was highly regarded for its stability plus fixation and PPS for its usefulness in puncture and extraction of the needle. PPS was found to be preferable to HP based on the overall evaluation.

On the Measurement of Procrastination: Comparing Two Scales in Six European Countries

PubMed Central

Svartdal, Frode; Pfuhl, Gerit; Nordby, Kent; Foschi, Gioel; Klingsieck, Katrin B.; Rozental, Alexander; Carlbring, Per; Lindblom-Ylänne, Sari; Rębkowska, Kaja

2016-01-01

Procrastination is a common problem, but defining and measuring it has been subject to some debate. This paper summarizes results from students and employees (N = 2893) in Finland, Germany, Italy, Norway, Poland, and Sweden using the Pure Procrastination Scale (PPS) and the Irrational Procrastination Scale (IPS; Steel, 2010), both assumed to measure unidimensional and closely related constructs. Confirmatory factor analyses indicated inadequate configural fit for the suggested one-factor model for PPS; however, acceptable fit was observed for a three-factor model corresponding to the three different scales the PPS is based on. Testing measurement invariance over countries and students–employees revealed configural but not strong or strict invariance, indicating that both instruments are somewhat sensitive to cultural differences. We conclude that the PPS and IPS are valid measures of procrastination, and that the PPS may be particularly useful in assessing cultural differences in unnecessary delay. PMID:27630595

On the Measurement of Procrastination: Comparing Two Scales in Six European Countries.

PubMed

Svartdal, Frode; Pfuhl, Gerit; Nordby, Kent; Foschi, Gioel; Klingsieck, Katrin B; Rozental, Alexander; Carlbring, Per; Lindblom-Ylänne, Sari; Rębkowska, Kaja

2016-01-01

Procrastination is a common problem, but defining and measuring it has been subject to some debate. This paper summarizes results from students and employees (N = 2893) in Finland, Germany, Italy, Norway, Poland, and Sweden using the Pure Procrastination Scale (PPS) and the Irrational Procrastination Scale (IPS; Steel, 2010), both assumed to measure unidimensional and closely related constructs. Confirmatory factor analyses indicated inadequate configural fit for the suggested one-factor model for PPS; however, acceptable fit was observed for a three-factor model corresponding to the three different scales the PPS is based on. Testing measurement invariance over countries and students-employees revealed configural but not strong or strict invariance, indicating that both instruments are somewhat sensitive to cultural differences. We conclude that the PPS and IPS are valid measures of procrastination, and that the PPS may be particularly useful in assessing cultural differences in unnecessary delay.

Quantitative muscle ultrasound and quadriceps strength in patients with post-polio syndrome.

PubMed

Bickerstaffe, Alice; Beelen, Anita; Zwarts, Machiel J; Nollet, Frans; van Dijk, Johannes P

2015-01-01

We investigated whether muscle ultrasound can distinguish muscles affected by post-polio syndrome (PPS) from healthy muscles and whether severity of ultrasound abnormalities is associated with muscle strength. Echo intensity, muscle thickness, and isometric strength of the quadriceps muscles were measured in 48 patients with PPS and 12 healthy controls. Patients with PPS had significantly higher echo intensity and lower muscle thickness than healthy controls. In patients, both echo intensity and muscle thickness were associated independently with muscle strength. A combined measure of echo intensity and muscle thickness was more strongly related to muscle strength than either parameter alone. Quantitative ultrasound distinguishes healthy muscles from those affected by PPS, and measures of muscle quality and quantity are associated with muscle strength. Hence, ultrasound could be a useful tool for assessing disease severity and monitoring changes resulting from disease progression or clinical intervention in patients with PPS. © 2014 Wiley Periodicals, Inc.

Pilot production system cost/benefit analysis: Digital document storage project

NASA Technical Reports Server (NTRS)

1989-01-01

The Digital Document Storage (DDS)/Pilot Production System (PPS) will provide cost effective electronic document storage, retrieval, hard copy reproduction, and remote access for users of NASA Technical Reports. The DDS/PPS will result in major benefits, such as improved document reproduction quality within a shorter time frame than is currently possible. In addition, the DDS/PPS will provide an important strategic value through the construction of a digital document archive. It is highly recommended that NASA proceed with the DDS Prototype System and a rapid prototyping development methodology in order to validate recent working assumptions upon which the success of the DDS/PPS is dependent.

[To the issue of postreperfusion syndrome predictors in orthotopic liver transplantation (OLT)].

PubMed

Kiseleva, E A; Ushakova, I A; Kim, E F; Matveev, G P; Biriulina, N Iu; Vabishchevich, A V

2012-01-01

The aim of the study is revelation of postperfusion syndrome (pPS) predictors in orthotopic liver transplantation (OLT). Was conducted a retrospective analysis of anesthesia maintainance protocols during orthotopic liver transplantation in 261 patients aged from 6 months to 60 years. Investigated the effect of various factors on the development of PPS by the application of methods of non-parametric statistics. Significantly more frequent development of the PPS is noted in the age group from 3 to 18 years (up to 30% of patients). In recipients older than 18 years the frequency of the development of the PPS does not depend on age, with an average of 14%. The development of the PPS does not depend on the recipient sex, the nature of the pathology which served as an indication to the OTP, the initial severity of the state, type of OTP (living related donor or cadaveric transplantation, primary or re-transplantation), the transplant warm ischemia duration, use, or the lack of venous-venous bypass, metabolic status of the patient. The obtained results do not contradict to the data of foreign publications. Among parameters available for screening, predictor of PPS was not detected.

NF-κB pathways are involved in M1 polarization of RAW 264.7 macrophage by polyporus polysaccharide in the tumor microenvironment

PubMed Central

Liu, Chun-Ping; Zhang, Xian; Tan, Qing-Long; Xu, Wen-Xing; Zhou, Chang-Yuan; Luo, Min; Li, Xiong; Zeng, Xing

2017-01-01

Bladder cancer is one of the most malignant tumors closely associated with macrophages. Polyporus polysaccharide (PPS) has shown excellent efficacy in treating bladder cancer with minimal side effects. However, the molecular mechanisms underlying the effects of PPS in inhibiting bladder cancer remain unclear. In this study, we used macrophages cultured alone or with T24 human bladder cancer cell culture supernatant as study models. We found that PPS enhanced the activities of IFN-γ-stimulated RAW 264.7 macrophages, as shown by the release of inducible nitric oxide synthase (INOS), secretion of tumor necrosis factor (TNF)-α and interleukin (IL)-6, phagocytosis activity, as well as expression of M1 phenotype indicators, such as CD40, CD284 and CD86. PPS acted upstream in activation cascade of nuclear factor (NF)-κB signaling pathways by interfering with IκB phosphorylation. In addition, PPS regulated NF-κB (P65) signaling by interfering with Toll-like receptor (TLR)-4, INOS and cyclooxygenase (COX)-2. Our results indicate that PPS activates macrophages through TLR4/NF-κB signaling pathways. PMID:29155869

Use of transcriptomic data for extending a model of the AppA/PpsR system in Rhodobacter sphaeroides.

PubMed

Pandey, Rakesh; Armitage, Judith P; Wadhams, George H

2017-12-28

Photosynthetic (PS) gene expression in Rhodobacter sphaeroides is regulated in response to changes in light and redox conditions mainly by PrrB/A, FnrL and AppA/PpsR systems. The PrrB/A and FnrL systems activate the expression of them under anaerobic conditions while the AppA/PpsR system represses them under aerobic conditions. Recently, two mathematical models have been developed for the AppA/PpsR system and demonstrated how the interaction between AppA and PpsR could lead to a phenotype in which PS genes are repressed under semi-aerobic conditions. These models have also predicted that the transition from aerobic to anaerobic growth mode could occur via a bistable regime. However, they lack experimentally quantifiable inputs and outputs. Here, we extend one of them to include such quantities and combine all relevant micro-array data publically available for a PS gene of this bacterium and use that to parameterise the model. In addition, we hypothesise that the AppA/PpsR system alone might account for the observed trend of PS gene expression under semi-aerobic conditions. Our extended model of the AppA/PpsR system includes the biological input of atmospheric oxygen concentration and an output of photosynthetic gene expression. Following our hypothesis that the AppA/PpsR system alone is sufficient to describe the overall trend of PS gene expression we parameterise the model and suggest that the rate of AppA reduction in vivo should be faster than its oxidation. Also, we show that despite both the reduced and oxidised forms of PpsR binding to the PS gene promoters in vitro, binding of the oxidised form as a repressor alone is sufficient to reproduce the observed PS gene expression pattern. Finally, the combination of model parameters which fit the biological data well are broadly consistent with those which were previously determined to be required for the system to show (i) the repression of PS genes under semi-aerobic conditions, and (ii) bistability. We found that despite at least three pathways being involved in the regulation of photosynthetic genes, the AppA/PpsR system alone is capable of accounting for the observed trends in photosynthetic gene expression seen at different oxygen levels.

Private Practitioners' Perspectives on Their Involvement With the Tuberculosis Control Programme in a Southern Indian State.

PubMed

Salve, Solomon; Sheikh, Kabir; Porter, John Dh

2016-05-08

Public and private health sectors both play a crucial role in the health systems of low- and middle-income countries (LMICs). The tuberculosis (TB) control strategy in India encourages the public sector to actively partner with private practitioners (PPs) to improve the quality of front line service delivery. However, ensuring effective and sustainable involvement of PPs constitutes a major challenge. This paper reports the findings from an empirical study focusing on the perspectives and experiences of PPs towards their involvement in TB control programme in India. The study was carried out between November 2010 and December 2011 in a district of a Southern Indian State and utilised qualitative methodologies, combining observations and in-depth interviews with 21 PPs from different medical systems. The collected data was coded and analysed using thematic analysis. PPs perceived themselves to be crucial healthcare providers, with different roles within the public-private mix (PPM) TB policy. Despite this, PPs felt neglected and undervalued in the actual process of implementation of the PPM-TB policy. The entire process was considered to be government driven and their professional skills and knowledge of different medical systems remained unrecognised at the policy level, and weakened their relationship and bond with the policy and with the programme. PPs had contrasting perceptions about the different components of the TB programme that demonstrated the public sector's dominance in the overall implementation of the DOTS strategy. Although PPs felt responsible for their TB patients, they found it difficult to perceive themselves as 'partners with the TB programme.' Public-private partnerships (PPPs) are increasingly utilized as a public health strategy to strengthen health systems. These policies will fail if the concerns of the PPs are neglected. To ensure their long-term involvement in the programme the abilities of PPs and the important perspectives from other Indian medical systems need to be recognised and supported. © 2016 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

MST's Programmable Power Supplies: Bt Update, Bp Prototype

NASA Astrophysics Data System (ADS)

Holly, D. J.; Chapman, B. E.; McCollam, K. J.; Morin, J. C.; Thomas, M. A.

2013-10-01

MST's toroidal field programmable power supply (Bt PPS) has now been in operation for several years and has provided important new capabilities. One of the primary goals for the Bt PPS is the partial optimization of inductive current profile control, involving control of the poloidal electric field. The Bt PPS has achieved fluctuation reduction over MST's entire range of Ip. At the largest Ip, the Bt PPS achieves fluctuation reduction with a smaller poloidal electric field than the previous passive system, implying that substantially longer periods of current profile control may be possible. The Bt PPS has also been used to produce Ohmic tokamak plasmas in MST. With an applied toroidal field of 0.135 T, and q(a) > 2, the estimated energy confinement time is roughly consistent with neo-Alcator scaling. Driving q(a) < 2 with larger Ip, the confinement time degrades, but the discharge duration does not terminate prematurely. To fully optimize current profile control and to test MST operational limits, a PPS is also needed for the Bp circuit. Currently in prototype stage, the Bp PPS will feature a number of innovations to increase its flexibility and performance. Isolated charging, control, and monitor systems will eliminate charging relays, reduce coupling between modules, and minimize capacitor heating. Seven-level pulse width modulation will reduce output ripple and switching losses. Solid state shorting bars will eliminate shorting relays and minimize wiring. A balanced switching algorithm will minimize capacitive noise generation. Work supported by U. S. D. o. E.

Functional impairment related to painful physical symptoms in patients with generalized anxiety disorder with or without comorbid major depressive disorder: post hoc analysis of a cross-sectional study

PubMed Central

2011-01-01

Background Generalized anxiety disorder (GAD) is the most frequent anxiety disorder in primary care patients. It is known that painful physical symptoms (PPS) are associated with GAD, regardless the presence of comorbid major depressive disorder (MDD). However the specific role of such symptoms in patients' functional impairment is not well understood. The objective of the present study is to assess functional impairment related to the presence of PPS in patients with GAD. Methods This is a post hoc analysis of a cross-sectional study. Functioning, in the presence (overall pain score >30; Visual Analog Scale) or absence of PPS, was assessed using the Sheehan Disability Scale (SDS) in three groups of patients; 1) GAD and comorbid MDD (GAD+MDD+), 2) GAD without comorbid MDD (GAD+MDD-), 3) controls (GAD-MDD-). ANCOVA models were used. Results Of those patients with GAD+MDD+ (n = 559), 436 (78.0%) had PPS, compared with GAD+MDD- (249 of 422, 59%) and controls (95 of 336, 28.3%). Functioning worsened in both GAD groups in presence of PPS (SDS least squares mean total score: 16.1 vs. 9.8, p < 0.0001, GAD+MDD+; 14.3 vs. 8.2, p < 0.0001, GAD+MDD-). The presence of PPS was significantly associated with less productivity. Conclusions Functional impairment related to the presence of PPS was relevant. Clinical implications should be considered. PMID:21510887

Interoceptive influences on peripersonal space boundary.

PubMed

Ardizzi, Martina; Ferri, Francesca

2018-08-01

Integration of body-related signals within the peripersonal space (PPS) contributes to bodily self-awareness. Whereas several studies have shown how individual PPS extension is shaped by external factors, e.g. during interactions with people and objects, no studies have looked at interoceptive influences on PPS extension. We exposed participants to an audio-tactile interaction task, to measure their PPS boundary (Session 1), and to a heartbeat counting task and a time estimation task, to specifically assess their interoceptive accuracy (Session 2). Participants' traits of private self-consciousness and social anxiety were also evaluated, to account for their possible effect on the relation between interoception and PPS representation. We found that higher interoceptive accuracy specifically predicts narrower PPS boundary. Moreover, this relation is moderated by individual traits of private self-consciousness, but not social anxiety. Extending the concept of interoceptive influences on exteroceptive body representations to PPS, our results, first, support the idea that a dynamic balance between intero-exteroceptive processing might represent a general principle underlying bodily self-awareness; second, they shed light on how interoception may affect also the way we interface with the external world. Finally, showing that, in order for interoceptive accuracy to be effective on the intero-exteroceptive balance, it is important that individuals tend to focus on inner sensations and feelings, our results suggest that a comprehensive intero-exteroceptive model of bodily self-awareness should be (at least) a three-dimensional model that includes individual self-consciousness traits. Copyright © 2018 Elsevier B.V. All rights reserved.

A new method to precisely control the depth of percutaneous screws into the pedicle by counting the rotation number of the screw with low radiation exposure: technical note.

PubMed

Li, Xu; Zhang, Feng; Zhang, Wenzhi; Shang, Xifu; Han, Jintao; Liu, Pengfei

2017-03-01

Technique note. To report a new method for precisely controlling the depth of percutaneous pedicle screws (PPS)-without radiation exposure to surgeons and less fluoroscopy exposure to patients than with conventional methods. PPS is widely used in minimal invasive spine surgery; the advantages include reduced muscle damage, pain, and hospital stays. However, placement of PPS demands repeated checking with fluoroscopy. Thus, radiation exposure is considerable for both surgeons and patients. The PPS depth was determined by counting rotations of the screws. The distance between screw threads can be measured for particular screws; thus, full rotations of the PPS results in the screw advancing in the pedicle the distance between screw threads. To fully insert screws into the pedicle, the number of full rotations is equal to the number of threads in the PPS. We applied this technique in 58 patients with thoracolumbar fracture. The position and depth of the screws was checked during the operation with the C-arm and after operation by anteroposterior X-ray film or computed tomography. No additional procedures were required to correct the screws; we observed no neurological deficits or malpositioning of the screws. In the screw placement procedure, the radiation exposure for surgeons is zero, and the patient is well protected from extensive radiation exposure. This method of counting rotation of screws is a safe way to precisely determine the depth of PPS in the placement procedure. IV.

Forecasting E > 50-MeV proton events with the proton prediction system (PPS)

NASA Astrophysics Data System (ADS)

Kahler, Stephen W.; White, Stephen M.; Ling, Alan G.

2017-11-01

Forecasting solar energetic (E > 10-MeV) particle (SEP) events is an important element of space weather. While several models have been developed for use in forecasting such events, satellite operations are particularly vulnerable to higher-energy (≥50-MeV) SEP events. Here we validate one model, the proton prediction system (PPS), which extends to that energy range. We first develop a data base of E ≥ 50-MeV proton events >1.0 proton flux units (pfu) events observed on the GOES satellite over the period 1986-2016. We modify the PPS to forecast proton events at the reduced level of 1 pfu and run PPS for four different solar input parameters: (1) all ≥M5 solar X-ray flares; (2) all ≥200 sfu 8800-MHz bursts with associated ≥M5 flares; (3) all ≥500 sfu 8800-MHz bursts; and (4) all ≥5000 sfu 8800-MHz bursts. The validation contingency tables and skill scores are calculated for all groups and used as a guide to use of the PPS. We plot the false alarms and missed events as functions of solar source longitude, and argue that the longitude-dependence employed by PPS does not match modern observations. Use of the radio fluxes as the PPS driver tends to result in too many false alarms at the 500 sfu threshold, and misses more events than the soft X-ray predictor at the 5000 sfu threshold.

Multi-PAS domain-mediated protein oligomerization of PpsR from Rhodobacter sphaeroides

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

Heintz, Udo; Meinhart, Anton; Winkler, Andreas, E-mail: andreas.winkler@mpimf-heidelberg.mpg.de

2014-03-01

Crystal structures of two truncated variants of the transcription factor PpsR from R. sphaeroides are presented that enabled the phasing of a triple PAS domain construct. Together, these structures reveal the importance of α-helical PAS extensions for multi-PAS domain-mediated protein oligomerization and function. Per–ARNT–Sim (PAS) domains are essential modules of many multi-domain signalling proteins that mediate protein interaction and/or sense environmental stimuli. Frequently, multiple PAS domains are present within single polypeptide chains, where their interplay is required for protein function. Although many isolated PAS domain structures have been reported over the last decades, only a few structures of multi-PAS proteinsmore » are known. Therefore, the molecular mechanism of multi-PAS domain-mediated protein oligomerization and function is poorly understood. The transcription factor PpsR from Rhodobacter sphaeroides is such a multi-PAS domain protein that, in addition to its three PAS domains, contains a glutamine-rich linker and a C-terminal helix–turn–helix DNA-binding motif. Here, crystal structures of two N-terminally and C-terminally truncated PpsR variants that comprise a single (PpsR{sub Q-PAS1}) and two (PpsR{sub N-Q-PAS1}) PAS domains, respectively, are presented and the multi-step strategy required for the phasing of a triple PAS domain construct (PpsR{sub ΔHTH}) is illustrated. While parts of the biologically relevant dimerization interface can already be observed in the two shorter constructs, the PpsR{sub ΔHTH} structure reveals how three PAS domains enable the formation of multiple oligomeric states (dimer, tetramer and octamer), highlighting that not only the PAS cores but also their α-helical extensions are essential for protein oligomerization. The results demonstrate that the long helical glutamine-rich linker of PpsR results from a direct fusion of the N-cap of the PAS1 domain with the C-terminal extension of the N-domain that plays an important role in signal transduction.« less

Brain volume and fatigue in patients with postpoliomyelitis syndrome.

PubMed

Trojan, Daria A; Narayanan, Sridar; Francis, Simon J; Caramanos, Zografos; Robinson, Ann; Cardoso, Mauro; Arnold, Douglas L

2014-03-01

Acute paralytic poliomyelitis is associated with encephalitis. Early brain inflammation may produce permanent neuronal injury with brain atrophy, which may result in symptoms such as fatigue. Brain volume has not been assessed in postpoliomyelitis syndrome (PPS). To determine whether brain volume is decreased compared with that in normal controls, and whether brain volume is associated with fatigue in patients with PPS. A cross-sectional study. Tertiary university-affiliated hospital postpolio and multiple sclerosis (MS) clinics. Forty-nine ambulatory patients with PPS, 28 normal controls, and 53 ambulatory patients with MS. We studied the brains of all study subjects with magnetic resonance imaging by using a 1.5 T Siemens Sonata machine. The subjects completed the Fatigue Severity Scale. Multivariable linear regression models were computed to evaluate the contribution of PPS and MS compared with controls to explain brain volume. Normalized brain volume (NBV) was assessed with the automated program Structured Image Evaluation, using Normalization, of Atrophy method from the acquired magnetic resonance images. This method may miss brainstem atrophy. Technically adequate NBV measurements were available for 42 patients with PPS, 27 controls, and 49 patients with MS. The mean (standard deviation) age was 60.9 ± 7.6 years for patients with PPS, 47.0 ± 14.6 years for controls, and 46.2 ± 9.4 years for patients with MS. In a multivariable model adjusted for age and gender, NBV was not significantly different in patients with PPS compared with that in controls (P = .28). As expected, when using a similar model for patients with MS, NBV was significantly decreased compared with that in controls (P = .006). There was no significant association between NBV and fatigue in subjects with PPS (Spearman ρ = 0.23; P = .19). No significant whole-brain atrophy was found, and no association of brain volume with fatigue in PPS. Brain atrophy was confirmed in MS. It is possible that brainstem atrophy was not recognized by this study. Copyright © 2014 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Surgical Repair of Mid-shaft Hypospadias Using a Transverse Preputial Island Flap and Pedicled Dartos Flap Around Urethral Orifice.

PubMed

Liang, Weiqiang; Ji, Chenyang; Chen, Yuhong; Zhang, Ganling; Zhang, Jiaqi; Yao, Yuanyuan; Zhang, Jinming

2016-08-01

To evaluate the effects, particularly the incidence of anastomotic fistula, of a pedicled dartos flap around the urethral orifice in the treatment of urethroplasty of mid-shaft hypospadias. A total of 46 cases of congenital mid-shaft hypospadias were included in this study. The patients ranged in age from 0.7 to 25.4 years and the average was 5.8 years. The patients received penis chordee correction. A transverse preputial island flap was developed for urethral reconstruction. The proximal dartos of the urethral orifice was used to develop a pedicled dartos flap, which was transposed to cover and strengthen neourethral anastomosis. The ventral penile skin defect was repaired by another flap. The 46 patients were examined during follow-up visits for 6 months to 3 years. An anastomotic fistula was observed in one case (2.2 %). Scar healing without fistula was observed in another patient due to poor blood supply to part of the ventral penile skin. No other incidences of fistula, urethral rupture, flap necrosis, wound infections, urinary tract (meatal) stenosis, or urethral diverticulum were observed in the patients. A pedicled dartos flap around the urethral orifice can take advantage of well-vascularized local tissue to add a protective layer to the proximal aspect of the neourethral anastomosis for reducing the incidence of anastomotic fistula in mid-shaft hypospadias repair using a transverse preputial island flap. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Auditory Temporal Acuity Probed With Cochlear Implant Stimulation and Cortical Recording

PubMed Central

Kirby, Alana E.

2010-01-01

Cochlear implants stimulate the auditory nerve with amplitude-modulated (AM) electric pulse trains. Pulse rates >2,000 pulses per second (pps) have been hypothesized to enhance transmission of temporal information. Recent studies, however, have shown that higher pulse rates impair phase locking to sinusoidal AM in the auditory cortex and impair perceptual modulation detection. Here, we investigated the effects of high pulse rates on the temporal acuity of transmission of pulse trains to the auditory cortex. In anesthetized guinea pigs, signal-detection analysis was used to measure the thresholds for detection of gaps in pulse trains at rates of 254, 1,017, and 4,069 pps and in acoustic noise. Gap-detection thresholds decreased by an order of magnitude with increases in pulse rate from 254 to 4,069 pps. Such a pulse-rate dependence would likely influence speech reception through clinical speech processors. To elucidate the neural mechanisms of gap detection, we measured recovery from forward masking after a 196.6-ms pulse train. Recovery from masking was faster at higher carrier pulse rates and masking increased linearly with current level. We fit the data with a dual-exponential recovery function, consistent with a peripheral and a more central process. High-rate pulse trains evoked less central masking, possibly due to adaptation of the response in the auditory nerve. Neither gap detection nor forward masking varied with cortical depth, indicating that these processes are likely subcortical. These results indicate that gap detection and modulation detection are mediated by two separate neural mechanisms. PMID:19923242

Moisture and temperature influence on mechanical behavior of PPS/buckypapers carbon fiber laminates

NASA Astrophysics Data System (ADS)

Rojas, J. A.; Santos, L. F. P.; Costa, M. L.; Ribeiro, B.; Botelho, E. C.

2017-07-01

In this work, multiwall carbon nanotubes (MWCNT) were dispersed in water with the assistance of water based surfactant and then sonicated in order to obtain a very well dispersed solution. The suspension was filtrate under vaccum conditions, generating a thin film called buckypapers (BP). Poly (phenylene sulphide) (PPS) reinforced carbon fiber (CF) and PPS reinforced CF/BP composites were manufactured through hot compression molding technique. Subsequently the samples were exposed to extreme humidity (90% of moisture) combined with high temperature (80 °C). The mechanical properties of the laminates were evaluated by dynamic mechanical analysis, compression shear test, interlaminar shear strength and impulse excitation of vibration. Volume fraction of pores were 10.93% for PPS/CF and 16.18% for PPS/BP/CF, indicating that the hot compression molding parameters employed in this investigation (1.4 MPa, 5 min and 330 °C) affected both the consolidation quality of the composites and the mechanical properties of the final laminates.

Intermolecular Structural Change for Thermoswitchable Polymeric Photosensitizer

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

Park, Wooram; Park, Sin-Jung; Cho, Soojeong

2016-08-17

A switchable photosensitizer (PS), which can be activated at a spe-cific condition beside light, has tremendous advantages for photo-dynamic therapy (PDT). Herein, we developed a thermo-switchable polymeric photosensitizer (T-PPS) by conjugating PS (Pheophor-bide-a, PPb-a) to a temperature-responsive polymer backbone of biocompatible hydroxypropyl cellulose (HPC). Self-quenched PS molecules linked in close proximity by pi-pi stacking in T-PPS were easily transited to an active monomeric state by the tempera-ture induced phase transition of polymer backbones. The tempera-ture responsive inter-molecular interaction changes of PS molecules in T-PPS were demonstrated in synchrotron small-angle X-ray scattering (SAXS) and UV-Vis spectrophotometer analysis. The T-PPS allowed switchablemore » activation and synergistically enhanced cancer cell killing effect at the hyperthermia temperature (45 °C). Our developed T-PPS has the considerable potential not only as a new class of photomedicine in clinics but also as a biosensor based on temperature responsiveness.« less

Circadian variation of fatigue in both patients with paralytic poliomyelitis and post-polio syndrome.

PubMed

Viana, Celiana Figueiredo; Pradella-Hallinan, Márcia; Quadros, Abrahão Augusto Juviniano; Marin, Luis Fabiano; Oliveira, Acary Souza Bulle

2013-07-01

It was to evaluate the degree of fatigue in patients with paralytic poliomyelitis (PP) and with post-polio syndrome (PPS), and correlate it with parameters of sleep and the circadian cycle. Thirty patients, 17 female (56.7%), participated in the study: they answered the Revised Piper Fatigue Scale and performed a nocturnal polysomnographic study. Eleven had PP (mean age±standard deviation of 47.9±6.4 years), and 19 had PPS (mean age±standard deviation of 46.4±5.6 years). Our study showed that fatigue was worse in the afternoon in the PP Group and had a progressive increase throughout the day in the PPS Group. We also observed compromised quality of sleep in both groups, but no statically significant difference was found in the sleep parameters measured by polysomnography. Fatigue has a well-defined circadian variation, especially in PPS Group. Poor sleep quality is associated with fatigue and, therefore, sleep disturbances should be evaluated and treated in this group of PPS.

Post-Polio Syndrome and the Late Effects of Poliomyelitis: Part 1. Pathogenesis, Biomechanical Considerations, Diagnosis, and Investigations.

PubMed

Lo, Julian K; Robinson, Lawrence R

2018-05-12

Post-Polio Syndrome (PPS) is characterized by new muscle weakness and/or muscle fatigability that occurs many years following the initial poliomyelitis illness. There are many theories that exist on the pathogenesis of PPS, which remains incompletely understood. In contrast, the Late Effects of Poliomyelitis are often a consequence of biomechanical alterations that occur as a result of polio-related surgeries, musculoskeletal deformities or weakness. Osteoporosis and fractures of the polio-involved limbs are common. A comprehensive clinical evaluation with appropriate investigations is essential to fulfilling the established PPS diagnostic criteria. PPS is a diagnosis of exclusion, in which a key clinical feature required for the diagnosis is new muscle weakness and/or muscle fatigability that is persistent for at least one year. Electromyographic and muscle biopsy findings including evidence of ongoing denervation cannot reliably distinguish between patients with or without PPS. This article is protected by copyright. All rights reserved. © 2018 Wiley Periodicals, Inc.

A ternary AppA-PpsR-DNA complex mediates light regulation of photosynthesis-related gene expression.

PubMed

Winkler, Andreas; Heintz, Udo; Lindner, Robert; Reinstein, Jochen; Shoeman, Robert L; Schlichting, Ilme

2013-07-01

The anoxygenic phototrophic bacterium Rhodobacter sphaeroides uses different energy sources, depending on environmental conditions including aerobic respiration or, in the absence of oxygen, photosynthesis. Photosynthetic genes are repressed at high oxygen tension, but at intermediate levels their partial expression prepares the bacterium for using light energy. Illumination, however, enhances repression under semiaerobic conditions. Here, we describe molecular details of two proteins mediating oxygen and light control of photosynthesis-gene expression: the light-sensing antirepressor AppA and the transcriptional repressor PpsR. Our crystal structures of both proteins and their complex and hydrogen/deuterium-exchange data show that light activation of AppA-PpsR2 affects the PpsR effector region within the complex. DNA binding studies demonstrate the formation of a light-sensitive ternary AppA-PpsR-DNA complex. We discuss implications of these results for regulation by light and oxygen, highlighting new insights into blue light-mediated signal transduction.

Audio-visual sensory deprivation degrades visuo-tactile peri-personal space.

PubMed

Noel, Jean-Paul; Park, Hyeong-Dong; Pasqualini, Isabella; Lissek, Herve; Wallace, Mark; Blanke, Olaf; Serino, Andrea

2018-05-01

Self-perception is scaffolded upon the integration of multisensory cues on the body, the space surrounding the body (i.e., the peri-personal space; PPS), and from within the body. We asked whether reducing information available from external space would change: PPS, interoceptive accuracy, and self-experience. Twenty participants were exposed to 15 min of audio-visual deprivation and performed: (i) a visuo-tactile interaction task measuring their PPS; (ii) a heartbeat perception task measuring interoceptive accuracy; and (iii) a series of questionnaires related to self-perception and mental illness. These tasks were carried out in two conditions: while exposed to a standard sensory environment and under a condition of audio-visual deprivation. Results suggest that while PPS becomes ill defined after audio-visual deprivation, interoceptive accuracy is unaltered at a group-level, with some participants improving and some worsening in interoceptive accuracy. Interestingly, correlational individual differences analyses revealed that changes in PPS after audio-visual deprivation were related to interoceptive accuracy and self-reports of "unusual experiences" on an individual subject basis. Taken together, the findings argue for a relationship between the malleability of PPS, interoceptive accuracy, and an inclination toward aberrant ideation often associated with mental illness. Copyright © 2018. Published by Elsevier Inc.

Determination of pharmaceutical residues and assessment of their removal efficiency at the Daugavgriva municipal wastewater treatment plant in Riga, Latvia.

PubMed

Reinholds, I; Muter, O; Pugajeva, I; Rusko, J; Perkons, I; Bartkevics, V

2017-01-01

Pharmaceutical products (PPs) belong to emerging contaminants that may accumulate along with other chemical pollutants in wastewaters (WWs) entering industrial and/or urban wastewater treatment plants (WWTPs). In the present study, the technique of ultra-high-performance liquid chromatography coupled to Orbitrap high-resolution mass spectrometry (Orbitrap-HRMS) was applied for the analysis of 24 multi-class PPs in WW samples collected at different technological stages of Daugavgriva WWTP located in Riga, Latvia. Caffeine and acetaminophen levels in the range of 7,570-11,403 ng/L and 810-1,883 ng/L, respectively, were the predominant compounds among 19 PPs determined in the WW. The results indicate that aerobic digestion in biological ponds was insufficiently effective to degrade most of the PPs (reduction efficiency <0-50.0%) with the exception of four PPs that showed degradation efficiency varying from 55.0 to 99.9%. Tests of short-term chemical and enzymatic hydrolysis for PP degradation in WW samples were performed, and the results reflected the complexity of different degradation mechanisms and physicochemical transformations of PPs. The toxicological studies of WW impact on Daphnia magna indicated gradual reduction of the total toxicity through the treatment stages at the WWTP.

Development of a robotic patient positioning system with a wide beam-angle range for fixed-beam particle therapy

NASA Astrophysics Data System (ADS)

Choi, Hongseok; Park, Jong-Oh; Ko, Seong Young; Park, Sukho; Cho, Sungho; Jung, Won-Gyun; Park, Yong Kyun; Kang, Jung Suk

2016-10-01

This paper describes a robotic patient positioning system (PPS) for a fixed-beam heavy-ion therapy system. In order to extend the limited irradiation angle range of the fixed beam, we developed a 6-degree-of-freedom (6-DOF) serial-link robotic arm and used it as the robotic PPS for the fixed-beam heavy-ion therapy system. This research aims to develop a robotic PPS for use in the Korea Heavy Ion Medical Accelerator (KHIMA) system, which is under development at the Korea Institute of Radiological & Medical Sciences (KIRAMS). In particular, we select constraints and criteria that will be used for designing and evaluating the robotic PPS through full consultation with KIRAMS. In accordance with the constraints and criteria, we develop a 6-DOF serial-link robotic arm that consists of six revolute joints for the robotic PPS, where the robotic arm covers the upper body of a patient as a treatment area and achieves a 15 ° roll and pitch angle in the treatment area without any collision. Various preliminary experiments confirm that the robotic PPS can meet all criteria for extension of the limited irradiation angle range in the treatment area and has a positioning repeatability of 0.275 mm.

Polynomial Phase Estimation Based on Adaptive Short-Time Fourier Transform

PubMed Central

Jing, Fulong; Zhang, Chunjie; Si, Weijian; Wang, Yu; Jiao, Shuhong

2018-01-01

Polynomial phase signals (PPSs) have numerous applications in many fields including radar, sonar, geophysics, and radio communication systems. Therefore, estimation of PPS coefficients is very important. In this paper, a novel approach for PPS parameters estimation based on adaptive short-time Fourier transform (ASTFT), called the PPS-ASTFT estimator, is proposed. Using the PPS-ASTFT estimator, both one-dimensional and multi-dimensional searches and error propagation problems, which widely exist in PPSs field, are avoided. In the proposed algorithm, the instantaneous frequency (IF) is estimated by S-transform (ST), which can preserve information on signal phase and provide a variable resolution similar to the wavelet transform (WT). The width of the ASTFT analysis window is equal to the local stationary length, which is measured by the instantaneous frequency gradient (IFG). The IFG is calculated by the principal component analysis (PCA), which is robust to the noise. Moreover, to improve estimation accuracy, a refinement strategy is presented to estimate signal parameters. Since the PPS-ASTFT avoids parameter search, the proposed algorithm can be computed in a reasonable amount of time. The estimation performance, computational cost, and implementation of the PPS-ASTFT are also analyzed. The conducted numerical simulations support our theoretical results and demonstrate an excellent statistical performance of the proposed algorithm. PMID:29438317

Permeable pavement and stormwater management systems: a review.

PubMed

Imran, H M; Akib, Shatirah; Karim, Mohamed Rehan

2013-01-01

Uncontrolled stormwater runoff not only creates drainage problems and flash floods but also presents a considerable threat to water quality and the environment. These problems can, to a large extent, be reduced by a type of stormwater management approach employing permeable pavement systems (PPS) in urban, industrial and commercial areas, where frequent problems are caused by intense undrained stormwater. PPS could be an efficient solution for sustainable drainage systems, and control water security as well as renewable energy in certain cases. Considerable research has been conducted on the function of PPS and their improvement to ensure sustainable drainage systems and water quality. This paper presents a review of the use of permeable pavement for different purposes. The paper focuses on drainage systems and stormwater runoff quality from roads, driveways, rooftops and parking lots. PPS are very effective for stormwater management and water reuse. Moreover, geotextiles provide additional facilities to reduce the pollutants from infiltrate runoff into the ground, creating a suitable environment for the biodegradation process. Furthermore, recently, ground source heat pumps and PPS have been found to be an excellent combination for sustainable renewable energy. In addition, this study has identified several gaps in the present state of knowledge on PPS and indicates some research needs for future consideration.

Polynomial Phase Estimation Based on Adaptive Short-Time Fourier Transform.

PubMed

Jing, Fulong; Zhang, Chunjie; Si, Weijian; Wang, Yu; Jiao, Shuhong

2018-02-13

Polynomial phase signals (PPSs) have numerous applications in many fields including radar, sonar, geophysics, and radio communication systems. Therefore, estimation of PPS coefficients is very important. In this paper, a novel approach for PPS parameters estimation based on adaptive short-time Fourier transform (ASTFT), called the PPS-ASTFT estimator, is proposed. Using the PPS-ASTFT estimator, both one-dimensional and multi-dimensional searches and error propagation problems, which widely exist in PPSs field, are avoided. In the proposed algorithm, the instantaneous frequency (IF) is estimated by S-transform (ST), which can preserve information on signal phase and provide a variable resolution similar to the wavelet transform (WT). The width of the ASTFT analysis window is equal to the local stationary length, which is measured by the instantaneous frequency gradient (IFG). The IFG is calculated by the principal component analysis (PCA), which is robust to the noise. Moreover, to improve estimation accuracy, a refinement strategy is presented to estimate signal parameters. Since the PPS-ASTFT avoids parameter search, the proposed algorithm can be computed in a reasonable amount of time. The estimation performance, computational cost, and implementation of the PPS-ASTFT are also analyzed. The conducted numerical simulations support our theoretical results and demonstrate an excellent statistical performance of the proposed algorithm.

Auditory-nerve single-neuron thresholds to electrical stimulation from scala tympani electrodes.

PubMed

Parkins, C W; Colombo, J

1987-12-31

Single auditory-nerve neuron thresholds were studied in sensory-deafened squirrel monkeys to determine the effects of electrical stimulus shape and frequency on single-neuron thresholds. Frequency was separated into its components, pulse width and pulse rate, which were analyzed separately. Square and sinusoidal pulse shapes were compared. There were no or questionably significant threshold differences in charge per phase between sinusoidal and square pulses of the same pulse width. There was a small (less than 0.5 dB) but significant threshold advantage for 200 microseconds/phase pulses delivered at low pulse rates (156 pps) compared to higher pulse rates (625 pps and 2500 pps). Pulse width was demonstrated to be the prime determinant of single-neuron threshold, resulting in strength-duration curves similar to other mammalian myelinated neurons, but with longer chronaxies. The most efficient electrical stimulus pulse width to use for cochlear implant stimulation was determined to be 100 microseconds/phase. This pulse width delivers the lowest charge/phase at threshold. The single-neuron strength-duration curves were compared to strength-duration curves of a computer model based on the specific anatomy of auditory-nerve neurons. The membrane capacitance and resulting chronaxie of the model can be varied by altering the length of the unmyelinated termination of the neuron, representing the unmyelinated portion of the neuron between the habenula perforata and the hair cell. This unmyelinated segment of the auditory-nerve neuron may be subject to aminoglycoside damage. Simulating a 10 micron unmyelinated termination for this model neuron produces a strength-duration curve that closely fits the single-neuron data obtained from aminoglycoside deafened animals. Both the model and the single-neuron strength-duration curves differ significantly from behavioral threshold data obtained from monkeys and humans with cochlear implants. This discrepancy can best be explained by the involvement of higher level neurologic processes in the behavioral responses. These findings suggest that the basic principles of neural membrane function must be considered in developing or analyzing electrical stimulation strategies for cochlear prostheses if the appropriate stimulation of frequency specific populations of auditory-nerve neurons is the objective.

Vibriosis: Demonstration of Vibrio fetus and Vibrio bubulus Organisms in Preputial Fluid by Immunofluorescence and Cultural Techniques

PubMed Central

Ruckerbauer, Gerda M.; Malkin, K.; Mitchell, D.; Boulanger, P.

1974-01-01

Fluorescent conjugates were prepared from the sera of calves immunized with four Vibrio fetus strains and one Vibrio bubulus strain. The fluorescent antibody technique (FAT) was then used to detect vibrio organisms in preputial fluid collected from 67 bulls belonging to a Canadian artificial insemination (AI) unit. The V. fetus conjugates reacted with both V. fetus var venerealis and V. fetus var intestinalis. V. fetus was found in 20 animals (29.9%), 13 of which also harboured V. bubulus. In two cases, the FAT failed to detect V. fetus which was isolated by concurrent bacteriological examinations. It was concluded that the FAT can be a rapid method of detecting some carrier bulls but more reliable results are obtained when a combination of FAT and bacteriological methods is employed. It was found that a single sample giving negative results is inconclusive and additional tests are required before making a final diagnosis. The FAT can also be used to differentiate V. fetus isolates from V. bubulus. PMID:4277756

Evaluation of long-acting oxytetracycline and a commercial monovalent vaccine for the control of Campylobacter fetus subsp. venerealis infection in beef bulls.

PubMed

Erickson, Nathan E N; Lanigan, Emily; Waugh, Taryn; Gesy, Karen; Waldner, Cheryl

2017-10-01

A blinded randomized controlled trial was used to evaluate a multi-modal therapeutic regime for treatment of beef bulls infected with Campylobacter fetus subsp. venerealis (Cfv) . Treatment included 2 doses of a commercially available monovalent vaccine and long-acting oxytetracycline applied twice at a 2-week interval with treatment completed 2 weeks before post-treatment observation. Fifteen confirmed Cfv infected bulls were randomly allocated to control ( n = 8) or treatment groups ( n = 7). Preputial scrapings were collected each week from before infection to 11 weeks following the last treatment. When the polymerase chain reaction (PCR) results for both culture and preputial scrapings were interpreted in parallel, there were no significant differences between treated and untreated bulls. Regardless of the type of diagnostic testing considered, treatment with 2 label doses of this regime did not stop shedding of Cfv in all treated bulls and is, therefore, not recommended as an effective management strategy.

Evaluation of long-acting oxytetracycline and a commercial monovalent vaccine for the control of Campylobacter fetus subsp. venerealis infection in beef bulls

PubMed Central

Erickson, Nathan E.N.; Lanigan, Emily; Waugh, Taryn; Gesy, Karen; Waldner, Cheryl

2017-01-01

A blinded randomized controlled trial was used to evaluate a multi-modal therapeutic regime for treatment of beef bulls infected with Campylobacter fetus subsp. venerealis (Cfv). Treatment included 2 doses of a commercially available monovalent vaccine and long-acting oxytetracycline applied twice at a 2-week interval with treatment completed 2 weeks before post-treatment observation. Fifteen confirmed Cfv infected bulls were randomly allocated to control (n = 8) or treatment groups (n = 7). Preputial scrapings were collected each week from before infection to 11 weeks following the last treatment. When the polymerase chain reaction (PCR) results for both culture and preputial scrapings were interpreted in parallel, there were no significant differences between treated and untreated bulls. Regardless of the type of diagnostic testing considered, treatment with 2 label doses of this regime did not stop shedding of Cfv in all treated bulls and is, therefore, not recommended as an effective management strategy. PMID:28966354

Transoral robotic approach to parapharyngeal space tumors: Case series and technical limitations.

PubMed

Boyce, Brian J; Curry, Joseph M; Luginbuhl, Adam; Cognetti, David M

2016-08-01

The transoral robotic approach to parapharyngeal space (PPS) tumors is a new technique with limited data available on its feasibility, safety, and efficacy. We analyzed our experience with transoral robotic excisions of PPS tumors to evaluate the safety and efficacy of this technique. Retrospective chart analysis at tertiary academic medical center. From July 2010 to June 2014, 17 patients who had transoral robotic excision of PPS tumors were included in the study. Our cohort had an average age of 61.6 years and was 52.9% male. All patients had successful removal of their PPS tumors, and the average size of the tumors was 27.3 cm(3) (range 2-80 cm(3) ). Two cases (11.7%) required a cervical incision to assist with tumor removal. The average total operative time was 140.5 minutes. Two PPS PAs had focal areas of capsule rupture and one was fragmented. The average length of stay was 1.8 days (range 1-7 days), and all patients were discharged on an oral diet. Three patients experienced complications. There was no clinical or radiographic evidence of recurrence. This is the largest single-institution case series of transoral robotic approaches to PPS tumors. We demonstrate that this approach is feasible and safe but also note limitations of the robotic approaches for tumors on the far lateral and superior areas of the PPS, which required transcervical assistance. There were no patients who demonstrated recurrent tumor either radiographically or clinically. 4. Laryngoscope, 126:1776-1782, 2016. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Co-expression of five genes in E coli for L-phenylalanine in Brevibacterium flavum

PubMed Central

Wu, Yong-Qing; Jiang, Pei-Hong; Fan, Chang-Sheng; Wang, Jian-Gang; Shang, Liang; Huang, Wei-Da

2003-01-01

AIM: To study the effect of co-expression of ppsA, pckA, aroG, pheA and tyrB genes on the production of L-phenylalanine, and to construct a genetic engineering strain for L-phenylalanine. METHODS: ppsA and pckA genes were amplified from genomic DNA of E. coli by polymerase chain reaction, and then introduced into shuttle vectors between E coli and Brevibacterium flavum to generate constructs pJN2 and pJN5. pJN2 was generated by inserting ppsA and pckA genes into vector pCZ; whereas pJN5 was obtained by introducing ppsA and pckA genes into pCZ-GAB, which was originally constructed for co-expression of aroG, pheA and tyrB genes. The recombinant plasmids were then introduced into B. flavum by electroporation and the transformants were used for L-phenylalanine fermentation. RESULTS: Compared with the original B. flavum cells, all the transformants were showed to have increased five enzyme activities specifically, and have enhanced L-phenylalanine biosynthesis ability variably. pJN5 transformant was observed to have the highest elevation of L-phenylalanine production by a 3.4-fold. Co-expression of ppsA and pckA increased activity of DAHP synthetase significantly. CONCLUSION: Co-expression of ppsA and pckA genes in B. flavum could remarkably increase the expression of DAHP synthetase; Co-expression of ppsA, pckA, aroG, pheA and tyrB of E. coli in B. flavum was a feasible approach to construct a strain for phenylalanine production. PMID:12532463

Long-term modelling of fly ash and radionuclide emissions as well as deposition fluxes due to the operation of large oil shale-fired power plants.

PubMed

Vaasma, Taavi; Kaasik, Marko; Loosaar, Jüri; Kiisk, Madis; Tkaczyk, Alan H

2017-11-01

Two of the world's largest oil shale-fired power plants (PPs) in Estonia have been operational over 40 years, emitting various pollutants, such as fly ash, SO x , NO x , heavy metals, volatile organic compounds as well as radionuclides to the environment. The emissions from these PPs have varied significantly during this period, with the maximum during the 1970s and 1980s. The oil shale burned in the PPs contains naturally occurring radionuclides from the 238 U and 232 Th decay series as well as 40 K. These radionuclides become enriched in fly ash fractions (up to 10 times), especially in the fine fly ash escaping the purification system. Using a validated Gaussian-plume model, atmospheric dispersion modelling was carried out to determine the quantity and a real magnitude of fly ash and radionuclide deposition fluxes during different decades. The maximum deposition fluxes of volatile radionuclides ( 210 Pb and 210 Po) were around 70 mBq m -2 d -1 nearby the PPs during 1970s and 1980s. Due to the reduction of burned oil shale and significant renovations done on the PPs, the deposition fluxes were reduced to 10 mBq m -2 d -1 in the 2000s and down to 1.5 mBq m -2 d -1 in 2015. The maximum deposition occurs within couple of kilometers of the PPs, but the impacted area extends to over 50 km from the sources. For many radionuclides, including 210 Po, the PPs have been larger contributors of radionuclides to the environment via atmospheric pathway than natural sources. This is the first time that the emissions and deposition fluxes of radionuclides from the PPs have been quantified, providing the information about their radionuclide deposition load on the surrounding environment during various time periods. Copyright © 2017 Elsevier Ltd. All rights reserved.

Post-Polio Syndrome and Risk Factors in Korean Polio Survivors: A Baseline Survey by Telephone Interview

PubMed Central

Bang, Hyun; Suh, Jee Hyun; Lee, Seung Yeol; Kim, Keewon; Yang, Eun Joo; Jung, Se Hee; Jang, Soong-Nang; Han, Soo Jeong; Kim, Wan-Ho; Oh, Min-Gyun; Kim, Jeong-Hwan; Lee, Sam-Gyu

2014-01-01

Objective To obtain information on the socioeconomic, medical, and functional status of polio survivors, and to use these results as the preliminary data for establishing the middle-aged cohort of polio survivors. Methods The subjects were recruited based on the medical records of multiple hospitals and centers. They were assessed through a structured questionnaire over the phone. Post-poliomyelitis syndrome (PPS) was identified according to the specified diagnostic criteria. Differences between polio survivors with or without PPS were evaluated, and the risk factors for PPS were analyzed by the odds ratio (OR). Results Majority of polio survivors were middle-aged and mean age was 51.2±8.3 years. A total of 188 out of 313 polio survivors met the adopted criteria for PPS based on the symptoms, yielding a prevalence of 61.6%. Mean interval between acute poliomyelitis and the development of PPS was 38.5±11.6 years. Female gender (OR 1.82; confidence interval [CI] 1.09-3.06), the age at onset of poliomyelitis (OR 1.75; CI 1.05-2.94), the use of orthoses or walking aids (OR 2.46; CI 1.44-4.20), and the history of medical treatment for paralysis, pain or gait disturbance (OR 2.62; CI 1.52-4.51) represented independent risk factors for PPS. Conclusion We found that the majority of Korean polio survivors entered middle age with many medical, functional, and social problems. Female gender, early age of onset of poliomyelitis, the use of orthoses or walking aids, and the history of medical treatment for paralysis, pain or gait disturbance were identified as the significant risk factors for PPS. A comprehensive and multidisciplinary plan should be prepared to manage polio survivors considering their need for health care services and the risk factors for late effects, such as PPS. PMID:25379493

MSL Lessons Learned and Knowledge Capture

NASA Technical Reports Server (NTRS)

Buxbaum, Karen L.

2012-01-01

The Mars Program has recently been informed of the Planetary Protection Subcommittee (PPS) recommendation, which was endorsed by the NAC, concerning Mars Science Lab (MSL) lessons learned and knowledge capture. The Mars Program has not had an opportunity to consider any decisions specific to the PPS recommendation. Some of the activities recommended by the PPS would involve members of the MSL flight team who are focused on cruise, entry descent & landing, and early surface operations; those activities would have to wait. Members of the MSL planetary protection team at JPL are still available to support MSL lessons learned and knowledge capture; some of the specifically recommended activities have already begun. The Mars Program shares the PPS/NAC concerns about loss of potential information & expertise in planetary protection practice.

Anatomic Severity, Midfacial Growth, and Speech Outcomes in Van der Woude/Popliteal Pterygium Syndromes Compared to Nonsyndromic Cleft Lip/Palate.

PubMed

Reardon, Jeffrey B; Brustowicz, Katherine A; Marrinan, Eileen M; Mulliken, John B; Padwa, Bonnie L

2015-11-01

To summarize the clinical characteristics and surgical and speech outcomes for patients with Van der Woude/popliteal pterygium syndromes (VWS/PPS) and to compare them with a historic cohort of patients with nonsyndromic cleft lip/cleft palate (CL/P). Retrospective chart review. Tertiary care center. All patients with VWS/PPS seen at Boston Children's Hospital from 1979 to 2012: 28 patients with VWS (n = 21)/PPS (n = 7) whose mean age was 17.3 ± 10.4 years, including 18 females (64%) and 10 males (36%); 18 patients (64%) had a family history of VWS/PPS. Cleft type, operative procedures, speech, and midfacial growth. Data were compared with historic cohorts of patients with nonsyndromic CL/P treated at one tertiary care center. There were 24 patients (86%) with CP±L, Veau types I (n = 4, 17%), II (n = 4, 17%), III (n = 5, 21%), and IV (n = 11, 46%). Nine patients (38%) had palatal fistula after palatoplasty. Fourteen of 23 (61%) patients with CL/P age 5 years or older had midfacial retrusion, and 10 (43%) required a pharyngeal flap for velopharyngeal insufficiency. Fisher's exact test demonstrated higher frequencies of Veau type IV CP±L (P = .0016), bilateral CL±P (P = .0001), and complete CL±P (P < .0001) in VWS/PPS compared with nonsyndromic patients. Incidences of midfacial retrusion (P = .0001), palatal fistula (P < .0001), and need for pharyngeal flap (P = .0014) were significantly greater in patients with VWS/PPS. Patients with VWS/PPS have more severe forms of labiopalatal clefting and higher incidences of midfacial retrusion, palatal fistula, and velopharyngeal insufficiency following primary repair as compared with nonsyndromic CL/P.

Helping members of a community-based health insurance scheme access quality inpatient care through development of a preferred provider system in rural Gujarat.

PubMed

Ranson, M Kent; Sinha, Tara; Gandhi, Fenil; Jayswal, Rupal; Mills, Anne J

2006-01-01

We describe and analyse the experience of piloting a preferred provider system (PPS) for rural members of Vimo SEWA, a fixed-indemnity, community-based health insurance (CBHI) scheme run by the Self-Employed Women's Association (SEWA). The objectives of the PPS were (i) to facilitate access to hospitalization by providing financial benefits at the time of service utilization; (ii) to shift the burden of compiling a claim away from members and towards Vimo SEWA staff; and (iii) to direct members to inpatient facilities of acceptable quality. The PPS was launched between August and October 2004, in 8 subdistricts covering 15,000 insured. The impact of the scheme was analysed using data from a household survey of claimants and qualitative data from in-depth interviews and focus group discussions. The PPS appears to have been successful in terms of two of the three primary objectives--it has transferred much of the burden of compiling a health Insurance claim onto Vimo SEWA staff, and it has directed members to inpatient facilities with acceptable levels of technical quality (defined in terms of structural Indicators). However, even under the PPS, user fees pose a financial barrier, as the insured have to mobilize funds to cover the costs of medicines, supplies, registration fee, etc. before receipt of cash payment from Vimo SEWA. Other barriers to the success of the PPS were the geographic Inaccessibility of some of the selected hospitals, lack of awareness about the PPS among members and a variety of administrative problems. This pilot project provides useful lessons relating to strategic purchasing by CBHI schemes and, more broadly, managed care in India. In particular, the pragmatic approach taken to assessing hospitals and identifying preferred providers is likely to be useful elsewhere.

The wheelchair as a full-body tool extending the peripersonal space

PubMed Central

Galli, Giulia; Noel, Jean Paul; Canzoneri, Elisa; Blanke, Olaf; Serino, Andrea

2015-01-01

Dedicated multisensory mechanisms in the brain represent peripersonal space (PPS), a limited portion of space immediately surrounding the body. Previous studies have illustrated the malleability of PPS representation through hand-object interaction, showing that tool use extends the limits of the hand-centered PPS. In the present study we investigated the effects of a special tool, the wheelchair, in extending the action possibilities of the whole body. We used a behavioral measure to quantify the extension of the PPS around the body before and after Active (Experiment 1) and Passive (Experiment 2) training with a wheelchair and when participants were blindfolded (Experiment 3). Results suggest that a wheelchair-mediated passive exploration of far space extended PPS representation. This effect was specifically related to the possibility of receiving information from the environment through vision, since no extension effect was found when participants were blindfolded. Surprisingly, the active motor training did not induce any modification in PPS representation, probably because the wheelchair maneuver was demanding for non-expert users and thus they may have prioritized processing of information from close to the wheelchair rather than at far spatial locations. Our results suggest that plasticity in PPS representation after tool use seems not to strictly depend on active use of the tool itself, but is triggered by simultaneous processing of information from the body and the space where the body acts in the environment, which is more extended in the case of wheelchair use. These results contribute to our understanding of the mechanisms underlying body–environment interaction for developing and improving applications of assistive technological devices in different clinical populations. PMID:26042069

Fengycin produced by Bacillus subtilis 9407 plays a major role in the biocontrol of apple ring rot disease.

PubMed

Fan, Haiyan; Ru, Jinjiang; Zhang, Yuanyuan; Wang, Qi; Li, Yan

2017-06-01

Apple ring rot, caused by Botryosphaeria dothidea, is a serious apple disease in China. Bacillus subtilis 9407 was isolated from healthy apples and showed strong antifungal activity against B. dothidea. To identify the primary antifungal compound of B. subtilis 9407 and determine its role in controlling apple ring rot, a transposon mutant library was constructed using TnYLB-1, and a mutant completely defective in antifungal activity was obtained. The gene inactivated in the antifungal activity mutant had 98.5% similarity to ppsB in B. subtilis subsp. subtilis str. 168, which encodes one of the five synthetases responsible for synthesizing fengycin. A markerless ppsB deletion mutant was constructed. Compared with the wild-type strain, lipopeptide crude extracts from ΔppsB showed almost no inhibition of B. dothidea mycelial growth. Furthermore, fengycin-like lipopeptides (retention factor 0.1-0.2) that exhibited antifungal activity against B. dothidea were observed in the wild-type strain by thin-layer chromatography (TLC)-bioautography analysis, but not in ΔppsB. Semipreparative reverse-phase high performance liquid chromatography (RP-HPLC) detection revealed that ΔppsB lost the ability to synthesize fengycin. These results suggest that ppsB is responsible for synthesizing fengycin and that fengycin is the major antifungal compound produced by B. subtilis 9407 against B. dothidea. Moreover, a biocontrol assay showed that the control efficacy of ΔppsB was reduced by half compared with the wild-type strain, indicating that fengycin plays a major role in controlling apple ring rot disease. This is the first report on the use of a B. subtilis strain as a potential biological control agent to control apple ring rot disease by the production of fengycin. Copyright © 2017 Elsevier GmbH. All rights reserved.

Simple prognostic model for patients with advanced cancer based on performance status.

PubMed

Jang, Raymond W; Caraiscos, Valerie B; Swami, Nadia; Banerjee, Subrata; Mak, Ernie; Kaya, Ebru; Rodin, Gary; Bryson, John; Ridley, Julia Z; Le, Lisa W; Zimmermann, Camilla

2014-09-01

Providing survival estimates is important for decision making in oncology care. The purpose of this study was to provide survival estimates for outpatients with advanced cancer, using the Eastern Cooperative Oncology Group (ECOG), Palliative Performance Scale (PPS), and Karnofsky Performance Status (KPS) scales, and to compare their ability to predict survival. ECOG, PPS, and KPS were completed by physicians for each new patient attending the Princess Margaret Cancer Centre outpatient Oncology Palliative Care Clinic (OPCC) from April 2007 to February 2010. Survival analysis was performed using the Kaplan-Meier method. The log-rank test for trend was employed to test for differences in survival curves for each level of performance status (PS), and the concordance index (C-statistic) was used to test the predictive discriminatory ability of each PS measure. Measures were completed for 1,655 patients. PS delineated survival well for all three scales according to the log-rank test for trend (P < .001). Survival was approximately halved for each worsening performance level. Median survival times, in days, for each ECOG level were: EGOG 0, 293; ECOG 1, 197; ECOG 2, 104; ECOG 3, 55; and ECOG 4, 25.5. Median survival times, in days, for PPS (and KPS) were: PPS/KPS 80-100, 221 (215); PPS/KPS 60 to 70, 115 (119); PPS/KPS 40 to 50, 51 (49); PPS/KPS 10 to 30, 22 (29). The C-statistic was similar for all three scales and ranged from 0.63 to 0.64. We present a simple tool that uses PS alone to prognosticate in advanced cancer, and has similar discriminatory ability to more complex models. Copyright © 2014 by American Society of Clinical Oncology.

Peripersonal space as the space of the bodily self.

PubMed

Noel, Jean-Paul; Pfeiffer, Christian; Blanke, Olaf; Serino, Andrea

2015-11-01

Bodily self-consciousness (BSC) refers to experience of one's self as located within an owned body (self-identification) and as occupying a specific location in space (self-location). BSC can be altered through multisensory stimulation, as in the Full Body Illusion (FBI). If participants view a virtual body from a distance being stroked, while receiving synchronous tactile stroking on their physical body, they feel as if the virtual body were their own and they experience, subjectively, to drift toward the virtual body. Here we hypothesized that--while normally the experience of the body in space depends on the integration of multisensory body-related signals within a limited space surrounding the body (i.e. peripersonal space, PPS)--during the FBI the boundaries of PPS would shift toward the virtual body, that is, toward the position of experienced self-location. To test this hypothesis, we used synchronous visuo-tactile stroking to induce the FBI, as contrasted with a control condition of asynchronous stroking. Concurrently, we applied an audio-tactile interaction paradigm to estimate the boundaries of PPS. PPS was measured in front of and behind the participants' body as the distance where tactile information interacted with auditory stimuli looming in space toward the participant's physical body. We found that during synchronous stroking, i.e. when participants experienced the FBI, PPS boundaries extended in the front-space, toward the avatar, and concurrently shrunk in the back-space, as compared to the asynchronous stroking control condition, when FBI was induced. These findings support the view that during the FBI, PPS boundaries translate toward the virtual body, such that the PPS representation shifts from being centered at the location of the physical body to being now centered at the subjectively experienced location of the self. Copyright © 2015 Elsevier B.V. All rights reserved.

Peripersonal Space as the space of the Bodily Self

PubMed Central

Noel, Jean-Paul; Pfeiffer, Christian; Blanke, Olaf; Serino, Andrea

2016-01-01

Bodily self-consciousness (BSC) refers to experience of our self as located within an owned body (self-identification) and as occupying a specific location in space (self-location). BSC can be altered through multisensory stimulation, as in the Full Body Illusion (FBI). If participants view a virtual body from a distance being stroked, while receiving synchronous tactile stroking on their physical body, they feel such as the virtual body were their own and they experience, subjectively, to drift toward the virtual body. Here we hypothesized that - while normally the experience of the body in space depends on the integration of multisensory body-related signals within a limited space surrounding the body (i.e. peripersonal space, PPS) - during the FBI the boundaries of PPS would shift toward the virtual body, that is toward the position of self-location. To test this hypothesis, we used synchronous visuo-tactile stroking to induce the FBI, as contrasted with a control condition of asynchronous stroking. Concurrently, we applied an audio-tactile interaction paradigm to estimate the boundaries of PPS. PPS was measured in front of and behind the participants' body as the distance where tactile information interacted with auditory stimuli looming in space toward the participant's physical body. We found that during synchronous stroking, i.e. when participants experienced the FBI, PPS boundaries extended in the front-space, toward the avatar, and concurrently shrunk in the back-space, as compared to the asynchronous stroking control condition, where no FBI was induced. These findings support the view that during the FBI, PPS boundaries translate toward the virtual body, such that the PPS representation shifts from being centered at the location of the physical body to being now centered at the subjectively experienced location of the self. PMID:26231086

Capacity upgrade in short-reach optical fibre networks: simultaneous 4-PAM 20 Gbps data and polarization-modulated PPS clock signal using a single VCSEL carrier

NASA Astrophysics Data System (ADS)

Isoe, G. M.; Wassin, S.; Gamatham, R. R. G.; Leitch, A. W. R.; Gibbon, T. B.

2017-11-01

In this work, a four-level pulse amplitude modulation (4-PAM) format with a polarization-modulated pulse per second (PPS) clock signal using a single vertical cavity surface emitting laser (VCSEL) carrier is for the first time experimentally demonstrated. We propose uncomplex alternative technique for increasing capacity and flexibility in short-reach optical communication links through multi-signal modulation onto a single VCSEL carrier. A 20 Gbps 4-PAM data signal is directly modulated onto a single mode 10 GHz bandwidth VCSEL carrier at 1310 nm, therefore, doubling the network bit rate. Carrier spectral efficiency is further maximized by exploiting the inherent orthogonal polarization switching of the VCSEL carrier with changing bias in transmission of a PPS clock signal. We, therefore, simultaneously transmit a 20 Gbps 4-PAM data signal and a polarization-based PPS clock signal using a single VCSEL carrier. It is the first time a signal VCSEL carrier is reported to simultaneously transmit a directly modulated 20 Gbps 4-PAM data signal and a polarization-based PPS clock signal. We further demonstrate on the design of a software-defined digital signal processing (DSP)-assisted receiver as an alternative to costly receiver hardware. Experimental results show that a 3.21 km fibre transmission with simultaneous 20 Gbps 4-PAM data signal and polarization-based PPS clock signal introduced a penalty of 3.76 dB. The contribution of polarization-based PPS clock signal to this penalty was found out to be 0.41 dB. Simultaneous distribution of data and timing clock signals over shared network infrastructure significantly increases the aggregated data rate at different optical network units (ONUs), without costly investment.

EAP recordings in ineraid patients--correlations with psychophysical measures and possible implications for patient fitting.

PubMed

Zimmerling, Martin J; Hochmair, Erwin S

2002-04-01

Objective measurements can be helpful for cochlear implant fitting of difficult populations, as for example very young children. One method, the recording of the electrically evoked compound action potential (EAP), measures the nerve recruitment in the cochlea in response to stimulation through the implant. For coding strategies implemented at a moderate stimulation rate of 250 pps per channel, useful correlations between EAP data and psychophysical data have been already found. With new systems running at higher rates, it is important to check these correlations again. This study investigates the correlations between psychophysical data and EAP measures calculated from EAP amplitude growth functions. EAP data were recorded in 12 Ineraid subjects. Additionally, behavioral thresholds (THR) and maximum acceptable loudness levels (MAL) were determined for stimulation rates of 80 pps and 2,020 pps for each electrode. Useful correlations between EAP data and psychophysical data were found at the low stimulation rate (80 pps). However, at the higher stimulation rate (2,020 pps) correlations were not significant. They were improved substantially, however, by introducing a factor that corrected for disparities due to temporal integration. Incorporation of this factor, which controls for the influence of the stimulation rate on the threshold, improved the correlations between EAP measures recorded at 80 pps and psychophysical MALs measured at 2,020 pps to better than r = 0.70. EAP data as such can only be used to predict behavioral THRs or MCLs at low stimulation rates. To cope with temporal integration effects at higher stimulation rates, EAP data must be rate corrected. The introduction of a threshold-rate-factor is a promising way to achieve that goal. Further investigations need to be performed.

Post-polio syndrome. Cases report and review of literature.

PubMed

Pastuszak, Żanna; Stępień, Adam; Tomczykiewicz, Kazimierz; Piusińska-Macoch, Renata; Galbarczyk, Dariusz; Rolewska, Agnieszka

It is estimated that around 15 million people survived polio infection worldwide since early twentieth century. In 1950 effective vaccination was used for first time. Since that time number of affected people decreased. The last epidemic of Haine-Medine disease in Poland was in 1950s. Another rare cases of infections were observed till 1970s. About at least 15 years after polio virus infection, slowly progressive muscle limbs paresis with muscle atrophy, joints pain, paresthesia were observed in polio survivors. That constellation of symptoms was called post-polio syndrome (PPS). PPS frequency among people after paralytic and nonparalytic polio infectious is ranged from 30% to 80%. Fatigue that leads to physical and mental activity deterioration is another important symptom that is observed in 90% of patients with PPS. Etiology of disease remains elusive. Probably it is an effect of spine frontal horns motoneurons damage during acute virus polio infection that leads to overloading and degeneration of remaining ones. The most important risk factors of PPS are female sex and respiratory symptoms during acute polio infection. Electromyography is an important part of PPS diagnostic process. Electrophysiological abnormalities are seen in clinically affected and unaffected muscles. The most frequent are fasciculations and fibrillations during rest activity, extension of motor unit area, time duration and amplitude. In this study we described three cases of people who developed PPS years after Haine-Medine disease and correlation between their EMG results and clinical status. We also analyzed electromyography results both after one month since first PPS signs occurred as well as after few years. Presentation of dynamic changes in EMG was the most important aim of that study. Copyright © 2017. Published by Elsevier Urban & Partner Sp. z o.o.

Testing for new physics: neutrinos and the primordial power spectrum

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

Canac, Nicolas; Abazajian, Kevork N.; Aslanyan, Grigor

2016-09-01

We test the sensitivity of neutrino parameter constraints from combinations of CMB and LSS data sets to the assumed form of the primordial power spectrum (PPS) using Bayesian model selection. Significantly, none of the tested combinations, including recent high-precision local measurements of H{sub 0} and cluster abundances, indicate a signal for massive neutrinos or extra relativistic degrees of freedom. For PPS models with a large, but fixed number of degrees of freedom, neutrino parameter constraints do not change significantly if the location of any features in the PPS are allowed to vary, although neutrino constraints are more sensitive to PPSmore » features if they are known a priori to exist at fixed intervals in log k . Although there is no support for a non-standard neutrino sector from constraints on both neutrino mass and relativistic energy density, we see surprisingly strong evidence for features in the PPS when it is constrained with data from Planck 2015, SZ cluster counts, and recent high-precision local measurements of H{sub 0}. Conversely combining Planck with matter power spectrum and BAO measurements yields a much weaker constraint. Given that this result is sensitive to the choice of data this tension between SZ cluster counts, Planck and H{sub 0} measurements is likely an indication of unmodeled systematic bias that mimics PPS features, rather than new physics in the PPS or neutrino sector.« less

The Incremental Cost-Effectiveness of Engaging Private Practitioners to Refer Tuberculosis Suspects to DOTS Services in Jogjakarta, Indonesia

PubMed Central

Mahendradhata, Yodi; Probandari, Ari; Ahmad, Riris A.; Utarini, Adi; Trisnantoro, Laksono; Lindholm, Lars; van der Werf, Marieke J.; Kimerling, Michael; Boelaert, Marleen; Johns, Benjamin; Van der Stuyft, Patrick

2010-01-01

We aimed to evaluate the incremental cost-effectiveness of engaging private practitioners (PPs) to refer tuberculosis (TB) suspects to public health centers in Jogjakarta, Indonesia. Effectiveness was assessed for TB suspects notified between May 2004 and April 2005. Private practitioners referred 1,064 TB suspects, of which 57.5% failed to reach a health center. The smear-positive rate among patients reaching a health center was 61.8%. Two hundred eighty (280) out of a total of 1,306 (21.4%) new smear-positive cases were enrolled through the PPs strategy. The incremental cost-effectiveness ratio per smear-positive case successfully treated for the PPs strategy was US$351.66 (95% CI 322.84–601.33). On the basis of an acceptability curve using the National TB control program's willingness-to-pay threshold (US$448.61), we estimate the probability that the PPs strategy is cost-effective at 66.8%. The strategy of engaging PPs was incrementally cost-effective, although under specific conditions, most importantly a well-functioning public directly observed treatment, short-course (DOTS) program. PMID:20519613

Surrogate endpoints for overall survival in advanced non-small-cell lung cancer patients with mutations of the epidermal growth factor receptor gene.

PubMed

Yoshino, Reiko; Imai, Hisao; Mori, Keita; Takei, Kousuke; Tomizawa, Mai; Kaira, Kyoichi; Yoshii, Akihiro; Tomizawa, Yoshio; Saito, Ryusei; Yamada, Masanobu

2014-09-01

Subsequent therapies confound the ability to discern the effect of first-line chemotherapy on overall survival (OS). We investigated whether progression-free survival (PFS), post-progression survival (PPS) and tumor response were valid surrogate endpoints for OS following first-line chemotherapy in individual patients with advanced non-small-cell lung cancer (NSCLC) harboring sensitive epidermal growth factor receptor gene mutations. We retrospectively analyzed 35 patients with advanced NSCLC treated with first-line gefitinib. The associations of PFS, PPS and tumor response with OS were analyzed. PPS was found to be strongly correlated with OS, unlike PFS and tumor shrinkage. The factors significantly associated with PPS were performance status (PS) after first-line treatment, best response to second-line treatment and number of regimens used after disease progression. PPS may be a surrogate for OS in this patient population and further therapy after disease progression following first-line chemotherapy may significantly affect OS. However, a larger study is required to validate these results.

Critical role of dendritic cells in T cell retention in the interfollicular region of Peyer's patches.

PubMed

Obata, Takashi; Shibata, Naoko; Goto, Yoshiyuki; Ishikawa, Izumi; Sato, Shintaro; Kunisawa, Jun; Kiyono, Hiroshi

2013-07-15

Peyer's patches (PPs) simultaneously initiate active and quiescent immune responses in the gut. The immunological function is achieved by the rigid regulation of cell distribution and trafficking, but how the cell distribution is maintained remains to be elucidated. In this study, we show that binding of stromal cell-derived lymphoid chemokines to conventional dendritic cells (cDCs) is essential for the retention of naive CD4(+) T cells in the interfollicular region (IFR) of PPs. Transitory depletion of CD11c(high) cDCs in mice rapidly impaired the IFR structure in the PPs without affecting B cell follicles or germinal centers, lymphoid chemokine production from stromal cells, or the immigration of naive T cells into the IFRs of PPs. The cDC-orchestrated retention of naive T cells was mediated by heparinase-sensitive molecules that were expressed on cDCs and bound the lymphoid chemokine CCL21 produced from stromal cells. These data collectively reveal that interactions among cDCs, stromal cells, and naive T cells are necessary for the formation of IFRs in the PPs.

THE EFFECT OF PLANET-PLANET SCATTERING ON THE SURVIVAL OF EXOMOONS

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

Gong Yanxiang; Zhou Jilin; Xie Jiwei

2013-05-20

Compared to the giant planets in the solar system, exoplanets have many remarkable properties, such as the prevalence of giant planets on eccentric orbits and the presence of hot Jupiters. Planet-planet scattering (PPS) between giant planets is a possible mechanism to interpret the above and other observed properties. If the observed giant planet architectures are indeed outcomes of PPS, such a drastic dynamical process must affect their primordial moon systems. In this Letter, we discuss the effect of PPS on the survival of exoplanets' regular moons. From an observational viewpoint, some preliminary conclusions are drawn from the simulations. (1) PPSmore » is a destructive process to the moon systems; single planets on eccentric orbits are not ideal moon-search targets. (2) If hot Jupiters formed through PPS, their original moons have little chance of survival. (3) Planets in multiple systems with small eccentricities are more likely to hold their primordial moons. (4) Compared with lower-mass planets, massive planets in multiple systems may not be the preferred moon-search targets if the system underwent a PPS history.« less

Quadriceps muscle strength and voluntary activation after polio.

PubMed

Beelen, Anita; Nollet, Frans; de Visser, Marianne; de Jong, Bareld A; Lankhorst, Gustaaf J; Sargeant, Anthony J

2003-08-01

Quadriceps strength, maximal anatomical cross-sectional area (CSA), maximal voluntary activation (MVA), and maximal relaxation rate (MRR) were studied in 48 subjects with a past history of polio, 26 with and 22 without postpoliomyelitis syndrome (PPS), and in 13 control subjects. It was also investigated whether, apart from CSA, MVA and MRR were determinants of muscle strength. Polio subjects had significantly less strength, CSA, and MRR in the more-affected quadriceps than control subjects. MVA was reduced in 18 polio subjects and normal in all controls. PPS subjects differed from non-PPS subjects only in that the MVA of the more-affected quadriceps was significantly lower. Both CSA and MVA were found to be associated with muscle strength. Quadriceps strength in polio subjects was dependent not only on muscle mass, but also on the ability to activate the muscles. Since impaired activation was more pronounced in PPS subjects, the new muscle weakness and functional decline in PPS may be due not only to a gradual loss of muscle fibers, but also to an increasing inability to activate the muscles.

Biodegradable Poly(polyol sebacate) Polymers

PubMed Central

Bruggeman, Joost P.; de Bruin, Berend-Jan; Bettinger, Christopher J.; Langer, Robert

2010-01-01

We have developed a family of synthetic biodegradable polymers that are composed of structural units endogenous to the human metabolism, designated poly(polyol sebacates) (PPS) polymers. Material properties of PPS polymers can be tuned by altering the polyol monomer and reacting stiochiometric ratio of sebacic acid. These thermoset networks exhibited tensile Young’s moduli ranging from 0.37 ± 0.08 to 378 ± 33 MPa with maximum elongations at break from 10.90 ± 1.37 to 205.16 ± 55.76%, and glass-transition temperatures ranged from ~7 to 46 °C. In vitro degradation under physiological conditions was slower than in vivo degradation rates observed for some PPS polymers. PPS polymers demonstrated similar in vitro and in vivo biocompatibility compared to poly(L-lactic-co-glycolic acid) (PLGA). PMID:18824260

Post-Polio Syndrome

MedlinePlus

... PPS is unknown but experts have offered several theories to explain the phenomenon—ranging from the fatigue ... families. Managing PPS can involve lifestyle changes. Support groups that encourage self-help, group participation, and positive ...

Dual keel Space Station payload pointing system design and analysis feasibility study

NASA Technical Reports Server (NTRS)

Smagala, Tom; Class, Brian F.; Bauer, Frank H.; Lebair, Deborah A.

1988-01-01

A Space Station attached Payload Pointing System (PPS) has been designed and analyzed. The PPS is responsible for maintaining fixed payload pointing in the presence of disturbance applied to the Space Station. The payload considered in this analysis is the Solar Optical Telescope. System performance is evaluated via digital time simulations by applying various disturbance forces to the Space Station. The PPS meets the Space Station articulated pointing requirement for all disturbances except Shuttle docking and some centrifuge cases.

Are former late-preterm children at risk for child vulnerability and overprotection?

PubMed

Samra, Haifa A; McGrath, Jacqueline M; Wey, Howard

2010-09-01

Parent perception of child vulnerability (PPCV) and parent overprotection (POP) are believed to have serious implications for age appropriate cognitive and psychosocial development in very low birth weight preterm children. With recent concerns about suboptimal developmental outcomes in late-preterm children, this study was aimed at examining the relationship between history of late-preterm birth (34-36 6/7 weeks gestation), and PPCV, POP, and healthcare utilization (HCU). This was a cross-sectional observational design. Study participants were mothers of 54 healthy singleton children recruited from community centers including Women and Children Clinics (WIC), primary care clinics and daycare centers in the upper Midwest region. Outcome measures included Forsyth Child Vulnerability Scale (CVS), Thomasgard Parent Protection Scale (PPS) scores, and healthcare utilization (HCU). Potential covariates included history of life-threatening illness, child and maternal demographics, and maternal stress and depression using the Center for Epidemiologic Studies Depression Scale (CESD). HCU (p=0.02) and the PPS subscales of supervision (p=0.003) and separation (p=0.03) were significant predictors of PPCV in mothers of 3-8 years old children with late-preterm history. Age of the child (p=0.008) and CVS scores (p=0.005) were significant predictors of POP. Maternal age (p=0.04), stress (p=0.04), and CVS scores (p=0.003) were significant predictors of HCU. Dependence, a subscale of the PPS, correlated with the child's age and gender even after controlling for age. History of late-preterm did not predict MPCV, MOP, or HCU in healthy children. Future research is needed in larger more diverse samples to better understand causal relationships and develop strategies to lessen risks of MPCV and MOP. Published by Elsevier Ireland Ltd.

Phase, compositional, and morphological changes of human dentin after Nd:YAG laser treatment.

PubMed

Lin, C P; Lee, B S; Lin, F H; Kok, S H; Lan, W H

2001-06-01

Although techniques for repairing root fracture have been proposed, the prognosis is generally poor. If the fusion of a root fracture by laser is possible, it will offer an alternative to extraction. Our group has attempted to use lasers to fuse a low melting-point bioactive glass to fractured dentin. This report is focused on the phase, compositional, and morphological changes observed by means of X-ray diffractometer, Fourier transforming infrared spectroscopy, and scanning electron microscopy-energy dispersive X-ray spectroscopy in human dentin after exposure to Nd:YAG laser. The irradiation energies were from 150 mJ/ pulse-10 pps-4 s to 150 mJ/pulse-30 pps-4 s. After exposure to Nd:YAG laser, dentin showed four peaks on the X-ray diffractometer that corresponding to a-tricalcium phosphate (TCP) and beta-TCP at 20 = 30.78 degrees/34.21 degrees and 32.47 degrees/33.05 degrees, respectively. The peaks of a-TCP and beta-TCP gradually increased in intensity with the elevation of irradiation energy. In Fourier transforming infrared analysis, two absorption bands at 2200 cm(-1) and 2015 cm(-1) could be traced on dentin treated by Nd:YAG laser with the irradiation energies beyond 150 mJ/pulse-10 pps-4 s. The energy dispersive X-ray results showed that the calcium/phosphorus ratios of the irradiated area proportionally increased with the elevation of irradiation energy. The laser energies of 150 mJ/ pulse-30 pps-4 s and 150 mJ/pulse-20 pps-4 s could result in the a-TCP formation and collagen breakdown. However, the formation of glass-like melted substances without a-TCP at the irradiated site was induced by the energy output of 150 mJ/ pulse-10 pps-4 s. Scanning electron micrographs also revealed that the laser energy of 150 mJ/ pulse-10 pps-4 s was sufficient to prompt melting and recrystallization of dentin crystals without cracking. Therefore, we suggest that the irradiation energy of Nd:YAG laser used to fuse a low melting-point bioactive glass to dentin is 150 mJ/ pulse-10 pps-4 s.

Technical Report Writer’s Style Manual. Revision.

DTIC Science & Technology

1987-01-01

number and followed by a per!od, a zero , and a second period. Two blank spaces separate the heading number and the heading words. All letters in major...the word "degrees" as shown: 9 490 below zero e -15 °C e 45 to 65 OF 4. * 150 million degrees Fahrenheit o a 45-degree angle ,o * 450 north latitude 4...dm pound-force lb f degree Celcius °C pound-mass Ibm degree Farenheit OF pounds per second pps degrees per second deg/s pounds per square inch lb/in

A leadership initiative to improve communication and enhance safety.

PubMed

Donahue, Moreen; Miller, Matthew; Smith, Lisa; Dykes, Patricia; Fitzpatrick, Joyce J

2011-01-01

The EMPOWER project was a collaborative effort to promote a culture of patient safety at Danbury Hospital through an interdisciplinary leadership-driven communication program. The "EMPOWER" component includes Educating and Mentoring Paraprofessionals On Ways to Enhance Reporting of changes in patient status. Specifically, the EMPOWER program was designed to prepare paraprofessional staff (PPS) to communicate changes in patient status using SBAR (situation, background, assessment, recommendations) structured communication. The specific project goals included (a) translation of SBAR structured communication methods for use with PPS, (b) reduction of cultural and educational barriers to interdisciplinary communication, and (c) examination of the effect of the EMPOWER intervention on the PPS communication practices and perceptions of the patient safety culture. Results of the project indicate a change in the use of SBAR throughout the institution, with particular improvement in communication from PPS to professional staff.

The role of Medicare reimbursement in contemporary hospital finance.

PubMed

Golub, S

1986-01-01

A hospital, while performing its major function of providing health care, is also viewed as a business. It needs capital from a wide variety of sources, many of which are government regulated. Over the past few years, federal expenditures for Medicare have increased dramatically, as has regulation of hospital revenue sources. Congress enacted the Medicare Prospective Payment System (PPS) to curb hospital cost inflation. This Note examines historical trends in health care financing and analyzes the Medicare reimbursement system, with emphasis on PPS and its impact on hospital revenues. The Note suggests that hospitals, due to the effects of PPS, will be forced to reduce their levels of financial leverage and will have to look for corporate financial alternatives. PPS may signal a new era in hospital finance. Survival mandates an increased focus on efficient corporate, financial and managerial policies.

Unique isothermal crystallization behavior of novel polyphenylene sulfide/inorganic fullerene-like WS2 nanocomposites.

PubMed

Naffakh, Mohammed; Marco, Carlos; Gómez, Marián A; Jiménez, Ignacio

2008-11-27

The isothermal crystallization of polyphenylene sulfide (PPS) nanocomposites with inorganic fullerene-like tungsten disulfide nanoparticles (IF-WS2) has been studied from a thermal and morphological point of view, using differential scanning calorimetry (DSC), scanning electron microscopy (SEM), polarized optical microscopy (POM) and time-resolved synchrotron X-ray diffraction. All the analyses revealed that the incorporation of the IF-WS2 altered significantly the crystallization behavior of PPS, in a way strongly dependent with the nanocomposite composition. The addition of IF-WS2 in 0.1 wt % proportion retarded the crystallization of PPS by increasing its fold surface free energy in a 10%. However, addition of the nanoparticles in excess of 1 wt % results in a promotion of the crystallization rate with reduction of the fold surface free energy to half the value of pure PPS.

Parapharyngeal space tumors: another consideration for otalgia and temporomandibular disorders.

PubMed

Grosskopf, Courtney C; Kuperstein, Arthur S; O'Malley, Bert W; Sollecito, Thomas P

2013-05-01

Parapharyngeal space (PPS) tumors are rare, accounting for 0.5% of all head and neck neoplasms. PPS tumors are difficult to diagnose due to limited presenting signs and symptoms and because of their location deep within the neck. A 60-year-old woman presented with complaints of otalgia, which appeared to be consistent with a temporomandibular disorder (TMD). Due to disproportionate symptoms, an MRI of the temporomandibular joints was ordered. The MRI revealed a mass within the PPS, which was later diagnosed as a mucoepidermoid carcinoma. A literature search failed to reveal otalgia, and facial pain, thought to be related to a TMD, as the primary presenting symptoms of a PPS neoplasm. Patients presenting with disproportionate signs and symptoms of a TMD should be evaluated with advanced imaging to rule out occult pathology. Copyright © 2012 Wiley Periodicals, Inc.

Prospective clinical evaluation of the Polyperf® Safe, a safety Huber needle, in cancer patients.

PubMed

Goossens, Godelieve A; Moons, Philip; Jérôme, Martine; Stas, Marguerite

2011-01-01

Evaluation of the Polyperf® Safe (PPS) needle on safety and user-friendliness, as experienced by first-time and non-first-time users of the device. A prospective, descriptive study was carried out at the University Hospitals Leuven, Belgium. Five hundred PPS needles were individually evaluated in cancer patients. Different aspects of the PPS were assessed: packaging, needle insertion, and needle removal. Nurses were asked whether they had previously inserted or removed this type of needle. We compared the PPS needle with the standard Gripper® needle in terms of safety, ease of use, and ease of training. Three hundred sixty-six evaluation forms were available for analysis (73.2%). Packaging and access evaluations were scored positively, except for two aspects: (1) needle stability, and (2) ease of dressing. Ease of removal was scored unsatisfactory in up to 22.4% of the registrations. Pain at insertion was reported in about 20% registrations, and blood contact was reported by 2.5% of non-first-time users. Safety was scored as good, although ease of use and ease in training scored 25.4% and 43.8%, respectively, lower than the Gripper®. In general, nurses evaluated the PPS positively, with the exception of needle stability, ease of dressing, and ease of removal. No needlestick accidents were recorded. Aspects of ease of use and ease of training for PPS needles scored less than those for the Gripper® needles in up to one-third of the registrations.

ROS-Responsive Microspheres for On Demand Antioxidant Therapy in a Model of Diabetic Peripheral Arterial Disease

PubMed Central

Poole, KM; Nelson, CE; Joshi, RV; Martin, JR; Gupta, MK; Haws, SC; Kavanaugh, TE; Skala, MC; Duvall, CL

2014-01-01

A new microparticle-based delivery system was synthesized from reactive oxygen species (ROS)-responsive poly(propylene sulfide) (PPS) and tested for “on demand” antioxidant therapy. PPS is hydrophobic but undergoes a phase change to become hydrophilic upon oxidation and thus provides a useful platform for ROS-demanded drug release. This platform was tested for delivery of the promising anti-inflammatory and antioxidant therapeutic molecule curcumin, which is currently limited in use in its free form due to poor pharmacokinetic properties. PPS microspheres efficiently encapsulated curcumin through oil-in-water emulsion and provided sustained, on demand release that was modulated in vitro by hydrogen peroxide concentration. The cytocompatible, curcumin-loaded microspheres preferentially targeted and scavenged intracellular ROS in activated macrophages, reduced in vitro cell death in the presence of cytotoxic levels of ROS, and decreased tissue-level ROS in vivo in the diabetic mouse hind limb ischemia model of peripheral arterial disease. Interestingly, due to the ROS scavenging behavior of PPS, the blank microparticles also showed inherent therapeutic properties that were synergistic with the effects of curcumin in these assays. Functionally, local delivery of curcumin-PPS microspheres accelerated recovery from hind limb ischemia in diabetic mice, as demonstrated using non-invasive imaging techniques. This work demonstrates the potential for PPS microspheres as a generalizable vehicle for ROS-demanded drug release and establishes the utility of this platform for improving local curcumin bioavailability for treatment of chronic inflammatory diseases. PMID:25522975

Poly(1,3-propylene sebacate) and Poly(sebacoyl diglyceride): A Pair of Potential Polymers for the Proliferation and Differentiation of Retinal Progenitor Cells.

PubMed

Ni, Ni; Ji, Jing; Chen, Shuo; Zhang, Dandan; Wang, Zi; Shen, Bingqiao; Guo, Chunyu; Zhang, Yi; Wang, Shaofei; Fan, Xianqun; You, Zhengwei; Luo, Min; Gu, Ping

2016-09-01

Using suitable polymers as a carrier for growing and delivering retinal progenitor cells (RPCs) is a promising therapeutic strategy in retinal cell-replacement therapy. Herein recently developed polymer, poly(sebacoyl diglyceride) (PSeD), is selected and its nonhydroxylized counterpart poly(1,3-propylene sebacate) (PPS) is designed to evaluate their potentials for RPC growth and future RPC application. The structures and mechanical properties of the polymers are characterized. The cytocompatibility and effects of these polymers on RPC proliferation, differentiation, and migration are systematically investigated in vitro. Our data show that PPS and PSeD display excellent cytocompatibility with low expression of inflammation and apoptosis factors, which benefit RPC growth. In proliferation assays reveal that RPCs expands well on the polymers, but PPS performs the best for RPC expansion, indicating that PPS can remarkably promote RPC proliferation. In differentiation conditions, RPCs grown on PSeD are more likely to differentiate toward retinal neurons, including photoreceptors, the most interesting type of cells for retinal cell-replacement therapy. Additionally, our results demonstrate that RPCs grown on PSeD display an outstanding ability to migrate. In conclusion, PPS can markedly promote RPC proliferation, whereas PSeD can enhance RPC differentiation toward retinal neurons, suggesting that PSeD and PPS have potential applications in future retinal cell-replacement therapies. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Charting a path forward: policy analysis of China's evolved DRG-based hospital payment system

PubMed Central

Liu, Rui; Shi, Jianwei; Yang, Beilei; Jin, Chunlin; Sun, Pengfei; Wu, Lingfang; Yu, Dehua; Xiong, Linping; Wang, Zhaoxin

2017-01-01

Abstract Background At present, the diagnosis-related groups-based prospective payment system (DRG-PPS) that has been implemented in China is merely a prototype called the simplified DRG-PPS, which is known as the ‘ceiling price for a single disease’. Given that studies on the effects of a simplified DRG-PPS in China have usually been controversial, we aim to synthesize evidence examining whether DRGs can reduce medical costs and length of stay (LOS) in China. Methods Data were searched from both Chinese [Wan Fang and China National Knowledge Infrastructure Database (CNKI)] and international databases (Web of Science and PubMed), as well as the official websites of Chinese health departments in the 2004–2016 period. Only studies with a design that included both experimental (with DRG-PPS implementation) and control groups (without DRG-PPS implementation) were included in the review. Results The studies were based on inpatient samples from public hospitals distributed in 12 provinces of mainland China. Among them, 80.95% (17/21) revealed that hospitalization costs could be reduced significantly, and 50.00% (8/16) indicated that length of stay could be decreased significantly. In addition, the government reports showed the enormous differences in pricing standards and LOS in various provinces, even for the same disease. Conclusions We conclude that the simplified DRGs are useful in controlling hospitalization costs, but they fail to reduce LOS. Much work remains to be done in China to improve the simplified DRG-PPS. PMID:28911128

HORMONAL AND PHYSICAL MARKERS OF PUBERTY AND THEIR RELATIONSHIP TO ADOLESCENT-TYPICAL NOVELTY-DIRECTED BEHAVIOR

PubMed Central

Vetter-O’Hagen, Courtney S.; Spear, Linda P.

2011-01-01

The extent to which characteristic adolescent behaviors are associated with pubertal changes or driven by more general, puberty-independent developmental alterations is largely unknown. Using physiological and hormonal markers of puberty, this experiment characterized pubertal timing across adolescence and examined the relationships among these variables and novelty-directed behaviors. Males and females were tested for response to novelty at P28, P32, P36, P40, P44, P48 and P75, and examined for balano-preputial skinfold separation and sperm presence (males) or vaginal opening (females), followed by blood collection for hormonal assessments. Despite earlier pubertal maturation in females, with maturation generally completed by P36 in females and P44 in males, novelty-directed behavior peaked at P32 and P36 in both sexes, and was unrelated to pubertal measures. These data support the suggestion that the ontogenetic peak in this behavior during adolescence is not notably puberty-dependent. PMID:21953609

Effects of Prenatal Exposure to a Low Dose Atrazine Metabolite Mixture on Pubertal Timing and Prostate Development of Male Long Evans Rats

PubMed Central

Stanko, Jason P.; Enoch, Rolondo R.; Rayner, Jennifer L.; Davis, Christine C.; Wolf, Douglas C.; Malarkey, David E.; Fenton, Suzanne E.

2010-01-01

The present study examines the postnatal reproductive development of male rats following prenatal exposure to an atrazine metabolite mixture (AMM) consisting of the herbicide atrazine and its environmental metabolites diaminochlorotriazine, hydroxyatrazine, deethylatrazine, and deisopropylatrazine. Pregnant Long Evans rats were treated by gavage with 0.09, 0.87, or 8.73 mg AMM/kg body weight (BW), vehicle, or 100 mg ATR/kg BW positive control, on gestation days 15-19. Preputial separation was significantly delayed in 0.87 mg and 8.73 mg AMM-exposed males. AMM-exposed males demonstrated a significant treatment-related increase in incidence and severity of inflammation in the prostate on postnatal day (PND) 120. A dose-dependent increase in epididymal fat masses and prostate foci were grossly visible in AMM-exposed offspring. These results indicate that a short, late prenatal exposure to mixture of chlorotriazine metabolites can cause chronic prostatitis in male LE rats. The mode of action for these effects is presently unclear. PMID:20727709

Depolarizing Effects of Daikenchuto on Interstitial Cells of Cajal from Mouse Small Intestine

PubMed Central

Kim, Hyungwoo; Kim, Hyun Jung; Yang, Dongki; Jung, Myeong Ho; Kim, Byung Joo

2017-01-01

Background: Daikenchuto (DKT; TJ-100, TU-100), a traditional herbal medicineis used in modern medicine to treat gastrointestinal (GI) functional disorders. Interstitial cells of Cajal (ICCs) are the pacemaker cells of the GI tract and play important roles in the regulation of GI motility. Objective: The objective of this study was to investigate the effects of DKT on the pacemaker potentials (PPs) of cultured ICCs from murine small intestine. Materials and Methods: Enzymatic digestions were used to dissociate ICCs from mouse small intestine tissues. All experiments on ICCs were performed after 12 h of culture. The whole-cell patch-clamp configuration was used to record ICC PPs (current clamp mode). All experiments were performed at 30-32°C. Results: In current-clamp modeDKT depolarized and concentration-dependently decreased the amplitudes of PPs. Y25130 (a 5-HT3 receptor antagonist) or SB269970 (a 5-HT7 receptor antagonist) did not block DKT-induced PP depolarization, but RS39604 (a 5-HT4 receptor antagonist) did. Methoctramine (a muscarinic M2 receptor antagonist) failed to block DKT-induced PP depolarization, but pretreating 4-diphenylacetoxy-N-methylpiperidine methiodide (a muscarinic M3 receptor antagonist) facilitated blockade of DKT-induced PP depolarization. Pretreatment with an external Ca2+-free solution or thapsigargin abolished PPsand under these conditions, DKT did not induce PP depolarization. Furthermore Ginseng radix and Zingiberis rhizomes depolarized PPs, whereas Zanthoxyli fructus fruit (the third component of DKT) hyperpolarized PPs. Conclusion: These results suggest that DKT depolarizes ICC PPs in an internal or external Ca2+-dependent manner by stimulating 5-HT4 and M3 receptors. Furthermore, the authors suspect that the component in DKT largely responsible for depolarization is probably also a component of Ginseng radix and Zingiberis rhizomes. SUMMARY Daikenchuto (DKT) depolarized and concentration-dependently decreased the amplitudes of pacemaker potentials (PPs)Y25130 (a 5-HT3 receptor antagonist) or SB269970 (a 5-HT7 receptor antagonist) did not block DKT-induced PP depolarization, but RS39604 (a 5-HT4 receptor antagonist) didMethoctramine (a muscarinic M2 receptor antagonist) failed to block DKT-induced PP depolarization, but pretreating 4-DAMP (a muscarinic M3 receptor antagonist) facilitated blockade of DKT-induced PP depolarizationGinseng radix and Zingiberis rhizomes depolarized PPswhereas Zanthoxyli fructus fruit (the third component of DKT) hyperpolarized PPs. Abbreviation used: DKT: Daikenchuto, GI: Gastrointestinal, ICCs: Interstitial cells of Cajal, PPs: Pacemaker Potentials. PMID:28216898

Depolarizing Effects of Daikenchuto on Interstitial Cells of Cajal from Mouse Small Intestine.

PubMed

Kim, Hyungwoo; Kim, Hyun Jung; Yang, Dongki; Jung, Myeong Ho; Kim, Byung Joo

2017-01-01

Daikenchuto (DKT; TJ-100, TU-100), a traditional herbal medicineis used in modern medicine to treat gastrointestinal (GI) functional disorders. Interstitial cells of Cajal (ICCs) are the pacemaker cells of the GI tract and play important roles in the regulation of GI motility. The objective of this study was to investigate the effects of DKT on the pacemaker potentials (PPs) of cultured ICCs from murine small intestine. Enzymatic digestions were used to dissociate ICCs from mouse small intestine tissues. All experiments on ICCs were performed after 12 h of culture. The whole-cell patch-clamp configuration was used to record ICC PPs (current clamp mode). All experiments were performed at 30-32°C. In current-clamp modeDKT depolarized and concentration-dependently decreased the amplitudes of PPs. Y25130 (a 5-HT 3 receptor antagonist) or SB269970 (a 5-HT 7 receptor antagonist) did not block DKT-induced PP depolarization, but RS39604 (a 5-HT 4 receptor antagonist) did. Methoctramine (a muscarinic M 2 receptor antagonist) failed to block DKT-induced PP depolarization, but pretreating 4-diphenylacetoxy-N-methylpiperidine methiodide (a muscarinic M 3 receptor antagonist) facilitated blockade of DKT-induced PP depolarization. Pretreatment with an external Ca 2+ -free solution or thapsigargin abolished PPsand under these conditions, DKT did not induce PP depolarization. Furthermore Ginseng radix and Zingiberis rhizomes depolarized PPs, whereas Zanthoxyli fructus fruit (the third component of DKT) hyperpolarized PPs. These results suggest that DKT depolarizes ICC PPs in an internal or external Ca 2+ -dependent manner by stimulating 5-HT 4 and M 3 receptors. Furthermore, the authors suspect that the component in DKT largely responsible for depolarization is probably also a component of Ginseng radix and Zingiberis rhizomes. Daikenchuto (DKT) depolarized and concentration-dependently decreased the amplitudes of pacemaker potentials (PPs)Y25130 (a 5-HT 3 receptor antagonist) or SB269970 (a 5-HT 7 receptor antagonist) did not block DKT-induced PP depolarization, but RS39604 (a 5-HT 4 receptor antagonist) didMethoctramine (a muscarinic M 2 receptor antagonist) failed to block DKT-induced PP depolarization, but pretreating 4-DAMP (a muscarinic M 3 receptor antagonist) facilitated blockade of DKT-induced PP depolarizationGinseng radix and Zingiberis rhizomes depolarized PPswhereas Zanthoxyli fructus fruit (the third component of DKT) hyperpolarized PPs. Abbreviation used: DKT: Daikenchuto, GI: Gastrointestinal, ICCs: Interstitial cells of Cajal, PPs: Pacemaker Potentials.

Evaluation of antioxidant and immuno-enhancing activities of Purslane polysaccharides in gastric cancer rats.

PubMed

Li, Yunqiao; Hu, Yanke; Shi, Shaojun; Jiang, Lei

2014-07-01

In the last three decades, numerous polysaccharides and polysaccharide-protein complexes have been isolated from plant or animal and used as a promising source of therapeutic agents for cancer. In this study, we examined the effects of Purslane polysaccharides (PPs) on the oxidative injury and immune status in N-methyl-N'-nitro-N-nitrosoguanidine (MNNG)-induced gastric cancer rats. PPs administration (200, 400 or 800mg/kg body weight) could not only increase the body weight, peripheral white blood cells (WBC) count, thymus and spleen indexes, but also remarkably promote splenocytes proliferation of gastric cancer rats. Furthermore, the production of serum cytokines in gastric cancer rats, such as interleukin-2 (IL-2), interleukin-4 (IL-4) and tumor necrosis factor-alpha (TNF-α) was enhanced by PPs treatment. Besides, treatment with PPs was found to provide a dose-dependent protection against MNNG-induced oxidative injury by enhancing SOD, CAT, GSH-Px activities of gastric cancer rats. Taken together, we concluded that enhancement of antioxidants and immune response might be responsible for the anticancer effect of PPs in gastric cancer. Copyright © 2014 Elsevier B.V. All rights reserved.

Development and characterization of hybrid thermoplastic composites

NASA Astrophysics Data System (ADS)

Karkhanis, Priyanka Chandrashekhar

This work is aimed at studying the possibility of using interply hybrid woven thermoplastic semi-pregs in secondary structures in aircrafts at TenCate Advanced Composites, Netherlands and Purdue University. Three different interply hybrids were designed from combination of Cetex(c) carbon-PPS semi-preg, Owen corning's woven glass with PPS sheets and discontinuous chopped Cetex(c) carbon-PPS semi-preg to get desired flexural, out of plane and bearing properties. The design calculations are done based on classical laminate theory and the selection of materials to be used with carbon-PPS was done based on cost and availability. The Hybrid laminate performances are analyzed and compared to the conventional Cetex (c) Carbon-PPS semi-preg laminates. Observations are reported on three point bend test (European standard 2562), four point bend test(ASTM D6415-99) and bearing test (Airbus standards AITM 1-0009) for the laminates and it was found that hybrid laminates show a reduction of 5-10% in bending stiffness, 20-40% reduction in out-of-plane strength and 2-5%reduction in bearing with a cost reduction of 20-30%. The research identifies and documents the different factors responsible for failures and reduction in strength in the Hybrids.

Validation of a French version of the pure procrastination scale (PPS).

PubMed

Rebetez, Marie My Lien; Rochat, Lucien; Gay, Philippe; Van der Linden, Martial

2014-08-01

Procrastination is a widespread phenomenon that affects everyone's day-to-day life and interferes with the clinical treatment of several psychopathological states. To assess this construct, Steel (2010) developed the Pure Procrastination Scale (PPS), a short scale intended to capture the general notion of dysfunctional delay. The aim of the current study was to present a French version of this questionnaire. To this end, the 12 items of the PPS were translated into French and data were collected from an online survey in a sample of 245 French-speaking individuals from the general population. The results revealed that one item had problematic face validity; it was therefore removed. Exploratory and confirmatory analyses performed on the resulting 11-item version of the French PPS indicated that the scale was composed of two factors ("voluntary delay" and "observed delay") depending on a common, higher-order construct ("general procrastination"). Good internal consistency and test-retest reliability were found. External validity was supported by specific relationships with measures of personality traits, impulsivity, and subjective well-being. The French PPS therefore presents satisfactory psychometric properties and may be considered a reliable and valid instrument for research, teaching and clinical practice. Copyright © 2014 Elsevier Inc. All rights reserved.

Forecasting E > 50-MeV Proton Events with the Proton Prediction System (PPS)

NASA Astrophysics Data System (ADS)

Kahler, S. W.; White, S. M.; Ling, A. G.

2017-12-01

Forecasting solar energetic (E > 10 MeV) particle (SEP) events is an important element of space weather. While several models have been developed for use in forecasting such events, satellite operations are particularly vulnerable to higher-energy (> 50 MeV) SEP events. Here we validate one model, the proton prediction system (PPS), which extends to that energy range. We first develop a data base of E > 50-MeV proton events > 1.0 proton flux units (pfu) events observed on the GOES satellite over the period 1986 to 2016. We modify the PPS to forecast proton events at the reduced level of 1 pfu and run PPS for four different solar input parameters: (1) all > M5 solar X-ray flares; (2) all > 200 sfu 8800-MHz bursts with associated > M5 flares; (3) all > 500 sfu 8800-MHz bursts; and (4) all > 5000 sfu 8800-MHz bursts. For X-ray flare inputs the forecasted event peak intensities and fluences are compared with observed values. The validation contingency tables and skill scores are calculated for all groups and used as a guide to use of the PPS. We plot the false alarms and missed events as functions of solar source longitude.

Asbestos exposure increases the incidence of histologically confirmed usual interstitial pneumonia.

PubMed

Kawabata, Yoshinori; Shimizu, Yoshihiko; Hoshi, Eishin; Murai, Kazumi; Kanauchi, Tetsu; Kurashima, Kazuyoshi; Sugita, Yutaka

2016-02-01

We hypothesized that asbestos exposure increases the incidence of macroscopically visible and histologically confirmed usual interstitial pneumonia (histological UIP). We retrospectively examined 1718 cases (1202 males; mean age 66.7 years) who underwent lobectomy for resection of pleuropulmonary tumours. Objective markers for asbestos exposure included: the presence of malignant pleural mesothelioma, the presence of pleural plaques (PPs) and asbestos bodies in the histological specimen. Risk factors for histological UIP were examined. Two separate groups were studied: 183 with asbestos exposure, and 239 with histological UIP. The 183 cases with asbestos exposure had higher rates of positive occupational history and histological UIP (31%) than the remaining 1535. Among the asbestos-exposed group, small numbers of asbestos bodies were found in histological specimens of 21 cases of histological UIP. PPs and asbestos bodies were more frequent in the 239 patients with histological UIP than in the remaining 1479 UIP-negative patients. Multivariate analysis showed that asbestos exposure, especially positivity for asbestos bodies, that does not meet the current criteria for asbestosis increases the risk of histological UIP (P < 0.0001). Asbestos exposure causes asbestosis and increases the incidence of histological UIP. © 2015 John Wiley & Sons Ltd.

Intra-operative hyperthermia in a young Angus bull with a fatal outcome.

PubMed

Skelding, Alicia; Valverde, Alexander

2017-06-01

A healthy, 9-month-old black Angus bull was presented for elective penile-preputial translocation and caudal epididymectomy. After premedication and induction, general anesthesia was maintained with inhalant anesthetic. Over an hour into the anesthetic period the bull developed severe hyperthermia and hypercapnia that resulted in fatality despite treatment efforts.

Identification of volatiles from the secretions and excretions of African wild dogs (Lycaon pictus).

PubMed

Apps, Peter; Mmualefe, Lesego; McNutt, J Weldon

2012-11-01

Gas chromatography/mass spectrometry was used to identify 103 organic compounds from urine, feces, anal glands, and preputial glands of free-ranging African wild dogs, Lycaon pictus. Aliphatic acids were the dominant class of compound in all materials. In addition to aliphatic acids, urine contained dimethyl sulfone, 1,3-propanediol, benzoic acid, 1-methyl-2,4-imidazolidinedione, and squalene as major components: feces contained indole and cholesterol; and both contained 2-piperidone, phenol, 4-methyl phenol, benzeneacetic acid, and benzenepropanoic acid and other compounds. Anal gland secretion was particularly rich in cholesterol and fatty acids, and preputial gland secretion rich in squalene. A large majority of the identified compounds have been reported from other mammals, including species sympatric with African wild dogs. Eleven of the African wild dog components have not been reported previously from mammals and have not been found in sympatric species; one component, 1-methylimidazole-5-carboxaldehyde has not been reported previously as a natural product. In the chemical profiles of their urine, feces, and anal gland secretion African wild dogs differ markedly from other canids.

Validating the Proton Prediction System (PPS)

DTIC Science & Technology

2006-12-01

hazards for astro - proton fluence model (Feynman et al., 2002) fits nauts on the missions to the Moon and Mars observed SEP event fluences of E>10MeV...events limited the useful PPS test cases to 78 of the J(E>10MeV) = 347 x ( Fx )0.941, (3) 101 solar flares. Although they can be serious radiation...hazards (Reames, 1999), PPS does not where Fx is the GOES 1-8 A X-ray flare half-power predict the E> 10MeV peaks often seen during the fluence in J cm -2

Plasma-panel based detectors

NASA Astrophysics Data System (ADS)

Friedman, Peter

2017-09-01

The plasma panel sensor (PPS) is a novel micropattern gas detector inspired by plasma display panels (PDPs), the core component of plasma-TVs. A PDP comprises millions of discrete cells per square meter, each of which, when provided with a signal pulse, can initiate and sustain a plasma discharge. Configured as a detector, a pixel or cell is biased to discharge when a free-electron is generated in the gas. The PPS consists of an array of small plasma discharge pixels, and can be configured to have either an ``open-cell'' or ``closed-cell'' structure, operating with high gain in the Geiger region. We describe both configurations and their application to particle physics. The open-cell PPS lends itself to ultra-low-mass, ultrathin structures, whereas the closed-cell microhexcavity PPS is capable of higher performance. For the ultrathin-PPS, we are fabricating 3-inch devices based on two types of extremely thin, inorganic, transparent, substrate materials: one being 8-10 µm thick, and the other 25-27 µm thick. These gas-filled ultrathin devices are designed to operate in a beam-line vacuum environment, yet must be hermetically-sealed and gas-filled in an ambient environment at atmospheric pressure. We have successfully fabricated high resolution, submillimeter pixel electrodes on both types of ultrathin substrates. We will also report on the fabrication, staging and operation of the first microhexcavity detectors (µH-PPS). The first µH-PPS prototype devices have a 16 by 16 matrix of closed packed hexagon pixels, each having a 2 mm width. Initial tests of these detectors, conducted with Ne based gases at atmospheric pressure, indicate that each pixel responds independent of its neighboring cells, producing volt level pulse amplitudes in response to ionizing radiation. Results will include the hit rate response to a radioactive beta source, cosmic ray muons, the background from spontaneous discharge, pixel isolation and uniformity, and efficiency measurements. This work was funded in part by a DOE Office of Nuclear Physics SBIR Phase-II Grant.

Measuring Responsible Gambling amongst Players: Development of the Positive Play Scale

PubMed Central

Wood, Richard T. A.; Wohl, Michael J. A.; Tabri, Nassim; Philander, Kahlil

2017-01-01

The modern gambling industry has, by-in-large, assumed a duty of care to minimize the risks associated with gambling, which has manifested in responsible gambling (RG) programming (e.g., educating players about the odds of success). The current study fills a void in gambling operators, regulators, and researchers ability to measure RG beliefs and behavior in their player-base, with the development and validation of the Positive Play Scale (PPS). In Study 1, we reviewed the literature and consulted 30 players as well as 10 RG experts to help generate a definition of RG beliefs and behavior that helped guide item generation. In Study 2, regular players (N = 1,551) of a Canadian provincial gambling operator completed a positive play survey. Four components from a principal components analysis (PCA) were extracted: Honesty and Control, Pre-commitment, Personal Responsibility, and Gambling Literacy. The PPS subscales were either not associated with gambling frequency or had small-to-moderate negative relationships with frequency of play for games most often associated with disordered gambling (e.g., electronic games). In Study 3 (N = 413), the factor structure of the PPS was confirmed and refined in a new sample of players. Moreover, a 1-month follow-up session demonstrated that the PPS has high test-retest reliability. The PPS is the first validated scale that reliably assesses the extent to which a consumer base has positive beliefs about gambling and gambles in a positive manner. The PPS can be used by the gambling industry to objectively assess the efficacy of their RG strategy, pinpoint specific areas for future focus, as well as examine the utility of new RG initiatives that aim to promote healthy patterns of gambling consumption. Furthermore, by examining the PPS scores for different player segments (e.g., sex, age, games played) it becomes possible to tailor RG strategy to the needs of specific players. In this way, RG strategy can be optimized by focusing resources where they will be most effective. PMID:28280472

Helping members of a community-based health insurance scheme access quality inpatient care through development of a preferred provider system in rural Gujarat

PubMed Central

RANSON, M. KENT; SINHA, TARA; GANDHI, FENIL; JAYSWAL, RUPAL; MILLS, ANNE J.

2007-01-01

We describe and analyse the experience of piloting a preferred provider system (PPS) for rural members of Vimo SEWA, a fixed-indemnity, community-based health insurance (CBHI) scheme run by the Self-Employed Women’s Association (SEWA). The objectives of the PPS were (i) to facilitate access to hospitalization by providing financial benefits at the time of service utilization; (ii) to shift the burden of compiling a claim away from members and towards Vimo SEWA staff; and (iii) to direct members to inpatient facilities of acceptable quality. The PPS was launched between August and October 2004, in 8 subdistricts covering 15 000 insured. The impact of the scheme was analysed using data from a household survey of claimants and qualitative data from in-depth interviews and focus group discussions. The PPS appears to have been successful in terms of two of the three primary objectives—it has transferred much of the burden of compiling a health insurance claim onto Vimo SEWA staff, and it has directed members to inpatient facilities with acceptable levels of technical quality (defined in terms of structural indicators). However, even under the PPS, user fees pose a financial barrier, as the insured have to mobilize funds to cover the costs of medicines, supplies, registration fee, etc. before receipt of cash payment from Vimo SEWA. Other barriers to the success of the PPS were the geographic inaccessibility of some of the selected hospitals, lack of awareness about the PPS among members and a variety of administrative problems. This pilot project provides useful lessons relating to strategic purchasing by CBHI schemes and, more broadly, managed care in India. In particular, the pragmatic approach taken to assessing hospitals and identifying preferred providers is likely to be useful elsewhere. PMID:17203684

Impact of road traffic “penalty points” on high energy pelvic trauma

PubMed Central

Ellanti, Prasad; Davarinos, Nikos; Morris, Seamus; McElwain, John Paul

2013-01-01

Background: The penalty points system (PPS) was introduced in 2002 in an attempt to reduce the increasing rate of road traffic accident (RTA) related fatalities and serious injuries. Points are awarded based on the severity of the offence and are cumulative. A total of 12 points results in the disqualification from driving. Objective: A few studies have looked at the immediate or short term impact of PPS on trauma services or specific injuries such as spine trauma in Ireland. Little data is available on the long term effect of the PPS. The aim of this study is to see if the PPS system has had an influence on the number of pelvic injuries referred to our unit for surgical intervention and if this influence is sustained in the longer term. Materials and Methods: A retrospective review of all pelvic and acetabular injuries admitted to our unit from 1999 to 2008 was undertaken. The mechanism of injury, the site and patient demographics were noted. Results: A total of 467 patients were identified over the ten year period. 454 patients were included in the study. There was a significant male preponderance of 76%. Mean age was 36.5 years (range 16 to 83). RTA's were the cause in 74% (n = 335) of the cases. The annual work load remained similar over the years. There has been a reduction in the number of RTA related pelvic injuries. There have been notable drops in the number of these cases corresponding to the introduction of the PPS and its subsequent expansion. The number of pelvic injuries due to falls continues to rise. Conslusion: The introduction of the PPS and its subsequent expansion has had a positive influence on the number of RTA related pelvic trauma. Continued surveillance and enforcement of the PPS is important for a sustained benefit from it in the long term. PMID:23723619

Endocrine active agents: implications of adverse and non-adverse changes.

PubMed

Foster, Paul M D; McIntyre, Barry S

2002-01-01

The US Environmental Protection Agency (EPA) is currently in the process of developing screening and testing methodologies for the assessment of agents that may possess endocrine-like activity--the so-called endocrine disruptors. Moreover, the EPA has signaled its intention of placing information arising from such studies on the worldwide web. This has created significant interest in how such information may be used in risk assessment and by policymakers and the public in the potential regulation or deselection of specific chemical agents. The construction of lists of endocrine disruptors, although fulfilling the requirements of some parties, is really of little use when the nature of the response, the dose level employed, and the lifestage of the test species used are not given. Thus, we have already seen positive in vitro information available on the interaction with a receptor being used as a key indicator when the results of large, high quality in vivo studies showing no adverse changes have been ignored. Clearly a number of in vitro systems are available to ascertain chemical interaction with specific (mainly steroid) hormone receptors including a number of reporter gene assays. These assays only provide indicators of potential problems and should not be, in isolation, indicators of toxicity. Likewise, short-term in vivo screens such as the uterotrophic and Hershberger studies are frequently conducted in castrated animals and thus indicate the potential for a pharmacological response in vivo rather than an adverse effect. A number of new end points have been added to standard rodent testing protocols in the belief of providing more sensitivity to detect endocrine related changes. These include the measurement of anogenital distance (AGD), developmental landmarks [vaginal opening (VO), preputial separation (PPS)], and in some studies the counting of nipples and areolae on males. AGD, VO, and PPS are all affected by the size of the pup in which they are measured and should always be compared using bodyweight as a covariate. The historical control database for such changes is gradually growing, albeit that if pups are not individually identified it becomes problematic to associate any change with a specific malformation or to assess whether a delay or advance in, for example, developmental landmarks is biologically significant. Agents that significantly reduce AGD in males (it is an androgen-dependent variable) frequently have other more adverse changes associated with this end point (eg, reproductive tract malformations), but a 2 to 3% change in AGD although measurable is unlikely to be biologically of importance and in isolation would not necessarily be considered adverse. Retention of thoracic nipples in male rat pups is also an indicator of impaired androgen status. Recent studies have also shown that this retention for some endocrine active chemicals is permanent. Thus, the presence of a permanent structural change that is rarely found in adult control animals could be considered a malformation and therefore a developmental adverse effect on which risk assessment decisions could be made. The advent of multigeneration reproduction studies as the definitive studies for the assessment of the dose-response relationships and risk assessment for endocrine disruptors has shown that current testing protocols may be inadequate to reliably detect the adverse effects of concern as only 1 adult/sex/litter is examined. A number of the effects on reproductive development although, due to an in utero exposure, will not be manifest until after puberty or at adulthood. The use of only a limited number of animals to examine such changes, particularly for weaker acting materials indicates that some agents may have been examined in well-conducted, modern protocols but have insufficient power to detect low incidence phenomena (eg, a 5% incidence of malformations).

Medicare's prospective payment system: A critical appraisal

PubMed Central

Coulam, Robert F.; Gaumer, Gary L.

1992-01-01

Implementation of the Medicare prospective payment system (PPS) for hospital payment has produced major changes in the hospital industry and in the way hospital services are used by physicians and their patients. The substantial published literature that examines these changes is reviewed in this article. This literature suggests that most of the intended effects of PPS on costs and intensity of care have been realized. But the literature fails to answer fundamental questions about the effectiveness and equity of administered pricing as a policy tool for cost containment. The literature offers some hope that the worst fears about the effects of PPS on quality of care and the health of the hospital industry have not materialized. But because of data lags, the studies done to date seem to tell us more about the effects of the early, more generous period of PPS than about the opportunity costs of reducing hospital cost inflation. PMID:25372306

The fairness of the PPS reimbursement methodology.

PubMed Central

Gianfrancesco, F D

1990-01-01

In FY 1984 the Medicare program implemented a new method of reimbursing hospitals for inpatient services, the Prospective Payment System (PPS). Under this system, hospitals are paid a predetermined amount per Medicare discharge, which varies according to certain patient and hospital characteristics. This article investigates the presence of systematic biases and other potential imperfections in the PPS reimbursement methodology as revealed by its effects on Medicare operating ratios. The study covers the first three years of the PPS (approximately 1984-1986) and is based on hospital data from the Medicare cost reports and other related sources. Regression techniques were applied to these data to determine how Medicare operating ratios were affected by specific aspects of the reimbursement methodology. Several possible imbalances were detected. The potential undercompensation relating to these can be harmful to certain classes of hospitals and to the Medicare populations that they serve. PMID:2109738

Amputation and prosthesis implantation shape body and peripersonal space representations

PubMed Central

Canzoneri, Elisa; Marzolla, Marilena; Amoresano, Amedeo; Verni, Gennaro; Serino, Andrea

2013-01-01

Little is known about whether and how multimodal representations of the body (BRs) and of the space around the body (Peripersonal Space, PPS) adapt to amputation and prosthesis implantation. In order to investigate this issue, we tested BR in a group of upper limb amputees by means of a tactile distance perception task and PPS by means of an audio-tactile interaction task. Subjects performed the tasks with stimulation either on the healthy limb or the stump of the amputated limb, while wearing or not wearing their prosthesis. When patients performed the tasks on the amputated limb, without the prosthesis, the perception of arm length shrank, with a concurrent shift of PPS boundaries towards the stump. Conversely, wearing the prosthesis increased the perceived length of the stump and extended the PPS boundaries so as to include the prosthetic hand, such that the prosthesis partially replaced the missing limb. PMID:24088746

In situ electrodeposition of CoP nanoparticles on carbon nanomaterial doped polyphenylene sulfide flexible electrode for electrochemical hydrogen evolution

NASA Astrophysics Data System (ADS)

Wang, Tingxia; Jiang, Yimin; Zhou, Yaxin; Du, Yongling; Wang, Chunming

2018-06-01

Active and durable electrocatalyst for hydrogen evolution reaction (HER) is pivotal to generate molecular hydrogen more energy-efficient, but directly grafting electrocatalyst on electrode material by a single-step method without compromising the catalytic activity and stability remains a challenge. Herein, an intriguing electrode, reduced graphene oxide modified carbon nanotube/reduced graphene oxide/polyphenylene sulfide (RGO-CNT/RGO/PPS) film, is used to replace conventional electrodes. In situ electrodeposition is proposed to fabricate CoP on the RGO-CNT/RGO/PPS (CoP-RGO-CNT/RGO/PPS) electrode and achieves a favorably electrical contact between CoP nanoparticles and RGO-CNT/RGO/PPS electrode due to without any polymer binder. Additionally, the coupling of different electrodeposition stages with scanning electron microscope (SEM) can investigate the nanostructure evolution of CoP nanoparticles, which gives valuable insights into the optimized electrodeposition cycles. The rational integration of RGO onto CNT/RGO/PPS film is an effective approach for enhancing its intrinsic electrical conductivity and favoring the formation of a high density of dispersive CoP nanoparticles. The CoP-RGO-CNT/RGO/PPS film has shown outstanding HER electrocatalytic behaviors performed a current density of 10 mA cm-2 at a relatively low overpotential of 160 mV with a Tafel slope of 60 mV dec-1 in acidic medium, which can be mainly attributed to the synergistic effect between optimized morphology and accelerated kinetics. Additionally, this film electrocatalyst exhibits a good HER activity and stability under both neutral and basic conditions.

Interaction of Selected Phenylpropenes with Dipalmitoylphosphatidylcholine Membrane and Their Relevance to Antibacterial Activity.

PubMed

Gharib, Riham; Najjar, Amal; Auezova, Lizette; Charcosset, Catherine; Greige-Gerges, Hélène

2017-06-01

The effect of structurally closely related phenylpropenes (PPs), estragole, anethole, eugenol, and isoeugenol, on the fluidity of dipalmitoyl phosphatidyl choline (DPPC) liposome membrane was investigated by DSC, Raman, and fluorescence anisotropy of 1,6-diphenyl-1,3,5-hexatriene (DPH). Liposomes were prepared by thin-film hydration method at various DPPC:PP molar ratios. The DPH anisotropy measurements of blank and PP-loaded liposomes were performed at 28, 41, and 50 °C, which correspond, respectively, to gel phase, main transition temperature of DPPC, and liquid phase. The Raman images showed the formation of nano- and micrometric spherical multi-lamellar vesicles. All studied PPs exhibited a membrane fluidizing effect which was reinforced by the presence of phenolic hydroxyl group in eugenol and isoeugenol. The PPs interacted with the choline head group and the alkyl chains of DPPC membrane, wherein isoeugenol and anethole possessing the same C7-C8 position of the double bond in the propenyl side chain, incorporated deeply in the bilayer. Additionally, the PPs were analyzed for antibacterial activity against E. coli by macrobroth dilution method. Anethole and estragole were more efficient in inhibiting the bacterial growth than eugenol and isoeugenol. We conclude that the fluidizing effect of PPs on the membrane is a common mechanism that is not related to the hydrophobicity of the PP molecule. Besides, other target sites may be involved in PP antibacterial activity against Gram-negative bacteria. The greater hydrophobicity of these PPs may contribute to their penetrability through the outer bacterial membrane.

Charting a path forward: policy analysis of China's evolved DRG-based hospital payment system.

PubMed

Liu, Rui; Shi, Jianwei; Yang, Beilei; Jin, Chunlin; Sun, Pengfei; Wu, Lingfang; Yu, Dehua; Xiong, Linping; Wang, Zhaoxin

2017-09-01

At present, the diagnosis-related groups-based prospective payment system (DRG-PPS) that has been implemented in China is merely a prototype called the simplified DRG-PPS, which is known as the 'ceiling price for a single disease'. Given that studies on the effects of a simplified DRG-PPS in China have usually been controversial, we aim to synthesize evidence examining whether DRGs can reduce medical costs and length of stay (LOS) in China. Data were searched from both Chinese [Wan Fang and China National Knowledge Infrastructure Database (CNKI)] and international databases (Web of Science and PubMed), as well as the official websites of Chinese health departments in the 2004-2016 period. Only studies with a design that included both experimental (with DRG-PPS implementation) and control groups (without DRG-PPS implementation) were included in the review. The studies were based on inpatient samples from public hospitals distributed in 12 provinces of mainland China. Among them, 80.95% (17/21) revealed that hospitalization costs could be reduced significantly, and 50.00% (8/16) indicated that length of stay could be decreased significantly. In addition, the government reports showed the enormous differences in pricing standards and LOS in various provinces, even for the same disease. We conclude that the simplified DRGs are useful in controlling hospitalization costs, but they fail to reduce LOS. Much work remains to be done in China to improve the simplified DRG-PPS. © The Author 2017. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

New entrants' practice patterns in Medicare home health care after the prospective payment system revision in 2008.

PubMed

Kim, Hyunjee; Jung, Jeah Kyoungrae

2015-09-01

Medicare home health care spending increased under the prospective payment system (PPS) that was introduced specifically to control the rising spending. To explain this unexpected spending rise, we focused on new home health agencies that entered the market under the PPS. The high profit margins under the PPS attracted many new agencies to the market partially due to home health care's unique feature of low entry costs. We examined whether new entrants were more likely to adopt the practice patterns leading to higher profit margins than incumbent agencies that had been operating in the market before the PPS. Using 2008 to 2010 Medicare Home Health Claims and Provider of Services File, we estimated regressions of agencies' practice patterns controlling for agency and patient characteristics. We found that new entrants were more likely than incumbents to adopt practice patterns leading to high profit margins. They were more likely to target the 14th and 20th therapy visit where marginal revenue is relatively greater than that of other number of visits. Under the payment system that compensates extra therapy visits but not for other types of visits, entrants were also more likely to provide therapy visits, but less likely to provide medical social service visits. Given the high entry rates of agencies under the PPS, distinct practice patterns among entrants explain the drastic home health spending increase under the PPS. Heterogeneity in agencies' practice patterns also suggests an opportunity to improve efficiency in the Medicare home health care market. Copyright © 2015 Elsevier Inc. All rights reserved.

Assessment of iron status in settings of inflammation: challenges and potential approaches.

PubMed

Suchdev, Parminder S; Williams, Anne M; Mei, Zuguo; Flores-Ayala, Rafael; Pasricha, Sant-Rayn; Rogers, Lisa M; Namaste, Sorrel Ml

2017-12-01

The determination of iron status is challenging when concomitant infection and inflammation are present because of confounding effects of the acute-phase response on the interpretation of most iron indicators. This review summarizes the effects of inflammation on indicators of iron status and assesses the impact of a regression analysis to adjust for inflammation on estimates of iron deficiency (ID) in low- and high-infection-burden settings. We overviewed cross-sectional data from 16 surveys for preschool children (PSC) ( n = 29,765) and from 10 surveys for nonpregnant women of reproductive age (WRA) ( n = 25,731) from the Biomarkers Reflecting the Inflammation and Nutritional Determinants of Anemia (BRINDA) project. Effects of C-reactive protein (CRP) and α1-acid glycoprotein (AGP) concentrations on estimates of ID according to serum ferritin (SF) (used generically to include plasma ferritin), soluble transferrin receptor (sTfR), and total body iron (TBI) were summarized in relation to infection burden (in the United States compared with other countries) and population group (PSC compared with WRA). Effects of the concentrations of CRP and AGP on SF, sTfR, and TBI were generally linear, especially in PSC. Overall, regression correction changed the estimated prevalence of ID in PSC by a median of +25 percentage points (pps) when SF concentrations were used, by -15 pps when sTfR concentrations were used, and by +14 pps when TBI was used; the estimated prevalence of ID in WRA changed by a median of +8 pps when SF concentrations were used, by -10 pps when sTfR concentrations were used, and by +3 pps when TBI was used. In the United States, inflammation correction was done only for CRP concentrations because AGP concentrations were not measured; regression correction for CRP concentrations increased the estimated prevalence of ID when SF concentrations were used by 3 pps in PSC and by 7 pps in WRA. The correction of iron-status indicators for inflammation with the use of regression correction appears to substantially change estimates of ID prevalence in low- and high-infection-burden countries. More research is needed to determine the validity of inflammation-corrected estimates, their dependence on the etiology of inflammation, and their applicability to individual iron-status assessment in clinical settings.

Quantum solution to a class of two-party private summation problems

NASA Astrophysics Data System (ADS)

Shi, Run-Hua; Zhang, Shun

2017-09-01

In this paper, we define a class of special two-party private summation (S2PPS) problems and present a common quantum solution to S2PPS problems. Compared to related classical solutions, our solution has advantages of higher security and lower communication complexity, and especially it can ensure the fairness of two parties without the help of a third party. Furthermore, we investigate the practical applications of our proposed S2PPS protocol in many privacy-preserving settings with big data sets, including private similarity decision, anonymous authentication, social networks, secure trade negotiation, secure data mining.

Consistent characterization of semiconductor saturable absorber mirrors with single-pulse and pump-probe spectroscopy.

PubMed

Fleischhaker, R; Krauss, N; Schättiger, F; Dekorsy, T

2013-03-25

We study the comparability of the two most important measurement methods used for the characterization of semiconductor saturable absorber mirrors (SESAMs). For both methods, single-pulse spectroscopy (SPS) and pump-probe spectroscopy (PPS), we analyze in detail the time-dependent saturation dynamics inside a SESAM. Based on this analysis, we find that fluence-dependent PPS at complete spatial overlap and zero time delay is equivalent to SPS. We confirm our findings experimentally by comparing data from SPS and PPS of two samples. We show how to interpret this data consistently and we give explanations for possible deviations.

Overcoming barriers to work participation for patients with postpoliomyelitis syndrome.

PubMed

Ten Katen, Kim; Beelen, Anita; Nollet, Frans; Frings-Dresen, Monique H W; Sluiter, Judith K

2011-01-01

This study aimed to explore the perceived work ability of patients with postpoliomyelitis syndrome (PPS), to identify barriers and factors that are impeding or conducive, respectively, to work participation, and to identify possible interventions. Qualitative cross-sectional interview study with 17 subjects with PPS, 12 women and 5 men, mean age 49 years (SD: 11). Semi-structured interviews were held with the subjects in their homes, with the aid of a topic list. The COREQ criteria list for qualitative research was used as guideline in design and analysis. Thirteen out of 17 subjects rated their work ability six or higher on a scale from 0 to 10. Most subjects worked in an administrative, educational or managerial function. Five subjects stopped working, four worked between 0 and 20 h/week and eight worked between 20 and 40 h/week. Factors conducive to working were physical adaptations in the workplace, accessibility of the workplace and high decision latitude. Barriers to full work ability in PPS patients were high physical job demands, low social support and the symptoms of PPS, especially fatigue and pain. These findings suggest that work-oriented interventions aimed at preventing PPS patients from dropping out of the workforce should primarily focus on reducing physical job demands, arranging adaptations in the workplace and increasing job control.

Medicare constrains social workers' and nurses' home care for clients with Alzheimer's disease.

PubMed

Cabin, William D

2015-01-01

The Medicare home health prospective payment system (PPS) has existed for 13 years, yielding significant profits to providers. However, studies indicate many unresolved questions about whether PPS improves patient quality of care, is cost-effective, and reduces patient levels of unmet need. In addition, PPS has undermined the provision of social work home health services. The article presents the views of 29 home health care nurses regarding the impact ofPPS on their care decisions for people with Alzheimer's disease and their caregivers. The nurses identify Alzheimer's disease symptom management and psychosocial needs as phantoms, omnipresent below the surface but not attended to by home care clinicians. The interviews support the greater involvement of social workers to more adequately address the psychosocial needs of Medicare home health patients. The article contends that the current failure to simultaneously address the cost, needs, and quality-of-life issues of people with Alzheimer's disease who are cared for at home is analogous to the end-of-life care situation before passage of the Medicare Hospice Benefit. A collaborative demonstration project--social work and nursing--is proposed to determine how PPS might better address quality of life and costs of home-based people with Alzheimer's disease and their caregivers.

Overview of MST Research

NASA Astrophysics Data System (ADS)

Chapman, B. E.

2017-10-01

MST progress in advancing the RFP for (1) fusion plasma confinement with ohmic heating and minimal external magnetization, (2) predictive capability in toroidal confinement physics, and (3) basic plasma physics is summarized. Validation of key plasma models is a program priority, which is enhanced by programmable power supplies (PPS) to maximize inductive capability. The existing PPS enables access to very low plasma current, down to Ip =0.02 MA. This greatly expands the Lundquist number range S =104 -108 and allows nonlinear, 3D MHD computation using NIMROD and DEBS with dimensionless parameters that overlap those of MST plasmas. A new, second PPS will allow simultaneous PPS control of the Bp and Bt circuits. The PPS also enables MST tokamak operation, thus far focused on disruptions and RMP suppression of runaway electrons. Gyrokinetic modeling with GENE predicts unstable TEM in improved-confinement RFP plasmas. Measured fluctuations have TEM properties including a density-gradient threshold larger than for tokamak plasmas. Turbulent energization of an electron tail occurs during sawtooth reconnection. Probe measurements hint that drift waves are also excited via the turbulent cascade in standard RFP plasmas. Exploration of basic plasma science frontiers in MST RFP and tokamak plasmas is proposed as part of WiPPL, a basic science user facility. Work supported by USDoE.

Loss of motor unit size and quadriceps strength over 10 years in post-polio syndrome.

PubMed

Bickerstaffe, A; van Dijk, J P; Beelen, A; Zwarts, M J; Nollet, F

2014-06-01

To investigate whether strength decline in post-polio syndrome (PPS) results from excessive distal axonal degeneration of enlarged motor units. We assessed changes over 10 years in isometric quadriceps strength, mean motor unit action potential (MUAP) size, root mean squared (RMS) amplitude, and level of interference (LOI) in 47 patients with PPS and 12 healthy controls, using high density surface EMG. At baseline, all patients had symptomatic quadriceps dysfunction, evidenced by transmission defects on single-fibre EMG. MU size and strength declined significantly by 20% and 15%, respectively in patients with PPS. Those with the largest initial MU sizes exhibited the greatest losses of mean MU size (27%) and proportional decreases in quadriceps strength (23%). Initial strength, change in LOI and change in RMS amplitude together explained 35% of the variability in strength changes in patients. MU size of controls did not change, although they lost 29% strength. MU size and strength declined concomitantly in a homogeneous cohort of patients with PPS and quadriceps dysfunction. This long term follow-up study provides evidence that size diminution of enlarged MUs combined with a reduced number of active MUs contributes to the gradual strength decline in PPS. Copyright © 2013 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

The Arecibo Pisces-Perseus Survey: An Undergraduate ALFALFA Team Project

NASA Astrophysics Data System (ADS)

O'Donoghue, Aileen A.; Koopmann, Rebecca A.; Haynes, Martha P.; Jones, Michael; Craig, David; Hallenbeck, Gregory L.; Rosenberg, Jessica L.; Venkatesan, Aparna; Undergraduate ALFALFA Team

2016-01-01

The Milky Way's position in an outer filament of Lanieakea affords us a striking view of the Pisces-Perseus Supercluster (PPS) arcing roughly from 22h to 4h and 0° to +50° concentrated between cz = 4,000 km/s and cz = 8,000 km/s as a "wall" parallel to the plane of the sky. It is bounded by voids both between Laniakea and PPS and beyond PPS. Within this box, the 70% ALFALFA survey has detected 4,800 galaxies within cz = 8,000 km/s. Of these, 80% have masses greater than 108 M⊙. At the distance of the PPS, galaxies with MHI ≤ 108 M⊙ are below the ALFALFA detection limit. Thus to further explore this rich diversity of galaxy environments and the adjoining voids, the Undergraduate ALFALFA Team is in the process of using the L-band Wide receiver at Arecibo Observatory for the Arecibo Pisces-Perseus Supercluster Survey (APPSS). We will observe galaxies with 108 M⊙ ≤ MHI ≤ 109 M⊙ chosen from the SDSS DR12 and GALEX catalogs. We are limiting our observations to the PPS ridge in 21h 30m to 3h 15m and 23° to 35°. Since this region lacks SDSS spectroscopy, targets have been selected using photometric criteria derived from SDSS and GALEX observations for galaxies detected by ALFALFA. The results of these observations will allow us to constrain the HI mass function along the PPS ridge. Application of the Tully-Fisher relation will allow a robust measure of the infall velocities of galaxies into the filament. This work has been supported by NSF grant AST-1211005.

A hybrid bioreactor based on insolubilized tyrosinase and laccase catalysis and microfiltration membrane remove pharmaceuticals from wastewater.

PubMed

Ba, Sidy; Haroune, Lounès; Soumano, Lassine; Bellenger, Jean-Phillipe; Jones, J Peter; Cabana, Hubert

2018-06-01

The increasing presence of pharmaceutical products (PPs) and other organic contaminants of emerging concern (CECs) in aquatic systems has become one of the major global environmental contamination concerns. Sewage treatment plants (STPs) are one of the major sources of PPs discharge into natural waters due to the deficiencies of conventional treatment processes to deal with these micropollutants. Numerous new treatment processes and technologies have been investigated for the removals of CECs in wastewaters with more or less success. In the present study, we investigated the efficiency of a hybrid bioreactor (HBR) of a combined crosslinked tyrosinase and laccase aggregates and hollow fiber microfiltration (MF) membrane to remove a mixture of 14 PPs from municipal wastewater at environmentally relevant concentration of 10 μg/L. After a 5-day continuous operation, the HBR achieved complete removal of all tested PPs. Results also highlight that these high performances result from a synergistic action of the MF membrane and the insoluble enzymes. The biocatalyst retained nearly 70% of its initial enzymatic activity over the treatment period. The removal of PPs is unlikely to result from their sole sorption on the membrane. Overall, the results suggest that the HBR is well suited to the biocatalysts (i.e. insolubilized tyrosinase and laccase). The results invite to further investigate how the HBR can be tailored with various types of enzymes and membranes for either specific or non-specific target substrates and to further explore the applicability of this technology for the continuous treatment of wastewater at environmentally relevant concentration of PPs. Copyright © 2018 Elsevier Ltd. All rights reserved.

Airborne ultrasonic transducer using polymer-based elastomer with high output-to-weight ratio

NASA Astrophysics Data System (ADS)

Wu, Jiang; Mizuno, Yosuke; Tabaru, Marie; Nakamura, Kentaro

2015-08-01

With the properties of low density, low elastic modulus, and low mechanical loss, poly(phenylene sulfide) (PPS) is a suitable material as the elastomer in an airborne ultrasonic transducer for generating large vibration velocity. In this study, we design and fabricate a transducer composed of a PPS-based longitudinal vibrator and a PPS-based disk of 0.3 mm thickness to obtain high-intensity ultrasound. The rated sound pressure at a distance of 300 mm reached 38.9 Pa (125 dB, 0 dB re. 0.02 mPa) when the frequency and voltage were 58.90 kHz and 20 V. The weight of this transducer is 6.3 g. The ratio of the sound pressure to the weight of the prototype transducer is 1.8 times larger than that of the commercial transducer. The experimental results indicate that PPS is a good substitute for metal as the elastomer for manufacturing airborne ultrasonic transducers with a high output-to-weight ratio.

Peyer’s patches: Organizing B cell responses at the intestinal frontier

PubMed Central

Reboldi, Andrea; Cyster, Jason G

2015-01-01

Summary Secondary lymphoid tissues share the important function of bringing together antigens and rare antigen-specific lymphocytes to foster induction of adaptive immune responses. Peyer’s patches (PPs) are unique compared to other secondary lymphoid tissues in their continual exposure to an enormous diversity of microbiome- and food-derived antigens and in the types of pathogens they encounter. Antigens are delivered to PPs by specialized microfold (M) epithelial cells and they may be captured and presented by resident dendritic cells (DCs). In accord with their state of chronic microbial antigen exposure, PPs exhibit continual germinal center (GC) activity. These GCs contribute to the generation of B cells and plasma cells producing somatically mutated gut antigen-specific IgA antibodies, but have also been suggested to support antigen-nonspecific diversification of the B cell repertoire. Here we review current understanding of how PPs foster B cell encounters with antigen, how they favor isotype switching to the secretory IgA isotype, and how their GC responses may uniquely contribute to mucosal immunity. PMID:27088918

A new timing detector for the CT-PPS project

NASA Astrophysics Data System (ADS)

Arcidiacono, R.; Cms; TOTEM Collaborations

2017-02-01

The CT-PPS detector will be installed close to the beam line on both sides of CMS, 200 m downstream the interaction point. This detector will measure forward scattered protons, allowing detailed studies of diffractive hadron physics and Central Exclusive Production. The main components of the CT-PPS detector are a silicon tracking system and a timing system. In this contribution we present the proposal of an innovative solution for the timing system, based on Ultra-Fast Silicon Detectors (UFSD). UFSD are a novel concept of silicon detectors potentially able to obtain the necessary time resolution (∼20 ps on the proton arrival time). The use of UFSD has also other attractive features as its material budget is small and the pixel geometries can be tailored to the precise physics distribution of protons. UFSD prototypes for CT-PPS have been designed by CNM (Barcelona) and FBK (Trento): we will present the status of the sensor productions and of the low-noise front-end electronics currently under development and test.

Encapsulation and release studies of strawberry polyphenols in biodegradable chitosan nanoformulation.

PubMed

Pulicharla, Rama; Marques, Caroline; Das, Ratul Kumar; Rouissi, Tarek; Brar, Satinder Kaur

2016-07-01

Polyphenols (negative groups) of strawberry extract interacts with positively protonated amino groups of chitosan which helps in maximum encapsulation. This approach can improve the bioavailability and sustained release of phytochemicals having lower bioavailability. The optimum mass ratio of chitosan-tripolyphosphate and polyphenols (PPs) loading was investigated to be 3:1 and 0.5mg/ml of strawberry extract, respectively. Prepared nanoformulation were characterized by UV-vis spectroscopy, Fourier transform infrared spectroscopy and scanning electron microscopy. The formed particles size ranged between 300 and 600nm and polydispersity index (PDI) of≈0.5. The optimized formulation showed encapsulation efficiency of 58.09% at 36.47% of polyphenols loading. Initial burst and continuous release of PPs was observed at pH 7.4 of in vitro release studies. PPs release profile at this pH was found to be non-Fickian analomous diffusion and the release was followed first order kinetics. And at pH 1.4, diffusion-controlled Fickian release of PPs was observed. Copyright © 2016 Elsevier B.V. All rights reserved.

Transoral robotic surgery for parapharyngeal space tumors.

PubMed

O'Malley, Bert W; Quon, Harry; Leonhardt, Fernando D; Chalian, Ara A; Weinstein, Gregory S

2010-01-01

To evaluate the outcomes of patients with parapharyngeal space (PPS) tumors treated with a transoral robotic surgery (TORS) approach. We prospectively enrolled well-defined benign PPS tumors accessible from the oropharynx with no carotid encasement or bone erosion. We designated outcome measures that included technical feasibility of the approach, local tumor control and complication rates. Descriptive statistics were used to summarize the outcome data. With a mean follow-up of 29.9 months (range 12-40 months), a total of 10 patients have been enrolled. TORS was completed in 9 of 10 patients with acceptable operative time and blood loss and no significant complications including hemorrhage, infection, trismus or tumor spillage. Local control has been 100% for 7 patients with pleomorphic adenomas. We confirm the safety and feasibility of the TORS approach for PPS tumors that achieves a high local control and low surgical complication rate. TORS is a viable approach for removing benign tumors and lesions of the PPS. Copyright © 2010 S. Karger AG, Basel.

The influence of a change in medicare reimbursement on the effectiveness of stage III or greater decubitus ulcer home health nursing care.

PubMed

Eaton, Melody K

2005-02-01

This study was designed to describe and evaluate the influence of a change in a Medicare reimbursement on the effectiveness of home health nursing care for stage III or greater decubitus ulcer patients. This health policy originated from the Balanced Budget Act (BBA) of 1997 and took its full effect with initiation of the Prospective Payment System (PPS) on October 1, 2000. A quantitative quasi-experimental design used OASIS data from the state of Virginia to evaluate 555 stage III or greater decubitus ulcer patients, age 65 or older. Comparisons were investigated between pre-PPS, 2000, and post-PPS, 2001, outcomes related to reported ulcer healing, lengths of stay, and discharge disposition. Results demonstrated significant differences for the outcomes studied. In addition, sanitation, ulcer healing, and discharge disposition were linked as predictors for length of stay. Results demonstrated that PPS has affected nursing care effectiveness for stage III or greater decubitus ulcer home health patients.

Spray-coating process in preparing PTFE-PPS composite super-hydrophobic coating

NASA Astrophysics Data System (ADS)

Weng, Rui; Zhang, Haifeng; Liu, Xiaowei

2014-03-01

In order to improve the performance of a liquid-floated rotor micro-gyroscope, the resistance of the moving interface between the rotor and the floating liquid must be reduced. Hydrophobic treatment can reduce the frictional resistance between such interfaces, therefore we proposed a method to prepare a poly-tetrafluoroethylene (PTFE)-poly-phenylene sulphide (PPS) composite super-hydrophobic coating, based on a spraying process. This method can quickly prepare a continuous, uniform PTFE-PPS composite super-hydrophobic surface on a 2J85 material. This method can be divided into three steps, namely: pre-treatment; chemical etching; and spraying. The total time for this is around three hours. When the PTFE concentration is 4%, the average contact angle of the hydrophobic coating surface is 158°. If silicon dioxide nanoparticles are added, this can further improve the adhesion and mechanical strength of the super-hydrophobic composite coating. The maximum average contact angle can reach as high as 164° when the mass fraction of PTFE, PPS and silicon dioxide is 1:1:1.

[Post-polio syndrome. A case report].

PubMed

Bartman, Wojciech; Biernawska, Jolanta; ŁAbuz-Roszak, Beata; Kumor, Klaudiusz; Pierzchała, Krystyna

2004-01-01

Certain acute anterior poliomyelitis survivors express complaints of abnormal fatigue, weakness and muscular atrophy many years after acute onset. These are basic clinical symptoms of so-called post-polio syndrome (PPS). PPS is characterized by a relatively slow, but progressive pathological muscular process, in some cases leading to functional impairment of daily living and professional activity. Breathing, speaking and swallowing impairment are common but not severe medical problems of post-polio patients. Diagnosis is usually based on a typical medical history, electromyographic investigation and exclusion of other diseases presenting similar features. We report a case of PPS in a 49-year-old woman diagnosed in the Neurological Department in Zabrze. Thirty six years after acute anterior poliomyelitis with partial recovery, new symptoms of fatigue, muscular atrophy, exertional dyspnea, walking impairment and joint pain developed. Electromyography revealed features of coexisting spinal denervation and reinnervation in tested muscles. The differential diagnosis excluded other neuromuscular diseases. The patient fulfilled clinical and electromyographic criteria of PPS.

In Vivo Efficacy of a "Smart" Antimicrobial Implant Coating.

PubMed

Stavrakis, Alexandra I; Zhu, Suwei; Hegde, Vishal; Loftin, Amanda H; Ashbaugh, Alyssa G; Niska, Jared A; Miller, Lloyd S; Segura, Tatiana; Bernthal, Nicholas M

2016-07-20

Postoperative infection is a devastating complication following arthroplasty. The goals of this study were to introduce a "smart" implant coating that combines passive elution of antibiotic with an active-release mechanism that "targets" bacteria, and to use an established in vivo mouse model of post-arthroplasty infection to longitudinally evaluate the efficacy of this polymer implant coating in decreasing bacterial burden. A novel, biodegradable coating using branched poly(ethylene glycol)-poly(propylene sulfide) (PEG-PPS) polymer was designed to deliver antibiotics both passively and actively. In vitro-release kinetics were studied using high-performance liquid chromatography (HPLC) quantification in conditions representing both the physiologic environment and the more oxidative, hyperinflammatory environment of periprosthetic infection. The in vivo efficacy of the PEG-PPS coating delivering vancomycin and tigecycline was tested using an established mouse model of post-arthroplasty infection. Noninvasive bioluminescence imaging was used to quantify the bacterial burden; radiography, to assess osseointegration and bone resorption; and implant sonication, for colony counts. In vitro-release kinetics confirmed passive elution above the minimum inhibitory concentration (MIC). A rapid release of antibiotic was noted when challenged with an oxidative environment (p < 0.05), confirming a "smart" active-release mechanism. The PEG-PPS coating with tigecycline significantly lowered the infection burden on all days, whereas PEG-PPS-vancomycin decreased infection on postoperative day (POD) 1, 3, 5, and 7 (p < 0.05). A mean of 0, 9, and 2.6 × 10(2) colony-forming units (CFUs) grew on culture from the implants treated with tigecycline, vancomycin, and PEG-PPS alone, respectively, and a mean of 1.2 × 10(2), 4.3 × 10(3), and 5.9 × 10(4) CFUs, respectively, on culture of the surrounding tissue (p < 0.05). The PEG-PPS coating provides a promising approach to preventing periprosthetic infection. This polymer is novel in that it combines both passive and active antibiotic-release mechanisms. The tigecycline-based coating outperformed the vancomycin-based coating in this study. PEG-PPS polymer provides a controlled, "smart" local delivery of antibiotics that could be used to prevent postoperative implant-related infections. Copyright © 2016 by The Journal of Bone and Joint Surgery, Incorporated.

Pressure pain and isometric strength of neck flexors are related in chronic tension-type headache.

PubMed

Castien, Rene; Blankenstein, Annette; De Hertogh, Willem

2015-01-01

In patients with chronic tension-type headache (CTTH) changes in pressure pain in the cervical region are associated with peripheral or central sensitization. It is hypothesized that an increase of isometric strength of neck flexors would lead to a decrease of pressure pain in CTTH, as an expression of reduced peripheral or central sensitization In this study we aimed to analyze the correlation between change in isometric strength of the neck flexors and change in pressure pain scores (PPS) in patients with CTTH. Comparative analysis of data from previous study. Primary healthcare center. Data from 145 patients with CTTH who underwent a manual therapy program including isometric strength training of the neck flexors were analyzed at 8 and 26 weeks post-treatment. PPS were measured as a total of pain scores on a numeric rating scale (score 0 to 10) on application of a pressure stimulus of 3kg/cm at 8 cervical- and suboccipital muscles. Isometric strength of the neck flexors was measured in seconds. Correlations were computed between changes in PPS and isometric neck flexor strength. Isometric strength of neck flexors scored significantly different compared to baseline measurement (mean 30.0 seconds, sd:25.2), and increased with a mean difference of 17.33 seconds (95%CI: 20.61 to 14.05) at 8 weeks and 19.18 seconds (95%CI: 23.48 to 14.87) at 26 weeks. Similarly, compared to PPS baseline measurement (31.6 points, sd:18.6), mean difference in PPS was significantly decreased at 8 and 26 weeks: -11.3 points (95%CI: -8.77 to -13.83) and -11.15 points (95%CI: -8.31 to -13.99). There is a negative correlation between changes in PPS and changes in isometric strength of neck flexors which is weak at 8 weeks (r = -0.243, P = 0.004) and moderate at 26 weeks (r = -0.318, P < 0.000). Correlational analysis. Decrease in PPS correlates with increases in isometric strength of neck flexors in patients with CTTH in short- and long-term.

Sequential algorithm analysis to facilitate selective biliary access for difficult biliary cannulation in ERCP: a prospective clinical study.

PubMed

Lee, Tae Hoon; Hwang, Soon Oh; Choi, Hyun Jong; Jung, Yunho; Cha, Sang Woo; Chung, Il-Kwun; Moon, Jong Ho; Cho, Young Deok; Park, Sang-Heum; Kim, Sun-Joo

2014-02-17

Numerous clinical trials to improve the success rate of biliary access in difficult biliary cannulation (DBC) during ERCP have been reported. However, standard guidelines or sequential protocol analysis according to different methods are limited in place. We planned to investigate a sequential protocol to facilitate selective biliary access for DBC during ERCP. This prospective clinical study enrolled 711 patients with naïve papillae at a tertiary referral center. If wire-guided cannulation was deemed to have failed due to the DBC criteria, then according to the cannulation algorithm early precut fistulotomy (EPF; cannulation time > 5 min, papillary contacts > 5 times, or hook-nose-shaped papilla), double-guidewire cannulation (DGC; unintentional pancreatic duct cannulation ≥ 3 times), and precut after placement of a pancreatic stent (PPS; if DGC was difficult or failed) were performed sequentially. The main outcome measurements were the technical success, procedure outcomes, and complications. Initially, a total of 140 (19.7%) patients with DBC underwent EPF (n = 71) and DGC (n = 69). Then, in DGC group 36 patients switched to PPS due to difficulty criteria. The successful biliary cannulation rate was 97.1% (136/140; 94.4% [67/71] with EPF, 47.8% [33/69] with DGC, and 100% [36/36] with PPS; P < 0.001). The mean successful cannulation time (standard deviation) was 559.4 (412.8) seconds in EPF, 314.8 (65.2) seconds in DGC, and 706.0 (469.4) seconds in PPS (P < 0.05). The DGC group had a relatively low successful cannulation rate (47.8%) but had a shorter cannulation time compared to the other groups due to early switching to the PPS method in difficult or failed DGC. Post-ERCP pancreatitis developed in 14 (10%) patients (9 mild, 1 moderate), which did not differ significantly among the groups (P = 0.870) or compared with the conventional group (P = 0.125). Based on the sequential protocol analysis, EPF, DGC, and PPS may be safe and feasible for DBC. The use of EPF in selected DBC criteria, DGC in unintentional pancreatic duct cannulations, and PPS in failed or difficult DGC may facilitate successful biliary cannulation.

Physiological and Transcriptional Characterization of Escherichia Coli Strains Lacking Interconversion of Phosphoenolpyruvate and Pyruvate When Glucose and Acetate are Coutilized

PubMed Central

Sabido, Andrea; Sigala, Juan Carlos; Hernández-Chávez, Georgina; Flores, Noemí; Gosset, Guillermo; Bolívar, Francisco

2013-01-01

Phosphoenolpyruvate (PEP) is a precursor involved in the biosynthesis of aromatics and other valuable compounds in Escherichia coli. The PEP:carbohydrate phosphotransferase system (PTS) is the major glucose transport system and the largest PEP consumer. To increase intracellular PEP availability for aromatics production purposes, mutant strains of E. coli JM101 devoid of the ptsHIcrr operon (PB11 strain) have been previously generated. In this derivative, transport and growth rate on glucose decreased significantly. A laboratory evolved strain derived from PB11 that partially recovered its growth capacity on glucose was named PB12. In the present study, we blocked carbon skeletons interchange between PEP and pyruvate (PYR) in these ptsHIcrr− strains by deleting the pykA, pykF, and ppsA genes. The PB11 pykAF− ppsA− strain exhibited no growth on glucose or acetate alone, but it was viable when both substrates were consumed simultaneously. In contrast, the PB12 pykAF− ppsA− strain displayed a low growth rate on glucose or acetate alone, but in the mixture, growth was significantly improved. RT-qPCR expression analysis of PB11 pykAF− ppsA− growing with both carbon sources showed a downregulation of all central metabolic pathways compared with its parental PB11 strain. Under the same conditions, transcription of most of the genes in PB12 pykAF− ppsA− did not change, and few like aceBAK, sfcA, and poxB were overexpressed compared with PB12. We explored the aromatics production capabilities of both ptsHIcrr− pykAF− ppsA− strains and the engineered PB12 pykAF− ppsA− tyrR− pheAev2+/pJLBaroGfbrtktA enhanced the yield of aromatic compounds when coutilizing glucose and acetate compared with the control strain PB12 tyrR− pheAev2+/pJLBaroGfbrtktA. Biotechnol. Bioeng. 2014;111: 1150–1160. © 2013 The Authors. Biotechnology and Bioengineering Published by Wiley Periodicals, Inc. PMID:24375081

Hand hygiene compliance rates: Fact or fiction?

PubMed

McLaws, Mary-Louise; Kwok, Yen Lee Angela

2018-05-16

The mandatory national hand hygiene program requires Australian public hospitals to use direct human auditing to establish compliance rates. To establish the magnitude of the Hawthorne effect, we compared direct human audit rates with concurrent automated surveillance rates. A large tertiary Australian teaching hospital previously trialed automated surveillance while simultaneously performing mandatory human audits for 20 minutes daily on a medical and a surgical ward. Subtracting automated surveillance rates from human audit rates provided differences in percentage points (PPs) for each of the 3 quarterly reporting periods for 2014 and 2015. Direct human audit rates for the medical ward were inflated by an average of 55 PPs in 2014 and 64 PPs in 2015, 2.8-3.1 times higher than automated surveillance rates. The rates for the surgical ward were inflated by an average of 32 PPs in 2014 and 31 PPs in 2015, 1.6 times higher than automated surveillance rates. Over the 6 mandatory reporting quarters, human audits collected an average of 255 opportunities, whereas automation collected 578 times more data, averaging 147,308 opportunities per quarter. The magnitude of the Hawthorne effect on direct human auditing was not trivial and produced highly inflated compliance rates. Mandatory compliance necessitates accuracy that only automated surveillance can achieve, whereas daily hand hygiene ambassadors or reminder technology could harness clinicians' ability to hyperrespond to produce habitual compliance. Crown Copyright © 2018. Published by Elsevier Inc. All rights reserved.

Immunome differences between porcine ileal and jejunal Peyer's patches revealed by global transcriptome sequencing of gut-associated lymphoid tissues.

PubMed

Maroilley, T; Berri, M; Lemonnier, G; Esquerré, D; Chevaleyre, C; Mélo, S; Meurens, F; Coville, J L; Leplat, J J; Rau, A; Bed'hom, B; Vincent-Naulleau, S; Mercat, M J; Billon, Y; Lepage, P; Rogel-Gaillard, C; Estellé, J

2018-06-13

The epithelium of the intestinal mucosa and the gut-associated lymphoid tissues (GALT) constitute an essential physical and immunological barrier against pathogens. In order to study the specificities of the GALT transcriptome in pigs, we compared the transcriptome profiles of jejunal and ileal Peyer's patches (PPs), mesenteric lymph nodes (MLNs) and peripheral blood (PB) of four male piglets by RNA-Seq. We identified 1,103 differentially expressed (DE) genes between ileal PPs (IPPs) and jejunal PPs (JPPs), and six times more DE genes between PPs and MLNs. The master regulator genes FOXP3, GATA3, STAT4, TBX21 and RORC were less expressed in IPPs compared to JPPs, whereas the transcription factor BCL6 was found more expressed in IPPs. In comparison between IPPs and JPPs, our analyses revealed predominant differential expression related to the differentiation of T cells into Th1, Th2, Th17 and iTreg in JPPs. Our results were consistent with previous reports regarding a higher T/B cells ratio in JPPs compared to IPPs. We found antisense transcription for respectively 24%, 22% and 14% of the transcripts detected in MLNs, PPs and PB, and significant positive correlations between PB and GALT transcriptomes. Allele-specific expression analyses revealed both shared and tissue-specific cis-genetic control of gene expression.

A unique mid-sequence linker used to multimerize the lipid-phosphatidylserine (PS) binding peptide-peptoid hybrid PPS1.

PubMed

Shukla, Satya Prakash; Manarang, Joseph C; Udugamasooriya, D Gomika

2017-09-08

Ligand multimerizations enhance the binding affinity towards cell surface biomarkers through their avidity effects. Typical linkers connect individual monomeric ligand moieties from one end (e.g., C- or N-terminus of a peptide) and exclusively target protein receptors. The lipid phosphatidylserine (PS) is normally present on the cytoplasmic side of the eukaryotic cell membrane, but in tumors and tumor endothelial cells, this negatively charged PS flips to the outer layer. We recently reported a PS binding peptide-peptoid hybrid (PPS1) that has distinct positively charged and hydrophobic residue-containing regions. The PPS1 monomer is inactive, and upon C-terminal dimerization (PPS1D1), it triggers cytotoxicity. In the current study, a unique series of PPS1 multimeric derivatives were synthesized by switching the linker from the C-terminus to an internal position. The unimportant fourth residue (N-lys) from the C-terminus was utilized to build the linker. The synthesis strategy was developed employing variations of (I) the linker size, (II) the number of positively charged residues, and (III) the number of hydrophobic regions. Cytotoxicity of these new derivatives on HCC4017 lung cancer cells showed that a minimum of two hydrophobic regions was important to retain the activity and that the shortest linker length was optimal for activity. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Motor unit activation patterns during concentric wrist flexion in humans with different muscle fibre composition.

PubMed

Søgaard, K; Christensen, H; Fallentin, N; Mizuno, M; Quistorff, B; Sjøgaard, G

1998-10-01

Muscle activity was recorded from the flexor carpi radialis muscle during static and dynamic-concentric wrist flexion in six subjects, who had exhibited large differences in histochemically identified muscle fibre composition. Motor unit recruitment patterns were identified by sampling 310 motor units and counting firing rates in pulses per second (pps). During concentric wrist flexion at 30% of maximal exercise intensity the mean firing rate was 27 (SD 13) pps. This was around twice the value of 12 (SD 5) pps recorded during sustained static contraction at 30% of maximal voluntary contraction, despite a larger absolute force level during the static contraction. A similar pattern of higher firing rates during dynamic exercise was seen when concentric wrist flexion at 60% of maximal exercise intensity [30 (SD 14) pps] was compared with sustained static contraction at 60% of maximal voluntary contraction [19 (SD 8) pps]. The increase in dynamic exercise intensity was accomplished by recruitment of additional motor units rather than by increasing the firing rate as during static contractions. No difference in mean firing rates was found among subjects with different muscle fibre composition, who had previously exhibited marked differences in metabolic response during corresponding dynamic contractions. It was concluded that during submaximal dynamic contractions motor unit firing rate cannot be deduced from observations during static contractions and that muscle fibre composition may play a minor role.

Use of Medicare services before and after introduction of the prospective payment system.

PubMed

Manton, K G; Woodbury, M A; Vertrees, J C; Stallard, E

1993-08-01

The case mix-adjusted pattern of use of health care services, especially posthospital care, is compared before and after the introduction of Medicare's Prospective Payment System (PPS). The 1982 and 1984 National Long Term Care Surveys (NLTCS) linked to Medicare administrative records 1982-1986 provide health and health service use data for 12-month periods before and after the introduction of PPS. Case-mix differences between pre- and post-periods are controlled by using the Grade of Membership model to identify health groups from the NLTCS data. Differences in timing (e.g., hospital length of stay) were controlled using life table models estimated for each health group, that is, service use patterns pre- and post-PPS are compared within groups. Hospital LOS and admission rates declined post-PPS. Changes in the timing and location of death occurred but, overall, mortality did not increase. Changes in post-acute care service use by elderly, chronically disabled Medicare beneficiaries were observed: home health service use increased overall and among the unmarried disabled population. PPS did not adversely affect quality of care as reflected in mortality or in hospital readmissions. Moreover, the differential use of post-acute care, and changes in hospital LOS by health group, indicate that the system responded, specific to marital status and age, to the severity of needs of chronically disabled persons.

New Technique for the Treatment of Buried Penis in Children.

PubMed

Liu, Feng; Lin, Tao; He, Dawei; Wei, Guanghui; Liu, Junhong; Liu, Xing; Hua, Yi; Zhang, Deying; Lu, Peng; Wu, Shengde; Li, Xuliang

2016-02-01

To present our treatment experience of buried penis, which has no consensus therapeutic technique for all cases of buried penis, by using a new technique for the repair of this condition, in which the approach is through the ventral penile root. We performed a retrospective review of 153 patients (median age: 6.5 years) who underwent repair of a buried penis between March 2005 and March 2013. The technique involves the creation of a wedge-shaped cut of the ventral penile skin, followed by fixation of the subcutaneous penile skin at the base of the degloved penis to the Buck fascia at the 2- and 10-o'clock positions. The ventral outer preputial skin is split down the midline, and the dorsal inner preputial skin is cut with oblique incision. All patients were followed for an average of 12 months after repair. Other than 2 cases (1.3%) of trapped penis with a ring of scar tissue, which required subsequent excision, there were no complications and the cosmetic appearance was satisfactory. The described ventral penile approach is a simple and effective procedure with good cosmetic outcomes and few complications. Copyright © 2016 Elsevier Inc. All rights reserved.

Severe forms of concealed penis without hypospadias: Surgical strategies

PubMed Central

de Jesus, Lisieux Eyer; Dekermacher, Samuel; Anderson, Kleber M.

2015-01-01

Introduction: Concealed penis (CP) may vary in severity and includes megaprepuce (MP) as a variant. Many different surgical strategies have been described in order to maximize penile exposure and to deal with skin deficiency. We describe the strategies that we use to overcome technical problems in severe cases of CP. Materials and Methods: Six consecutive cases of severe CP (including 3 with MP) were treated in a 2-year period between January 2011 and April 2013. These patients were treated using extensive degloving, removal of dysplastic dartos, Alexander's preputial flap, scrotal flaps and skin grafts. Three patients had been previously circumcised. Cases associated with hypospadias, obesity, disorders of sexual differentiation and micropenises were excluded. Results: All six patients attained good results, with good exposure of the penis, ability to void standing with a well-directed flow and reasonable esthetic results. A technical algorithm for the treatment of primary or recurring cases of CP is proposed. Conclusion: Alexander’ s distally based ventral preputial flap is a useful technical resource to treat MP cases. Free skin grafts and/or laterally based scrotal flaps may be used to cover the penis after release in severe cases of CP. PMID:26604447

How To Become a Great Public Space.

ERIC Educational Resources Information Center

Block, Marylaine

2003-01-01

Presents interviews with Fred Kent, founder of the Project for Public Spaces (PPS) and Phil Myrick, PPS's assistant vice president, about transforming libraries into desirable public spaces. Discusses qualities people value in public spaces; great library buildings and what they are doing right; the first thing library directors should do when…

The laryngeal primordium and epithelial lamina. A new interpretation.

PubMed Central

Sañudo, J R; Domenech-Mateu, J M

1990-01-01

The laryngeal primordium is present in both the laryngotracheal sulcus (LTS) and the primitive pulmonary sac (PPS). Its early period of development may be subdivided into two phases. The first phase (Stage 11) is represented by what is traditionally referred to as the LTS, located directly beneath the PP4 on the ventral wall of the foregut (primary segment), and by the PPS which is situated at its caudal end. The LTS will represent the primordium of the upper or membranous infraglottic cavity region; whereas the PPS, will give rise not only to the bronchial tree, but also to the primordium of the trachea and the lower or cartilaginous region of the infraglottic cavity. The second phase (Stages 13 and 14) is distinguished by the cranial growth of the LTS above the PP4 and therefore by its absorption into the floor of the primitive pharynx in the mesobranchial area (secondary segment), which will develop into the primordium of the vestibule of the larynx. Similarly, we observed that in the development of the laryngeal cavity there are two temporally and spatially separate epithelial structures: the epithelial septum and the epithelial lamina. In this respect we differ from other authors who are of the opinion that there is a single structure (the epithelial lamina). The epithelial septum is a primary structure responsible for the final configuration of the LTS, as it contributes to the development of the lower end of the primary segment of the LTS and also to the creation of the secondary segment. The epithelial lamina is a secondary structure which appears inside the LTS as a result of pressure exerted by the mesenchyme on its lateral walls, without having any effect on the morphogenesis of the LTS. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 6 Fig. 7 PMID:2081706

Effects of prenatal exposure to a low dose atrazine metabolite mixture on pubertal timing and prostate development of male Long-Evans rats

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

Stanko, Jason; Enoch, Rolondo; Rayner, Jennifer L

The present study examines the postnatal reproductive development of male rats following prenatal exposure to an atrazine metabolite mixture (AMM) consisting of the herbicide atrazine and its environmental metabolites diaminochlorotriazine, hydroxyatrazine, deethylatrazine, and deisopropylatrazine. Pregnant Long-Evans rats were treated by gavage with 0.09, 0.87, or 8.73 mg AMM/kg body weight (BW), vehicle, or 100 mg ATR/kg BW positive control, on gestation days 15 19. Preputial separation was significantly delayed in 0.87 mg and 8.73 mg AMM-exposed males. AMM-exposed males demonstrated a significant treatment-related increase in incidence and severity of inflammation in the prostate on postnatal day (PND) 120. A dose-dependentmore » increase in epididymal fat masses and prostate foci were grossly visible in AMM-exposed offspring. These results indicate that a short, late prenatal exposure to mixture of chlorotriazine metabolites can cause chronic prostatitis in male LE rats. The mode of action for these effects is presently unclear.« less

Development and Initial Validation of the Performance Perfectionism Scale for Sport (PPS-S)

ERIC Educational Resources Information Center

Hill, Andrew P.; Appleton, Paul R.; Mallinson, Sarah H.

2016-01-01

Valid and reliable instruments are required to appropriately study perfectionism. With this in mind, three studies are presented that describe the development and initial validation of a new instrument designed to measure multidimensional performance perfectionism for use in sport (Performance Perfectionism Scale--Sport [PPS-S]). The instrument is…

42 CFR 1001.1401 - Violations of PPS corrective action.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Violations of PPS corrective action. 1001.1401 Section 1001.1401 Public Health OFFICE OF INSPECTOR GENERAL-HEALTH CARE, DEPARTMENT OF HEALTH AND HUMAN... documented history of criminal, civil or administrative wrongdoing (The lack of any prior record is to be...

Assessing Object-to-Picture and Picture-to-Object Matching as Prerequisite Skills for Pictorial Preference Assessments

ERIC Educational Resources Information Center

Clevenger, Theresa M.; Graff, Richard B.

2005-01-01

Tangible and pictorial paired-stimulus (PPS) preference assessments were compared for 6 individuals with developmental disabilities. During tangible and PPS assessments, two edible items or photographs were presented on each trial, respectively, and approach responses were recorded. Both assessments yielded similar preference hierarchies for 3…

Comparison of gene expression levels of appA, ppsR, and EL368 in Erythrobacter litoralis spheroplasts under aerobic and anaerobic conditions, and under blue light, red light, and dark conditions.

PubMed

Nishino, Koki; Takahashi, Sawako; Nishida, Hiromi

2018-03-31

We compared the gene expression levels of the blue-light-responsive genes, appA (encoding photosynthesis promoting protein AppA), ppsR (encoding photosynthesis suppressing protein PpsR), and EL368 (encoding a blue-light-activated histidine kinase with a light, oxygen, or voltage domain) between aerobic and anaerobic conditions in spheroplasts of the aerobic photosynthetic bacterium Erythrobacter litoralis. The spheroplasts conducted photosynthesis under red light but not under blue light. All three blue-light-responsive genes showed higher expression under aerobic conditions than under anaerobic conditions under blue light. In contrast, under red light, although the expression level of appA was higher in the presence of oxygen than in the absence of oxygen, the expression levels of ppsR and EL368 were similar in the presence and absence of oxygen. Our findings demonstrate that the expression of blue-light-responsive genes is strongly affected by oxygen in E. litoralis spheroplasts.

Formation and Characterization of Silver Nanoparticle Composite with Poly(p-Br/F-phenylsilane).

PubMed

Roh, Sung-Hee; Noh, Ji Eun; Woo, Hee-Gweon; Cho, Myong-Shik; Sohn, Honglae

2015-02-01

The one-pot production and structural characterization of composites of silver nanoparticles with poly(p-Br/F-phenylsilane), Br/F-PPS, have been performed. The conversion of Ag+ ions to stable Ag0 nanoparticles is mediated by the copolymer Br/F-PPS having both possibly reactive Si-H bonds in the polymer backbone and C-Br bonds in the substituents along with relatively inert C-F bonds. Transmission electron microscopy and field emission scanning electron microscopy analyses show the formation of the composites where silver nanoparticles (less than 30 nm of size) are well dispersed over the Br/F-PPS matrix. X-ray diffraction patterns are consistent with that for face-centered-cubic typed silver. The polymer solubility in toluene implys that the cleavage of C-Br bond and the Si-F dative bonding may not be occurred appreciably at ambient temperature. Nonetheless, thermogravimetric analysis data suggest that some sort of cross-linking could take place at high temperature. Most of the silver particles undergo macroscopic aggregation without Br/F-PPS, which indicates that the polysilane is necessary for stabilizing the silver nanoparticles.

76 FR 68525 - Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2012

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-04

...This final rule sets forth updates to the home health prospective payment system (HH PPS) rates, including: the national standardized 60-day episode rates; the national per-visit rates; and the low utilization payment amount (LUPA) under the Medicare PPS for home health agencies effective January 1, 2012. This rule applies a 1.4 percent update factor to the episode rates, which reflects a 1 percent reduction applied to the 2.4 percent market basket update factor, as mandated by the Affordable Care Act. This rule also updates the wage index used under the HH PPS, and further reduces home health payments to account for continued nominal growth in case-mix which is unrelated to changes in patient health status. This rule removes two hypertension codes from the HH PPS case-mix system, thereby requiring recalibration of the case-mix weights. In addition, the rule implements two structural changes designed to decrease incentives to upcode and provide unneeded therapy services. Finally, this rule incorporates additional flexibility regarding face-to-face encounters with providers related to home health care.

Unique nucleation activity of inorganic fullerene-like WS2 nanoparticles in polyphenylene sulfide nanocomposites: isokinetic and isoconversional study of dynamic crystallization kinetics.

PubMed

Naffakh, Mohammed; Marco, Carlos; Gómez, Marián A; Jiménez, Ignacio

2009-05-21

The dynamic crystallization kinetics of polyphenylene sulfide (PPS) nanocomposites with inorganic fullerene WS2 nanopartices (IF-WS2) content varying from 0.05 to 8 wt % has been studied using differential scanning calorimetry (DSC). The analysis of the crystallization at different cooling rates demonstrates that the completely isokinetic description of the crystallization process is not possible. However, the isoconversional methods in combination with the JMAEK equation provide a better understanding of the kinetics of the dynamic crystallization process. The addition of IF-WS2 influences the crystallization kinetics of PPS but in ways unexpected for polymer nanocomposites. A drastic change from retardation to promotion of crystallization is observed with increasing nanoparticle content. In the same way, the results of the nucleation activity and the effective energy barrier confirmed the unique dependence of the crystallization behavior of PPS on composition. In addition, the morphological data obtained from the polarized optical microscopy (POM) and time-resolved synchrotron X-ray diffraction is consistent with results of the crystallization kinetics of PPS/IF-WS2 nanocomposites.

Early performance of the 12-GHz, 200-watt transmitter experiment package in the communications technology satellite

NASA Technical Reports Server (NTRS)

1977-01-01

Measured performance characteristics of the transmitter experiment package (TEP) aboard the Communications Technology Satellite for the first 90 operating days in orbit are presented. The TEP consists of a nominal 200-watt output stage tube (OST), a supporting power processing system (PPS), and a variable-conductance heat pipe system (VCHPS). The OST, a traveling-wave tube augmented with a 10-stage depressed collector, has an overall saturated average efficiency of 51.5 percent and an average saturated radiofrequency (RF) output power at center-band frequency of 240 watts. The PPS operated with a measured efficiency of 86.5 percent to 88.5 percent. The VCHPS, using three pipes to conduct heat from the PPS and the body of the OST to a 52-centimeter by 124-centimeter (20.5-in. by 48.75-in.) radiator fin, maintained by the PPS baseplate temperature below 50 C for all operating conditions. The TEP performance characteristics presented include frequency response, RF output power, efficiency, and distortions. Communications characteristics were evaluated by using both video and audio modulated signals.

Effect of fiber-matrix adhesion on the creep behavior of CF/PPS composites: temperature and physical aging characterization

NASA Astrophysics Data System (ADS)

Motta Dias, M. H.; Jansen, K. M. B.; Luinge, J. W.; Bersee, H. E. N.; Benedictus, R.

2016-06-01

The influence of fiber-matrix adhesion on the linear viscoelastic creep behavior of `as received' and `surface modified' carbon fibers (AR-CF and SM-CF, respectively) reinforced polyphenylene sulfide (PPS) composite materials was investigated. Short-term tensile creep tests were performed on ±45° specimens under six different isothermal conditions, 40, 50, 60, 65, 70 and 75 °C. Physical aging effects were evaluated on both systems using the short-term test method established by Struik. The results showed that the shapes of the curves were affected neither by physical aging nor by the test temperature, allowing then superposition to be made. A unified model was proposed with a single physical aging and temperature-dependent shift factor, a_{T,te}. It was suggested that the surface treatment carried out in SM-CF/PPS had two major effects on the creep response of CF/PPS composites at a reference temperature of 40 °C: a lowering of the initial compliance of about 25 % and a slowing down of the creep response of about 1.1 decade.

Simultaneous 10 Gbps data and polarization-based pulse-per-second clock transmission using a single VCSEL for high-speed optical fibre access networks

NASA Astrophysics Data System (ADS)

Isoe, G. M.; Wassin, S.; Gamatham, R. R. G.; Leitch, A. W. R.; Gibbon, T. B.

2017-01-01

Access networks based on vertical cavity surface emitting laser (VCSEL) transmitters offer alternative solution in delivering different high bandwidth, cost effective services to the customer premises. Clock and reference frequency distribution is critical for applications such as Coordinated Universal Time (UTC), GPS, banking and big data science projects. Simultaneous distribution of both data and timing signals over shared infrastructure is thus desirable. In this paper, we propose and experimentally demonstrate a novel, cost-effective technique for multi-signal modulation on a single VCSEL transmitter. Two signal types, an intensity modulated 10 Gbps data signal and a polarization-based pulse per second (PPS) clock signal are directly modulated onto a single VCSEL carrier at 1310 nm. Spectral efficiency is maximized by exploiting inherent orthogonal polarization switching of the VCSEL with changing bias in transmission of the PPS signal. A 10 Gbps VCSEL transmission with PPS over 11 km of G.652 fibre introduced a transmission penalty of 0.52 dB. The contribution of PPS to this penalty was found to be 0.08 dB.

Concomitant CNS pathology in a patient with amyotropic lateral sclerosis following poliomyelitis in childhood.

PubMed

Casula, M; Steentjes, K; Aronica, E; van Geel, B M; Troost, D

2011-01-01

Post-polio syndrome (PPS) develops in approximately 30% of polio survivors several decades after the acute attack of paralytic poliomyelitis. Some of these patients develop post-poliomyelitis muscular atrophy (PPMA) which is characterized by a slowly progressive muscle weakness. Due to its clinicopathological features, investigators have often studied PPS and PPMA in association with amyotrophic lateral sclerosis (ALS), the underlying hypothesis being an increased risk of developing ALS from a prior acute paralytic poliomyelitis. Various studies, however, have indicated that de novo ALS cases in patients with prior acute paralytic poliomyelitis are rare. Herein, we describe a rare case of a 75-year-old woman who at post-mortem examination presented a combination of a PPS with proven histopathological sporadic ALS features. Furthermore, neuropathology of this case also revealed several other histopathological findings reminiscent of a tauopathy, synucleinopathy and amyloid angiopathy and a large pituitary cyst. To our knowledge, this is the first reported case of PPS with clear pathological hallmarks of sporadic ALS, including ubiquitin-, TDP-43, phosphorylated TDP-43- and p62-positive inclusions, with accompanying features compatible with Alzheimer's and Parkinson's disease.

Medicare program; home health prospective payment system rate update for calendar year 2012. Final rule.

PubMed

2011-11-04

This final rule sets forth updates to the home health prospective payment system (HH PPS) rates, including: the national standardized 60-day episode rates; the national per-visit rates; and the low utilization payment amount (LUPA) under the Medicare PPS for home health agencies effective January 1, 2012. This rule applies a 1.4 percent update factor to the episode rates, which reflects a 1 percent reduction applied to the 2.4 percent market basket update factor, as mandated by the Affordable Care Act. This rule also updates the wage index used under the HH PPS, and further reduces home health payments to account for continued nominal growth in case-mix which is unrelated to changes in patient health status. This rule removes two hypertension codes from the HH PPS case-mix system, thereby requiring recalibration of the case-mix weights. In addition, the rule implements two structural changes designed to decrease incentives to upcode and provide unneeded therapy services. Finally, this rule incorporates additional flexibility regarding face-to-face encounters with providers related to home health care.

Environmental colonization and onward clonal transmission of carbapenem-resistant Acinetobacter baumannii (CRAB) in a medical intensive care unit: the case for environmental hygiene.

PubMed

Ng, Deborah H L; Marimuthu, Kalisvar; Lee, Jia Jun; Khong, Wei Xin; Ng, Oon Tek; Zhang, Wei; Poh, Bee Fong; Rao, Pooja; Raj, Maya Devi Rajinder; Ang, Brenda; De, Partha Pratim

2018-01-01

In May 2015, we noticed an increase in carbapenem-resistant Acinetobacter baumannii (CRAB) infections in the Medical Intensive Care Unit (MICU). To investigate this, we studied the extent of environmental contamination and subsequent onward clonal transmission of CRAB. We conducted a one-day point prevalence screening (PPS) of the patients and environment in the MICU. We screened patients using endotracheal tube aspirates and swabs from nares, axillae, groin, rectum, wounds, and exit sites of drains. We collected environmental samples from patients' rooms and environment outside the patients' rooms. CRAB isolates from the PPS and clinical samples over the subsequent one month were studied for genetic relatedness by whole genome sequencing (WGS). We collected 34 samples from seven patients and 244 samples from the environment. On the day of PPS, we identified 8 CRAB carriers: 3 who screened positive and 5 previously known clinical infections. We detected environmental contamination in nearly two-thirds of the rooms housing patients with CRAB. WGS demonstrated genetic clustering of isolates within rooms but not across rooms. We analysed 4 CRAB isolates from clinical samples following the PPS. One genetically-related CRAB was identified in the respiratory sample of a patient with nosocomial pneumonia, who was admitted to the MICU five days after the PPS. The extensive environmental colonization of CRAB by patients highlights the importance of environmental hygiene. The transmission dynamics of CRAB needs further investigation.

Resistance of the genome of Escherichia coli and Listeria monocytogenes to irradiation evaluated by the induction of cyclobutane pyrimidine dimers and 6-4 photoproducts using gamma and UV-C radiations

NASA Astrophysics Data System (ADS)

Beauchamp, S.; Lacroix, M.

2012-08-01

The effect of gamma and UV-C irradiation on the production of cyclobutane pyrimidine dimers (CPDs) and 6-4 photoproducts (6-4 PPs) in DNA was investigated to compare the natural resistance of the genome of a Gram-positive bacterium and a Gram-negative bacterium against irradiation. Solution of pure DNA and bacterial strains Listeria monocytogenes and Escherichia coli were irradiated using gamma and UV-C rays. Extracted DNA from bacteria and pure DNA samples were then analysed by ELISA using anti-CPDs and anti-6-4 PPs monoclonal antibodies. The results show that gamma rays, as well as UV-C rays, induce the formation of CPDs and 6-4 PPs in DNA. During UV-C irradiation, the three samples showed a difference in their sensitivity against formation of CPDs (P≤0.05). Pure DNA was the most sensitive while the genome of L. monocytogenes was the most resistant. Also during UV-C irradiation, the genome of L. monocytogenes was the only one to show a significant resistance against formation of 6-4 PPs (P≤0.05). During gamma irradiation, for both types of lesion, pure DNA and the genome of E. coli did not show significant difference in their sensitivity (P>0.05) while the genome of L. monocytogenes showed a resistance against formation of CPDs and 6-4 PPs.

Post-Progression Survival Associated with Overall Survival in Patients with Advanced Non-Small-Cell Lung Cancer Receiving Docetaxel Monotherapy as Second-Line Chemotherapy.

PubMed

Kotake, Mie; Miura, Yosuke; Imai, Hisao; Mori, Keita; Sakurai, Reiko; Kaira, Kyoichi; Tomizawa, Yoshio; Minato, Koichi; Saito, Ryusei; Hisada, Takeshi

2017-01-01

In patients with non-small-cell lung cancer (NSCLC), the effects of second-line chemotherapy on overall survival (OS) might be confounded by subsequent therapies. Therefore, using individual-level data, we aimed to determine the relationships between progression-free survival (PFS) and post-progression survival (PPS) with OS in patients with advanced NSCLC treated with docetaxel monotherapy as second-line chemotherapy. Between April 2002 and December 2014, data from 86 patients with advanced NSCLC who underwent second-line docetaxel monotherapy following first-line treatment with platinum combination chemotherapy were analyzed. The relationships of PFS and PPS with OS were analyzed at the individual level. Spearman rank correlation and linear regression analyses showed that PPS was strongly associated with OS (r = 0.86, p < 0.05, R2 = 0.93), whereas PFS was moderately correlated with OS (r = 0.50, p < 0.05, R2 = 0.21). Performance status at the end of second-line treatment and the number of regimens after progression beyond second-line chemotherapy were significantly associated with PPS (p < 0.05). In patients with advanced NSCLC with unknown oncogenic driver mutations undergoing docetaxel monotherapy as second-line chemotherapy, when compared with PFS, PPS had a stronger association with OS. This finding suggests that subsequent treatment after disease progression following second-line docetaxel monotherapy has a significant influence on OS. © 2017 S. Karger AG, Basel.

The Design, Usability, and Feasibility of a Family-Focused Diabetes Self-Care Support mHealth Intervention for Diverse, Low-Income Adults with Type 2 Diabetes.

PubMed

Mayberry, Lindsay Satterwhite; Berg, Cynthia A; Harper, Kryseana J; Osborn, Chandra Y

2016-01-01

Family members' helpful and harmful actions affect adherence to self-care and glycemic control among adults with type 2 diabetes (T2D) and low socioeconomic status. Few family interventions for adults with T2D address harmful actions or use text messages to reach family members. Through user-centered design and iterative usability/feasibility testing, we developed a mHealth intervention for disadvantaged adults with T2D called FAMS. FAMS delivers phone coaching to set self-care goals and improve patient participant's (PP) ability to identify and address family actions that support/impede self-care. PPs receive text message support and can choose to invite a support person (SP) to receive text messages. We recruited 19 adults with T2D from three Federally Qualified Health Centers to use FAMS for two weeks and complete a feedback interview. Coach-reported data captured coaching success, technical data captured user engagement, and PP/SP interviews captured the FAMS experience. PPs were predominantly African American, 83% had incomes <$35,000, and 26% were married. Most SPs ( n = 7) were spouses/partners or adult children. PPs reported FAMS increased self-care and both PPs and SPs reported FAMS improved support for and communication about diabetes. FAMS is usable and feasible and appears to help patients manage self-care support, although some PPs may not have a SP.

The Design, Usability, and Feasibility of a Family-Focused Diabetes Self-Care Support mHealth Intervention for Diverse, Low-Income Adults with Type 2 Diabetes

PubMed Central

Berg, Cynthia A.; Harper, Kryseana J.; Osborn, Chandra Y.

2016-01-01

Family members' helpful and harmful actions affect adherence to self-care and glycemic control among adults with type 2 diabetes (T2D) and low socioeconomic status. Few family interventions for adults with T2D address harmful actions or use text messages to reach family members. Through user-centered design and iterative usability/feasibility testing, we developed a mHealth intervention for disadvantaged adults with T2D called FAMS. FAMS delivers phone coaching to set self-care goals and improve patient participant's (PP) ability to identify and address family actions that support/impede self-care. PPs receive text message support and can choose to invite a support person (SP) to receive text messages. We recruited 19 adults with T2D from three Federally Qualified Health Centers to use FAMS for two weeks and complete a feedback interview. Coach-reported data captured coaching success, technical data captured user engagement, and PP/SP interviews captured the FAMS experience. PPs were predominantly African American, 83% had incomes <$35,000, and 26% were married. Most SPs (n = 7) were spouses/partners or adult children. PPs reported FAMS increased self-care and both PPs and SPs reported FAMS improved support for and communication about diabetes. FAMS is usable and feasible and appears to help patients manage self-care support, although some PPs may not have a SP. PMID:27891524

Use of lomustine (CCNU) in a case of cutaneous equine lymphoma

PubMed Central

Doyle, Aimie J.; MacDonald, Valerie S.; Bourque, Andrea

2013-01-01

A 12-year-old gelding was diagnosed with recurrent lymphoma in multiple cutaneous sites. A highly invasive preputial mass caused urethral obstruction. The horse was treated with surgery and chemotherapy consisting of lomustine (CCNU) and prednisolone. The treatment was well-tolerated and effective. This is the first reported use of lomustine (CCNU) in a horse for the treatment of equine lymphoma. PMID:24293673

Primordial power spectrum from Planck

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

Hazra, Dhiraj Kumar; Shafieloo, Arman; Souradeep, Tarun, E-mail: dhiraj@apctp.org, E-mail: arman@apctp.org, E-mail: tarun@iucaa.ernet.in

2014-11-01

Using modified Richardson-Lucy algorithm we reconstruct the primordial power spectrum (PPS) from Planck Cosmic Microwave Background (CMB) temperature anisotropy data. In our analysis we use different combinations of angular power spectra from Planck to reconstruct the shape of the primordial power spectrum and locate possible features. Performing an extensive error analysis we found the dip near ℓ ∼ 750–850 represents the most prominent feature in the data. Feature near ℓ ∼ 1800–2000 is detectable with high confidence only in 217 GHz spectrum and is apparently consequence of a small systematic as described in the revised Planck 2013 papers. Fixing the background cosmological parameters andmore » the foreground nuisance parameters to their best fit baseline values, we report that the best fit power law primordial power spectrum is consistent with the reconstructed form of the PPS at 2σ C.L. of the estimated errors (apart from the local features mentioned above). As a consistency test, we found the reconstructed primordial power spectrum from Planck temperature data can also substantially improve the fit to WMAP-9 angular power spectrum data (with respect to power-law form of the PPS) allowing an overall amplitude shift of ∼ 2.5%. In this context low-ℓ and 100 GHz spectrum from Planck which have proper overlap in the multipole range with WMAP data found to be completely consistent with WMAP-9 (allowing amplitude shift). As another important result of our analysis we do report the evidence of gravitational lensing through the reconstruction analysis. Finally we present two smooth form of the PPS containing only the important features. These smooth forms of PPS can provide significant improvements in fitting the data (with respect to the power law PPS) and can be helpful to give hints for inflationary model building.« less

Relationships between molecular structure and kinetic and thermodynamic controls in lipid systems. Part II: Phase behavior and transformation paths of SSS, PSS and PPS saturated triacylglycerols--effect of chain length mismatch.

PubMed

Bouzidi, Laziz; Narine, Suresh S

2012-01-01

The kinetic phase behavior and phase transformation paths of purified tristearoylglycerol (SSS), 3-palmitoyl-1,2-distearoyl-sn-glycerol (PSS) and 1,2-dipalmitoyl-3-stearoyl-sn-glycerol (PPS) were investigated in terms of polymorphism, crystallization and melting. The details of the phase transformation paths were obtained using the heating cycles of two sets of experiments: (a) cooling rate was varied and heating rate fixed and (b) cooling rate was fixed and heating rate varied. Kinetic effects were manifest in all measured properties, underscoring the complexity of the phase transformation paths for each TAG, and the intricate thermodynamics-molecular relationships. For the first time, XRD data obtained for SSS, PSS and PPS TAGs, cooled at rates higher than 0.5°C/min, suggested the formation of a transient structure similar to the so-called α(2)-phase which has been observed in mixed saturated-unsaturated TAGs quenched from the melt. The more stable phases (β' in PSS and PPS, and β in SSS) were only observed for cooling rates lower than 1.0°C/min. The kinetic and thermodynamic differences observed in the crystallization, structure and melting of SSS, PSS and PPS are proposed to be mainly due to the disturbances introduced at the "terrace" level via methyl-end group interactions, i.e., the missing of two or four CH(2) groups compared to SSS. The symmetrical SSS with a relatively flat "terrace" crystallizes preferably in the most stable β-form. Two missing CH(2) groups at the sn-1 position (PSS) introduces enough structural disturbances to promote the relative prevalence and persistence of the β'-phase, and four missing CH(2) groups at the sn-1 and sn-2 positions (PPS) is relatively too large of a disturbance and therefore favors the α-form. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Managing oral phosphate binder medication expenditures within the Medicare bundled end-stage renal disease prospective payment system: economic implications for large U.S. dialysis organizations.

PubMed

Park, Haesuk; Rascati, Karen L; Keith, Michael S

2015-06-01

From January 2016, payment for oral-only renal medications (including phosphate binders and cinacalcet) was expected to be included in the new Medicare bundled end-stage renal disease (ESRD) prospective payment system (PPS). The implementation of the ESRD PPS has generated concern within the nephrology community because of the potential for inadequate funding and the impact on patient quality of care. To estimate the potential economic impact of the new Medicare bundled ESRD PPS reimbursement from the perspective of a large dialysis organization in the United States. We developed an interactive budget impact model to evaluate the potential economic implications of Medicare payment changes to large dialysis organizations treating patients with ESRD who are receiving phosphate binders. In this analysis, we focused on the budget impact of the intended 2016 integration of oral renal drugs, specifically oral phosphate binders, into the PPS. We also utilized the model to explore the budgetary impact of a variety of potential shifts in phosphate binder market shares under the bundled PPS from 2013 to 2016. The base model predicts that phosphate binder costs will increase to $34.48 per dialysis session in 2016, with estimated U.S. total costs for phosphate binders of over $682 million. Based on these estimates, a projected Medicare PPS $33.44 reimbursement rate for coverage of all oral-only renal medications (i.e., phosphate binders and cinacalcet) would be insufficient to cover these costs. A potential renal drugs and services budget shortfall for large dialysis organizations of almost $346 million was projected. Our findings suggest that large dialysis organizations will be challenged to manage phosphate binder expenditures within the planned Medicare bundled rate structure. As a result, large dialysis organizations may have to make treatment choices in light of potential inadequate funding, which could have important implications for the quality of care for patients with ESRD.

Primary payer status is significantly associated with postoperative mortality, morbidity, and hospital resource utilization in pediatric surgical patients within the United States.

PubMed

Stone, Matthew L; LaPar, Damien J; Mulloy, Daniel P; Rasmussen, Sara K; Kane, Bartholomew J; McGahren, Eugene D; Rodgers, Bradley M

2013-01-01

Current healthcare reform efforts have highlighted the potential impact of insurance status on patient outcomes. The influence of primary payer status (PPS) within the pediatric surgical patient population remains unknown. The purpose of this study was to examine risk-adjusted associations between PPS and postoperative mortality, morbidity, and resource utilization in pediatric surgical patients within the United States. A weighted total of 153,333 pediatric surgical patients were evaluated using the national Kids' Inpatient Database (2003 and 2006): appendectomy, intussusception, decortication, pyloromyotomy, congenital diaphragmatic hernia repair, and colonic resection for Hirschsprung's disease. Patients were stratified according to PPS: Medicare (n=180), Medicaid (n=51,862), uninsured (n=12,539), and private insurance (n=88,753). Multivariable hierarchical regression modeling was utilized to evaluate risk-adjusted associations between PPS and outcomes. Overall median patient age was 12 years, operations were primarily non-elective (92.4%), and appendectomies accounted for the highest proportion of cases (81.3%). After adjustment for patient, hospital, and operation-related factors, PPS was independently associated with in-hospital death (p<0.0001) and postoperative complications (p<0.02), with increased risk for Medicaid and uninsured populations. Moreover, Medicaid PPS was also associated with greater adjusted lengths of stay and total hospital charges (p<0.0001). Importantly, these results were dependent on operation type. Primary payer status is associated with risk-adjusted postoperative mortality, morbidity, and resource utilization among pediatric surgical patients. Uninsured patients are at increased risk for postoperative mortality while Medicaid patients accrue greater morbidity, hospital lengths of stay, and total charges. These results highlight a complex interaction between socioeconomic and patient-related factors, and primary payer status should be considered in the preoperative risk stratification of pediatric patients. Copyright © 2013 Elsevier Inc. All rights reserved.

Medication decision making and patient outcomes in GP, nurse and pharmacist prescriber consultations.

PubMed

Weiss, Marjorie C; Platt, Jo; Riley, Ruth; Chewning, Betty; Taylor, Gordon; Horrocks, Susan; Taylor, Andrea

2015-09-01

Aim The aims of this study were twofold: (a) to explore whether specific components of shared decision making were present in consultations involving nurse prescribers (NPs), pharmacist prescribers (PPs) and general practitioners (GPs) and (b) to relate these to self-reported patient outcomes including satisfaction, adherence and patient perceptions of practitioner empathy. There are a range of ways for defining and measuring the process of concordance, or shared decision making as it relates to decisions about medicines. As a result, demonstrating a convincing link between shared decision making and patient benefit is challenging. In the United Kingdom, nurses and pharmacists can now take on a prescribing role, engaging in shared decision making. Given the different professional backgrounds of GPs, NPs and PPs, this study sought to explore the process of shared decision making across these three prescriber groups. Analysis of audio-recordings of consultations in primary care in South England between patients and GPs, NPs and PPs. Analysis of patient questionnaires completed post consultation. Findings A total of 532 consultations were audio-recorded with 20 GPs, 19 NPs and 12 PPs. Prescribing decisions occurred in 421 (79%). Patients were given treatment options in 21% (102/482) of decisions, the prescriber elicited the patient's treatment preference in 18% (88/482) and the patient expressed a treatment preference in 24% (118/482) of decisions. PPs were more likely to ask for the patient's preference about their treatment regimen (χ 2=6.6, P=0.036, Cramer's V=0.12) than either NPs or GPs. Of the 275 patient questionnaires, 192(70%) could be matched with a prescribing decision. NP patients had higher satisfaction levels than patients of GPs or PPs. More time describing treatment options was associated with increased satisfaction, adherence and greater perceived practitioner empathy. While defining, measuring and enabling the process of shared decision making remains challenging, it may have patient benefit.

Influence of the prospective payment system on speech-language pathology services.

PubMed

Frymark, Tobi B; Mullen, Robert C

2005-01-01

The present study was performed to determine the clinical effects of the Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS) on speech and language intervention services and to examine the feasibility of using the federally mandated FIM instrument to establish resource allocation to patients with cognitive, communication, and swallowing disorders. A pre-IRF PPS and post-IRF PPS comparative study was conducted over a 1-yr time interval using data from the American Speech-Language-Hearing Association's National Outcomes Measurement System. Toward this end, the National Outcomes Measurement System's Functional Communication Measures were used to obtain data from 2,631 patients residing in 96 freestanding rehabilitation hospitals or hospitals with rehabilitation units implementing the prospective payment system on or after January 1, 2002. To ensure reliable retrospective and prospective data comparisons, all sites were active participants within the National Outcomes Measurement System program before the introduction of IRF PPS within their facilities. Findings revealed changes in both the utilization of speech-language pathologists and patient outcomes. Under the IRF PPS, there was a clear decline in speech- and language-related lengths of stay. However, clinicians attempted to compensate for these decrements in lengths of stay by increasing the intensity and frequency of their speech and language services. Despite these compensatory efforts, further analyses of the data revealed that under the IRF PPS, fewer patients achieved multiple levels of functional progress in speech and language abilities than before this payment system was implemented. This trend was most noteworthy in the treatment areas of swallowing, motor speech, and memory. In addition, this study revealed that, compared with the National Outcomes Measurement System's Functional Communication Measures, the FIM instrument significantly under-represented and undervalued the extent of a patient's overall progress in recovering from their cognitive, communication, or swallowing disabilities. These findings support the notion that the introduction of the IRF PPS has, perhaps unintentionally, caused more patients with cognitive, communication, and swallowing disorders to be discharged from inpatient rehabilitative care with less than adequate functional skill levels. The discouraging results in speech-language pathology utilization and patient outcomes will be useful for clinicians in the future when facing the ongoing challenges of maintaining quality care while streamlining services under the prospective payment system.

Natural carcinogenic fiber and pleural plaques assessment in a general population: A cross-sectional study

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

Ledda, Caterina, E-mail: cledda@unict.it

Natural carcinogenic fibers are asbestos and asbestiform fibers present as a natural component of soils or rocks. These fibers are released into the environment resulting in exposure of the general population. Environmental contamination by fibers are those cases occurred in: rural regions of Turkey, in Mediterranean countries and in other sites of the world, including northern Europe, USA and China. Fluoro-edenite(FE) is a natural mineral species first isolated in Biancavilla, Sicily. The fibers are similar in size and morphology to some amphibolic asbestos fibers, whose inhalation can cause chronic inflammation and cancer. The aim of the current study is tomore » assess the presence and features of pleural plaques (PPs) in Biancavilla's general population exposed to FE through a retrospective cross-sectional study. All High-Resolution Computed Tomography (HRCT) chest scans carried out between June 2009 and June 2015 in Biancavilla municipality hospital site (exposed subjects) were reviewed. The exposed groups were 1:1 subjects, matched according to age and sex distributions, with unexposed subjects (n.1.240) randomly selected among HRCT chest scans carried out in a Hospital 30 km away from Biancavilla. Subjects from Biancavilla with PPs were significantly more numerous than the control group ones (218 vs 38). Average age of either group was >60 years; the age of exposed subjects was significantly (p=0.0312) lesser than the unexposed group. In exposed subjects, in most PPs thickness ranged between 2 and 4.9 cm(38%, n=83); while in unexposed ones PPs thickness was less than 2 cm (55%, n=21). As to the size of PPs in exposed subjects, in most cases it ranged between 1 cm and 24% of chest wall (53%, n=116); while in unexposed ones the size of PPs was lesser than 1 cm (23%, n=58). Among exposed subjects, 36 cases (17%) PPs were detected with calcification, whereas in unexposed ones only three (8%) presented calcification. 137 lung parenchymal abnormalities were observed in exposed group; whereas, 12 lung parenchymal involvement were registered in unexposed subjects. The RR for PPs is 6,74 CI 95% (4,47–9,58) p<0,0001 in the exposed population. These findings, suggested the urge to extend the screening on the possible involvement of the respiratory tract to all Biancavilla's population, particularly in those aged more than 30. Besides, it seems essential to start indoor monitoring Biancavilla's municipality. - Highlights: • High risk for pleural plaques in people exposed to fluoro-edenite. • Naturally carcinogenic fibers increase the risk of parenchymal abnormalities. • It is important to organize an extended screening to all Biancavilla's population.« less

Registered Nurse Staffing in Pennsylvania Nursing Homes: Comparison before and after Implementation of Medicare's Prospective Payment System.

ERIC Educational Resources Information Center

Kanda, Katsuya; Mezey, Mathy

1991-01-01

Examined changes in resident acuity and registered nurse staffing in all nursing homes in Pennsylvania before and after introduction of Medicare Prospective Payment System (PPS) in 1983. Found that acuity of nursing home residents increased significantly since introduction of PPS, full-time registered nurse staffing remained unchanged, and…

Army 86 Cost Sensitivity Analysis.

DTIC Science & Technology

1980-05-01

NI VI AN/PVS-4 W/IMG 5 Q15414 RADAR ST AN/MPQ-4A LP 25 Q16110 RADAR SET AN/PPS- SALP 773 Q34308 RADIO SET AN/GRC-160 191 Q45779 RADIO SET AN/VRC-12 654...VI AN/PVS-4 W/ING 5 Q15414 RADAR ST AN/MPQ-4A LP 25 Q16110 RADAR SET AN/PPS- SALP 592 Q34308 RADIO SET AN/GRC-160 555 Q38299 RADIO SET AN/PRC-25 474...PVS-4 W/IMG Q15414 RADAR ST AN/MPQ-4A LP Q16110 RADAR SET AN/PPS- SALP Q34308 RADIO SET AN/GRC-160 Q38299 RADIO SET AN/PRC-25 Q45779 RADIO SET AN/VRC-12

Treatment with L-citrulline in patients with post-polio syndrome: study protocol for a single-center, randomised, placebo-controlled, double-blind trial.

PubMed

Schmidt, Simone; Gocheva, Vanya; Zumbrunn, Thomas; Rubino-Nacht, Daniela; Bonati, Ulrike; Fischer, Dirk; Hafner, Patricia

2017-03-09

Post-polio syndrome (PPS) is a condition that affects polio survivors years after recovery from an initial acute infection by the Poliomyelitis virus. Most often, patients who suffered from polio start to experience gradual new weakening in muscles, a gradual decrease in the size of muscles (muscle atrophy) and fatigue years after the acute illness. L-citrulline is known to change muscular metabolism synthesis by raising nitric oxide (NO) levels and increasing protein synthesis. This investigator-initiated, randomised, placebo-controlled, double-blind, trial aims to demonstrate that L-citrulline positively influences muscle function and increases muscular energy production in patients with PPS. Thirty ambulant PPS patients will be recruited in Switzerland. Patients will be randomly allocated to one of the two arms of the study (placebo:verum 1:1). After a 24-week run-in phase to observe natural disease history and progression, participants will be treated either with L-citrulline or placebo for 24 weeks. The primary endpoint is change in the 6-min Walking Distance Test. Secondary endpoints will include motor function measure, quantitative muscle force, quantitative muscle magnetic resonance imaging and magnetic resonance spectroscopy and serum biomarker laboratory analysis DISCUSSION: The aim of this phase IIa trial is to determine if treatment with L-citrulline shows a positive effect on clinical function and paraclinical biomarkers in PPS. If treatment with L-citrulline shows positive effects, this might represent a cost-efficient symptomatic therapy for PPS patients. ClinicalTrial.gov, ID: NCT02801071 . Registered on 6 June 2016.

Racial Differences in the Extracellular Matrix and Histone Acetylation of the Lamina Cribrosa and Peripapillary Sclera.

PubMed

Park, Hae-Young Lopilly; Kim, Jie Hyun; Jung, Younhea; Park, Chan Kee

2017-08-01

We investigated the extracellular matrix (ECM) of the lamina cribrosa (LC) and peripapillary sclera (PPS) and compared histone acetylation and related enzymes to identify racial differences between Korean and Caucasian donor eyes. Posterior segment tissues were obtained from 30 Caucasian donors and 42 age and axial length-matched Korean donors. Histone modification was assessed for histone deacetylase (HDAC) 2, HDAC3, and acetylated histone H3. The promoter regions of the major ECM in the LC and PPS including collagen type I and III, and elastic fiber components (elastin and fibrillin-1) and lysyl oxidase enzymes including lysyl oxidase-like 1 and 2 (LOXL2) were evaluated by chromatin immunoprecipitation (ChIP) assay. Protein and mRNA expression of major ECM components were assessed using real-time polymerase chain reaction analysis, western blot analysis, and immunohistochemical staining. HDAC2 and HDAC3 expression levels were decreased and acetylated histone H3 was increased in the LC and PPS of Korean eyes than Caucasian eyes. The promoter regions of LOXL2, elastin, and fribrillin-1 genes were highly acetylated in Korean LC. Expression of LOXL2 and elastic fiber components (elastin and fibrillin-1) were significantly increased in Korean LC and PPS than Caucasians according to the real-time polymerase chain reaction, western blot analyses, and quantification of elastic fiber staining. Histone acetylation status differed in the promoter regions of the elastic fiber components and LOXL2 in the LC and PPS according to race. Further study to reveal the association with these findings to the pathogenesis of glaucoma in Korean eyes is needed.

High dynamic range pixel architecture for advanced diagnostic medical x-ray imaging applications

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

Izadi, Mohammad Hadi; Karim, Karim S.

2006-05-15

The most widely used architecture in large-area amorphous silicon (a-Si) flat panel imagers is a passive pixel sensor (PPS), which consists of a detector and a readout switch. While the PPS has the advantage of being compact and amenable toward high-resolution imaging, small PPS output signals are swamped by external column charge amplifier and data line thermal noise, which reduce the minimum readable sensor input signal. In contrast to PPS circuits, on-pixel amplifiers in a-Si technology reduce readout noise to levels that can meet even the stringent requirements for low noise digital x-ray fluoroscopy (<1000 noise electrons). However, larger voltagesmore » at the pixel input cause the output of the amplified pixel to become nonlinear thus reducing the dynamic range. We reported a hybrid amplified pixel architecture based on a combination of PPS and amplified pixel designs that, in addition to low noise performance, also resulted in large-signal linearity and consequently higher dynamic range [K. S. Karim et al., Proc. SPIE 5368, 657 (2004)]. The additional benefit in large-signal linearity, however, came at the cost of an additional pixel transistor. We present an amplified pixel design that achieves the goals of low noise performance and large-signal linearity without the need for an additional pixel transistor. Theoretical calculations and simulation results for noise indicate the applicability of the amplified a-Si pixel architecture for high dynamic range, medical x-ray imaging applications that require switching between low exposure, real-time fluoroscopy and high-exposure radiography.« less

Film and digital periapical radiographs for the measurement of apical root shortening.

PubMed

El-Angbawi, Ahmed M F; McIntyre, Grant T; Bearn, David R; Thomson, Donald J

2012-12-01

The aim of this study was to compare the accuracy and agreement of scanned film and digital periapical radiographs for the measurement of apical root shortening. Twenty-four film and digital [phosphor plate sensor (PPS)] periapical radiographs were taken using the long-cone paralleling technique for six extracted teeth before and after 1mm of apical root trimming. All teeth were mounted using a typodont and the radiographs were recorded using a film holder and polysiloxane occlusal index for each tooth to ensure standardization during the different radiographic exposures. The film radiographs were scanned and the tooth length measurements for the scanned film and digital (PPS) images were calculated using Image-J-Link 1.4 software (http://rebweb.nih.gov/ij/index.html) for the two groups. The accuracy and agreement among the tooth length measurements from each group and the true tooth length measurements were calculated using intra-class correlation (ICC) tests and Bland and Altman plots. A high level of agreement was found between the true tooth length measurements and the scanned film measurements (ICC=0.979, limit of agreement 0.579 to -0.565) and the digital (PPS) radiograph measurements (ICC= 0.979, limit of agreement 0.596 to -0.763). Moreover, a high level of agreement was found between the scanned film and digital (PPS) radiographs for the measurement of tooth length ICC=0.991, limit of agreement 0.411-0.231. Film and digital (PPS) periapical radiographs are accurate methods for measuring apical root shortening with a high level of agreement. Key words:Root shortening, measurement, periapical radiographs, film, digital.

The first 3 years of Medicare prospective payment: An overview

PubMed Central

Guterman, Stuart; Eggers, Paul W.; Riley, Gerald; Greene, Timothy F.; Terrell, Sherry A.

1988-01-01

This article provides a synopsis of the available evidence on the impact of the Medicare prospective payment system (PPS) for hospitals over the first 3 years of its implementation. The impact of PPS on hospitals, Medicare beneficiaries, post-hospital care, other payers for inpatient hospital services, other health care providers, and Medicare program operations and expenditures is examined. PMID:10312519

Measuring Procrastination: Psychometric Properties of the Norwegian Versions of the Irrational Procrastination Scale (IPS) and the Pure Procrastination Scale (PPS)

ERIC Educational Resources Information Center

Svartdal, Frode

2017-01-01

Procrastination has been defined in different ways. Two instruments--the Irrational Procrastination Scale (IPS) and the Pure Procrastination Scale (PPS)--focus on a core problem in procrastination--the irrational delay of intended behavior. The present paper examined the psychometric properties of the Norwegian translations of these scales. In…

Fear of falling, balance confidence and health-related quality of life in individuals with postpolio syndrome.

PubMed

Legters, Kristine; Verbus, Nicole Barber; Kitchen, Sara; Tomecsko, Jennifer; Urban, Nicole

2006-06-01

The purposes of this study were to examine prevalence of fear of falling (FOF) and decreased balance confidence in individuals with postpolio syndrome (PPS) and to determine whether balance confidence was correlated with health-related quality of life (HRQOL) in this population. A survey, which included demographic questions, the Activities-specific Balance Confidence (ABC) Scale, and the MOS SF-36v2, was made available by mail and electronically to individuals with PPS. Descriptive and correlation statistics were used to analyze the responses. Fear of falling was reported in 95% of respondents, with 80% indicating that FOF affected their quality of life. Median ABC score (42 of 100), physical component score (27 of 100), and mental component score (47 of 100) were below average compared with the general population. A moderate correlation (r = 0.4; p < 0.001) was found between balance confidence and the physical component score of HRQOL in PPS. There was an overwhelming presence of FOF and severely impaired balance confidence in the majority of those with PPS. A fair correlation between the physical functioning component of HRQOL and balance confidence was noted in this population.

The stigma of having psychological problems: relations with engagement, working alliance, and depression in psychotherapy.

PubMed

Kendra, Matthew S; Mohr, Jonathan J; Pollard, Jeffrey W

2014-12-01

The stigma of having psychological problems is a barrier to seeking mental health treatment, but little research has examined whether this stigma influences the experiences of those in treatment. In a sample of 42 psychotherapy clients, we explored links over the first few sessions between 2 facets of stigma (self-stigma and perceived public stigma) and 3 variables germane to the therapeutic process (depression, working alliance, and engagement). Initial self-stigma (SS) level was positively associated with initial depression, negatively associated with initial working alliance, and unrelated to initial engagement. Initial perceived public stigma (PPS) level was unrelated to initial levels in the 3 outcome variables. Initial SS and PPS levels were both generally unrelated to linear changes in the outcomes over the initial phase of counseling. Relations between stigma and outcome variables often differed within- and between-persons. For example, the association between PPS and engagement was negative at the between-person level but positive at the within-person level. Finally, on average, PPS decreased over the first few sessions but SS remained constant. Such findings may help therapists better understand the role of stigma in their clinical work, and stimulate research examining how to address stigmatization in psychotherapy.

Synthesis and characterization of silver nanoparticle composite with poly(p-Br-phenylsilane).

PubMed

Kim, Myoung-Hee; Lee, Jun; Mo, Soo-Yong; Woo, Hee-Gweon; Yang, Kap Seung; Kim, Bo-Hye; Lee, Byeong-Gweon; Sohn, Honglae

2012-05-01

The one-pot synthesis and characterization of silver nanoparticle-poly(p-Br-phenylsilane) composites have been carried out. The conversion of silver(+1) salt to stable silver(0) nanoparticles is promoted by poly(p-Br-phenylsilane), Br-PPS possessing both possible reactive Si-H bonds in the polymer backbone and C-Br bonds in the substituents. The composites were characterized using XRD, TEM, FE-SEM, and solid-state UV-vis analytical techniques. TEM and FE-SEM data show the formation of the composites where large number of silver nanoparticles (less than 30 nm of size) are well dispersed throughout the Br-PPS matrix. XRD patterns are consistent with that for fcc-typed silver. The elemental analysis for Br atom and the polymer solubility confirm that the cleavage of C-Br bond and the Si-Br dative bonding were not occurred appreciably at ambient temperature. Nonetheless, TGA data suggest that some sort of cross-linking was occurred at high temperature. The size and processability of such nanoparticles depend on the ratio of metal to Br-PPS. In the absence of Br-PPS, most of the silver particles undergo macroscopic aggregation, which indicates that the polysilane is necessary for stabilizing the silver nanoparticles.

Leadership, management and technical lessons learnt from a successful public-private partnership for TB control in Nepal.

PubMed

Newell, J N; Pande, S B; Baral, S C; Bam, D S; Malla, P

2005-09-01

There is considerable interest in involving private practitioners (PPs) in tuberculosis (TB) control, but little experience. To describe and discuss leadership, management and technical lessons learnt from the successful implementation of a public-private partnership (PPP) for TB control in Nepal. Description and discussion of implementation of the PPP is based on feedback from the working group charged with developing the PPP, PPs involved in diagnosis and referral, NGOs providing direct observation of treatment and tracing of late patients, and members of the Nepal National TB Programme. The process of building the partnership was slow and demoralising, yet with perseverance partners gradually increased their involvement and commitment to the PPP. Leadership was needed to foster communication and openness between partners. It was not necessary to involve all PPs: many patients bypassed PPs and went directly to the free DOTS centres. An understanding of issues that arose during development of the Lalitpur PPP may assist assessment of the feasibility of PPPs in other settings, and increase the likelihood of successful implementation. The wider literature on partnerships may be useful to further inform the development of PPPs for health in developing countries.

Alternative Treatment in Prostate Pain Syndrome Based on Iranian Traditional Medicine

PubMed Central

Latifi, Seied Amirhossein; Kamalinejad, Mohammad; Minaiee, Bagher; Bahrami, Mohsen; Gooran, Shahram; Nikbakht Nasrabadi, Alireza

2014-01-01

Introduction: Unknown etiology and pathophysiology of prostate pain syndrome (PPS) has led to a lack of proper and competent treatment in modern medicine. According to the guidelines of European Association of Urology (EAU), use of complementary treatments is recommended for PPS. In this preliminary study, analyzing the signs and symptoms of PPS from the viewpoint of Iranian traditional medicine (ITM) was helpful in selecting the appropriate alternative treatment. Case Presentation: Two male patients diagnosed with PPS were evaluated and treated according to the ITM. Each patient took 15 mL oxymel 45 minutes after lunch and dinner. For each patient, four clinical visits were made with one week intervals and the validated Farsi version of international prostate symptom score (IPSS) and numeric pain rating score (NPRS) were completed for them. Conclusions: Considering the fact that other major pathological causes are ruled out, many of the symptoms and signs observed in these patients were similar to those associated with flatulency-related diseases in ITM. Selecting treatment with oxymel was based on this view and led to improvements in the digestive and urinary symptoms according to Farsi version of the IPSS and NPRS. PMID:25237573

An appealing photo-powered multi-functional energy system for the poly-generation of hydrogen and electricity

NASA Astrophysics Data System (ADS)

Tang, Tiantian; Li, Kan; Shen, Zhemin; Sun, Tonghua; Wang, Yalin; Jia, Jinping

2015-10-01

This paper focuses on a photo-powered poly-generation system (PPS) that is powered by the photocatalytic oxidation of organic substrate to produce hydrogen energy and electrical energy synchronously. This particular device runs entirely on light energy and chemical energy of substrate without external voltage. The performance measurements and optimization experiments are all investigated by using the low concentration of pure ethanol (EtOH) solution. Compared with the conventional submerged reactor for the photogeneration of hydrogen, the hydrogen and the electric current obtained in the constructed PPS are all relatively stable in experimental period and the numerical values detected are many times higher than that of the former by using various simulated ethanol waste liquid. When using Chinese rice wine as substrate at the same ethanol content level (i.e., 0.1 mol L-1), the production of hydrogen is close to that of the pure ethanol solution in the constructed PPS, but no hydrogen is detected in the conventional submerged reactor. These results demonstrate that the constructed PPS could effectively utilize light energy and perform good capability in poly-generation of hydrogen and electricity.

Interaction of two photoreceptors in the regulation of bacterial photosynthesis genes

PubMed Central

Metz, Sebastian; Haberzettl, Kerstin; Frühwirth, Sebastian; Teich, Kristin; Hasewinkel, Christian; Klug, Gabriele

2012-01-01

The expression of photosynthesis genes in the facultatively photosynthetic bacterium Rhodobacter sphaeroides is controlled by the oxygen tension and by light quantity. Two photoreceptor proteins, AppA and CryB, have been identified in the past, which are involved in this regulation. AppA senses light by its N-terminal BLUF domain, its C-terminal part binds heme and is redox-responsive. Through its interaction to the transcriptional repressor PpsR the AppA photoreceptor controls expression of photosynthesis genes. The cryptochrome-like protein CryB was shown to affect regulation of photosynthesis genes, but the underlying signal chain remained unknown. Here we show that CryB interacts with the C-terminal domain of AppA and modulates the binding of AppA to the transcriptional repressor PpsR in a light-dependent manner. Consequently, binding of the transcription factor PpsR to its DNA target is affected by CryB. In agreement with this, all genes of the PpsR regulon showed altered expression levels in a CryB deletion strain after blue-light illumination. These results elucidate for the first time how a bacterial cryptochrome affects gene expression. PMID:22434878

Interaction of two photoreceptors in the regulation of bacterial photosynthesis genes.

PubMed

Metz, Sebastian; Haberzettl, Kerstin; Frühwirth, Sebastian; Teich, Kristin; Hasewinkel, Christian; Klug, Gabriele

2012-07-01

The expression of photosynthesis genes in the facultatively photosynthetic bacterium Rhodobacter sphaeroides is controlled by the oxygen tension and by light quantity. Two photoreceptor proteins, AppA and CryB, have been identified in the past, which are involved in this regulation. AppA senses light by its N-terminal BLUF domain, its C-terminal part binds heme and is redox-responsive. Through its interaction to the transcriptional repressor PpsR the AppA photoreceptor controls expression of photosynthesis genes. The cryptochrome-like protein CryB was shown to affect regulation of photosynthesis genes, but the underlying signal chain remained unknown. Here we show that CryB interacts with the C-terminal domain of AppA and modulates the binding of AppA to the transcriptional repressor PpsR in a light-dependent manner. Consequently, binding of the transcription factor PpsR to its DNA target is affected by CryB. In agreement with this, all genes of the PpsR regulon showed altered expression levels in a CryB deletion strain after blue-light illumination. These results elucidate for the first time how a bacterial cryptochrome affects gene expression.

Hot pressing of nanocrystalline tantalum using high frequency induction heating and pulse plasma sintering

NASA Astrophysics Data System (ADS)

Jakubowicz, J.; Adamek, G.; Sopata, M.; Koper, J. K.; Siwak, P.

2017-12-01

The paper presents the results of nanocrystalline powder tantalum consolidation using hot pressing. The authors used two different heating techniques during hot pressing: high-frequency induction heating (HFIH) and pulse plasma sintering (PPS). A comparison of the structure, microstructure, mechanical properties and corrosion resistance of the bulk nanocrystalline tantalum obtained in both techniques was performed. The nanocrystalline powder was made to start from the microcrystalline one using the high-energy ball milling process. The nanocrystalline powder was hot-pressed at 1000 °C, whereas, for comparison, the microcrystalline powder was hot pressed up to 1500 °C for proper consolidation. The authors found that during hot pressing, the powder partially reacts with the graphite die covered by boron nitride, which facilitated punches and powder displacement in the die during densification. Tantalum carbide and boride in the nanocrystalline material was found, which can improve the mechanical properties. The hardness of the HFIH and PPS nanocrystalline tantalum was as high as 625 and 615 HV, respectively. The microstructure was more uniform in the PPS nanomaterial. The corrosion resistance in both cases deteriorated, in comparison to the microcrystalline material, while the PPS material corrosion resistance was slightly better than that of the HFIH one.

Overview of MST Research

NASA Astrophysics Data System (ADS)

Sarff, J. S.

2016-10-01

MST progress in advancing the RFP for (1) fusion plasma confinement with ohmic heating and minimal external magnetization, (2) predictive capability in toroidal confinement physics, and (3) basic plasma physics is summarized. Validation of key plasma models is a program priority. Programmable power supplies (PPS) are being developed to maximize inductive capability. Well-controlled flattops with current as low as 0.02 MA are produced with an existing PPS, and Ip <= 0.8 MA is anticipated with a second PPS under construction. The Lundquist number spans S =10(4 - 9) for 0.02-0.8 MA, allowing nonlinear MHD validation using NIMROD and DEBS at low S to be connected to highest S experiments. The PPS also enables MST tokamak operation for studying transients and runaway electron suppression with RMPs. Gyrokinetic modeling with GENE predicts unstable TEM in improved-confinement plasmas. Fluctuations are measured with TEM properties including a density-gradient threshold larger than for tokamak plasmas. Probe measurements hint that drift waves are also excited via the turbulent cascade in standard RFP plasmas. Turbulent energization of an electron tail occurs during sawtooth reconnection. New diagnostics are being developed to measure the energetic ion profile and transport from EP instabilities with NBI. Supported by US DoE and NSF.

Overview of GPM Missions's Ground Validation Program

NASA Technical Reports Server (NTRS)

Smith, Eric A.; Mugnai, Alberto; Nakamura, Kenji

2004-01-01

An important element of the internationally structured Global Precipitation Measurement (GPM) mission will be its ground validation research program. Within the last year, the initial architecture of this program has taken shape. This talk will describe that architecture, both in terms of the international program and in terms of the separate regional programs of the principle participating space agencies, i.e., ESA, JAXA, and NASA. There are three overriding goals being addressed in the planning of this program; (1) establishing various new, challenging and important scientific research goals vis-a-vis current ground validation programs supporting satellite retrieval of precipitation; (2) designing the program as an international partnership which operates, out of necessity, heterogeneous sites in terms of their respective observational foci and science thrusts, but anneals itself in terms of achieving a few overarching scientific objectives; and (3) developing a well-designed protocol that allows specific sites or site networks, at their choosing, to operate in a 'supersite' mode - defined as the capability to routinely transmit GV information at low latency to GPM's Precipitation Processing System (PPS). (The PPS is being designed as GPM's data information system, a distributed data system with main centers at the Goddard Space Flight Center (GSFC) within NASA, the Earth Observation Research Center (EORC) within JAXA, and a TBD facility to be identified by the ESA s ESTEC facility in Noordwijk.)

[Tampa Electric Company IGCC project]. 1996 DOE annual technical report, January--December 1996

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

NONE

1997-12-31

Tampa Electric Company`s Polk Power Station Unit 1 (PPS-1) Integrated Gasification Combined Cycle (IGCC) demonstration project uses a Texaco pressurized, oxygen-blown, entrained-flow coal gasifier to convert approximately 2,000 tons per day of coal to syngas. The gasification plant is coupled with a combined cycle power block to produce a net 250 MW electrical power output. Coal is slurried in water, combined with 95% pure oxygen from an air separation unit, and sent to the gasifier to produce a high temperature, high pressure, medium-Btu syngas with a heat content of about 250 BTUs/cf (HHV). The syngas then flows through a highmore » temperature heat recovery unit which cools the syngas prior to its entering the cleanup systems. Molten coal ash flows from the bottom of the high temperature heat recovery unit into a water-filled quench chamber where it solidifies into a marketable slag by-product. Approximately 10% of the raw, hot syngas at 900 F is designed to pass through an intermittently moving bed of metal-oxide sorbent which removes sulfur-bearing compounds from the syngas. PPS-1 will be the first unit in the world to demonstrate this advanced metal oxide hot gas desulfurization technology on a commercial unit. The emphasis during 1996 centered around start-up activities.« less

The etiology and determinants of hospital closure.

PubMed

Longo, D R; Sohn, M W; Shortell, S M

1996-01-01

This article examines the etiology of hospital closure and the correlates of hospital closure and the extent of similarity in this organizational outcome between pre- and post-Prospective Payment System (PPS) implementation. It also replicates a study from an earlier time period. Findings support the study's main hypotheses: in more stringent and turbulent markets, institutional and strategic variables are more important determinants of hospital closure. Merger acquisitions are found to be similar to both system acquisitions and autonomous hospitals. Standard Metropolitan Statistical Area (SMSA) status and regulation show an effect on hospital closure and merger acquisition. While many similarities exist when compared to the replicated study and findings prior to PPS implementation, it appears that sufficient differences exist to support the hypothesis that the PPS has an impact upon hospital organizational outcome.

The experience of purchaser-provider split in the implementation of family physician and rural health insurance in Iran: an institutional approach.

PubMed

Takian, Amirhossein; Rashidian, Arash; Doshmangir, Leila

2015-12-01

The Iranian health system, under the banner of family physician (FP) programme, has undergone substantial reforms to change utilization of health services, improve quality of care and enhance affordability. The national implementation of FP initiated in 2005 in parallel with rural health insurance (RHI) in rural areas and cities of <20 000 populations in Iran. The implementation of FP was the first national attempt to split the purchaser and provider of the primary health-care services in Iran. Using an adapted institutional approach, this article aims to explore the process of purchaser-provider split (PPS) during the implementation of FP and RHI reforms, and its consequences for the health system in Iran. We conducted 71 face-to-face interviews and three focus group discussions at national, provincial and local levels with policy makers, managers, researchers, health-care practitioners and representatives of the public. Interviews and focus groups were digitally recorded and transcribed verbatim. Data collection was supplemented by the review of relevant documents at all three levels. We analysed the data using an inductive-deductive framework analysis approach. Views towards PPS and its consequences on the implementation of FP were diverse. Some participants identified the PPS as an essential reform for undertaking the parallel implementation of FP and RHI. Others wondered whether the split has been beneficial as expected and asked for more scrutiny. The implementation of FP and RHI in Iran demonstrated the mixed effects of PPS on health system performance. Our research revealed that PPS did not succeed in changing the status quo, became a reason for fighting, misunderstanding, lack of co-operation and failure of the fragile partnership between the purchaser and provider. We advocate careful contextual preparation prior to large-scale application of PPS during nationwide implementation of FP in Iran as well as other settings. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2015; all rights reserved.

An investigation into the magnitude of the current window and perception of transcutaneous electrical nerve stimulation (TENS) sensation at various frequencies and body sites in healthy human participants.

PubMed

Hughes, Nicola; Bennett, Michael I; Johnson, Mark I

2013-02-01

Strong nonpainful transcutaneous electrical nerve stimulation (TENS) is prerequisite to a successful analgesic outcome although the ease with which this sensation is achieved is likely to depend on the magnitude of current amplitude (mA) between sensory detection threshold (SDT) and pain threshold, that is, the current window. To measure the current window and participant's perception of the comfort of the TENS sensation at different body sites. A repeated measure cross-over study was conducted using 30 healthy adult volunteers. Current amplitudes (mA) of TENS [2 pulses per second (pps); 30 pps; 80 pps] at SDT, pain threshold, and strong nonpainful intensities were measured at the tibia (bone), knee joint (connective tissue), lower back [paraspinal (skeletal) muscle], volar surface of forearm (nerve) and waist (fat). The amplitude to achieve a strong nonpainful intensity was represented as a percentage of the current window. Data were analyzed using repeated measures analysis of variance. Effects were detected for body site and frequency for SDT (P<0.001, P=0.018, respectively), current window (P<0.001, P<0.001, respectively), and strong nonpainful TENS as a percentage of the current window (P=0.002, P<0.001, respectively). The current window was larger for the knee joint compared with tibia (difference [95% confidence interval]=12.76 mA [4.25, 21.28]; P=0.001) and forearm (10.33 mA [2.62, 18.40]; P=0.006), and for the lower back compared with tibia (12.10 mA [1.65, 22.52]; P=0.015) and forearm (9.65 mA [1.06, 18.24]; P=0.019). The current window was larger for 2 pps compared with 30 pps (P<0.001) and 80 pps (P<0.001). Participants rated strong nonpainful TENS as most comfortable at the lower back (P<0.001) and least comfortable at the tibia and forearm (P<0.001). TENS is most comfortable and easiest to titrate to a strong nonpainful intensity when applied over areas of muscle and soft tissue.

Trends in the supply of inpatient rehabilitation facilities services: 1996 to 2004.

PubMed

Mallinson, Trudy R; Manheim, Larry M; Almagor, Orit; Demark, Holly M; Heinemann, Allen W

2008-11-01

Describe the supply of inpatient rehabilitation facilities (IRFs) services in 1996 and examine changes between 1996 and 2004, including the impact of the IRF prospective payment system (PPS) in 2002 on organizational trends. Retrospective pre-post design. Freestanding and subprovider (distinct-part units) IRFs. IRFs (N=1424), including 257 freestanding IRFs and 1167 IRF units reported in the Healthcare Cost Report Information System database, from years 1996 to 2004. Not applicable. Number of IRF openings, IRF closures, beds, and inpatient days. The number of IRFs grew from 1037 to 1183 between 1996 and 2001 and grew to 1235 between 2001 and 2004. The likelihood of IRF closures trended lower after PPS, and there was a significant increase in the likelihood of openings when PPS was introduced. For-profit, rural, and small IRFs were more likely to open over the entire period. There was a 12.9% increase in the number of total inpatient days, somewhat less than the 15.7% growth in IRF beds over the period. There was no impact of PPS on beds available but a significant decline in total inpatient days after PPS. Inpatient days rose under the Tax Equity and Fiscal Responsibility Act and declined after 2002. Yet the likelihood of openings and closures did not appear to respond to these changes, perhaps because they were modest compared with changes in local IRF markets. The IRF PPS did little to affect service distribution in less well-served areas, although we did find growth in rural areas. Occupancy rates in 2004 were close to rates at the start of the period (70%). This observation implies that IRFs were implementing strategies to recruit a sufficient number of patients, even though bed numbers were increasing and length of stay was declining. Consequently, policy that limits the potential of IRFs to increase patient admissions, such as the limits on admissions to IRFs of patients with conditions other than those included in the 75% rule, is likely to produce substantial decreases in total inpatient days.

The integrated care pathway for post stroke patients (iCaPPS): a shared care approach between stakeholders in areas with limited access to specialist stroke care services.

PubMed

Abdul Aziz, Aznida Firzah; Mohd Nordin, Nor Azlin; Ali, Mohd Fairuz; Abd Aziz, Noor Azah; Sulong, Saperi; Aljunid, Syed Mohamed

2017-01-13

Lack of intersectoral collaboration within public health sectors compound efforts to promote effective multidisciplinary post stroke care after discharge following acute phase. A coordinated, primary care-led care pathway to manage post stroke patients residing at home in the community was designed by an expert panel of specialist stroke care providers to help overcome fragmented post stroke care in areas where access is limited or lacking. Expert panel discussions comprising Family Medicine Specialists, Neurologists, Rehabilitation Physicians and Therapists, and Nurse Managers from Ministry of Health and acadaemia were conducted. In Phase One, experts chartered current care processes in public healthcare facilities, from acute stroke till discharge and also patients who presented late with stroke symptoms to public primary care health centres. In Phase Two, modified Delphi technique was employed to obtain consensus on recommendations, based on current evidence and best care practices. Care algorithms were designed around existing work schedules at public health centres. Indication for patients eligible for monitoring by primary care at public health centres were identified. Gaps in transfer of care occurred either at post discharge from acute care or primary care patients diagnosed at or beyond subacute phase at health centres. Essential information required during transfer of care from tertiary care to primary care providers was identified. Care algorithms including appropriate tools were summarised to guide primary care teams to identify patients requiring further multidisciplinary interventions. Shared care approaches with Specialist Stroke care team were outlined. Components of the iCaPPS were developed simultaneously: (i) iCaPPS-Rehab© for rehabilitation of stroke patients at community level (ii) iCaPPS-Swallow© guided the primary care team to screen and manage stroke related swallowing problems. Coordinated post stroke care monitoring service for patients at community level is achievable using the iCaPPS and its components as a guide. The iCaPPS may be used for post stroke care monitoring of patients in similar fragmented healthcare delivery systems or areas with limited access to specialist stroke care services. No.: ACTRN12616001322426 (Registration Date: 21st September 2016).

Pentosan Polysulfate: Oral Versus Subcutaneous Injection in Mucopolysaccharidosis Type I Dogs

PubMed Central

Simonaro, Calogera M.; Tomatsu, Shunji; Sikora, Tracy; Kubaski, Francyne; Frohbergh, Michael; Guevara, Johana M.; Wang, Raymond Y.; Vera, Moin; Kang, Jennifer L.; Smith, Lachlan J.; Schuchman, Edward H.; Haskins, Mark E.

2016-01-01

Background We previously demonstrated the therapeutic benefits of pentosan polysulfate (PPS) in a rat model of mucopolysaccharidosis (MPS) type VI. Reduction of inflammation, reduction of glycosaminoglycan (GAG) storage, and improvement in the skeletal phenotype were shown. Herein, we evaluate the long-term safety and therapeutic effects of PPS in a large animal model of a different MPS type, MPS I dogs. We focused on the arterial phenotype since this is one of the most consistent and clinically significant features of the model. Methodology/Principal Findings MPS I dogs were treated with daily oral or biweekly subcutaneous (subQ) PPS at a human equivalent dose of 1.6 mg/kg for 17 and 12 months, respectively. Safety parameters were assessed at 6 months and at the end of the study. Following treatment, cytokine and GAG levels were determined in fluids and tissues. Assessments of the aorta and carotid arteries also were performed. No drug-related increases in liver enzymes, coagulation factors, or other adverse effects were observed. Significantly reduced IL-8 and TNF-alpha were found in urine and cerebrospinal fluid (CSF). GAG reduction was observed in urine and tissues. Increases in the luminal openings and reduction of the intimal media thickening occurred in the carotids and aortas of PPS-treated animals, along with a reduction of storage vacuoles. These results were correlated with a reduction of GAG storage, reduction of clusterin 1 staining, and improved elastin integrity. No significant changes in the spines of the treated animals were observed. Conclusions PPS treatment led to reductions of pro-inflammatory cytokines and GAG storage in urine and tissues of MPS I dogs, which were most evident after subQ administration. SubQ administration also led to significant cytokine reductions in the CSF. Both treatment groups exhibited markedly reduced carotid and aortic inflammation, increased vessel integrity, and improved histopathology. We conclude that PPS may be a safe and useful therapy for MPS I, either as an adjunct or as a stand-alone treatment that reduces inflammation and GAG storage. PMID:27064989

Pb-210 and Po-210 atmospheric releases via fly ash from oil shale-fired power plants.

PubMed

Vaasma, Taavi; Loosaar, Jüri; Gyakwaa, Francis; Kiisk, Madis; Özden, Banu; Tkaczyk, Alan H

2017-03-01

During high temperature processes in the furnace volatile and semi-volatile elements and radionuclides are partially emitted to the environment, depending on their chemical form in the original fuel, the technological set-up of the combustion system, and the prevailing combustion conditions. Two of the world's largest oil shale-fired power plants (PPs) have been operational in Estonia from the 1960s, during which time creation of significant environmental emissions and waste containing naturally occurring radionuclides has occurred. Pb-210 and 210 Po are considered natural radionuclides with the highest emission rates from PPs and possess elevated potential radiation exposure risks to humans and the environment. These radionuclides have the highest activity concentration values in fine ash fractions, especially in fractions remaining below 2.5 μm. To determine the activity concentrations of 210 Pb and 210 Po in the PPs' outlet, sampling was conducted from boilers operating on pulverized fuel (PF) technology with novel integrated desulphurization (NID) system and bag filters as well as with electrostatic precipitators (ESPs). The 210 Pb and 210 Po activity concentrations remained around 300 Bq kg -1 for the NID system compared to 60-80 Bq kg -1 in the ESP system. The dominant ash fraction in both systems was PM2.5, constituting over 50% of the fly ash mass collected from the outlet. The authors estimate that the total atmospherically emitted activity for the modernized PPs remains dominantly below 1% of the activity that is inserted via fuel. The implementation of higher efficiency purifications systems has significantly reduced the negative effect of these PPs. Based on annually emitted fly ash and boilers' working hours, the 210 Pb and 210 Po activity released relative to energy production were up to 68.3 kBq GWh el -1 for 210 Pb and 64.6 kBq GWh el -1 for 210 Po. These values are 1 to 2 orders of magnitude lower compared to the situation in the 1980s. These findings represent the first publicly available quantitative results estimating the 210 Po emissions from large oil shale-fired PPs. Copyright © 2016 Elsevier Ltd. All rights reserved.

A Venom Serpin Splicing Isoform of the Endoparasitoid Wasp Pteromalus puparum Suppresses Host Prophenoloxidase Cascade by Forming Complexes with Host Hemolymph Proteinases*

PubMed Central

Yan, Zhichao; Fang, Qi; Liu, Yang; Xiao, Shan; Yang, Lei; Wang, Fei; An, Chunju; Werren, John H.; Ye, Gongyin

2017-01-01

To ensure successful parasitism, parasitoid wasps inject venom along with their eggs into their hosts. The venom serves to suppress host immune responses, including melanization. Venom from Pteromalus puparum, a pupal endoparasitoid, inhibits melanization of host hemolymph in vitro in a dose-dependent manner. Using assay-guided fractionation, a serpin splicing isoform with phenoloxidase inhibitory activity was identified as P. puparum serpin-1, venom isoform (PpS1V). This serpin gene has 16 predicted splicing isoforms that differ only in the C-terminal region. RT-PCR results show that the specific serpin isoform is differentially expressed in the venom gland. Recombinant PpS1V (rPpS1V) suppresses host prophenoloxidase (PPO) activation rather than inhibiting the phenoloxidase directly. Pulldown assays show that PpS1V forms complexes with two host hemolymph proteins, here named Pieris rapae hemolymph proteinase 8 (PrHP8) and P. rapae prophenoloxidase-activating proteinase 1 (PrPAP1), based on gene sequence blasting and phylogenetic analysis. The role of rPrPAP1 in the PPO activation cascade and its interaction with rPpS1V were confirmed. The stoichiometry of inhibition of PrPAP1 by PpS1V is 2.3. PpS1V also inhibits PPO activation in a non-natural host, Ostrinia furnacalis, through forming a complex with O. furnacalis serine protease 13 (OfSP13), an ortholog to PrPAP1. Our results identify a venom-enriched serpin isoform in P. puparum that inhibits host PPO activation, probably by forming a complex with host hemolymph proteinase PrPAP1. PMID:27913622

Real-world outcomes in patients with depression treated with duloxetine or a selective serotonin reuptake inhibitor in East Asia.

PubMed

Hong, Jihyung; Novick, Diego; Montgomery, William; Moneta, Maria Victoria; Dueñas, Héctor; Peng, Xiaomei; Haro, Josep Maria

2016-03-01

This study compared treatment outcomes in patients with major depressive disorder treated with either duloxetine with a daily dose of ≤60 mg or a selective serotonin reuptake inhibitor (SSRI) as monotherapy for up to 6 months in a naturalistic setting in East Asia. In addition, this study examined the impact of painful physical symptoms (PPS) on the effects of these treatments. This post-hoc analysis of data from a 6-month prospective observational study involving 1,549 major depressive disorder patients without sexual dysfunction focused on a subgroup of patients from East Asia (n = 587). Depression severity was measured using the Clinical Global Impression of Severity and the 16-item Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR16 ), whereas quality of life (QoL) was measured using EuroQoL instruments. PPS were rated using the modified Somatic Symptom Inventory. Multiple regression analyses were performed to compare the treatment outcomes. Duloxetine-treated patients had higher odds of achieving remission (odds ratio = 2.578, P < 0.001) and response (odds ratio = 2.704, P < 0.001) during follow-up, compared with SSRI-treated patients. They also had lower levels of disease severity and higher levels of QoL during follow-up. A similar pattern was observed in each subgroup of patients with and without PPS at baseline, but the effects of duloxetine relative to SSRIs were in general greater in patients with PPS. Patients treated with duloxetine had better treatment outcomes in terms of remission, response, depressive symptoms, and QoL, compared with SSRIs. Treatment with duloxetine may have additional advantages for patients with concurrent PPS. © 2015 Wiley Publishing Asia Pty Ltd.

The Fate of Pollutants in Porous Asphalt Pavements, Laboratory Experiments to Investigate Their Potential to Impact Environmental Health.

PubMed

Charlesworth, Susanne M; Beddow, Jamie; Nnadi, Ernest O

2017-06-21

Pervious Paving Systems (PPS) are part of a sustainable approach to drainage in which excess surface water is encouraged to infiltrate through their structure, during which potentially toxic elements, such as metals and hydrocarbons are treated by biodegradation and physical entrapment and storage. However, it is not known where in the PPS structure these contaminants accumulate, which has implications for environmental health, particularly during maintenance, as well as consequences for the recycling of material from the PPS at the end-of-life. A 1 m³ porous asphalt (PA) PPS test rig was monitored for 38 months after monthly additions of road sediment (RS) (367.5 g in total) and unused oil (430 mL in total), characteristic of urban loadings, were applied. Using a rainfall simulator, a typical UK rainfall rate of 15 mm/h was used to investigate its efficiency in dealing with contamination. Water quality of the effluent discharged from the rig was found to be suitable for discharge to most environments. On completion of the monitoring, a core was taken down through its surface, and samples of sediment and aggregate were taken. Analysis showed that most of the sediment remained in the surface course, with metal levels lower than the original RS, but higher than clean, unused aggregate or PA. However, even extrapolating these concentrations to 20 years' worth of in-service use (the projected life of PPS) did not suggest their accumulation would present an environmental pollution risk when carrying out maintenance of the pavement and also indicates that the material could be recycled at end-of-life.

A diagnostic model for impending death in cancer patients: Preliminary report.

PubMed

Hui, David; Hess, Kenneth; dos Santos, Renata; Chisholm, Gary; Bruera, Eduardo

2015-11-01

Several highly specific bedside physical signs associated with impending death within 3 days for patients with advanced cancer were recently identified. A diagnostic model for impending death based on these physical signs was developed and assessed. Sixty-two physical signs were systematically documented every 12 hours from admission to death or discharge for 357 patients with advanced cancer who were admitted to acute palliative care units (APCUs) at 2 tertiary care cancer centers. Recursive partitioning analysis was used to develop a prediction model for impending death within 3 days with admission data. The model was validated with 5 iterations of 10-fold cross-validation, and the model was also applied to APCU days 2 to 6. For the 322 of 357 patients (90%) with complete data for all signs, the 3-day mortality rate was 24% on admission. The final model was based on 2 variables (Palliative Performance Scale [PPS] and drooping of nasolabial folds) and had 4 terminal leaves: PPS score ≤ 20% and drooping of nasolabial folds present, PPS score ≤ 20% and drooping of nasolabial folds absent, PPS score of 30% to 60%, and PPS score ≥ 70%. The 3-day mortality rates were 94%, 42%, 16%, and 3%, respectively. The diagnostic accuracy was 81% for the original tree, 80% for cross-validation, and 79% to 84% for subsequent APCU days. Based on 2 objective bedside physical signs, a diagnostic model was developed for impending death within 3 days. This model was applicable to both APCU admission and subsequent days. Upon further external validation, this model may help clinicians to formulate the diagnosis of impending death. © 2015 American Cancer Society.

Stormwater harvesting for irrigation purposes: an investigation of chemical quality of water recycled in pervious pavement system.

PubMed

Nnadi, Ernest O; Newman, Alan P; Coupe, Stephen J; Mbanaso, Fredrick U

2015-01-01

Most available water resources in the world are used for agricultural irrigation. Whilst this level of water use is expected to increase due to rising world population and land use, available water resources are expected to become limited due to climate change and uneven rainfall distribution. Recycled stormwater has the potential to be used as an alternative source of irrigation water and part of sustainable water management strategy. This paper reports on a study to investigate whether a sustainable urban drainage system (SUDS) technique, known as the pervious pavements system (PPS) has the capability to recycle water that meets irrigation water quality standard. Furthermore, the experiment provided information on the impact of hydrocarbon (which was applied to simulate oil dripping from parked vehicles onto PPS), leaching of nutrients from different layers of the PPS and effects of nutrients (applied to enhance bioremediation) on the stormwater recycling efficiency of the PPS. A weekly dose of 6.23 × 10(-3) L of lubricating oil and single dose of 17.06 g of polymer coated controlled-release fertilizer granules were applied to the series of 710 mm × 360 mm model pervious pavement structure except the controls. Rainfall intensity of 7.4 mm/h was applied to the test models at the rate of 3 events per week. Analysis of the recycled water showed that PPS has the capability to recycle stormwater to a quality that meets the chemical standards for use in agricultural irrigation irrespective of the type of sub-base used. There is a potential benefit of nutrient availability in recycled water for plants, but care should be taken not to dispose of this water in natural water courses as it might result in eutrophication problems. Copyright © 2014 Elsevier Ltd. All rights reserved.

Change in inpatient rehabilitation admissions for individuals with traumatic brain injury after implementation of the Medicare inpatient rehabilitation facility prospective payment system.

PubMed

Hoffman, Jeanne M; Donoso Brown, Elena; Chan, Leighton; Dikmen, Sureyya; Temkin, Nancy; Bell, Kathleen R

2012-08-01

To evaluate the impact of Medicare's inpatient rehabilitation facility (IRF) prospective payment system (PPS) on use of inpatient rehabilitation for individuals with traumatic brain injury (TBI). Retrospective cohort study of patients with TBI. One hundred twenty-three level I and II trauma centers across the U.S. who contributed data to the National Trauma Data Bank. Patients (N=135,842) with TBI and an Abbreviated Injury Score of the head of 2 or greater admitted to trauma centers between 1995 and 2004. None. Discharge location: IRF, skilled nursing facility, home, and other hospitals. Compared with inpatient rehabilitation admissions before IRF PPS came into effect, demographic characteristics of admitted patients changed. Those admitted to acute care trauma centers after PPS was enacted (January 2002) were older and nonwhite. No differences were found in rates of injury between men and women. Over time, there was a significant drop in the percent of patients being discharged to inpatient rehabilitation, which varied by region, but was found across all insurance types. In a logistic regression, after controlling for patient characteristics (age, sex, race), injury characteristics (cause, severity), insurance type, and facility, the odds of being discharged to an IRF after a TBI decreased 16% after Medicare's IRF PPS system was enacted. The enactment of the Medicare PPS appears to be associated with a reduction in the chance that patients receive inpatient rehabilitation treatment after a TBI. The impact of these changes on the cost, quality of care, and patient outcome is unknown and should be addressed in future studies. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Risk of overweight and obesity in preschoolers attending private and philanthropic schools.

PubMed

Nascimento, Viviane Gabriela; Schoeps, Denise de Oliveira; Souza, Sônia Buongermino de; Souza, José Maria Pacheco de; Leone, Claudio

2011-01-01

To assess the risk prevalence of overweight and obesity in children enrolled in private and philanthropic preschools in the State of São Paulo. Comparison of two cross sectional studies with children enrolled in private preschools (PPS) or philanthropic (PHP) of the São Paulo Metropolitan Region. Both surveys evaluated the children's environment. To determine the risk of overweight, excess weight and obesity, body mass index (BMI) values were transformed into z scores (according to the World Health Organization - 2006 and 2007). The risk prevalence of overweight (≥ 1 BMIz < 2) in PPS was 21.9% and 24.6% in PHP, with PR = 1.12 (95% CI: 0.96-1.32), without statistical difference. Considering the children with overweight or obesity, (BMIz ≥ 2) the prevalence in PPS was 14.3% and in PHP was 9.0%, with PR = 1.54 (95% CI: 1.23-1.93), p = 0.0002. Overweight and obesity prevalence in males in PPS was 16.4% (n = 409) and in PHP, 11.1% (n = 829), PR = 1.48 (95% CI: 1.10-1.98) and in females it was 12.5% (n = 400) in the PPS and 6.6% (n = 698) in PHP, corresponding to PR = 1.90 (95% CI: 1.30-2.78), both significant differences. Both groups showed a similar and very high prevalence of weight excess. However, overweight and obesity showed a higher prevalence in children from private preschools. This indicates that even though a better socioeconomic level is still a risk factor for overweight and obesity in preschoolers, the same does not seem to occur when analyzing the risk of overweight.

Determining the anaerobic threshold in postpolio syndrome: comparison with current guidelines for training intensity prescription.

PubMed

Voorn, Eric L; Gerrits, Karin H; Koopman, Fieke S; Nollet, Frans; Beelen, Anita

2014-05-01

To determine whether the anaerobic threshold (AT) can be identified in individuals with postpolio syndrome (PPS) using submaximal incremental exercise testing, and to compare current guidelines for intensity prescription in PPS with the AT. Cohort study. Research laboratory. Individuals with PPS (N=82). Not applicable. Power output, gas exchange variables, heart rate, and rating of perceived exertion (RPE) were measured in an incremental submaximal cycle ergometry test. Two independent observers identified the AT. Comparison of current guidelines for training intensity prescription in PPS (40%-60% heart rate reserve [HRR] or RPE of 12) with the AT was based on correlations between recommended heart rate and the heart rate at the AT. In addition, we determined the proportion of individuals that would have been recommended to train at an intensity corresponding to their AT. The AT was identified in 63 (77%) of the participants. Pearson correlation coefficients between the recommended heart rate and the heart rate at the AT were lower in cases of 40% HRR (r=.56) and 60% HRR (r=.50) than in cases of prescription based on the RPE (r=.86). Based on the RPE, 55% of the individuals would have been recommended to train at an intensity corresponding to their AT. This proportion was higher compared with 40% HRR (41%) or 60% HRR (18%) as criterion. The AT can be identified in most individuals with PPS offering an individualized target for aerobic training. If the AT cannot be identified (eg, because gas analysis equipment is not available), intensity prescription can best be based on the RPE. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

The Fate of Pollutants in Porous Asphalt Pavements, Laboratory Experiments to Investigate Their Potential to Impact Environmental Health

PubMed Central

Charlesworth, Susanne M.; Beddow, Jamie; Nnadi, Ernest O.

2017-01-01

Pervious Paving Systems (PPS) are part of a sustainable approach to drainage in which excess surface water is encouraged to infiltrate through their structure, during which potentially toxic elements, such as metals and hydrocarbons are treated by biodegradation and physical entrapment and storage. However, it is not known where in the PPS structure these contaminants accumulate, which has implications for environmental health, particularly during maintenance, as well as consequences for the recycling of material from the PPS at the end-of-life. A 1 m3 porous asphalt (PA) PPS test rig was monitored for 38 months after monthly additions of road sediment (RS) (367.5 g in total) and unused oil (430 mL in total), characteristic of urban loadings, were applied. Using a rainfall simulator, a typical UK rainfall rate of 15 mm/h was used to investigate its efficiency in dealing with contamination. Water quality of the effluent discharged from the rig was found to be suitable for discharge to most environments. On completion of the monitoring, a core was taken down through its surface, and samples of sediment and aggregate were taken. Analysis showed that most of the sediment remained in the surface course, with metal levels lower than the original RS, but higher than clean, unused aggregate or PA. However, even extrapolating these concentrations to 20 years’ worth of in-service use (the projected life of PPS) did not suggest their accumulation would present an environmental pollution risk when carrying out maintenance of the pavement and also indicates that the material could be recycled at end-of-life. PMID:28635641

Removing heavy metals using permeable pavement system with a titanate nano-fibrous adsorbent column as a post treatment.

PubMed

Sounthararajah, Danious Pratheep; Loganathan, Paripurnanda; Kandasamy, Jayakumar; Vigneswaran, Saravanamuthu

2017-02-01

Permeable pavement systems (PPS) are a widely-used treatment measure in sustainable stormwater management and groundwater recharge. However, PPS are not very efficient in removing heavy metals from stormwater. A pilot scale study using zeolite or basalt as bed material in PPS removed 41-72%, 67-74%, 38-43%, 61-72%, 63-73% of Cd, Cu, Ni, Pb, and Zn, respectively, from synthetic stormwater (pH 6.5; Cd, Cu, Ni, Pb, and Zn concentrations of 0.04, 0.6, 0.06, 1.0, and 2.0 mg L -1 , respectively) over a period of 80 h. The total volume of stormwater that passed through the PPS was equivalent to runoff in 10 years of rainfall in Sydney, Australia. The concentrations of metals in the PPS effluent failed fresh and marine water quality trigger values recommended in the Australian and New Zealand guidelines. An addition of a post-treatment of a horizontal filter column containing a titanate nano-fibrous (TNF) material with a weight < 1% of zeolite weight and mixed in with granular activated carbon (GAC) at a GAC:TNF weight ratio of 25:1 removed 77% of Ni and 99-100% of all the other metals. The effluent easily met the required standards of marine waters and just met those concerning fresh waters. Batch adsorption data from solutions of metals mixtures fitted the Langmuir model with adsorption capacities in the following order, TNF ≫ zeolite > basalt; Pb > Cu > Cd, Ni, Zn. Copyright © 2016 Elsevier Ltd. All rights reserved.

Antimicrobial usage in German acute care hospitals: results of the third national point prevalence survey and comparison with previous national point prevalence surveys.

PubMed

Aghdassi, Seven Johannes Sam; Gastmeier, Petra; Piening, Brar Christian; Behnke, Michael; Peña Diaz, Luis Alberto; Gropmann, Alexander; Rosenbusch, Marie-Luise; Kramer, Tobias Siegfried; Hansen, Sonja

2018-04-01

Previous point prevalence surveys (PPSs) revealed the potential for improving antimicrobial usage (AU) in German acute care hospitals. Data from the 2016 German national PPS on healthcare-associated infections and AU were used to evaluate efforts in antimicrobial stewardship (AMS). A national PPS in Germany was organized by the German National Reference Centre for Surveillance of Nosocomial Infections in 2016 as part of the European PPS initiated by the ECDC. The data were collected in May and June 2016. Results were compared with data from the PPS 2011. A total of 218 hospitals with 64 412 observed patients participated in the PPS 2016. The prevalence of patients with AU was 25.9% (95% CI 25.6%-26.3%). No significant increase or decrease in AU prevalence was revealed in the group of all participating hospitals. Prolonged surgical prophylaxis was found to be common (56.1% of all surgical prophylaxes on the prevalence day), but significantly less prevalent than in 2011 (P < 0.01). The most frequently administered antimicrobial groups were penicillins plus β-lactamase inhibitors (BLIs) (23.2%), second-generation cephalosporins (12.9%) and fluoroquinolones (11.3%). Significantly more penicillins plus BLIs and fewer second-generation cephalosporins and fluoroquinolones were used in 2016. Overall, an increase in the consumption of broad-spectrum antimicrobials was noted. For 68.7% of all administered antimicrobials, the indication was documented in the patient notes. The current data reaffirm the points of improvement that previous data identified and reveal that recent efforts in AMS in German hospitals require further intensification.

Pelvic inflammatory disease and puerperal sepsis in Ethiopia. II. Treatment.

PubMed

Duncan, M E; Perine, P L; Krause, D W; Awoke, S; Zaidi, A A

1980-12-01

Where bacteriologic support is lacking, a combination of penicillin and streptomycin (P/S) is used empirically to treat serious gynecologic infections in Ethiopia. We compared the efficacy of P/S to a combination of penicillin and chloramphenicol (P/C) in hospitalized women who had bacteriologically confirmed pelvic inflammatory disease or puerperal sepsis (PPS). Treatment of PPS with P/C was significantly more effective in limiting the duration of fever than was treatment with P/S. Twenty-eight of 40 PPS patients had endometritis with retained products of conception that required evacuation of the uterus. The duration of fever in patients with PID who were treated with the P/C regimen was no different than that in those treated with P/S. Twenty of the 24 PID patients required surgery for drainage of abscesses, in addition to antibiotics.

Effect of current on the maximum possible reward.

PubMed

Gallistel, C R; Leon, M; Waraczynski, M; Hanau, M S

1991-12-01

Using a 2-lever choice paradigm with concurrent variable interval schedules of reward, it was found that when pulse frequency is increased, the preference-determining rewarding effect of 0.5-s trains of brief cathodal pulses delivered to the medial forebrain bundle of the rat saturates (stops increasing) at values ranging from 200 to 631 pulses/s (pps). Raising the current lowered the saturation frequency, which confirms earlier, more extensive findings showing that the rewarding effect of short trains saturates at pulse frequencies that vary from less than 100 pps to more than 800 pps, depending on the current. It was also found that the maximum possible reward--the magnitude of the reward at or beyond the saturation pulse frequency--increases with increasing current. Thus, increasing the current reduces the saturation frequency but increases the subjective magnitude of the maximum possible reward.

The fatigue life study of polyphenylene sulfide composites filled with continuous glass fibers

NASA Astrophysics Data System (ADS)

Ye, Junjie; Hong, Yun; Wang, Yongkun; Zhai, Zhi; Shi, Baoquan; Chen, Xuefeng

2018-04-01

In this study, an effective microscopic model is proposed to investigate the fatigue life of composites containing continuous glass fibers, which is surrounded by polyphenylene sulfide (PPS) matrix materials. The representative volume element is discretized by parametric elements. Moreover, the microscopic model is established by employing the relation between average surface displacements and average surface tractions. Based on the experimental data, the required fatigue failure parameters of the PPS are determined. Two different fiber arrangements are considered for comparisons. Numerical analyses indicated that the square edge packing provides a more accuracy. In addition, microscopic structural parameters (fiber volume fraction, fiber off-axis angle) effect on the fatigue life of Glass/PPS composites is further discussed. It is revealed that fiber strength degradation effects on the fatigue life of continuous fiber-reinforced composites can be ignored.

Traveling wave ultrasonic motor using polymer-based vibrator

NASA Astrophysics Data System (ADS)

Wu, Jiang; Mizuno, Yosuke; Tabaru, Marie; Nakamura, Kentaro

2016-01-01

With the characteristics of low density, low elastic modulus, and low mechanical loss, poly(phenylene sulfide) (PPS) is a promising material for fabricating lightweight ultrasonic motors (USMs). For the first time, we used PPS to fabricate an annular elastomer with teeth and glued a piece of piezoelectric-ceramic annular disk to the bottom of the elastomer to form a vibrator. To explore for a material suitable for the rotor surface coming in contact with the PPS-based vibrator, several disk-shaped rotors made of different materials were fabricated to form traveling wave USMs. The polymer-based USM rotates successfully as the conventional metal-based USMs. The experimental results show that the USM with the aluminum rotor has the largest torque, which indicates that aluminum is the most suitable for the rotor surface among the tested materials.

Life characteristics assessment of the communications technology satellite transmitter experiment package

NASA Technical Reports Server (NTRS)

Smetana, J.; Curren, A. N.

1979-01-01

The performance characteristics of the transmitter experiment package (TEP) aboard the Communications Technology Satellite (CTS) measured during its first 2 years in orbit are presented. The TEP consists of a nominal 200 watt output stage tube (OST), a supporting power processing system (PPS), and a variable conductance heat pipe system (VCHPS). The OST, a traveling wave tube augmented with a 10 stage depressed collector has an overall saturated average efficiency of 51.5 percent and an average saturated radio frequency (rf) output power at center band frequency of 240 watts. The PPS operated with a measured efficiency of 86.5 to 88.5 percent. The VCHPS, using three pipes to conduct heat from the PPS and the OST to a 52 by 124 centimeter radiator fin, maintained the PPS baseplate temperature below 50 C for all operating conditions. The TEP performance characteristics presented include frequency response, rf output power, thermal performance, and efficiency. Communications characteristics were evaluated by using both video and audio modulated signals. On four occasions, the TEP experienced temporary thermal control system malfunctions. The anomalies were terminated safely, and the problem was investigated because of the potential for TEP damage due to the signficant temperature increases. Safe TEP operating procedures were established.

Characterization and identification of the proteins bound to two types of polyhydroxyalkanoate granules in Pseudomonas sp. 61-3.

PubMed

Hokamura, Ayaka; Fujino, Kanako; Isoda, Yoshiko; Arizono, Koji; Shiratsuchi, Hideki; Matsusaki, Hiromi

2015-01-01

Pseudomonas sp. 61-3 accumulates two types of polyhydroxyalkanoates (PHAs), poly(3-hydroxybutyrate) [P(3HB)], and poly(3HB-co-3-hydroxyalkanoates) [P(3HB-co-3HA)], and some proteins associated with their PHA granules have been identified. To date, PhaFPs (GA36) and PhaIPs (GA18) were identified from P(3HB-co-3HA) granules. In this study, the gene encoding GA24 associated with P(3HB) granule was identified as phbPPs. PhbPPs was composed of 192 amino acids with a calculated molecular mass of 20.4 kDa and was assumed to be a phasin. phbFPs gene and unknown ORF were also found on phb locus. PhbFPs was anticipated to be the transcriptional repressor of phbPPs gene. PhbPPs was bound to the P(3HB-co-3HA) granules with 3HB composition of more than 87 mol%, and PhaIPs and PhaFPs were bound to the P(3HB-co-3HA) granules with 3HA (C6-C12) composition of more than 13 mol% in the producing cells, suggesting that localization of these proteins is attributed to the monomer compositions of the copolymers.

Pulse-rate discrimination by cochlear-implant and normal-hearing listeners with and without binaural cues

PubMed Central

Carlyon, Robert P.; Long, Christopher J.; Deeks, John M.

2008-01-01

Experiment 1 measured rate discrimination of electric pulse trains by bilateral cochlear implant (CI) users, for standard rates of 100, 200, and 300 pps. In the diotic condition the pulses were presented simultaneously to the two ears. Consistent with previous results with unilateral stimulation, performance deteriorated at higher standard rates. In the signal interval of each trial in the dichotic condition, the standard rate was presented to the left ear and the (higher) signal rate was presented to the right ear; the non-signal intervals were the same as in the diotic condition. Performance in the dichotic condition was better for some listeners than in the diotic condition for standard rates of 100 and 200 pps, but not at 300 pps. It is concluded that the deterioration in rate discrimination observed for CI users at high rates cannot be alleviated by the introduction of a binaural cue, and is unlikely to be limited solely by central pitch processes. Experiment 2 performed an analogous experiment in which 300-pps acoustic pulse trains were bandpass filtered (3900-5400 Hz) and presented in a noise background to normal-hearing listeners. Unlike the results of experiment 1, performance was superior in the dichotic than in the diotic condition. PMID:18397032

New Compressor Added to Glenn's 450- psig Combustion Air System

NASA Technical Reports Server (NTRS)

Swan, Jeffrey A.

2000-01-01

In September 1999, the Central Process Systems Engineering Branch and the Maintenance and the Central Process Systems Operations Branch, released for service a new high pressure compressor to supplement the 450-psig Combustion Air System at the NASA Glenn Research Center at Lewis Field. The new compressor, designated C-18, is located in Glenn s Central Air Equipment Building and is remotely operated from the Central Control Building. C-18 can provide 40 pounds per second (pps) of airflow at pressure to our research customers. This capability augments our existing system capacity (compressors C 4 at 38 pps and C-5 at 32 pps), which is generated from Glenn's Engine Research Building. The C-18 compressor was originally part of Glenn's 21-Inch Hypersonic Tunnel, which was transferred from the Jet Propulsion Laboratory to Glenn in the mid-1980's. With the investment of construction of facilities funding, the compressor was modified, new mechanical and electrical support equipment were purchased, and the unit was installed in the basement of the Central Air Equipment Building. After several weeks of checkout and troubleshooting, the new compressor was ready for long-term, reliable operations. With a total of 110 pps in airflow now available, Glenn is well positioned to support the high-pressure air test requirements of our research customers.

Solar UV radiation-induced DNA Bipyrimidine photoproducts: formation and mechanistic insights.

PubMed

Cadet, Jean; Grand, André; Douki, Thierry

2015-01-01

This review chapter presents a critical survey of the main available information on the UVB and UVA bipyrimidine photoproducts which constitute the predominant recipient classes of photo-induced DNA damage. Evidence is provided that UVB irradiation of isolated DNA in aqueous solutions and in cells gives rise to the predominant generation of cis-syn cyclobutane pyrimidine dimers (CPDs) and, to a lesser extent, of pyrimidine (6-4) pyrimidone photoproducts (6-4PPs), the importance of which is strongly primary sequence dependent. A notable change in the photoproduct distribution is observed when DNA either in the dry or in desiccated microorganisms is exposed to UVC or UVB photons with an overwhelming formation of 5-(α-thymidyl)-5,6-dihydrothymidine, also called spore photoproduct (dSP), at the expense of CPDs and 6-4PPs. UVA irradiation of isolated and cellular DNA gives rise predominantly to bipyrimidine photoproducts with the overwhelming formation of thymine-containing cyclobutane pyrimidine dimers at the exclusion of 6-4PPs. UVA photons have been shown to modulate the distribution of UVB dimeric pyrimidine photoproducts by triggering isomerization of the 6-4PPs into related Dewar valence isomers. Mechanistic aspects of the formation of bipyrimidine photoproducts are discussed in the light of recent photophysical and theoretical studies.

Aerobic Exercise Training in Post-Polio Syndrome: Process Evaluation of a Randomized Controlled Trial.

PubMed

Voorn, Eric L; Koopman, Fieke S; Brehm, Merel A; Beelen, Anita; de Haan, Arnold; Gerrits, Karin H L; Nollet, Frans

2016-01-01

To explore reasons for the lack of efficacy of a high intensity aerobic exercise program in post-polio syndrome (PPS) on cardiorespiratory fitness by evaluating adherence to the training program and effects on muscle function. A process evaluation using data from an RCT. Forty-four severely fatigued individuals with PPS were randomized to exercise therapy (n = 22) or usual care (n = 22). Participants in the exercise group were instructed to exercise 3 times weekly for 4 months on a bicycle ergometer (60-70% heart rate reserve). The attendance rate was high (median 89%). None of the participants trained within the target heart rate range during >75% of the designated time. Instead, participants exercised at lower intensities, though still around the anaerobic threshold (AT) most of the time. Muscle function did not improve in the exercise group. Our results suggest that severely fatigued individuals with PPS cannot adhere to a high intensity aerobic exercise program on a cycle ergometer. Despite exercise intensities around the AT, lower extremity muscle function nor cardiorespiratory fitness improved. Improving the aerobic capacity in PPS is difficult through exercise primarily focusing on the lower extremities, and may require a more individualized approach, including the use of other large muscle groups instead. Netherlands National Trial Register NTR1371.

Client characteristics and the cost of home care in the prospective payment system.

PubMed

Livesay, Jody L; Hanson, Kathleen S; Anderson, Mary Ann; Oelschlaeger, Mary

2003-01-01

There has been much speculation in the literature about the effect of the prospective payment system (PPS) on the home care industry but few reports of systematic investigation. Clearly, comprehension of client characteristics is essential for categorizing home care clients into the correct Home Health Resource Groups, for allocating resources appropriately, and for implementing necessary organizational changes to accommodate clients who require variations in the amount of resources predicted by the PPS. The purposes of this study were to compare the characteristics of home health clients that resulted in a financial gain or a financial loss for one agency under the PPS with those of the interim payment system. A secondary data analysis of 140 cases compiled by one not-for-profit hospital-affiliated home care organization was completed. Results suggested that client characteristics of the projected loss group had more recertifications on admission and at the end of the 60-day episode, a longer stay (3 weeks), and more visits, particularly from skilled nursing. Comprehension of client characteristics and the subsequent ability to adjust for the proper case mix will be crucial if home care agencies are to remain financially viable under the PPS. Replication of this project needs to be done using more variables and multiple sites.

Effects of cochlear-implant pulse rate and inter-channel timing on channel interactions and thresholds

NASA Astrophysics Data System (ADS)

Middlebrooks, John C.

2004-07-01

Interactions among the multiple channels of a cochlear prosthesis limit the number of channels of information that can be transmitted to the brain. This study explored the influence on channel interactions of electrical pulse rates and temporal offsets between channels. Anesthetized guinea pigs were implanted with 2-channel scala-tympani electrode arrays, and spike activity was recorded from the auditory cortex. Channel interactions were quantified as the reduction of the threshold for pulse-train stimulation of the apical channel by sub-threshold stimulation of the basal channel. Pulse rates were 254 or 4069 pulses per second (pps) per channel. Maximum threshold reductions averaged 9.6 dB when channels were stimulated simultaneously. Among nonsimultaneous conditions, threshold reductions at the 254-pps rate were entirely eliminated by a 1966-μs inter-channel offset. When offsets were only 41 to 123 μs, however, maximum threshold shifts averaged 3.1 dB, which was comparable to the dynamic ranges of cortical neurons in this experimental preparation. Threshold reductions at 4069 pps averaged up to 1.3 dB greater than at 254 pps, which raises some concern in regard to high-pulse-rate speech processors. Thresholds for various paired-pulse stimuli, pulse rates, and pulse-train durations were measured to test possible mechanisms of temporal integration.

Accelerating large-scale protein structure alignments with graphics processing units

PubMed Central

2012-01-01

Background Large-scale protein structure alignment, an indispensable tool to structural bioinformatics, poses a tremendous challenge on computational resources. To ensure structure alignment accuracy and efficiency, efforts have been made to parallelize traditional alignment algorithms in grid environments. However, these solutions are costly and of limited accessibility. Others trade alignment quality for speedup by using high-level characteristics of structure fragments for structure comparisons. Findings We present ppsAlign, a parallel protein structure Alignment framework designed and optimized to exploit the parallelism of Graphics Processing Units (GPUs). As a general-purpose GPU platform, ppsAlign could take many concurrent methods, such as TM-align and Fr-TM-align, into the parallelized algorithm design. We evaluated ppsAlign on an NVIDIA Tesla C2050 GPU card, and compared it with existing software solutions running on an AMD dual-core CPU. We observed a 36-fold speedup over TM-align, a 65-fold speedup over Fr-TM-align, and a 40-fold speedup over MAMMOTH. Conclusions ppsAlign is a high-performance protein structure alignment tool designed to tackle the computational complexity issues from protein structural data. The solution presented in this paper allows large-scale structure comparisons to be performed using massive parallel computing power of GPU. PMID:22357132

OECD validation of the rodent Hershberger assay using three reference chemicals; 17alpha-methyltestosterone, procymidone, and p,p'-DDE.

PubMed

Shin, Jae-Ho; Moon, Hyun Ju; Kang, Il Hyun; Kim, Tae Sung; Lee, Su Jung; Ahn, Ji Youn; Bae, Hoon; Jeung, Eui Bae; Han, Soon Young

2007-05-01

The rodent Hershberger assay is being validated as an in vivo test method for detecting androgenic or antiandrogenic compounds by the Organization for Economic Cooperation and Development (OECD). As part of the international validation work, we studied 17alpha-methyltestosterone for evaluating androgenic activity, and procymidone and p,p'-DDE for evaluating antiandrogenic activity. Male Sprague-Dawley rats were castrated at postnatal day 42, and only the rats that showed preputial separation were used in this study. Seven days after castration, chemicals were administered daily by gavages to groups of rats for 10 days, as recommended by OECD phase-2 protocol. Administration of 17alpha-methyltestosterone induced increases of weights of accessory sex tissues and glands in a dose-dependent manner. Administration of procymidone and p,p'-DDE produced a dose-dependent decrease of weights of accessory sex tissues and glands in the rats co-treated with testosterone propionate (0.4 mg/kg/day) subcutaneously. Our data strongly suggested that the current protocol of OECD Hershberger assay (phase-2) should be used as a reliable method for the detection of endocrine related toxicity of other chemicals.

Controller's role in monitoring prospective payment system.

PubMed

Margrif, F D

1986-05-01

The challenge for hospital controllers in overseeing the prospective payment system (PPS) lies not in acquiring technical expertise but in working with the chief executive officer to coordinate organizational change. Specifically, the controller should assist in creating a prospective payment committee (PPC)--an interdisciplinary group of executives, middle managers, and medical staff. The PPC's duties, among others, include educating staff about the PPS, development of a productivity reporting system, and review of the responsibility accounting structure.

Army 86 Cost Sensitivity Analysis Verification.

DTIC Science & Technology

1980-09-01

NIGHT VIS SI AN/TAS-6 11 P21220 (Z50154) P-A DET SYS AN/USQ-70 24 QUANTITY LINE ITEM NUMBER NOMENCLATURE 26 Q16110 RADAR SET AN/PPS- SALP 54 Q16173...4 W/IMG 48 N04982 NIGHT VIS SI AN/TAS-4 55 NOSOSO NIGHT VIS SI AN/TAS-6 13 P21220 (Z50154) P-A BET SYS AN/USQ-70 -6 Q16110 RADAR SET AN/PPS- SALP 36

Emission of positronium in a nanometric PMMA film

NASA Astrophysics Data System (ADS)

Palacio, C. A.; De Baerdemaeker, J.; Van Thourhout, D.; Dauwe, C.

2008-10-01

Positron beam experiments have been performed for the first time on a self-supporting polymethyl metacrylate (PMMA) film of 310 nm-thick made by spin coating. The positronium (Ps) emission from the PMMA surface is studied as a function of the positron implantation energy by using Doppler profile spectroscopy and Compton-to-peak ratio analysis. When the sample and the Ge-detector are perpendicular to the positron beam, the emission of para-positronium ( p-Ps) is detected as a narrow central peak. By rotating the sample 45° with respect to the beam, the emission of p-Ps is detected as a blue-shifted fly-away peak. The bulk Ps fraction, the efficiency for the emission of Ps by picking up an electron from the surface, and the diffusion lengths of positrons (thermal and or epithermal), p-Ps and ortho-positronium ( o-Ps) are obtained.

Use of inorganic Fullerene-like WS2 to produce new high-performance polyphenylene sulfide nanocomposites: role of the nanoparticle concentration.

PubMed

Naffakh, Mohammed; Marco, Carlos; Gómez, Marián A; Gómez-Herrero, Julio; Jiménez, Ignacio

2009-07-30

The use of tungsten disulfide (WS2) nanoparticles offers the opportunity to produce novel and advanced polymer-based nanocomposite materials via melt blending. The developed materials, based on the high-performance engineering thermoplastic polyphenylene sulfide (PPS), display a unique nanostructure on variation of the nanoparticle concentration, as confirmed by time-resolved synchrotron X-ray diffraction. The cold-crystallization kinetics and morphology of PPS chains under confined conditions in the nanocomposite, as determined by differential scanning calorimetry (DSC) and atomic force microscopy (AFM), also manifest a dependence on the IF-WS2 concentration which are unexpected for polymer nanocomposites. The addition of IF-WS2 with concentrations greater than or equal to 0.5 wt % of IF-WS2 remarkably improves the mechanical performance of PPS with an increase in the storage modulus of 40-75%.

Irrational Delay Revisited: Examining Five Procrastination Scales in a Global Sample

PubMed Central

Svartdal, Frode; Steel, Piers

2017-01-01

Scales attempting to measure procrastination focus on different facets of the phenomenon, yet they share a common understanding of procrastination as an unnecessary, unwanted, and disadvantageous delay. The present paper examines in a global sample (N = 4,169) five different procrastination scales – Decisional Procrastination Scale (DPS), Irrational Procrastination Scale (IPS), Pure Procrastination Scale (PPS), Adult Inventory of Procrastination Scale (AIP), and General Procrastination Scale (GPS), focusing on factor structures and item functioning using Confirmatory Factor Analysis and Item Response Theory. The results indicated that The PPS (12 items selected from DPS, AIP, and GPS) measures different facets of procrastination even better than the three scales it is based on. An even shorter version of the PPS (5 items focusing on irrational delay), corresponds well to the nine-item IPS. Both scales demonstrate good psychometric properties and appear to be superior measures of core procrastination attributes than alternative procrastination scales. PMID:29163302

Irrational Delay Revisited: Examining Five Procrastination Scales in a Global Sample.

PubMed

Svartdal, Frode; Steel, Piers

2017-01-01

Scales attempting to measure procrastination focus on different facets of the phenomenon, yet they share a common understanding of procrastination as an unnecessary, unwanted, and disadvantageous delay. The present paper examines in a global sample ( N = 4,169) five different procrastination scales - Decisional Procrastination Scale (DPS), Irrational Procrastination Scale (IPS), Pure Procrastination Scale (PPS), Adult Inventory of Procrastination Scale (AIP), and General Procrastination Scale (GPS), focusing on factor structures and item functioning using Confirmatory Factor Analysis and Item Response Theory. The results indicated that The PPS (12 items selected from DPS, AIP, and GPS) measures different facets of procrastination even better than the three scales it is based on. An even shorter version of the PPS (5 items focusing on irrational delay), corresponds well to the nine-item IPS. Both scales demonstrate good psychometric properties and appear to be superior measures of core procrastination attributes than alternative procrastination scales.

Characterization of polyphenols and evaluation of antioxidant capacity in grape pomace of the cv. Malbec.

PubMed

Antoniolli, Andrea; Fontana, Ariel R; Piccoli, Patricia; Bottini, Rubén

2015-07-01

Low molecular weight polyphenols (LMW-PPs) and anthocyanins, along with the antioxidant capacity, were assessed in grape pomace extract (GPE) of red grape (Vitis vinifera L.) cv. Malbec. Twenty-six phenolics (13 LMW-PPs and 13 anthocyanins) were characterized and quantified by HPLC-MWD and UPLC-ESI-MS. The maximum concentrations of LMW-PPs corresponded to the flavanols (+)-catechin and (-)-epicatechin, whereas malvidin-3-glucoside was the most abundant anthocyanin. Piceatannol, a stilbene analogue to resveratrol with higher antioxidant activity, was firstly identified and quantified in GPE of the cv. Malbec. The antioxidant activity for Malbec GPE determined by oxygen radical absorbance capacity (ORAC) assay was 2,756 μmol TEg(-1) GPE. Therefore, the data reported sustain the use of winemaking by-products as a cheap source of phenolic compounds suitable for biotechnological applications, as a strategy for sustainable oenology. Copyright © 2015 Elsevier Ltd. All rights reserved.

Mammalian Wax Biosynthesis

PubMed Central

Cheng, Jeffrey B.; Russell, David W.

2009-01-01

Wax monoesters are synthesized by the esterification of fatty alcohols and fatty acids. A mammalian enzyme that catalyzes this reaction has not been isolated. We used expression cloning to identify cDNAs encoding a wax synthase in the mouse preputial gland. The wax synthase gene is located on the X chromosome and encodes a member of the acyltransferase family of enzymes that synthesize neutral lipids. Expression of wax synthase in cultured cells led to the formation of wax monoesters from straight chain saturated, unsaturated, and polyunsaturated fatty alcohols and acids. Polyisoprenols also were incorporated into wax monoesters by the enzyme. The wax synthase had little or no ability to synthesize cholesteryl esters, diacylglycerols, or triacylglycerols, whereas other acyltransferases, including the acyl-CoA:monoacylglycerol acyltransferase 1 and 2 enzymes and the acyl-CoA:diacylglycerol acyltransferase 1 and 2 enzymes, exhibited modest wax monoester synthesis activities. Confocal light microscopy indicated that the wax synthase was localized in membranes of the endoplasmic reticulum. Wax synthase mRNA was abundant in tissues rich in sebaceous glands such as the preputial gland and eyelid and was present at lower levels in other tissues. Coexpression of cDNAs specifying fatty acyl-CoA reductase 1 and wax synthase led to the synthesis of wax monoesters. The data suggest that wax monoester synthesis in mammals involves a two step biosynthetic pathway catalyzed by fatty acyl-CoA reductase and wax synthase enzymes. PMID:15220349

Sole Community Hospitals: Are They Different? A Statistical Analysis of the Hospitals and Their Treatment under TEFRA and PPS. Hospital Studies Program. Hospital Cost and Utilization Project. Research Note 5.

ERIC Educational Resources Information Center

Farley, Dean E.

A study examined the treatment of sole community hospitals under the Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA) and the Prospective Payment System (PPS) for Medicare as compared to the treatment of hospitals not designated as sole community hospitals under these same two policy guidelines. (A sole community hospital is defined as a…

Developing a case-mix model for PPS.

PubMed

Goldberg, H B; Delargy, D

2000-01-01

Agencies are pinning hopes for success under PPS on an accurate case-mix adjustor. The Health Care Financing Administration (HCFA) tasked Abt Associates Inc. to develop a system to accurately predict the volume and type of home health services each patient requires, based on his or her characteristics (not the service actually received). HCFA wanted this system to be feasible, clinically logical, and valid and accurate. Authors Goldberg and Delargy explain how Abt approached this daunting task.

Study for analysis of benefit versus cost of low thrust propulsion system

NASA Technical Reports Server (NTRS)

Hamlyn, K. M.; Robertson, R. I.; Rose, L. J.

1983-01-01

The benefits and costs associated with placing large space systems (LSS) in operational orbits were investigated, and a flexible computer model for analyzing these benefits and costs was developed. A mission model for LSS was identified that included both NASA/Commercial and DOD missions. This model included a total of 68 STS launches for the NASA/Commercial missions and 202 launches for the DOD missions. The mission catalog was of sufficient depth to define the structure type, mass and acceleration limits of each LSS. Conceptual primary propulsion stages (PPS) designs for orbital transfer were developed for three low thrust LO2/LH2 engines baselined for the study. The performance characteristics for each of these PPS was compared to the LSS mission catalog to create a mission capture. The costs involved in placing the LSS in their operational orbits were identified. The two primary costs were that of the PPS and of the STS launch. The cost of the LSS was not included as it is not a function of the PPS performance. The basic relationships and algorithms that could be used to describe the costs were established. The benefit criteria for the mission model were also defined. These included mission capture, reliability, technical risk, development time, and growth potential. Rating guidelines were established for each parameter. For flexibility, each parameter is assigned a weighting factor.

The Association Between Physical Performance and Executive Function in a Sample of Rural Older Adults from South Carolina, USA.

PubMed

Falck, Ryan S; Wilcox, Sara; Best, John R; Chandler, Jessica L; Liu-Ambrose, Teresa

2017-01-01

Mobility and executive functions (EFs) decline with age, although associations between mobility and EFs are less clear. This study examined relationships between different mobility measures and EFs among rural older adults. This cross-sectional study recruited 56 older adults (60+ years) in rural South Carolina. Mobility was assessed via gait speed, timed up-and-go, chair stand, and as a composite physical performance score (PPS). EFs was assessed via Trail Making Test, semantic fluency, and phonemic fluency. Bivariate analyses were performed and regressions were calculated controlling for appropriate covariates, with PPS as the independent variable and each EF test as the dependent variable. Mean age was 74.22 years (SD = 8.02), 80.40% were female and 64.71% were white. Bivariate analysis revealed associations between gait speed and Trail Making Test (r = -.33; p = .03), between timed up-and-go and Trail Making Test (r = .34; p = .01), and between PPS and Trail Making Test (r = -.33; p = .03). The regression models indicated higher PPS was associated with better performance on Trail Making Test (β = -1.12; p < 0.01), phonemic fluency (β = 0.68; p = .01), and semantic fluency (β = 0.81; p = .02). In a rural setting, mobility is associated with multiple EF processes. Higher mobility and physical ability are desired for maintaining EFs capability.

Hydrocephalus, agenesis of the corpus callosum, and cleft lip/palate represent frequent associations in fetuses with Peters' plus syndrome and B3GALTL mutations. Fetal PPS phenotypes, expanded by Dandy Walker cyst and encephalocele.

PubMed

Schoner, Katharina; Kohlhase, Juergen; Müller, Annette M; Schramm, Thomas; Plassmann, Margit; Schmitz, Ralf; Neesen, Juergen; Wieacker, Peter; Rehder, Helga

2013-01-01

Fetal pathology aims to recognize syndromal patterns of anomalies for goal-directed mutation analyses, genetic counseling, and early prenatal diagnosis in consecutive pregnancies. Here, we report on five fetuses with Peters' plus syndrome (PPS) from two distinct families aborted after prenatal ultrasound diagnosis of hydrocephaly. We performed fetal autopsies and molecular analyses. Among 44 fetuses with prenatally diagnosed hydrocephaly, four fetuses of 16 to 21 gestational weeks presented with additional cleft lip/palate and/or agenesis of the corpus callosum. Other features were growth retardation, hypertelorism, anomalies of the eyes, in part consistent with Peters' anterior chamber anomalies, mild brachymelia, brachydactyly, and also internal anomalies. Suspected PPS was confirmed by detection of B3GALTL mutation in these four fetuses and in one additional sib fetus, revealing homozygosity for the common c.660 + 1G > A donor splice site mutation in intron 8. Autosomal-recessive PPS has not yet been diagnosed prenatally. We want to alert ultrasonographers to the diagnosis of this disorder in growth-retarded fetuses with (recurrent) hydrocephaly, agenesis of the corpus callosum, and cleft lip/palate and stress the more severe fetal manifestation, describing a first such case with additional Dandy-Walker cyst and occult meningoencephalocele. © 2012 John Wiley & Sons, Ltd.

Aerobic Exercise Training in Post-Polio Syndrome: Process Evaluation of a Randomized Controlled Trial

PubMed Central

Voorn, Eric L.; Koopman, Fieke S.; Brehm, Merel A.; Beelen, Anita; de Haan, Arnold; Gerrits, Karin H. L.; Nollet, Frans

2016-01-01

Objective To explore reasons for the lack of efficacy of a high intensity aerobic exercise program in post-polio syndrome (PPS) on cardiorespiratory fitness by evaluating adherence to the training program and effects on muscle function. Design A process evaluation using data from an RCT. Patients Forty-four severely fatigued individuals with PPS were randomized to exercise therapy (n = 22) or usual care (n = 22). Methods Participants in the exercise group were instructed to exercise 3 times weekly for 4 months on a bicycle ergometer (60–70% heart rate reserve). Results The attendance rate was high (median 89%). None of the participants trained within the target heart rate range during >75% of the designated time. Instead, participants exercised at lower intensities, though still around the anaerobic threshold (AT) most of the time. Muscle function did not improve in the exercise group. Conclusion Our results suggest that severely fatigued individuals with PPS cannot adhere to a high intensity aerobic exercise program on a cycle ergometer. Despite exercise intensities around the AT, lower extremity muscle function nor cardiorespiratory fitness improved. Improving the aerobic capacity in PPS is difficult through exercise primarily focusing on the lower extremities, and may require a more individualized approach, including the use of other large muscle groups instead. Trial Registration Netherlands National Trial Register NTR1371 PMID:27419388

Medicare and Medicaid programs; CY 2015 Home Health Prospective Payment System rate update; Home Health Quality Reporting Requirements; and survey and enforcement requirements for home health agencies. Final rule.

PubMed

2014-11-06

This final rule updates Home Health Prospective Payment System (HH PPS) rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor under the Medicare prospective payment system for home health agencies (HHAs), effective for episodes ending on or after January 1, 2015. As required by the Affordable Care Act, this rule implements the second year of the four-year phase-in of the rebasing adjustments to the HH PPS payment rates. This rule provides information on our efforts to monitor the potential impacts of the rebasing adjustments and the Affordable Care Act mandated face-to-face encounter requirement. This rule also implements: Changes to simplify the face-to-face encounter regulatory requirements; changes to the HH PPS case-mix weights; changes to the home health quality reporting program requirements; changes to simplify the therapy reassessment timeframes; a revision to the Speech-Language Pathology (SLP) personnel qualifications; minor technical regulations text changes; and limitations on the reviewability of the civil monetary penalty provisions. Finally, this rule also discusses Medicare coverage of insulin injections under the HH PPS, the delay in the implementation of the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), and a HH value-based purchasing (HH VBP) model.

Evaluation of carotid plaque vulnerability in vivo: Correlation between dynamic contrast-enhanced MRI and MRI-modified AHA classification.

PubMed

Ge, Xiaoqian; Zhou, Zien; Zhao, Huilin; Li, Xiao; Sun, Beibei; Suo, Shiteng; Hackett, Maree L; Wan, Jieqing; Xu, Jianrong; Liu, Xiaosheng

2017-09-01

To noninvasively monitor carotid plaque vulnerability by exploring the relationship between pharmacokinetic parameters (PPs) of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and plaque types based on MRI-modified American Heart Association (AHA) classification, as well as to assess the ability of PPs in discrimination between stable and vulnerable plaques suspected on MRI. Of 70 consecutive patients with carotid plaques who volunteered for 3.0T MRI (3D time-of-flight [TOF], T 1 -weighted, T 2 -weighted, 3D magnetization-prepared rapid acquisition gradient-echo [MP-RAGE] and DCE-MRI), 66 participants were available for analysis. After plaque classification according to MRI-modified AHA Lesion-Type (LT), PPs (K trans , k ep , v e , and v p ) of DCE-MRI were measured. The Extended Tofts model was used for calculation of PPs. For participants with multiple carotid plaques, the plaque with the worst MRI-modified AHA LT was chosen for analysis. Correlations between PPs and plaque types and the ability of these parameters to distinguish stable and vulnerable plaques suspected on MRI were assessed. Significant positive correlation between K trans and LT III to VI was found (ρ = 0.532, P < 0.001), as was the correlation between k ep and LT III to VI (ρ = 0.409, P < 0.001). Stable and vulnerable plaques suspected on MRI could potentially be distinguished by K trans (sensitivity 83%, specificity 100%) and k ep (sensitivity 77%, specificity 91%). K trans and k ep from DCE-MRI can provide quantitative information to monitor plaque vulnerability in vivo and differentiate vulnerable plaques suspected on MRI from stable ones. These two parameters could be adopted as imaging biomarkers for plaque characterization and risk stratification. 1 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;46:870-876. © 2017 International Society for Magnetic Resonance in Medicine.

Doxycycline alters collagen composition following ventral hernia repair.

PubMed

Tharappel, Job C; Harris, Jennifer W; Totten, Crystal; Zwischenberger, Brittany A; Roth, John S

2017-04-01

Doxycycline, a nonspecific metalloproteinase (MMP) inhibitor, has been demonstrated to impact the strength of the polypropylene (PP) mesh-repaired hernia with an increase in the deposition of collagen type 1. The impact of doxycycline with porcine acellular dermal matrices (PADM) is unknown; therefore, we evaluated the impact of doxycycline administration upon hernia repair with PP and PADM mesh. Sprague-Dawley rats weighing ~400 g underwent laparotomy with creation of a midline ventral hernia. After a 27-day recovery, animals were randomly assigned to four groups of eight and underwent intraperitoneal underlay hernia repair with either PP or PADM. Groups were assigned to daily normal saline (S) or daily doxycycline in normal saline 10 mg/kg (D) via oral gavage for 8 weeks beginning 24 h preoperatively. Animals were euthanized at 8 weeks and underwent tensiometric testing of the abdominal wall and western blot analyses for collagen subtypes and MMPs. Thirty-two animals underwent successful hernia creation and repair with either PADM or PP. At 8 weeks, 15 of 16 PP-implanted animals survived with only 12 of 16 PADM-implanted animals surviving. There were no differences in the mesh to fascial interface tensiometric strength between groups. Densitometric counts in the PADM-D group demonstrated increased collagen type 1 compared to PP-S (PADM-D [1286.5], PADM-S [906.9], PP-S [700.4], p = 0.037) and decreased collagen type 3 compared to PP-S (PADM-D [7446.9], PADM-S [8507.6], PP-S [11,297.1], p = 0.01). MMP-9 levels were increased in PADM-D (PP-S vs. PADM-D, p = 0.04), while MMP-2 levels were similar between PADM-D and PADM-S, respectively. Collagen type 1 deposition at the mesh to fascial interface is enhanced following administration of doxycycline in ventral hernia repairs with porcine acellular dermal matrices. Doxycycline administration may have implications for enhancing hernia repair outcomes using biologic mesh.

Laboratory-based experiments to investigate the impact of glyphosate-containing herbicide on pollution attenuation and biodegradation in a model pervious paving system.

PubMed

Mbanaso, F U; Coupe, S J; Charlesworth, S M; Nnadi, E O

2013-01-01

An experimental investigation was carried out to determine the effect of glyphosate-containing herbicides (GCHs) on the hydrocarbon retention and biodegradation processes known to occur in pervious pavement systems (PPSs). The PPS test rigs were based on the four-layered design detailed in CIRIA C582. This enabled the pollutant retention capacity of the PPS and biodegradation of retained pollutants by microorganisms to be investigated. The use of test rigs also enabled the impact of GCH on PPS eukaryotic organisms to be studied, by the monitoring of protist bioindicators. Results showed that GCH disrupted hydrocarbon retention by the geotextiles relative to rigs with mineral oil only added, as 9.3% and 24.5% of added hydrocarbon were found in herbicide only rigs and herbicide plus oil rigs respectively. In previous studies, PPS contaminated by mineral oil had been shown to retain 98.7% of added oils and over several weeks, biodegrade this oil in situ. Where GCH was added to experimental models, much higher concentrations of heavy metals, including Pb, Cu, and Zn, were released from the PPS in effluent, particularly where GCH and mineral oil were added together. The source of the majority of the metal contamination was thought to be the used engine oil. The herbicide generally increased the total activity of microbial communities in rig systems and had a stimulating effect on bacterial and fungal population numbers. Although the protists, which are part of the microbial community directly or indirectly responsible for biodegradation, were initially strongly affected by the herbicide, they showed resilience by quickly recovering and increasing their population compared with rigs without added herbicide, including the rigs with mineral oil added to them. However, the presence of herbicide was associated with a decrease in the species richness of recorded protist taxa and a predominance of robust, cosmopolitan or ubiquitous protist genera. Copyright © 2012 Elsevier Ltd. All rights reserved.

Experimental studies on particle impaction and bounce: effects of substrate design and material

NASA Astrophysics Data System (ADS)

Chang, Mingchih; Kim, Seongheon; Sioutas, Constantinos

This paper presents an experimental investigation of the effects of impaction substrate designs and material in reducing particle bounce and reentrainment. Particle collection without coating by using combinations of different impaction substrate designs and surface materials was conducted using a personal particle sampler (PPS) developed by the University of Southern California. The PPS operates at flow rate of 4 l min -1 with a 50% cutpoint of approximately 0.9 μm in aerodynamic diameter. The laboratory results showed that the PPS collection efficiency for particles larger than 50% cutpoint is strikingly low (e.g., less than 50%) when an uncoated open cavity made of aluminum was used as an impaction substrate. The collection efficiency gradually increased when Teflon tape, Nuclepore, and glass fiber filters were used as impaction surfaces, respectively. Conical or partially enclosed cavity substrate designs increased collection efficiency of particles of 9 μm up to 80-90%. A conical cavity with glass fiber filter used as impaction surface was identified as the optimum configuration, resulting in a collection efficiency of 92% at Stokes numbers as high as 15.4 (corresponding to 9 μm in aerodynamic diameter). Particle losses were low (less than 10%) and relatively independent of particle size in any design with glass fiber filter. Losses seemed to increase slightly with particle size in all other configurations. Finally, outdoor PM 1 concentrations obtained with the PPS (in its optimum configuration) and a modified micro-orifice uniform deposit impactor (MOUDI) with coated impaction stages were in excellent agreement. The mean ratio of the PPS-to-MOUDI concentration was 1.13(±0.17) with a correlation coefficient R2=0.95. Results from this investigation can be readily applied to design particle bounce-free impaction substrates without the use of coating. This is a very important feature of impactors, especially when chemical analysis of the collected particulate matter is desirable.

Clinical & financial operations. Partnership for quality.

PubMed

Mackin, Annette

2002-11-01

PPS has brought to the forefront the "patient care vs. dollars" tension that has long existed between the clinical and financial functions. Recognition of the legitimacy of this very natural tension is critical to successful clinical and financial management under PPS. Clinical and financial staff members who recognize the interdependencies of their functions and work collaboratively will likely view themselves as members of one interdisciplinary team. An organization that can achieve this major shift in corporate culture will also achieve its most sought after goals.

A novel plant protection strategy for transient reactors

NASA Astrophysics Data System (ADS)

Bhattacharyya, Samit K.; Lipinski, Walter C.; Hanan, Nelson A.

The present plant protection system (PPS) has been defined for use in the TREAT-upgrade (TU) reactor for controlled transient operation of reactor-fuel behavior testing under simulated reactor-accident conditions. A PPS with energy-dependent trip set points lowered worst-case clad temperatures by as much as 180 K, relative to the use of conventional fixed-level trip set points. The multilayered multilevel protection strategy represents the state-of-the-art in terrestrial transient reactor protection systems, and should be applicable to multi-MW space reactors.

Helium Bottle Pressure Measurement by Portable Ultrasonic Technique

DTIC Science & Technology

1989-02-07

revision extends the study to include EMI testing, and -develorynent of g Rrotgtype tester . The Contractor shall: 1. Perform EMI test of ultrasonic eq...amp/1 watt power ap- plied to the bridgerires. The tester pulse of 250 volts for 100 ns at 1500 pps has an average value of 250v x 100ns x 1500pps...34 connector. Mount transducer in fixture and connect transducer to cable microdot connector. 5. Pulse-Echo transit time measurement: Assure that the

Treatment for postpolio syndrome.

PubMed

Koopman, Fieke Sophia; Beelen, Anita; Gilhus, Nils Erik; de Visser, Marianne; Nollet, Frans

2015-05-18

Postpolio syndrome (PPS) may affect survivors of paralytic poliomyelitis and is characterised by a complex of neuromuscular symptoms leading to a decline in physical functioning. The effectiveness of pharmacological treatment and rehabilitation management in PPS is not yet established. This is an update of a review first published in 2011. To systematically review the evidence from randomised and quasi-randomised controlled trials for the effect of any pharmacological or non-pharmacological treatment for PPS compared to placebo, usual care or no treatment.  We searched the following databases on 21 July 2014: Cochrane Neuromuscular Disease Group Specialized Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, PsycINFO and CINAHL Plus. We also checked reference lists of all relevant articles, searched the Database of Abstracts of Reviews of Effects (DARE), the Health Technology Assessment (HTA) Database and trial registers and contacted investigators known to be involved in research in this area. Randomised and quasi-randomised trials of any form of pharmacological or non-pharmacological treatment for people with PPS. The primary outcome was self perceived activity limitations and secondary outcomes were muscle strength, muscle endurance, fatigue, pain and adverse events. We used standard methodological procedures expected by The Cochrane Collaboration. We included 10 pharmacological (modafinil, intravenous immunoglobulin (IVIg), pyridostigmine, lamotrigine, amantadine, prednisone) and three non-pharmacological (muscle strengthening, rehabilitation in a warm climate (that is temperature ± 25°C, dry and sunny) and a cold climate (that is temperature ± 0°C, rainy or snowy), static magnetic fields) studies with a total of 675 participants with PPS in this review. None of the included studies were completely free from any risk of bias, the most prevalent risk of bias being lack of blinding.There was moderate- and low-quality evidence that IVIg has no beneficial effect on activity limitations in the short term and long term, respectively, and inconsistency in the evidence for effectiveness on muscle strength. IVIg caused minor adverse events in a substantial proportion of the participants. Results of one trial provided very low-quality evidence that lamotrigine might be effective in reducing pain and fatigue, resulting in fewer activity limitations without generating adverse events. Data from two single trials suggested that muscle strengthening of thumb muscles (very low-quality evidence) and static magnetic fields (moderate-quality evidence) are safe and beneficial for improving muscle strength and pain, respectively, with unknown effects on activity limitations. Finally, there was evidence varying from very low quality to high quality that modafinil, pyridostigmine, amantadine, prednisone and rehabilitation in a warm or cold climate are not beneficial in PPS. Due to insufficient good-quality data and lack of randomised studies, it was impossible to draw definite conclusions about the effectiveness of interventions for PPS. Results indicated that IVIg, lamotrigine, muscle strengthening exercises and static magnetic fields may be beneficial but need further investigation to clarify whether any real and meaningful effect exists.

Radical SAM Enzymes in the Biosynthesis of Ribosomally Synthesized and Post-translationally Modified Peptides (RiPPs).

PubMed

Benjdia, Alhosna; Balty, Clémence; Berteau, Olivier

2017-01-01

Ribosomally-synthesized and post-translationally modified peptides (RiPPs) are a large and diverse family of natural products. They possess interesting biological properties such as antibiotic or anticancer activities, making them attractive for therapeutic applications. In contrast to polyketides and non-ribosomal peptides, RiPPs derive from ribosomal peptides and are post-translationally modified by diverse enzyme families. Among them, the emerging superfamily of radical SAM enzymes has been shown to play a major role. These enzymes catalyze the formation of a wide range of post-translational modifications some of them having no counterparts in living systems or synthetic chemistry. The investigation of radical SAM enzymes has not only illuminated unprecedented strategies used by living systems to tailor peptides into complex natural products but has also allowed to uncover novel RiPP families. In this review, we summarize the current knowledge on radical SAM enzymes catalyzing RiPP post-translational modifications and discuss their mechanisms and growing importance notably in the context of the human microbiota.

75 FR 70371 - Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2011...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-17

...This final rule sets forth an update to the Home Health Prospective Payment System (HH PPS) rates, including: the national standardized 60-day episode rates, the national per-visit rates, the nonroutine medical supply (NRS) conversion factors, and the low utilization payment amount (LUPA) add-on payment amounts, under the Medicare prospective payment system for HHAs effective January 1, 2011. This rule also updates the wage index used under the HH PPS and, in accordance with the Patient Protection and Affordable Care Act of 2010 (Affordable Care Act), updates the HH PPS outlier policy. In addition, this rule revises the home health agency (HHA) capitalization requirements. This rule further adds clarifying language to the ``skilled services'' section. The rule finalizes a 3.79 percent reduction to rates for CY 2011 to account for changes in case-mix, which are unrelated to real changes in patient acuity. Finally, this rule incorporates new legislative requirements regarding face-to-face encounters with providers related to home health and hospice care.

Organization and functioning of primary healthcare for pre-school children in Croatia: a longitudinal study from 1995 to 2012.

PubMed

Buljan, Josip; Prljević, Gordana; Menegoni, Martina; Bralić, Irena

2014-12-01

Primary health care for children in Croatia are mostly provided by primary pediatricians (PP) in the urban and by family doctors in rural areas. During past decades, as apart of health care reforms, primary pediatric care experiences several changes. This study was undertaken in order to investigate the trends in organizational structure and functioning of the PPs, based on routinely collected data from Croatian Health Service Yearbooks, 1995 to 2012. The results have consistently shown a shortage of PPs in Croatia. The shortage obviously affects the average number of children per PP; number increased from 994 in 1995, to 1556 children in 2010, which was far above the standard. The shortage of PPs is also related to the high number of visits (30 to 40) per PP and per working day. The obtained results clearly show only the trends, therefore further research is needed for a full understanding of the PHC for pre-school children.

Phage display and selection of lanthipeptides on the carboxy-terminus of the gene-3 minor coat protein.

PubMed

Urban, Johannes H; Moosmeier, Markus A; Aumüller, Tobias; Thein, Marcus; Bosma, Tjibbe; Rink, Rick; Groth, Katharina; Zulley, Moritz; Siegers, Katja; Tissot, Kathrin; Moll, Gert N; Prassler, Josef

2017-11-15

Ribosomally synthesized and post-translationally modified peptides (RiPPs) are an emerging class of natural products with drug-like properties. To fully exploit the potential of RiPPs as peptide drug candidates, tools for their systematic engineering are required. Here we report the engineering of lanthipeptides, a subclass of RiPPs characterized by multiple thioether cycles that are enzymatically introduced in a regio- and stereospecific manner, by phage display. This was achieved by heterologous co-expression of linear lanthipeptide precursors fused to the widely neglected C-terminus of the bacteriophage M13 minor coat protein pIII, rather than the conventionally used N-terminus, along with the modifying enzymes from distantly related bacteria. We observe that C-terminal precursor peptide fusions to pIII are enzymatically modified in the cytoplasm of the producing cell and subsequently displayed as mature cyclic peptides on the phage surface. Biopanning of large C-terminal display libraries readily identifies artificial lanthipeptide ligands specific to urokinase plasminogen activator (uPA) and streptavidin.

Palliative Sedation at the End of Life: Patterns of Use in an Israeli Hospice.

PubMed

Azoulay, Daniel; Shahal-Gassner, Ruth; Yehezkel, Malka; Eliyahu, Ester; Weigert, Nir; Ein-Mor, Eliana; Jacobs, Jeremy M

2016-05-01

Palliative sedation (PS) is indicated for refractory symptoms among dying patients. This retrospective descriptive study examines PS in an Israeli hospice. Palliative sedation was defined as PS to unconsciousness (PSU), PS proportionate to symptoms (proportional palliative sedation [PPS]), or intermittent PS (IPS). Among 179 patients who died during 2012, PS was used among 21.2% (n = 38): (PSU 34.2%, PPS 34.2%, and IPS 31.6%), using midazolam (n = 33/38), halidol (21/38), and concurrent morphine (n = 35/38). Indications included agitation (71%), pain (36.8%), and dyspnea (21%). Survival following initiation of PS was 73 ± standard deviation 54 hours. No differences in survival were observed according to who initiated the decision to use PS (patients/medical staff/family) or type of PS (PSU/PPS/IPS). Survival following PS was longest with higher sedative doses, an observation that may help dispel fears concerning the use of PS to hasten death. © The Author(s) 2015.

The Balanced Budget Act (1997) and the supplyof nursing home subacute care.

PubMed

Qaseem, Amir; Weech-Maldonado, Robert; Mkanta, William

2007-01-01

This article examines the impact of the Medicare prospective payment system (PPS) on the supply of subacute care services by nursing homes. A quasi-experimental interrupted time-series design using Heckman's two-stage regression model is employed to test for changes before and after the implementation of Medicare PPS. Our findings suggest that the change in Medicare reimbursement from cost-based to PPS under the Balanced Budget Act of 1997 resulted in a decrease of 1.7 percent in the supply of subacute care beds by nursing homes. However, this was a one-time, short-term negative effect. The supply of nursing home subacute care remained stable in the long-term. Other environmental factors, such as Medicare hospital discharges, hospital-based subacute care, Medicare managed care penetration, availability of home health, and per capita income were associated with nursing home subacute care supply. Organizational-level factors, such as occupancy rate, RN staff mix, and Medicare payer mix were also predictors of nursing home subacute care supply.

Direct-Y: Fast Acquisition of the GPS PPS Signal

NASA Technical Reports Server (NTRS)

Namoos, Omar M.; DiEsposti, Raymond S.

1996-01-01

The NAVSTAR Global Positioning System (GPS) provides positioning and time information to military users via the Precise Positioning Service (PPS) which typically allows users a significant margin of precision over the commercially available Standard Positioning Service (SPS), Military sets that rely on first acquiring the SPS Coarse Acquisition (C/A) code, read from the data message the handover word (HOW) that provides the time-of-signal transmission needed to acquire and lock onto the PPS Y-code. Under extreme battlefield conditions, the use of GPS would be denied to the warfighter who cannot pick up the un-encrypted C/A code. Studies are underway at the GPS Joint Program Office (JPO) at the Space and Missile Center, Los Angeles Air Force Base that are aimed at developing the capability to directly acquire Y-code without first acquiring C/A code. This paper briefly outlines efforts to develop 'direct-Y' acquisition, and various approaches to solving this problem. The potential ramifications of direct-Y to military users are also discussed.

The FBXO7 homologue nutcracker and binding partner PI31 in Drosophila melanogaster models of Parkinson's disease.

PubMed

Merzetti, Eric M; Dolomount, Lindsay A; Staveley, Brian E

2017-01-01

Parkinsonian-pyramidal syndrome (PPS) is an early onset form of Parkinson's disease (PD) that shows degeneration of the extrapyramidal region of the brain to result in a severe form of PD. The toxic protein build-up has been implicated in the onset of PPS. Protein removal is mediated by an intracellular proteasome complex: an E3 ubiquitin ligase, the targeting component, is essential for function. FBXO7 encodes the F-box component of the SCF E3 ubiquitin ligase linked to familial forms of PPS. The Drosophila melanogaster homologue nutcracker (ntc) and a binding partner, PI31, have been shown to be active in proteasome function. We show that altered expression of either ntc or PI31 in dopaminergic neurons leads to a decrease in longevity and locomotor ability, phenotypes both associated with models of PD. Furthermore, expression of ntc-RNAi in an established α-synuclein-dependent model of PD rescues the phenotypes of diminished longevity and locomotor control.

Preliminary results on the Arecibo Pisces-Perseus Supercluster Survey

NASA Astrophysics Data System (ADS)

Cortes, Rosemary; Lebron, Mayra; Jones, Michael G.; Koopmann, Rebecca A.; Haynes, Martha P.; APPSS Team, Undergraduate ALFALFA Team, and the ALFALFA Team

2018-01-01

The Arecibo Pisces-Perseus Supercluster Survey (APPSS) aims to exploit the Baryonic Tully-Fisher Relation to derive distances and peculiar velocities of galaxies in and near the main ridge of the Pisces-Perseus Supercluster (PPS), one of the most prominent features of the Cosmic Web in the nearby Universe. The sample of galaxies contains ~ 600 sources in the low-mass range (8 < log MHI / M⊙ < 9). The source selection was based on the ALFALFA HI survey, SDSS and GALEX photometric data. The sample galaxies have HI masses just below the ALFALFA detection threshold, and were selected to be blue disk systems (low surface brightness sources from optical photometry data). The HI data were obtained at the Arecibo Observatory between the years 2015 and 2016. With this sample, the nature of the galaxy population in and around the PPS will be investigated. The HIMF to log MHI ~ 8.0 along the PPS filament will be measured and using the Tully-Fisher relation it will be possible to make a robust measurement of the infall and backflow onto the filamentary structure.APPSS is collaborative project between more than 10 Undergraduate ALFALFA Team institutions in which each group contributes to the analysis of a subset of the HI PPS data. In this poster, we will present the contributions of the U.P.R. team to the APPSS project. We will show the procedure used for the Arecibo HI data analysis, including some examples, and will show our preliminary results.

Restless legs syndrome in patients with sequelae of poliomyelitis.

PubMed

Kumru, Hatice; Portell, Enric; Barrio, Manuela; Santamaria, Joan

2014-10-01

No studies have examined the association between RLS and the sequelae of poliomyelitis (PM). We studied the frequency and severity of RLS in a group of consecutive patients with the sequelae of poliomyelitis (PM) and the effect of treatment with dopaminergic drugs. A diagnosis of RLS was made according to the criteria of the International RLS Study Group, and severity was assessed by the RLS rating scale. Information on sex, age, age at onset, site affected by PM, disease duration of PM, and history of post-polio syndrome (pPS) was obtained in a cohort of 52 PM patients. The mean age was 55.9 ± 6.5 years; 39 patients had post-polio syndrome (75%). RLS was diagnosed in 21 (40.4%) patients. Sixteen of the 21 patients (76.2%) with RLS had pPS, which was similar to the non-RLS group (74.2% patients with pPS). RLS symptoms were very severe in 5 patients, severe in 13, moderate in 2 and mild in 1. Nineteen of the 21 patients with RLS had symptoms predominantly in the more affected lower limb (90% of patients). Sixteen patients received dopaminergic agonist treatment with a significant reduction in their scores on the RLS severity scale from 28.3 ± 4.7 to 6.9 ± 7.3 (p < 0.001). RLS occurs frequently in patients with PM, both in those with and without pPS, and responds well to treatment with dopaminergic drugs. Copyright © 2014 Elsevier Ltd. All rights reserved.

Proactive enteral tube feeding in pediatric patients undergoing chemotherapy.

PubMed

Sacks, Nancy; Hwang, Wei-Ting; Lange, Beverly J; Tan, Kay-See; Sandler, Eric S; Rogers, Paul C; Womer, Richard B; Pietsch, John B; Rheingold, Susan R

2014-02-01

To determine feasibility and safety of proactive enteral tube feeding (ETF) in pediatric oncology patients. Pediatric patients with newly diagnosed brain tumors, myeloid leukemia or high-risk solid tumors were eligible. Subjects agreeing to start ETF before cycle 2 chemotherapy were considered proactive participants (PPs). Those who declined could enroll as chart collection receiving nutritional standard of care. Nutritional status was assessed using standard anthropometric measurements. Episodes of infection and toxicity related to ETF were documented from diagnosis to end of therapy. A descriptive comparison between PPs and controls was conducted. One hundred four eligible patients were identified; 69 enrolled (20 PPs and 49 controls). At diagnosis, 17% of all subjects were underweight and 26% overweight. Barriers to enrollment included physician, subject and/or family refusal, and inability to initiate ETF prior to cycle 2 of chemotherapy. Toxicity of ETF was minimal, but higher percentage of subjects in the proactive group had episodes of infection than controls. Thirty-nine percent of controls eventually started ETF and were twice as likely to receive parenteral nutrition. PPs experienced less weight loss at ETF initiation than controls receiving ETF and were the only group to demonstrate improved nutritional status at end of study. Proactive ETF is feasible in children with cancer and results in improved nutritional status at end of therapy. Episodes of infection in this study are concerning; therefore, a larger randomized trial is required to further delineate infectious risks and toxicities that may be mitigated by improved nutritional status. © 2013 Wiley Periodicals, Inc.

Changes in the Medicare home health care market: the impact of reimbursement policy.

PubMed

Choi, Sunha; Davitt, Joan K

2009-03-01

The Balanced Budget Act of 1997 introduced 2 new reimbursement structures, the Interim Payment System (IPS, 1997-2000) and the Prospective Payment System (PPS, begun October 2000) for Medicare home health agencies (HHAs) under the fee-for-service program. This article describes and compares the impact of these changes on the Medicare home health market from a period before the BBA through the IPS and PPS in relation to agency characteristics. A secondary analysis of 1996, 1999, and 2002 Provider of Services data was conducted on all Medicare-certified HHAs. Frequencies and rates of change were calculated by agency characteristics to describe changes in the number of active agencies through those years. Logistic regression models were used to compare factors associated with market exits under different payment systems. The results indicate dramatic but disproportional changes in response to the IPS and the PPS among Medicare home health care agencies. Agency closures were greater and market entries fewer during the IPS, but more branch offices/subunits were closed during the PPS. Proprietary and freestanding agencies experienced greater volatility throughout, with the greatest number of closures seen in Region VI (Dallas). These results demonstrate the direct impact of policy changes on the home health care market and highlight the need to evaluate policy changes to understand both intended and unintended impacts on health markets. Future research should analyze the effect of these policy changes on other healthcare providers and systems and their impact on health outcomes for Medicare beneficiaries.

RB1 is the crucial target of the Merkel cell polyomavirus Large T antigen in Merkel cell carcinoma cells.

PubMed

Hesbacher, Sonja; Pfitzer, Lisa; Wiedorfer, Katharina; Angermeyer, Sabrina; Borst, Andreas; Haferkamp, Sebastian; Scholz, Claus-Jürgen; Wobser, Marion; Schrama, David; Houben, Roland

2016-05-31

The pocket protein (PP) family consists of the three members RB1, p107 and p130 all possessing tumor suppressive properties. Indeed, the PPs jointly control the G1/S transition mainly by inhibiting E2F transcription factors. Notably, several viral oncoproteins are capable of binding and inhibiting PPs. Merkel cell polyomavirus (MCPyV) is considered as etiological factor for Merkel cell carcinoma (MCC) with expression of the viral Large T antigen (LT) harboring an intact PP binding domain being required for proliferation of most MCC cells. Therefore, we analyzed the interaction of MCPyV-LT with the PPs. Co-IP experiments indicate that MCPyV-LT binds potently only to RB1. Moreover, MCPyV-LT knockdown-induced growth arrest in MCC cells can be rescued by knockdown of RB1, but not by p107 or p130 knockdown. Accordingly, cell cycle arrest and E2F target gene repression mediated by the single PPs can only in the case of RB1 be significantly reverted by MCPyV-LT expression. Moreover, data from an MCC patient indicate that loss of RB1 rendered the MCPyV-positive MCC cells LT independent. Thus, our results suggest that RB1 is the dominant tumor suppressor PP in MCC, and that inactivation of RB1 by MCPyV-LT is largely sufficient for its growth supporting function in established MCPyV-positive MCC cells.

Characteristics of Dynamic Magnetic Resonance Image Enhancement in Prolactinomas Resistant to Dopamine Agonist Therapy

PubMed Central

Guo, Qinghua; Erickson, Bradley J.; Chang, Alice Y.; Erickson, Dana

2015-01-01

Objective To determine whether dynamic magnetic resonance imaging (dMRI) enhancement parameters could predict dopamine agonist (DA) resistance in prolactinomas. Methods We retrospectively identified patients with prolactinomas who were treated with DA and underwent dMRI from 2001 through 2012 at Mayo Clinic (Rochester, Minnesota). Intensities of the adenoma and pituitary gland were measured by drawing regions of interest on the images. Enhancement ratio, enhancement peak, prepeak slope (PPS), and enhancement time were compared between DA-resistant and DA-responsive groups, between DA-treated and DA-naïve groups, and between the first and follow-up dMRIs. Results We identified 49 patients with prolactinomas, with 6 (12.2%) that showed DA resistance. Thirty-seven patients (75.5%) underwent dMRI while receiving treatment, 12 (25.5%) underwent dMRI before starting therapy, and 10 (20.4%) had follow-up dMRI after DA therapy. The PPS of the tumor was higher in the treatment-resistant group vs the responsive group (mean [SD], 4.42 [3.19] vs 2.65 [1.59]; P=.03), whereas no difference was noted in the pituitary gland (5.79 [2.21] vs 4.06 [2.48]; P=.11). Logistic regression analysis indicated that tumor PPS was associated with DA resistance (odds ratio, 1.71; 95% CI, 1.07-3.27; P=.02). Conclusions dMRI with PPS analysis potentially can be used early in the treatment course to evaluate DA resistance in pituitary prolactinomas. PMID:25551412

Characteristics of dynamic magnetic resonance image enhancement in prolactinomas resistant to dopamine agonist therapy.

PubMed

Guo, Qinghua; Erickson, Bradley J; Chang, Alice Y; Erickson, Dana

2015-03-01

The objective of this study was to determine whether dynamic magnetic resonance imaging (dMRI) enhancement parameters could predict dopamine agonist (DA) resistance in prolactinomas. We retrospectively identified patients with prolactinomas who were treated with DA and underwent dMRI from 2001 through 2012 at Mayo Clinic (Rochester, MN). Intensities of the adenoma and pituitary gland were measured by drawing regions of interest on the images. Enhancement ratio, enhancement peak, prepeak slope (PPS), and enhancement time were compared between DA-resistant and DA-responsive groups, between DA-treated and DA-naive groups, and between the first and follow-up dMRIs. We identified 49 patients with prolactinomas, with 6 (12.2%) showing DA resistance. Thirty-seven patients (75.5%) underwent dMRI while receiving treatment, 12 (25.5%) underwent dMRI before starting therapy, and 10 (20.4%) had follow-up dMRI after DA therapy. The PPS of the tumor was higher in the treatment-resistant group versus the responsive group (mean [SD], 4.42 [3.19] vs 2.65 [1.59]; P = 0.03), whereas no difference was noted in the pituitary gland (5.79 [2.21] vs 4.06 [2.48]; P = 0.11). Logistic regression analysis indicated that tumor PPS was associated with DA resistance (odds ratio, 1.71; 95% confidence interval, 1.07-3.27; P = 0.02). Dynamic MRI with PPS analysis potentially can be used early in the treatment course to evaluate DA resistance in pituitary prolactinomas.

Effect of red maca (Lepidium meyenii) on prostate zinc levels in rats with testosterone-induced prostatic hyperplasia.

PubMed

Gonzales, C; Leiva-Revilla, J; Rubio, J; Gasco, M; Gonzales, G F

2012-05-01

Lepidium meyenii (maca) is a plant that grows exclusively above 4000 m in the Peruvian central Andes. Red maca (RM) extract significantly reduced prostate size in rats with benign prostatic hyperplasia (BPH) induced by testosterone enanthate (TE). Zinc is an important regulator of prostate function. This study aimed to determine the effect of RM on prostate zinc levels in rats with BPH induced by TE. Also, the study attempted to determine the best marker for the effect of RM on sex accessory glands. Rats treated with RM extract from day 1 to day 14 reversed the effect of TE administration on prostate weight and zinc levels. However, RM administered from day 7 to day 14 did not reduce the effect of TE on all studied variables. Finasteride (FN) reduced prostate, seminal vesicle and preputial gland weights in rats treated with TE. Although RM and FN reduced prostate zinc levels, the greatest effect was observed in TE-treated rats with RM from day 1 to day 14. In addition, prostate weight and zinc levels showed the higher diagnosis values than preputial and seminal vesicle weights. In conclusion, RM administered from day 1 to day 14 reduced prostate size and zinc levels in rats where prostatic hyperplasia was induced with TE. Also, this experimental model could be used as accurately assay to determine the effect of maca obtained under different conditions and/or the effect of different products based on maca. © 2011 Blackwell Verlag GmbH.

The penalty points system in Ireland - Does it remain effective 14 years on?

PubMed

Downey, C; Donnelly, M

2018-06-01

Road traffic accidents (RTAs) are the leading cause of trauma related mortality in Ireland. The penalty points system (PPS) was introduced in Ireland in 2002 to incentivise safer driving and reduce injury. Its early effect was studied previously 1 which concluded that there was a slight reduction in RTA related femoral shaft fractures (a sensitive indicator of high energy trauma) and a dramatic reduction in RTA related discharges. We hypothesized that over the following 14 years, the penalty points system might lose its effectiveness. Data was again collected from the same HIPE departments from six Dublin teaching hospitals and also University Hospital Waterford (to represent both an urban and a more rural population cohort respectively) examining RTA related femoral shaft fractures over an identical 6 month period (October-April). RTA related discharge data over an identical 6 month period was again acquired and analysed from Beaumont Hospital, Dublin (identical data source to previous study). These results were compared with the identical 6 month period in 2001/02 & 2002/03 (October-April). The total number of RTA related femoral shaft fracture discharges in Dublin decreased from 16 post introduction of PPS in the 2002/03 6-month period to 7 in 2015/16 6-month period. The number remained the same in the Waterford region (n = 5). The total RTA related discharges in Beaumont Hospital, Dublin decreased from 70 post PPS introduction to 57 in the 2015/16 6-month period. This represents an incidence rate of 4.5/1000 discharges (vs 6.9 post introduction) which was a statistically significant reduction (p = 0.014). The mean length of stay for these patients reduced from 13 to 7.7 days. There were consistent reductions in head injury (major & minor), lower limb fracture and facial fracture since the introduction of the PPS. The upper limb, pelvic/acetabular and thoracic injuries remained largely unchanged. Whilst RTA related spinal and abdominal injuries decreased after the introduction of the PPS, this study shows that these injuries have unfortunately increased since the post-PPS study in 2002/03. These results further support the effectiveness of the penalty points system and at a time where road death figures are under the spotlight, endorse the efficacious strategies implemented by the road safety authority in Ireland. Copyright © 2017 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

Weak measurements beyond the Aharonov-Albert-Vaidman formalism

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

Wu Shengjun; Li Yang

2011-05-15

We extend the idea of weak measurements to the general case, provide a complete treatment, and obtain results for both the regime when the preselected and postselected states (PPS) are almost orthogonal and the regime when they are exactly orthogonal. We surprisingly find that for a fixed interaction strength, there may exist a maximum signal amplification and a corresponding optimum overlap of PPS to achieve it. For weak measurements in the orthogonal regime, we find interesting quantities that play the same role that weak values play in the nonorthogonal regime.

Obesity causes weight increases in prepubertal and pubertal male offspring and is related to changes in spermatogenesis and sperm production in rats.

PubMed

Navya, Harish; Yajurvedi, Hanumant Narasinhacharya

2017-04-01

The effect of obesity on testicular activity in prepubertal and pubertal rats was investigated in the present study. Obesity was induced in adult females by feeding a high-calorie diet (HCD). These females were mated with normal males and were fed an HCD during pregnancy and lactation. The male offspring born to obese mothers and fed an HCD after weaning were found to be obese. Seminiferous tubules of offspring from control mothers (OCM) and offspring from HCD-fed mothers (OHCDM) had the same set of germ cells at different age intervals, namely spermatogonia, leptotene spermatocytes, zygotene spermatocytes, pachytene spermatocytes and round and elongated spermatids on postnatal days (PND) 7, 13, 17, 24 and 36, and on the day of preputial separation, respectively. However, there was a significant decrease in round and elongated spermatids and the epididymal sperm count, coupled with a significant decrease in testosterone and an increase in leptin serum concentrations in OHCDM compared with OCM. These results show that obesity in prepubertal rats does not affect the age-dependent appearance of germ cells according to developmental hierarchy, but it does interfere with spermatid formation, resulting in a reduced sperm count, which may be due to a deficiency of testosterone mediated by hyperleptinaemia.

Disrupted kisspeptin signaling in GnRH neurons leads to hypogonadotrophic hypogonadism.

PubMed

Novaira, Horacio J; Sonko, Momodou L; Hoffman, Gloria; Koo, Yongbum; Ko, Chemyong; Wolfe, Andrew; Radovick, Sally

2014-02-01

Landmark studies have shown that mutations in kisspeptin and the kisspeptin receptor (Kiss1r) result in reproductive dysfunction in humans and genetically altered mouse models. However, because kisspeptin and its receptor are present in target cells of the central and peripheral reproductive axis, the precise location(s) for the pathogenic signal is unknown. The study described herein shows that the kisspeptin-Kiss1r signaling pathway in the GnRH neuron is singularly critical for both the onset of puberty as well as the attainment of normal reproductive function. In this study, we directly test the hypothesis that kisspeptin neurons regulate GnRH secretion through the activation of Kiss1r on the plasma membrane of GnRH neurons. A GnRH neuron-specific Kiss1r knockout mouse model (GKirKO) was generated, and reproductive development and phenotype were assessed. Both female and male GKirKO mice were infertile, having low serum LH and FSH levels. External abnormalities such as microphallus and decreased anogenital distance associated with failure of preputial gland separation were present in GKirKO males. A delay in pubertal onset and abnormal estrous cyclicity were observed in female GKirKO mice. Taken together, these data provide in vivo evidence that Kiss1r in GnRH neurons is critical for reproductive development and fertility.

Investigation and development of friction stir welding process for unreinforced polyphenylene sulfide and reinforced polyetheretherketone

NASA Astrophysics Data System (ADS)

Ahmed, Hossain

The joining of thermoplastics through welding, a specific form of fusion bonding, offers numerous advantages over mechanical joining. It eliminates the use of costly fasteners and has only a limited effect on the strength of the parts being joined since it does not require the introduction of holes and loading pins, and it does not create significant stress concentrations. A specific form of welding, Friction Stir Welding, was investigated for the creation of butt joints of unreinforced polyphenylene sulfide (PPS) and short carbon fiber reinforced polyetheretherketone (PEEK) plates. Friction stir welding requires a rotating pin, a shoulder arrangement, relative movement between the tool and the weld piece and a clamping mechanism to hold the weld piece in place. Analytical models and experimental results show that the heat generated by the FSW tool is insufficient to produce the heat required to weld thermoplastic materials which makes FSW of polymers different from FSW of metals. A second heat source is required for preheating the thermoplastic parts prior to welding. A resistance type surface heater was placed at the bottom of two identical weld pieces for the experiments. Two types of shoulder design i.e. a rotating shoulder and a stationary shoulder were developed. Taguchi's Design of Experiment method was utilized to investigate the welding process, where duration of heating, process temperature, tool rotational speed and tool traverse speed were used as the welding parameters. The quality of the welding process was assumed to be indicated by the weld strength. DoE revealed that one of the process parameters, tool traverse speed, had significant influence on the tensile strength of PPS samples. While PPS sample showed relatively lower tensile strength with higher traverse speed, short carbon fiber reinforced PEEK samples had higher tensile strength with higher traverse speeds. In addition to tensile tests on dog bone shaped specimen, fracture toughness tests were performed for both PPS and PEEK samples to identify the fracture toughness of these materials. Presence of un-welded section in the welded specimen due to the setup of the experiments yielded notched tensile strengths during the tensile test process. With the help of fracture toughness values of these materials, notched tensile strengths of the welded samples were compared with the notched tensile strengths or residual tensile strengths of the base materials. In this study, residual joint efficiency of PEEK samples was found higher than that of PPS samples. Additionally, notched tensile strengths of the welded samples were compared with un-notched tensile strengths of the materials. The notched tensile strengths of PPS and PEEK were found about 80% and 75% of the respective base materials. Micrographs of PEEK samples showed the presence of more voids and cracks in the weld line compared to the un-welded samples. In this study, continuous friction stir welding process has been developed for butt joining of unreinforced PPS and short carbon fiber reinforced PEEK. The process parameters and the experimental setup can be utilized to investigate the weldability of different types of thermoplastic composites and various types of joint configurations.

[Venereal granuloma (donovaniasis) in France].

PubMed

Duperrat, B; Labouche, F

1975-01-01

The study of six cases of MacLeod-Donovan chancre, 2 in Paris, 4 in Brest, in young men coming from the West Indies, showed after 15 days incubation, a balano-preputial lesion consisting of an oval-shaped granuloma, 1 to 4 cm diameter, raised, indurated, ulcerated, reddish-yellow, spontaneously painful, bleeding easily, accompanied in 50 p. 100 of cases by inguinal adenitis, due to secondary infection. Swabs, which should be repeated, showed Donovan bodies within numerous histiocytes. The inactivity of penicillin may be contrasted with the rapidly favourable effect of streptomycin, chloramphenicol or aureomycin.

The effect of resuscitation position on cerebral and coronary perfusion pressure during mechanical cardiopulmonary resuscitation in porcine cardiac arrest model.

PubMed

Kim, Taeyun; Shin, Sang Do; Song, Kyoung Jun; Park, Yong Joo; Ryu, Hyun Ho; Debaty, Guillaume; Lurie, Keith; Hong, Ki Jeong

2017-04-01

It is unknown whether patient position is associated with the optimal cerebral (CePP) and coronary (CoPP) perfusion pressure. This study utilized a randomized experimental design and anesthetized, intubated and paralyzed female pigs (n=12) (mean 42, SD 3kg). After 6min of untreated ventricular fibrillation, mechanical CPR with was performed for 3min in 0° supine position. The CPR was then performed for 5min in a position randomly assigned to either 1) head-up tilt (HUT) by three angles (30°, 45°, or 60°) or 2) head-down tilt (HDT) by three angles (30°, 45°, or 60°) and at 3) supine position between HUT and HDT positions. 4 Pigs were assigned to each angle of HUT or HDT position and 12 pigs were assigned to supine position. CePPs and CoPPs were measured and compared using MIXED procedure with pig as a random effect among angles and compared between angles with Tukey post-hoc analysis. With 60°, 45°, 30° head-down, 0° (supine), and 30°, 45°, 60° head-up positioning, mean(SD) CePPs increased consistently as follows: 2.4(0.4), 9.3(1.6), 16.5(1.6), 27.0(1.5), 35.1(0.4), 39.4(0.6), and 39.9(0.3) mmHg, respectively. CoPPs were followings according to same angle: 12.9(2.5), 13.3(2.5), 12.8(0.4), 18.1(0.7), 30.3(0.4), 24.1(0.6), and 26.5(0.9) mmHg, respectively. The CePPs were peak at HUT(45°) and HUT(60°), but CoPP was peak in HUT(30°) and higher than HUT(45°) and HUT(60°). Cerebral perfusion pressure during mechanical CPR were similar and highest in the HUT(45° and 60°) positions whereas the peak coronary perfusion pressure was observed with HUT(30°). Copyright © 2017 Elsevier B.V. All rights reserved.

SU-E-T-562: Motion Tracking Optimization for Conformal Arc Radiotherapy Plans: A QUASAR Phantom Based Study

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

Xu, Z; Wang, I; Yao, R

Purpose: This study is to use plan parameters optimization (Dose rate, collimator angle, couch angle, initial starting phase) to improve the performance of conformal arc radiotherapy plans with motion tracking by increasing the plan performance score (PPS). Methods: Two types of 3D conformal arc plans were created based on QUASAR respiratory motion phantom with spherical and cylindrical targets. Sinusoidal model was applied to the MLC leaves to generate motion tracking plans. A MATLAB program was developed to calculate PPS of each plan (ranges from 0–1) and optimize plan parameters. We first selected the dose rate for motion tracking plans andmore » then used simulated annealing algorithm to search for the combination of the other parameters that resulted in the plan of the maximal PPS. The optimized motion tracking plan was delivered by Varian Truebeam Linac. In-room cameras and stopwatch were used for starting phase selection and synchronization between phantom motion and plan delivery. Gaf-EBT2 dosimetry films were used to measure the dose delivered to the target in QUASAR phantom. Dose profiles and Truebeam trajectory log files were used for plan delivery performance evaluation. Results: For spherical target, the maximal PPS (PPSsph) of the optimized plan was 0.79: (Dose rate: 500MU/min, Collimator: 90°, Couch: +10°, starting phase: 0.83π). For cylindrical target, the maximal PPScyl was 0.75 (Dose rate: 300MU/min, Collimator: 87°, starting phase: 0.97π) with couch at 0°. Differences of dose profiles between motion tracking plans (with the maximal and the minimal PPS) and 3D conformal plans were as follows: PPSsph=0.79: %ΔFWHM: 8.9%, %Dmax: 3.1%; PPSsph=0.52: %ΔFWHM: 10.4%, %Dmax: 6.1%. PPScyl=0.75: %ΔFWHM: 4.7%, %Dmax: 3.6%; PPScyl=0.42: %ΔFWHM: 12.5%, %Dmax: 9.6%. Conclusion: By achieving high plan performance score through parameters optimization, we can improve target dose conformity of motion tracking plan by decreasing total MLC leaf travel distance and leaf speed.« less

Mobility and settling rate of agglomerates of polydisperse nanoparticles.

PubMed

Spyrogianni, Anastasia; Karadima, Katerina S; Goudeli, Eirini; Mavrantzas, Vlasis G; Pratsinis, Sotiris E

2018-02-14

Agglomerate settling impacts nanotoxicology and nanomedicine as well as the stability of engineered nanofluids. Here, the mobility of nanostructured fractal-like SiO 2 agglomerates in water is investigated and their settling rate in infinitely dilute suspensions is calculated by a Brownian dynamics algorithm tracking the agglomerate translational and rotational motion. The corresponding friction matrices are obtained using the HYDRO++ algorithm [J. G. de la Torre, G. del Rio Echenique, and A. Ortega, J. Phys. Chem. B 111, 955 (2007)] from the Kirkwood-Riseman theory accounting for hydrodynamic interactions of primary particles (PPs) through the Rotne-Prager-Yamakawa tensor, properly modified for polydisperse PPs. Agglomerates are generated by an event-driven method and have constant mass fractal dimension but varying PP size distribution, mass, and relative shape anisotropy. The calculated diffusion coefficient from HYDRO++ is used to obtain the agglomerate mobility diameter d m and is compared with that from scaling laws for fractal-like agglomerates. The ratio d m /d g of the mobility diameter to the gyration diameter of the agglomerate decreases with increasing relative shape anisotropy. For constant d m and mean d p , the agglomerate settling rate, u s , increases with increasing PP geometric standard deviation σ p,g (polydispersity). A linear relationship between u s and agglomerate mass to d m ratio, m/d m , is revealed and attributed to the fast Brownian rotation of such small and light nanoparticle agglomerates. An analytical expression for the u s of agglomerates consisting of polydisperse PPs is then derived, u s =1-ρ f ρ p g3πμmd m (ρ f is the density of the fluid, ρ p is the density of PPs, μ is the viscosity of the fluid, and g is the acceleration of gravity), valid for agglomerates for which the characteristic rotational time is considerably shorter than their settling time. Our calculations demonstrate that the commonly made assumption of monodisperse PPs underestimates u s by a fraction depending on σ p,g and agglomerate mass mobility exponent. Simulations are in excellent agreement with deposition rate measurements of fumed SiO 2 agglomerates in water.

Coping with tuberculosis and directly observed treatment: a qualitative study among patients from South India.

PubMed

Yellappa, Vijayashree; Lefèvre, Pierre; Battaglioli, Tullia; Narayanan, Devadasan; Van der Stuyft, Patrick

2016-07-19

In India, the Revised National TB control programme (RNTCP) offers free diagnosis and treatment for tuberculosis (TB), based on the Directly Observed Treatment Short course (DOTS) strategy. We conducted a qualitative study to explore the experience and consequences of having TB on patients enrolled in DOTS and their caretakers in Tumkur district, located in a southern state of India, Karnataka. We conducted 33 in-depth interviews on a purposive sample of TB patients from three groups: (1) patients who reached RNTCP directly on their own and took DOTS at RNTCP; (2) patients who were referred by private practitioners (PPs) to RNTCP and took DOTS at RNTCP; and (3) patients diagnosed by RNTCP and took DOTS from PPs. Data was analyzed using a thematic approach with the support of NVivo9. The study revealed that TB and DOTS have a large impact on patient's lives, which is often extended to the family and caretakers. The most vulnerable patients faced the most difficulty in accessing and completing DOTS. The family was the main source of support during patient's recovery. Patients residing in rural areas and, taking DOTS from the government facilities had to overcome many barriers to adhere to the DOTS therapy, such as long travelling distance to DOTS centers, inconvenient timings and unfavorable attitude of the RNTCP staff, when compared to patients who took DOTS from PPs. Advantages of taking DOTS from PPs cited by the patients were privacy, flexibility in timings, proximity and more immediate access to care. Patients and their family had to cope with stigmatization and fear and financial hardships that surfaced from TB and DOTS. Young patients living in urban areas were more worried about stigmatisation, than elderly patients living in rural areas. Patients who were referred by PPs experienced more financial problems compared to those who reached RNTCP services directly. Our study provided useful information about patient's needs and expectations while taking DOTS. The development of mechanisms within RNTCP towards patient centered care is needed to enable patients and caretakers cope with disease condition and adhere to DOTS.

Associations among depression severity, painful physical symptoms, and social and occupational functioning impairment in patients with major depressive disorder: a 3-month, prospective, observational study.

PubMed

Harada, Eiji; Satoi, Yoichi; Kuga, Atsushi; Tokuoka, Hirofumi; Kikuchi, Toshiaki; Watanabe, Koichiro; Alev, Levent; Mimura, Masaru

2017-01-01

To investigate associations among depression severity, painful physical symptoms (PPS), and social and occupational functioning impairment in patients with major depressive disorder (MDD) who had achieved complete remission (CR) or partial remission (PR) after acute treatment. This was a 12-week, multicenter, prospective, observational study. Patients with MDD treated with an antidepressant medication for the previous 12 weeks (±3 weeks) who had achieved CR (defined as a 17-item Hamilton Rating Scale for Depression [HAM-D17] score ≤7) or PR (HAM-D17 score ≥8 and ≤18) were enrolled. Depression severity, PPS, and impairment in social and occupational functioning were assessed using the HAM-D17, the Brief Pain Inventory (Short Form) (BPI-SF), and the Social and Occupational Functioning Assessment Scale (SOFAS), respectively, at enrollment (Week 12) and after 12 weeks (Week 24). Overall, 323 Japanese patients with MDD were enrolled (CR n=158, PR n=165) and 288 patients completed the study (CR n=139, PR n=149). HAM-D17 and SOFAS scores were strongly and negatively correlated at enrollment (Week 12; P <0.0001) and Week 24 ( P <0.0001). A weak negative correlation between the BPI-SF and SOFAS was observed at Week 24 ( P =0.0011), but not at enrollment ( P =0.164). Remission status at enrollment (CR or PR) was associated with achieving normal social and occupational functioning (SOFAS score ≥80) at Week 24 in patients who had not achieved normal social and occupational functioning (SOFAS score <80) at enrollment (CR vs PR, OR=0.05 [95% CIs 0.01-0.18], P <0.0001). A greater proportion of patients with CR and no PPS at enrollment achieved SOFAS scores ≥80 at Week 24 than those with CR and PPS. Our results suggest that treating both depressive symptoms and PPS is important for achieving a normal level of functioning on a long-term basis in patients with MDD.

Mobility and settling rate of agglomerates of polydisperse nanoparticles

NASA Astrophysics Data System (ADS)

Spyrogianni, Anastasia; Karadima, Katerina S.; Goudeli, Eirini; Mavrantzas, Vlasis G.; Pratsinis, Sotiris E.

2018-02-01

Agglomerate settling impacts nanotoxicology and nanomedicine as well as the stability of engineered nanofluids. Here, the mobility of nanostructured fractal-like SiO2 agglomerates in water is investigated and their settling rate in infinitely dilute suspensions is calculated by a Brownian dynamics algorithm tracking the agglomerate translational and rotational motion. The corresponding friction matrices are obtained using the HYDRO++ algorithm [J. G. de la Torre, G. del Rio Echenique, and A. Ortega, J. Phys. Chem. B 111, 955 (2007)] from the Kirkwood-Riseman theory accounting for hydrodynamic interactions of primary particles (PPs) through the Rotne-Prager-Yamakawa tensor, properly modified for polydisperse PPs. Agglomerates are generated by an event-driven method and have constant mass fractal dimension but varying PP size distribution, mass, and relative shape anisotropy. The calculated diffusion coefficient from HYDRO++ is used to obtain the agglomerate mobility diameter dm and is compared with that from scaling laws for fractal-like agglomerates. The ratio dm/dg of the mobility diameter to the gyration diameter of the agglomerate decreases with increasing relative shape anisotropy. For constant dm and mean dp, the agglomerate settling rate, us, increases with increasing PP geometric standard deviation σp,g (polydispersity). A linear relationship between us and agglomerate mass to dm ratio, m/dm, is revealed and attributed to the fast Brownian rotation of such small and light nanoparticle agglomerates. An analytical expression for the us of agglomerates consisting of polydisperse PPs is then derived, us=(1/-{ρf/ρp})g 3 π μ m/dm (ρf is the density of the fluid, ρp is the density of PPs, μ is the viscosity of the fluid, and g is the acceleration of gravity), valid for agglomerates for which the characteristic rotational time is considerably shorter than their settling time. Our calculations demonstrate that the commonly made assumption of monodisperse PPs underestimates us by a fraction depending on σp,g and agglomerate mass mobility exponent. Simulations are in excellent agreement with deposition rate measurements of fumed SiO2 agglomerates in water.

Incorporating patient partner scores into high stakes assessment: an observational study into opinions and attitudes.

PubMed

Thomson, Fiona C; MacKenzie, Rhoda K; Anderson, Marie; Denison, Alan R; Currie, Graeme P

2017-11-15

Volunteer patients (also known as patient partners (PPs)) play a vital role in undergraduate healthcare curricula. They frequently take part in objective structured clinical examinations (OSCE) and rate aspects of students' performance. However, the inclusion and weighting of PP marks varies, while attitudes and opinions regarding how (and if) they should contribute towards the pass/fail outcome are uncertain. A prospective observational study was conducted to explore beliefs of PPs regarding inclusion of their scores in a high stakes undergraduate OSCE in a single UK medical school. All PPs delivering components of the local MBChB curriculum were asked to participate in the questionnaire study. Quantitative and qualitative data were analysed using descriptive statistics and framework analysis respectively. Fifty out of 160 (31% response rate) PPs completed the questionnaire; 70% had participated in a final year OSCE. Thirty (60%) felt their marks should be incorporated into a student's overall score, while 28% were uncertain. The main reasons for inclusion were recognition of the patient perspective (31%) and their ability to assess attitudes and professionalism (27%), while reasons against inclusion included lack of PP qualification/training (18%) and concerns relating to consistency (14%). The majority of PPs were uncertain what proportion of the total mark they should contribute, although many felt that 5-10% of the total score was reasonable. Most respondents (70%) felt that globally low PP scores should not result in an automatic fail and many (62%) acknowledged that prior to mark inclusion, further training was required. These data show that most respondents considered it reasonable to "formalise their expertise" by contributing marks in the overall assessment of students in a high stakes OSCE, although what proportion they believe this should represent was variable. Some expressed concerns that using marks towards progress decisions may alter PP response patterns. It would therefore seem reasonable to compare outcomes (i.e. pass/fail status) using historical data both incorporating and not incorporating PP marks to evaluate the effects of doing so. Further attention to existing PP training programmes is also required in order to provide clear instruction on how to globally rate students to ensure validity and consistency.

Consumer perceptions of cigarette pack design in France: a comparison of regular, limited edition and plain packaging.

PubMed

Gallopel-Morvan, Karine; Moodie, Crawford; Hammond, David; Eker, Figen; Beguinot, Emmanuelle; Martinet, Yves

2012-09-01

In the face of comprehensive bans on the marketing of tobacco products, packaging has become an increasingly important promotional tool for the tobacco industry. A ban on the use of branding on tobacco packaging, known as 'plain' packaging, has emerged as a promising regulatory strategy. The current study sought to examine perceptions of cigarette packaging among adults in France. Adult smokers and non-smokers (N=836) were surveyed using computer-assisted personal interviewing to assess perceptions of pack design by comparing 'regular' branded packs and 'limited edition' packs (with novel designs or innovations) with 'plain' versions of these packs with all branding, including colour, removed. Plain packs (PP) were less likely than regular packs, and particularly limited edition packs, to be considered attractive, attention grabbing and likely to motivate youth purchase. PPs were also rated as the most effective in convincing non-smokers not to start and smokers to reduce consumption and quit. Logistic regression showed that smokers motivated to quit, in comparison to smokers not motivated to quit, were significantly more likely to consider the PPs as the packs most likely to motivate cessation. Novel cigarette packaging, in the form of limited edition packs, had the highest ratings of consumer appeal, ahead of regular branded packs and also PPs. Interestingly, PPs were perceived to be the packs most likely to promote cessation among those adults with quitting intentions. Plain packaging, therefore, may be a means of helping existing adult smokers motivated to quit to do so.

Morphologic observation of mucosa-associated lymphoid tissue in the large intestine of Bactrian camels (Camelus bactrianus).

PubMed

ZhaXi, Yingpai; Wang, Wenhui; Zhang, Wangdong; Gao, Qiang; Guo, Minggang; Jia, Shuai

2014-07-01

The structure and distribution of the mucosa-associated lymphoid tissue (MALT) throughout the large intestine of 10 Bactrian camels were comparatively studied by anatomical and histological methods. The results showed that Peyer's patches (PPs) were mainly located on the mucosal surfaces of the entire ileocecal orifice, the beginning of the cecum and the first third of the colon. The shape of PPs gradually changed from "scrotiform" to "faviform" along the large intestine with the scrotiform PP as the major type in the ileocecal orifice. The distribution density also gradually decreased from the ileocecal orifice to the colon. The histological observations further revealed that the MALT in the form of PPs or isolated lymphoid follicles (ILF) and lamina propria lymphocytes was mainly present in the lamina propria and submucosa from the entire ileocecal orifice, where the muscularis mucosa is usually incomplete, to the colonic forepart. In addition, lymphoid tissue was much more abundant in the lamina propria and submucosa of the ileocecal orifice as compared to the cecum and colon. Statistically, the MALT of the ileocecal orifice contained a higher number of lymphoid follicles (37.7/10 mm(2) ) than that of the cecum, colon, or rectum (P < 0.05). The germinal centers of the lymphoid follicles were clearly visible. Together, our data suggest that the ileocecal orifice constitutes the main inductive site for the mucosal immunity in the large intestine of the Bactrian camel; and that scrotiform PPs are likely to the result of long-term adaptation of the Bactrian camel to the harsh living environment. © 2014 Wiley Periodicals, Inc.

Medicare and Medicaid Programs; CY 2017 Home Health Prospective Payment System Rate Update; Home Health Value-Based Purchasing Model; and Home Health Quality Reporting Requirements. Final rule.

PubMed

2016-11-03

This final rule updates the Home Health Prospective Payment System (HH PPS) payment rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor; effective for home health episodes of care ending on or after January 1, 2017. This rule also: Implements the last year of the 4-year phase-in of the rebasing adjustments to the HH PPS payment rates; updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking; implements the 2nd-year of a 3-year phase-in of a reduction to the national, standardized 60-day episode payment to account for estimated case-mix growth unrelated to increases in patient acuity (that is, nominal case-mix growth) between CY 2012 and CY 2014; finalizes changes to the methodology used to calculate payments made under the HH PPS for high-cost "outlier" episodes of care; implements changes in payment for furnishing Negative Pressure Wound Therapy (NPWT) using a disposable device for patients under a home health plan of care; discusses our efforts to monitor the potential impacts of the rebasing adjustments; includes an update on subsequent research and analysis as a result of the findings from the home health study; and finalizes changes to the Home Health Value-Based Purchasing (HHVBP) Model, which was implemented on January 1, 2016; and updates to the Home Health Quality Reporting Program (HH QRP).

Thin-Film Phase Plates for Transmission Electron Microscopy Fabricated from Metallic Glasses.

PubMed

Dries, Manuel; Hettler, Simon; Schulze, Tina; Send, Winfried; Müller, Erich; Schneider, Reinhard; Gerthsen, Dagmar; Luo, Yuansu; Samwer, Konrad

2016-10-01

Thin-film phase plates (PPs) have become an interesting tool to enhance the contrast of weak-phase objects in transmission electron microscopy (TEM). The thin film usually consists of amorphous carbon, which suffers from quick degeneration under the intense electron-beam illumination. Recent investigations have focused on the search for alternative materials with an improved material stability. This work presents thin-film PPs fabricated from metallic glass alloys, which are characterized by a high electrical conductivity and an amorphous structure. Thin films of the zirconium-based alloy Zr65.0Al7.5Cu27.5 (ZAC) were fabricated and their phase-shifting properties were evaluated. The ZAC film was investigated by different TEM techniques, which reveal beneficial properties compared with amorphous carbon PPs. Particularly favorable is the small probability for inelastic plasmon scattering, which results from the combined effect of a moderate inelastic mean free path and a reduced film thickness due to a high mean inner potential. Small probability plasmon scattering improves contrast transfer at high spatial frequencies, which makes the ZAC alloy a promising material for PP fabrication.

Radical SAM Enzymes in the Biosynthesis of Ribosomally Synthesized and Post-translationally Modified Peptides (RiPPs)

PubMed Central

Benjdia, Alhosna; Balty, Clémence; Berteau, Olivier

2017-01-01

Ribosomally-synthesized and post-translationally modified peptides (RiPPs) are a large and diverse family of natural products. They possess interesting biological properties such as antibiotic or anticancer activities, making them attractive for therapeutic applications. In contrast to polyketides and non-ribosomal peptides, RiPPs derive from ribosomal peptides and are post-translationally modified by diverse enzyme families. Among them, the emerging superfamily of radical SAM enzymes has been shown to play a major role. These enzymes catalyze the formation of a wide range of post-translational modifications some of them having no counterparts in living systems or synthetic chemistry. The investigation of radical SAM enzymes has not only illuminated unprecedented strategies used by living systems to tailor peptides into complex natural products but has also allowed to uncover novel RiPP families. In this review, we summarize the current knowledge on radical SAM enzymes catalyzing RiPP post-translational modifications and discuss their mechanisms and growing importance notably in the context of the human microbiota. PMID:29167789

Effects of extraction methods on the yield, chemical structure and anti-tumor activity of polysaccharides from Cordyceps gunnii mycelia.

PubMed

Zhu, Zhen-Yuan; Dong, Fengying; Liu, Xiaocui; Lv, Qian; YingYang; Liu, Fei; Chen, Ling; Wang, Tiantian; Wang, Zheng; Zhang, Yongmin

2016-04-20

This study was to investigate the effects of different extraction methods on the yield, chemical structure and antitumor activity of polysaccharides from Cordyceps gunnii (C. gunnii) mycelia. Five extraction methods were used to extract crude polysaccharides (CPS), which include room-temperature water extraction (RWE), hot-water extraction (HWE), microwave-assisted extraction (MAE), ultrasound-assisted extraction (UAE) and cellulase-assisted extraction (CAE). Then Sephadex G-100 was used for purification of CPS. As a result, the antitumor activities of CPS and PPS on S180 cells were evaluated. Five CPS and purified polysaccharides (PPS) were obtained. The yield of CPS by microwave-assisted extraction (CPSMAE) was the highest and its anti-tumor activity was the best and its macromolecular polysaccharide (3000-1000kDa) ratio was the largest. The PPS had the same monosaccharide composition, but their obvious difference was in the antitumor activity and the physicochemical characteristics, such as intrinsic viscosity, specific rotation, scanning electron microscopy and circular dichroism spectra. Copyright © 2015 Elsevier Ltd. All rights reserved.

The Balanced Budget Act of 1997 and U.S. hospital operations.

PubMed

Bazzoli, Gloria J; Lindrooth, Richard C; Hasnain-Wynia, Romana; Needleman, Jack

The Balanced Budget Act (BBA) of 1997 initiated several changes to Medicare payment policy in an effort to slow the growth of hospital Medicare payments and ensure the future of the Medicare Hospital Insurance Trust Fund. Although subsequent federal legislation relaxed some original proposals, restored funds were limited and directed to specific types of hospitals. In addition, these Medicare policy changes came at a time when hospitals faced private sector payment constraints. This paper assesses the short-term effects of the BBA on operations of nonprofit hospitals in the United States and compares these effects to those observed in the early 1980s during implementation of the Medicare prospective payment system (PPS). We found that some operational changes instituted by hospitals facing financial pressures from the BBA were similar to those observed for hospitals that faced pressure from Medicare PPS, including efforts to contain Medicare cost growth, to expand outpatient service provision, and to contain hospital staffing. However, during PPS implementation hospitals experienced declining inpatient use and growing profit margins, whereas post-BBA hospitals experienced growing inpatient use and declining margins.

Spinor Bose-Einstein Condensates of Positronium

NASA Astrophysics Data System (ADS)

Wang, Yi-Hsieh; Anderson, Brandon; Clark, Charles

2014-05-01

Bose-Einstein condensates (BECs) of positronium (Ps) have been of experimental and theoretical interest due to their potential application as the gain medium of a γ-ray laser. Ps BECs are intrinsically spinor due to the presence of ortho-positronium (o-Ps) and para-positronium (p-Ps), whose annihilation lifetimes differ by three orders of magnitude. In this paper, we study the spinor dynamics and annihilation processes in the p-Ps/o-Ps system using both solutions of the time-dependent Gross-Pitaevskii equations and a semiclassical rate-equation approach. The spinor interactions have an O (4) symmetry which is broken to SO (3) by an internal energy difference between o-Ps and p-Ps. For an initially unpolarized condensate, there is a threshold density of ~1019 cm-3 at which spin mixing between o-Ps and p-Ps occurs. Beyond this threshold, there are unstable spatial modes accompanied by spin mixing. To ensure a high production yield above the critical density, a careful choice of external field must be made to avoid the spin mixing instability. NSF Physics Frontiers Center, ARO Atomtronics MURI, DARPA OLE.

The crystallization of tough thermoplastic resins in the presence of carbon fibers

NASA Technical Reports Server (NTRS)

Theil, Michael H.

1988-01-01

The presence of carbon fibers increased the crystallization rates of both PEEK and PPS thermoplastic polymers. The effect was most pronounced at higher crystallization temperatures. Isothermal crystallization rates were analyzed by applying classical phenomenological nucleation theory. Unusually high values of the so-called Avrami exponent were found for neat PEEK. Isothermal crystallization of PEEK and PPS polymers produced crystalline samples having a wide variety of melting temperatures. The melting as observed by differential scanning calorimetry occurred as dual endotherms which were called primary (higher temperature) and secondary melting peaks. Each primary peak accounted for most of the crystallinity present. The secondary peaks represented the melting of crystallites formed later than those attributable to the primary endotherms. The presence of carbon fibers increased the thermal stability of both PEEK and PPS crystallites as manifested by higher temperatures for the primary melting peaks. This may be attributable to increased crystallite size, greater crystallite perfection, and/or favorable modification of the crystallite interface. Over the range studied, crystallization temperature strongly influenced the positions of the secondary peaks but not the primary peaks.

Can outcome of pancreatic pseudocysts be predicted? Proposal for a new scoring system.

PubMed

Şenol, Kazım; Akgül, Özgür; Gündoğdu, Salih Burak; Aydoğan, İhsan; Tez, Mesut; Coşkun, Faruk; Tihan, Deniz Necdet

2016-03-01

The spontaneous resolution rate of pancreatic pseudocysts (PPs) is 86%, and the serious complication rate is 3-9%. The aim of the present study was to develop a scoring system that would predict spontaneous resolution of PPs. Medical records of 70 patients were retrospectively reviewed. Two patients were excluded. Demographic data and laboratory measurements were obtained from patient records. Mean age of the 68 patients included was 56.6 years. Female:male ratio was 1.34:1. Causes of pancreatitis were stones (48.5%), alcohol consumption (26.5%), and unknown etiology (25%). Mean size of PP was 71 mm. Pseudocysts disappeared in 32 patients (47.1%). With univariate analysis, serum direct bilirubin level (>0.95 mg/dL), cyst carcinoembryonic antigen (CEA) level (>1.5), and cyst diameter (>55 mm) were found to be significantly different between patients with and without spontaneous resolution. In multivariate analysis, these variables were statistically significant. Scores were calculated with points assigned to each variable. Final scores predicted spontaneous resolution in approximately 80% of patients. The scoring system developed to predict resolution of PPs is simple and useful, but requires validation.

Medicare program; home health prospective payment system rate update for calendar year 2011; changes in certification requirements for home health agencies and hospices. Final rule.

PubMed

2010-11-17

This final rule sets forth an update to the Home Health Prospective Payment System (HH PPS) rates, including: the national standardized 60-day episode rates, the national per-visit rates, the nonroutine medical supply (NRS) conversion factors, and the low utilization payment amount (LUPA) add-on payment amounts, under the Medicare prospective payment system for HHAs effective January 1, 2011. This rule also updates the wage index used under the HH PPS and, in accordance with the Patient Protection and Affordable Care Act of 2010 (Affordable Care Act), updates the HH PPS outlier policy. In addition, this rule revises the home health agency (HHA) capitalization requirements. This rule further adds clarifying language to the "skilled services" section. The rule finalizes a 3.79 percent reduction to rates for CY 2011 to account for changes in case-mix, which are unrelated to real changes in patient acuity. Finally, this rule incorporates new legislative requirements regarding face-to-face encounters with providers related to home health and hospice care.

Psychological Resilience and Depressive Symptoms in Older Adults Diagnosed with Post-polio Syndrome

PubMed Central

Pierini, Diana; Stuifbergen, Alexa

2012-01-01

Depression is a serious co-morbidity in persons with disability, yet few studies have focused on depressive symptoms in persons aging with post-polio syndrome (PPS). We used a resilience conceptual framework that focused on patient psychosocial strengths to investigate the relationship between psychological resilience factors (acceptance, self-efficacy, personal resources, interpersonal relationships, self-rated health, spiritual growth, and stress management) and depressive symptoms in a large sample (n = 630) of persons over age 65 who were diagnosed with PPS. A higher percentage (40%) of the sample scored ≥ 10 on the CES-D 10 than was previously cited in other studies; however, 53% of the sample had good or excellent self-rated health, suggesting psychological resilience. Depression scores were regressed on seven selected resilience factors after controlling for functional limitations. Four of the seven variables accounted for 30% of the variance in depressive symptoms with spiritual growth representing the main predictor (β = −.26). The implications for rehabilitation nurses in developing a patient-strengths perspective in the assessment and counseling of individuals aging with PPS are discussed. PMID:20681392

Responses to prospective payment by rural New Mexico hospitals.

PubMed

Smith, H L; Piland, N F; Phillipp, A M

1991-12-01

A cross-sectional study is used to determine how rural New Mexico hospitals altered service diversification, inpatient service emphasis, and service promotion during Medicare's prospective payment system (PPS) transition and posttransition phases. Results suggest that the hospitals implemented distinct strategies in response to PPS. The posttransition strategies were examined for their association with improved revenue and utilization indicators. Few of the service diversification and promotional strategies were consistent predictors of performance. Emphasis on fine-tuning inpatient services was the most promising predictor of higher utilization and revenue measures. The implications for other rural hospitals are discussed.

[Polio, late effects and post-polio].

PubMed

Kay, Lise

2014-10-20

Approximately 7,000 Danes are still living with sequelae after surviving an acute polio infection. Late effects of polio include deformities, arthrosis and overloaded muscles. In the long run polio patients are at risk of having a further decrease of muscle function and a wide variety of other symptoms, a condition called post-polio syndrome (PPS). Treatment of PPS is in general symptomatic. Recently it has been shown that treatment with intravenous immunoglobulin may have an effect on pain, tiredness and walking distance. Patients with prior polio have an increase in morbidity and mortality, and may be more sensitive to a variety of medicine.

Occupational adjustment of the prospective payment system wage index

PubMed Central

Pope, Gregory C.

1989-01-01

In this article, the bias in the Medicare prospective payment system (PPS) hospital wage index that results from its failure to hold hospital occupation mix constant is examined. On average, the difference between the current PPS wage index and a fixed-occupation-mix Laspeyres index is small, approximately 2 percent. However, occupation-mix distortions are substantially larger for a small proportion of labor market areas, especially some in the South. Biases in the wage index resulting from its failure to appropriately account for labor substitution and intra-occupational worker characteristics are also analyzed but are not found to be significant. PMID:10313354

Responses to prospective payment by rural New Mexico hospitals.

PubMed Central

Smith, H L; Piland, N F; Phillipp, A M

1991-01-01

A cross-sectional study is used to determine how rural New Mexico hospitals altered service diversification, inpatient service emphasis, and service promotion during Medicare's prospective payment system (PPS) transition and posttransition phases. Results suggest that the hospitals implemented distinct strategies in response to PPS. The posttransition strategies were examined for their association with improved revenue and utilization indicators. Few of the service diversification and promotional strategies were consistent predictors of performance. Emphasis on fine-tuning inpatient services was the most promising predictor of higher utilization and revenue measures. The implications for other rural hospitals are discussed. PMID:1743969

Cognitive Style and Mobile E-Learning in Emergent Otorhinolaryngology-Head and Neck Surgery Disorders for Millennial Undergraduate Medical Students: Randomized Controlled Trial

PubMed Central

Chao, Yi-Ping; Huang, Chung-Guei; Fang, Ji-Tseng; Wang, Shu-Ling; Chuang, Cheng-Keng; Kang, Chung-Jan; Hsin, Li-Jen; Lin, Wan-Ni; Fang, Tuan-Jen; Li, Hsueh-Yu

2018-01-01

Background Electronic learning (e-learning) through mobile technology represents a novel way to teach emergent otorhinolaryngology-head and neck surgery (ORL-HNS) disorders to undergraduate medical students. Whether a cognitive style of education combined with learning modules can impact learning outcomes and satisfaction in millennial medical students is unknown. Objective The aim of this study was to assess the impact of cognitive styles and learning modules using mobile e-learning on knowledge gain, competence gain, and satisfaction for emergent ORL-HNS disorders. Methods This randomized controlled trial included 60 undergraduate medical students who were novices in ORL-HNS at an academic teaching hospital. The cognitive style of the participants was assessed using the group embedded figures test. The students were randomly assigned (1:1) to a novel interactive multimedia (IM) group and conventional Microsoft PowerPoint show (PPS) group matched by age, sex, and cognitive style. The content for the gamified IM module was derived from and corresponded to the textbook-based learning material of the PPS module (video lectures). The participants were unblinded and used fully automated courseware containing the IM or PPS module on a 7-inch tablet for 100 min. Knowledge and competence were assessed using multiple-choice questions and multimedia situation tests, respectively. Each participant also rated their global satisfaction. Results All of the participants (median age 23 years, range 22-26 years; 36 males and 24 females) received the intended intervention after randomization. Overall, the participants had significant gains in knowledge (median 50%, interquartile range [IQR]=17%-80%, P<.001) and competence (median 13%, IQR=0%-33%, P=.006). There were no significant differences in knowledge gain (40%, IQR=13%-76% vs 60%, IQR=20%-100%, P=.42) and competence gain (0%, IQR= −21% to 38% vs 25%, IQR=0%-33%, P=.16) between the IM and PPS groups. However, the IM group had a higher satisfaction score (8, IQR=6-9 vs 6, IQR=4-7, P=.01) compared with the PPS group. Using Friedman’s two-way nonparametric analysis of variance, cognitive styles (field-independent, field-intermediate, or field-dependent classification) and learning modules (IM or PPS) had significant effects on both knowledge gain (both adjusted P<.001) and satisfaction (both adjusted P<.001). Conclusions Mobile e-learning is an effective modality to improve knowledge of emergent ORL-HNS in millennial undergraduate medical students. Our findings suggest the necessity of developing various modules for undergraduate medical students with different cognitive styles. Trial Registration Clinicaltrials.gov NCT02971735; https://clinicaltrials.gov/ct2/show/NCT02971735 (Archived by WebCite at http://www.webcitation.org/6waoOpCEV) PMID:29439943

Evaluation of a Campylobacter fetus subspecies venerealis real-time quantitative polymerase chain reaction for direct analysis of bovine preputial samples

PubMed Central

Chaban, Bonnie; Chu, Shirley; Hendrick, Steven; Waldner, Cheryl; Hill, Janet E.

2012-01-01

The detection and subspeciation of Campylobacter fetus subsp. venerealis (CFV) from veterinary samples is important for both clinical and economic reasons. Campylobacter fetus subsp. venerealis is the causative agent of bovine genital campylobacteriosis, a venereal disease that can lead to serious reproductive problems in cattle, and strict international regulations require animals and animal products to be CFV-free for trade. This study evaluated methods reported in the literature for CFV detection and reports the translation of an extensively tested CFV-specific polymerase chain reaction (PCR) primer set; including the VenSF/VenSR primers and a real-time, quantitative PCR (qPCR) platform using SYBR Green chemistry. Three methods of preputial sample preparation for direct qPCR were evaluated and a heat lysis DNA extraction method was shown to allow for CFV detection at the level of approximately one cell equivalent per reaction (or 1.0 × 103 CFU/mL) from prepuce. The optimized sample preparation and qPCR protocols were then used to evaluate 3 western Canadian bull cohorts, which included 377 bulls, for CFV. The qPCR assay detected 11 positive bulls for the CFV-specific parA gene target. DNA sequence data confirmed the identity of the amplified product and revealed that positive samples were comprised of 2 sequence types; one identical to previously reported CFV parA gene sequences and one with a 9% sequence divergence. These results add valuable information towards our understanding of an important CFV subspeciation target and offer a significantly improved format for an internationally recognized PCR test. PMID:23277694

Tissue-specific and hormonally regulated expression of a rat alpha 2u globulin gene in transgenic mice.

PubMed Central

Soares, V da C; Gubits, R M; Feigelson, P; Costantini, F

1987-01-01

To investigate the tissue-specific and hormonal regulation of the rat alpha 2u globulin gene family, we introduced one cloned member of the gene family into the mouse germ line and studied its expression in the resulting transgenic mice. Alpha 2u globulingene 207 was microinjected on a 7-kilobase DNA fragment, and four transgenic lines were analyzed. The transgene was expressed at very high levels, specifically in the liver and the preputial gland of adult male mice. The expression in male liver was first detected at puberty, and no expression was detected in female transgenic mice. This pattern of expression is similar to the expression of endogenous alpha 2u globulin genes in the rat but differs from the expression of the homologous mouse major urinary protein (MUP) gene family in that MUPs are synthesized in female liver and not in the male preputial gland. We conclude that these differences between rat alpha 2u globulin and mouse MUP gene expression are due to evolutionary differences in cis-acting regulatory elements. The expression of the alpha 2u globulin transgene in the liver was abolished by castration and fully restored after testosterone replacement. The expression could also be induced in the livers of female mice by treatment with either testosterone or dexamethasone, following ovariectomy and adrenalectomy. Therefore, the cis-acting elements responsible for regulation by these two hormones, as well as those responsible for tissue-specific expression, are closely linked to the alpha 2u globulin gene. Images PMID:2446121

The B1 Protein Guides the Biosynthesis of a Lasso Peptide

NASA Astrophysics Data System (ADS)

Zhu, Shaozhou; Fage, Christopher D.; Hegemann, Julian D.; Mielcarek, Andreas; Yan, Dushan; Linne, Uwe; Marahiel, Mohamed A.

2016-10-01

Lasso peptides are a class of ribosomally synthesized and post-translationally modified peptides (RiPPs) with a unique lariat knot-like fold that endows them with extraordinary stability and biologically relevant activity. However, the biosynthetic mechanism of these fascinating molecules remains largely speculative. Generally, two enzymes (B for processing and C for cyclization) are required to assemble the unusual knot-like structure. Several subsets of lasso peptide gene clusters feature a “split” B protein on separate open reading frames (B1 and B2), suggesting distinct functions for the B protein in lasso peptide biosynthesis. Herein, we provide new insights into the role of the RiPP recognition element (RRE) PadeB1, characterizing its capacity to bind the paeninodin leader peptide and deliver its peptide substrate to PadeB2 for processing.

Presentation of Functional, PPS and Hall's Methods in Comparison with other Research on Space Quality / Prezentacja Metod: Funkcjonalnej, Pps I Hall'A Na Tle Innych Badań Jakości Przestrzeni

NASA Astrophysics Data System (ADS)

Kossak-Jagodzińska, Anna

2015-03-01

The end of the twentieth century was a period in which the need for quality control was developing in all areas of life in post-industrial countries. The impulse for the development of numerous methods of evaluating the quality in architecture and construction was "Green Paper" and "Agenda 21" concerning the idea of sustainable development. First of all, creation of a system of evaluation criteria is the basis for elaboration of any system of quality control. Several years of cooperation between J. Serdyńska and the author resulted in a cycle of studies on urban public space (squares in the city of Katowice) based upon functional, Hall's and PPS methods. This study aims to embed them in a typology of other studies of space quality. Koniec XX w jest okresem, w którym potrzeba kontroli jakości rozwija się w krajach postindustrialnych we wszystkich dziedzinach życia. Impulsem dla rozwoju licznych metod oceny jakości w architekturze i budownictwie była "Zielona księga" i "Agenda 21" dotyczące idei zrównoważonego rozwoju. Podstawą opracowania jakiegokolwiek systemu kontroli jakości jest przede wszystkim stworzenie systemu kryteriów oceny. Kilkuletnia współpraca autorki z J. Serdyńską zaowocowała cyklem badań miejskiej przestrzeni publicznej (place Katowic), opartych na metodach: funkcjonalnej (określenie dominującej funkcji przestrzeni publicznej), Hall'a (zagospodarowanie tej przestrzeni) I PPS (badanie jej potencjału). Niniejsze opracowanie ma na celu osadzić je w typologii innych badań jakości przestrzeni

No psychological distress in sportsmen aged 45 years and older after cardiovascular screening, including cardiac CT: The Measuring Athlete's Risk of Cardiovascular events (MARC) study.

PubMed

Schurink, M M; Braber, T L; Prakken, N H J; Doevendans, P A F M; Backx, F J G; Grobbee, D E; Rienks, R; Nathoe, H M; Bots, M L; Velthuis, B K; Mosterd, A

2017-04-01

Psychological distress caused by cardiovascular pre-participation screening (PPS) may be a reason not to implement a PPS program. We assessed the psychological impact of PPS, including cardiac computed tomography (CT), in 318 asymptomatic sportsmen aged ≥45 years. Coronary artery disease (CAD) was defined as a coronary artery calcium score ≥100 Agatson units and/or ≥50% luminal stenosis on contrast-enhanced cardiac CT. Psychological impact was measured with the Impact of Event Scale (IES) (seven items) on a six-point scale (grade 0-5). A sum score ≥19 indicates clinically relevant psychological distress. A Likert scale was used to assess overall experiences and impact on sports and lifestyle. A total of 275 participants (86.5% response rate, 95% CI 83-90%) with a mean age of 54.5 ± 6.4 years completed the questionnaires, 48 (17.5%, 95% CI 13-22%) of whom had CAD. The median IES score was 1 (IQR 0-2, [0-23]). IES was slightly higher in those with CAD (mean rank 175 vs. 130, p < 0.001). One participant (with CAD) experienced clinically relevant psychological distress (IES = 23). Participants reported numerous benefits, including feeling safer exercising (58.6%, 95% CI 53-65%) and positive lifestyle changes, especially in those with CAD (17.2 vs. 52.1%, p < 0.001). The majority were satisfied with their participation (93.8%, 95% CI 91-97%). Cardiovascular PPS, including cardiac CT, causes no relevant psychological distress in older sportsmen. Psychological distress should not be a reason to forego screening in sportsmen.

Automated hand hygiene auditing with and without an intervention.

PubMed

Kwok, Yen Lee Angela; Juergens, Craig P; McLaws, Mary-Louise

2016-12-01

Daily feedback from continuous automated auditing with a peer reminder intervention was used to improve compliance. Compliance rates from covert and overt automated auditing phases with and without intervention were compared with human mandatory audits. An automated system was installed to covertly detect hand hygiene events with each depression of the alcohol-based handrub dispenser for 5 months. The overt phase included key clinicians trained to share daily rates with clinicians, set compliance goals, and nudge each other to comply for 6 months. During a further 6 months, the intervention continued without being refreshed. Hand Hygiene Australia (HHA) human audits were performed quarterly during the intervention in accordance with the World Health Organization guidelines. Percentage point (PP) differences between compliance rates were used to determine change. HHA rates for June 2014 were 85% and 87% on the medical and surgical wards, respectively. These rates were 55 PPs and 38 PPs higher than covert automation rates for June 2014 on the medical and surgical ward at 30% and 49%, respectively. During the intervention phase, average compliance did not change on the medical ward from their covert rate, whereas the surgical ward improved compared with the covert phase by 11 PPs to 60%. On average, compliance during the intervention without being refreshed did not change on the medical ward, whereas the average rate on the surgical ward declined by 9 PPs. Automation provided a unique opportunity to respond to daily rates, but compliance will return to preintervention levels once active intervention ceases or human auditors leave the ward, unless clinicians are committed to change. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

Evaluating the impact of prioritization of antiretroviral pre-exposure prophylaxis (PrEP) in New York City

PubMed Central

Kessler, Jason; Myers, Julie E.; Nucifora, Kimberly A.; Mensah, Nana; Toohey, Christopher; Khademi, Amin; Cutler, Blayne; Braithwaite, R. Scott

2015-01-01

Objective To compare the value and effectiveness of different prioritization strategies of pre-exposure prophylaxis (PrEP) in New York City (NYC). Design Mathematical modeling utilized as clinical trial is not feasible. Methods Using a model accounting for both sexual and parenteral transmission of HIV we compare different prioritization strategies (PPS) for PrEP to two scenarios—no PrEP and PrEP for all susceptible at-risk individuals. The PPS included PrEP for all MSM, only high-risk MSM, high-risk heterosexuals, and injection drug users, and all combinations of these four strategies. Outcomes included HIV infections averted, and incremental cost effectiveness (per-infection averted) ratios. Initial assumptions regarding PrEP included a 44% reduction in HIV transmission, 50% uptake in the prioritized population and an annual cost per person of $9,762. Sensitivity analyses on key parameters were conducted. Results Prioritization to all MSM results in a 19% reduction in new HIV infections. Compared to PrEP for all persons at-risk this PPS retains 79% of the preventative effect at 15% of the total cost. PrEP prioritized to only high-risk MSM results in a reduction in new HIV infections of 15%. This PPS retains 60% of the preventative effect at 6% of the total cost. There are diminishing returns when PrEP utilization is expanded beyond this group. Conclusions PrEP implementation is relatively cost-inefficient under our initial assumptions. Our results suggest that PrEP should first be promoted among MSM who are at particularly high-risk of HIV acquisition. Further expansion beyond this group may be cost-effective, but is unlikely to be cost-saving. PMID:25493594

Differentiation and specialization in the California hospital industry 1983 to 1988.

PubMed

Zwanziger, J; Melnick, G A; Simonson, L

1996-04-01

This article examines changes in the service mix of California hospitals as part of their response to shifts in the system of reimbursement between 1983 and 1988. The Hospital Discharge Data Set and the Annual Hospital Disclosure Report produced by California Office of Statewide Health Planning and Development were used in this study. Characteristics of inpatient hospital services in California before and after the introduction of new reimbursement mechanisms (including the Medicare Prospective Payment System [PPS] and the growth of selective contracting plans) were compared. The factors that influence two measures of hospital service mix, one focusing on specialization and the other on differentiation, were studied. The factors included hospital characteristics and changes in hospital reimbursement. Variables describing a hospital's service mix and the level in its market were constructed from data in the annual discharge abstracts. Data pertaining to average hospital costs and reimbursements under the Medicare PPS were drawn from a file containing a 20% sample of hospital stay records for the year of PPS. Other hospital data, such as ownership and bed size, were taken from the California Annual Disclosure Report data set. The results indicate that completion among hospitals tended to increase differentiation whereas higher financial PPS pressure is associated with increased specialization. Hospitals tend to adopt some high visibility services offered by their competitors while filling market niches selectively overall. It also appears that the cost savings expected for specialization may prevail only for narrowly defined services. Study of subsequent data sets should show whether the cost containment strategies used by the hospitals to achieve these results have been maintained over a period of sustained financial pressure.

Measuring Deformation in the Mouse Optic Nerve Head and Peripapillary Sclera

PubMed Central

Nguyen, Cathy; Midgett, Dan; Kimball, Elizabeth C.; Steinhart, Matthew R.; Nguyen, Thao D.; Pease, Mary E.; Oglesby, Ericka N.; Jefferys, Joan L.; Quigley, Harry A.

2017-01-01

Purpose To develop an ex vivo explant system using multiphoton microscopy and digital volume correlation to measure the full-field deformation response to intraocular pressure (IOP) change in the peripapillary sclera (PPS) and in the optic nerve head (ONH) astrocytic structure. Methods Green fluorescent protein (GFP)-glutamate transporter-GLT1 (GLT1/GFP) mouse eyes were explanted and imaged with a laser-scanning microscope under controlled inflation. Images were analyzed for regional strains and changes in astrocytic lamina and PPS shape. Astrocyte volume fraction in seven control GLT1/GFP mice was measured. The level of fluorescence of GFP fluorescent astrocytes was compared with glial fibrillary acidic protein (GFAP) labeled astrocytes using immunohistochemistry. Results The ONH astrocytic structure remained stable during 3 hours in explants. Control strain—globally, in the central one-half or two-thirds of the astrocytic lamina—was significantly greater in the nasal-temporal direction than in the inferior-superior or anterior-posterior directions (each P ≤ 0.03, mixed models). The PPS opening (perimeter) in normal eye explants also became wider nasal-temporally than superior-inferiorly during inflation from 10 to 30 mm Hg (P = 0.0005). After 1 to 3 days of chronic IOP elevation, PPS area was larger than in control eyes (P = 0.035), perimeter elongation was 37% less than controls, and global nasal-temporal strain was significantly less than controls (P = 0.007). Astrocyte orientation was altered by chronic IOP elevation, with processes redirected toward the longitudinal axis of the optic nerve. Conclusions The explant inflation test measures the strain response of the mouse ONH to applied IOP. Initial studies indicate regional differences in response to both acute and chronic IOP elevation within the ONH region. PMID:28146237

The insight study of SnO pico size particles in an ethanol-water system followed by its biosensing application.

PubMed

Ejaz, Ammara; Jeon, Seungwon

2018-06-05

Pico sized Stannous oxide particles (SnO PPs) were synthesized in an ethanol-water solvent system on the surface of nitrogen doped graphene oxide (GO). The highly conductive support was a combination of dual interactions between 4-aminomethylbenzylamine (AMBA) and GO. The oppositely positioned -NH 2 linkers of the AMBA were covalently incorporated into the GO matrix through condensation reaction followed by the strong π - π stacking interactions between aromatic rings of AMBA and GO. The change in the local chemical environment of GO via dual interactions provided a suitable atmosphere for the growth and dispersion of SnO PPs on GO-AMBA surface. The possible mechanism for the formation of SnO in an ethanol-water solvent system was evaluated. Furthermore, a light was shed on the factors responsible for the pico size of SnO particles synthesis along with its phenomenal distribution on the GO-AMBA surface. The catalyst containing SnO PPs was deployed as a biosensor for the detection of ascorbic acid (AA) for the very first time. A very wide linear range of 5.0 × 10 -5 -7.0 × 10 -3 M, limit of detection (LOD) of 1.19 × 10 -5 M along with excellent practical feasibility, storage stability, repeatability and selectivity towards AA electrooxidation showed the excellent synergy between nitrogen-rich GO surface and SnO PPs. The sensitivity (885.54 µAmM -1 cm -2 ) of the catalyst was the most attractive feature, as it was obtained in the presence of 5 and 2-fold higher concentration of UA and DA interfering species respectively. Copyright © 2018 Elsevier B.V. All rights reserved.

Grape Polyphenols Prevent Fructose-Induced Oxidative Stress and Insulin Resistance in First-Degree Relatives of Type 2 Diabetic Patients

PubMed Central

Hokayem, Marie; Blond, Emilie; Vidal, Hubert; Lambert, Karen; Meugnier, Emmanuelle; Feillet-Coudray, Christine; Coudray, Charles; Pesenti, Sandra; Luyton, Cedric; Lambert-Porcheron, Stéphanie; Sauvinet, Valerie; Fedou, Christine; Brun, Jean-Frédéric; Rieusset, Jennifer; Bisbal, Catherine; Sultan, Ariane; Mercier, Jacques; Goudable, Joelle; Dupuy, Anne-Marie; Cristol, Jean-Paul; Laville, Martine; Avignon, Antoine

2013-01-01

OBJECTIVE To assess the clinical efficacy of nutritional amounts of grape polyphenols (PPs) in counteracting the metabolic alterations of high-fructose diet, including oxidative stress and insulin resistance (IR), in healthy volunteers with high metabolic risk. RESEARCH DESIGN AND METHODS Thirty-eight healthy overweight/obese first-degree relatives of type 2 diabetic patients (18 men and 20 women) were randomized in a double-blind controlled trial between a grape PP (2 g/day) and a placebo (PCB) group. Subjects were investigated at baseline and after 8 and 9 weeks of supplementation, the last 6 days of which they all received 3 g/kg fat-free mass/day of fructose. The primary end point was the protective effect of grape PPs on fructose-induced IR. RESULTS In the PCB group, fructose induced 1) a 20% decrease in hepatic insulin sensitivity index (P < 0.05) and an 11% decrease in glucose infusion rate (P < 0.05) as evaluated during a two-step hyperinsulinemic-euglycemic clamp, 2) an increase in systemic (urinary F2-isoprostanes) and muscle (thiobarbituric acid–reactive substances and protein carbonylation) oxidative stress (P < 0.05), and 3) a downregulation of mitochondrial genes and decreased mitochondrial respiration (P < 0.05). All the deleterious effects of fructose were fully blunted by grape PP supplementation. Antioxidative defenses, inflammatory markers, and main adipokines were affected neither by fructose nor by grape PPs. CONCLUSIONS A natural mixture of grape PPs at nutritional doses efficiently prevents fructose-induced oxidative stress and IR. The current interest in grape PP ingredients and products by the global food and nutrition industries could well make them a stepping-stone of preventive nutrition. PMID:23275372

Copeptin role in polyuria-polydipsia syndrome differential diagnosis and reference range in paediatric age.

PubMed

Tuli, Gerdi; Tessaris, Daniele; Einaudi, Silvia; Matarazzo, Patrizia; De Sanctis, Luisa

2018-06-01

Plasma arginine-vasopressin (AVP) analysis can help in the differential diagnosis of the polyuria-polydipsia syndrome (PPS), even if such investigation is hampered by technical difficulties, conversely to its surrogate copeptin. This study aims to enlarge the existing data on normal copeptin levels in childhood, to evaluate the correlation between copeptin, serum sodium and plasma and urine osmolality, and to assess the utility of the copeptin analysis in the diagnostic work-up of PPS in the paediatric age. Plasma copeptin levels were evaluated in 53 children without AVP disorders (control population), in 12 hypopituitaric children and in 15 patients with PPS after water deprivation test (WDT). Mean basal copeptin levels were 5.2 ± 1.56 (range 2.4-8.6 pmol/L) in the control population, 2.61 ± 0.49 pmol/L in the hypopituitaric children with complete diabetes insipidus (CDI) (P = .04) and 6.21 ± 1.17 pmol/L in the hypopituitaric patients without DI (P = .02). After WDT, among 15 naïve polyuric/polydipsic children, copeptin values greater than 20 pmol/L allowed to identify nephrogenic diabetes insipidus (NDI), concentrations below 2.2 pmol/L complete central DI (CCDI) and between 5 and 20 pmol/L primary polydipsia (PP). Copeptin cut-off level of 3.5 pmol/L distinguished CDI from PP, with a sensitivity and specificity of 75% and 83.3%, respectively. Copeptin evaluation holds promises as a diagnostic tool in paediatric PPS; its interpretation might be useful to promptly distinguish NDI, even avoiding the WDT need. © 2018 John Wiley & Sons Ltd.

Full-Scale Accident Testing in Support of Used Nuclear Fuel Transportation.

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

Durbin, Samuel G.; Lindgren, Eric R.; Rechard, Rob P.

2014-09-01

The safe transport of spent nuclear fuel and high-level radioactive waste is an important aspect of the waste management system of the United States. The Nuclear Regulatory Commission (NRC) currently certifies spent nuclear fuel rail cask designs based primarily on numerical modeling of hypothetical accident conditions augmented with some small scale testing. However, NRC initiated a Package Performance Study (PPS) in 2001 to examine the response of full-scale rail casks in extreme transportation accidents. The objectives of PPS were to demonstrate the safety of transportation casks and to provide high-fidelity data for validating the modeling. Although work on the PPSmore » eventually stopped, the Blue Ribbon Commission on America’s Nuclear Future recommended in 2012 that the test plans be re-examined. This recommendation was in recognition of substantial public feedback calling for a full-scale severe accident test of a rail cask to verify evaluations by NRC, which find that risk from the transport of spent fuel in certified casks is extremely low. This report, which serves as the re-assessment, provides a summary of the history of the PPS planning, identifies the objectives and technical issues that drove the scope of the PPS, and presents a possible path for moving forward in planning to conduct a full-scale cask test. Because full-scale testing is expensive, the value of such testing on public perceptions and public acceptance is important. Consequently, the path forward starts with a public perception component followed by two additional components: accident simulation and first responder training. The proposed path forward presents a series of study options with several points where the package performance study could be redirected if warranted.« less

Poly(ethylene oxide monomethyl ether)- block-poly(propylene succinate) Nanoparticles: Synthesis and Characterization, Enzymatic and Cellular Degradation, Micellar Solubilization of Paclitaxel, and in Vitro and in Vivo Evaluation.

PubMed

Jäger, Alessandro; Jäger, Eliézer; Syrová, Zdeňka; Mazel, Tomas; Kováčik, Lubomír; Raška, Ivan; Höcherl, Anita; Kučka, Jan; Konefal, Rafal; Humajova, Jana; Poučková, Pavla; Štěpánek, Petr; Hrubý, Martin

2018-04-11

Polyester-based nanostructures are widely studied as drug-delivery systems due to their biocompatibility and biodegradability. They are already used in the clinic. In this work, we describe a new and simple biodegradable and biocompatible system as the Food and Drug Administration approved polyesters (poly-ε-caprolactone, polylactic acid, and poly(lactic- co-glycolic acid)) for the delivery of the anticancer drug paclitaxel (PTX) as a model drug. A hydrophobic polyester, poly(propylene succinate) (PPS), was prepared from a nontoxic alcohol (propylene glycol) and monomer from the Krebs's cycle (succinic acid) in two steps via esterification and melt polycondensation. Furthermore, their amphiphilic block copolyester, poly(ethylene oxide monomethyl ether)- block-poly(propylene succinate) (mPEO- b-PPS), was prepared by three steps via esterification followed by melt polycondensation and the addition of mPEO to the PPS macromolecules. Analysis of the in vitro cellular behavior of the prepared nanoparticle carriers (NPs) (enzymatic degradation, uptake, localization, and fluorescence resonance energy-transfer pair degradation studies) was performed by fluorescence studies. PTX was loaded to the NPs of variable sizes (30, 70, and 150 nm), and their in vitro release was evaluated in different cell models and compared with commercial PTX formulations. The mPEO- b-PPS copolymer analysis displays glass transition temperature < body temperature < melting temperature, lower toxicity (including the toxicity of their degradation products), drug solubilization efficacy, stability against spontaneous hydrolysis during transport in bloodstream, and simultaneous enzymatic degradability after uptake into the cells. The detailed cytotoxicity in vitro and in vivo tumor efficacy studies have shown the superior efficacy of the NPs compared with PTX and PTX commercial formulations.

The CMS-TOTEM Precision Proton Spectrometer: CT-PPS

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

Albrow, Michael G.

The CMS-TOTEM Precison Proton Spectrometer, CT-PPS, is an approved project to add 3D silicon tracking and quartz Cherenkov timing detectors in Roman pots at z = ±204-215 m from the CMS collision point to study final states p+X + p. The central state X can be aW-pair from a photon-photon interaction, high ET jets from gluon collisions, etc., with M(X) obtained directly as well as from the two outgoing protons. The project is designed to operate at high luminosity, with up to about 50 interactions per 25 ns bunch crossing, and to be fully operational for physics in 2016.

76 FR 26431 - Medicare Program; Inpatient Psychiatric Facilities Prospective Payment System-Update for Rate...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-06

...This final rule updates the prospective payment rates for Medicare inpatient hospital services provided by inpatient psychiatric facilities (IPFs) for discharges occurring during the rate year (RY) beginning July 1, 2011 through September 30, 2012. The final rule also changes the IPF prospective payment system (PPS) payment rate update period to a RY that coincides with a fiscal year (FY). In addition, the rule implements policy changes affecting the IPF PPS teaching adjustment. It also rebases and revises the Rehabilitation, Psychiatric, and Long-Term Care (RPL) market basket, and makes some clarifications and corrections to terminology and regulations text.

Vulnerability of Rural Hospitals to Medicare Outpatient Payment Reform

PubMed Central

Mohr, Penny E.; Franco, Sheila J.; Blanchfield, Bonnie B.; Cheng, C. Michael; Evans, William N.

1999-01-01

Because the Balanced Budget Act (BBA) of 1997 requires implementation of a Medicare prospective payment system (PPS) for hospital outpatient services, the authors evaluated the potential impact of outpatient PPS on rural hospitals. Areas examined include: (1) How dependent are rural hospitals on outpatient revenue? (2) Are they more likely than urban hospitals to be vulnerable to payment reform? (3) What types of rural hospitals will be most vulnerable to reform? Using Medicare cost report data, the authors found that small size and government ownership are more common among rural than urban hospitals and are the most important determinants of vulnerability to payment reform. PMID:11481724

A possible propellantless propulsion system

NASA Astrophysics Data System (ADS)

Goodwin, David P.

2001-02-01

A newly developed high power solid state switch might have enabled a propellantless propulsion system (PPS), based on the Lenz's Law interactions of a very rapidly pulsed magnet. Although only limited propulsion would be provided with each pulse, and then only during the 100-nanosecond ramp-up of the pulse, the newly developed switch produces 400,000 high power pulses per second. A PPS of this type would consist of an electrical power supply, the switch, and a solenoid with a plate on one end to produce an asymmetry in the magnetic field. Other applications might include propulsion with reduced thermal and acoustical signatures, and a means to dampen inertia. .

Post-Polio Syndrome and the Late Effects of Poliomyelitis: Part 2. Treatment, Management and Prognosis.

PubMed

Lo, Julian K; Robinson, Lawrence R

2018-05-12

Post-Polio Syndrome (PPS) is characterized by new muscle weakness and/or muscle fatigability that occurs many years following the initial poliomyelitis illness. An individualized approach to rehabilitation management is critical. Interventions may include rehabilitation management strategies, adaptive equipment, orthotic equipment, gait/mobility aids and a variety of therapeutic exercises. The progression of muscle weakness in PPS is typically slow and gradual; however, there is also variability in both the natural history of weakness and functional prognosis. Further research is required to determine the effectiveness of selected medical treatment. This article is protected by copyright. All rights reserved. © 2018 Wiley Periodicals, Inc.

Probing features in the primordial perturbation spectrum with large-scale structure data

NASA Astrophysics Data System (ADS)

L'Huillier, Benjamin; Shafieloo, Arman; Hazra, Dhiraj Kumar; Smoot, George F.; Starobinsky, Alexei A.

2018-06-01

The form of the primordial power spectrum (PPS) of cosmological scalar (matter density) perturbations is not yet constrained satisfactorily in spite of the tremendous amount of information from the Cosmic Microwave Background (CMB) data. While a smooth power-law-like form of the PPS is consistent with the CMB data, some PPSs with small non-smooth features at large scales can also fit the CMB temperature and polarization data with similar statistical evidence. Future CMB surveys cannot help distinguish all such models due to the cosmic variance at large angular scales. In this paper, we study how well we can differentiate between such featured forms of the PPS not otherwise distinguishable using CMB data. We ran 15 N-body DESI-like simulations of these models to explore this approach. Showing that statistics such as the halo mass function and the two-point correlation function are not able to distinguish these models in a DESI-like survey, we advocate to avoid reducing the dimensionality of the problem by demonstrating that the use of a simple three-dimensional count-in-cell density field can be much more effective for the purpose of model distinction.

Oxide-free aC/Zr0.65Al0.075Cu0.275/aC phase plates for transmission electron microscopy.

PubMed

Dries, M; Obermair, M; Hettler, S; Hermann, P; Seemann, K; Seifried, F; Ulrich, S; Fischer, R; Gerthsen, D

2018-06-01

Thin-film phase plates (PP) have become a valuable tool for the imaging of organic objects in transmission electron microscopy (TEM). The thin film usually consists of amorphous carbon (aC), which undergoes rapid aging under intense illumination with high-energy electrons. The limited lifetime of aC film PPs calls for alternative PP materials with improved material stability. This work presents thin-film PPs fabricated from the metallic glass alloy Zr 0.65 Al 0.075 Cu 0.275 (ZAC), which was identified as a promising PP material with beneficial properties, such as a large inelastic mean free path. An adverse effect of the ZAC alloy is the formation of a surface oxide layer in ambient air, which reduces the electrical conductivity and causes electrostatic charging in the electron beam. To avoid surface oxidation, the ZAC alloy is enclosed by thin aC layers. The resulting aC/ZAC/aC layer system is used to fabricate Zernike and Hilbert PPs. Phase-contrast TEM imaging is demonstrated for a sample of carbon nanotubes, which show strong contrast enhancement in PP TEM images. Copyright © 2018 Elsevier B.V. All rights reserved.

Study on In-mold Punching during PPS/GF Injection Molding

NASA Astrophysics Data System (ADS)

Inuzuka, Takayuki; Fujita, Akihiro; Nakai, Asami; Hamada, Hiroyuki

The influence of the punching condition on strength and the amount of shear droop was investigated to optimize the processing condition for punching in the mold during glass fiber reinforced polyphenylenesulfide (PPS/GF) injection molding. For in-mold punching part during cooling process, the tensile strength was constant because the pressure loss by the punch did not occur. The amount of the shear droop decreased in line with the increase in delay time because the rigidity of injection molded part in the mold increased when the resin was cooled. Moreover, when the resin temperature lowered more than the glass transition temperature, the amount of the shear droop was constant because the rigidity became constant. It is necessary to begin punching when the resin temperature lowers more than the glass transition temperature after holding pressure process is completed, to secure high strength and to assume 0.05 mm or less, at which level the shear droop cannot be visually recognized. The shortest delay time for PPS/GF is 8 sec. The delay time to minimize the amount of the shear droop can be guessed by analyzing the temperature change of the resin in the mold by injection molding CAE.

Assessment of topsoil contamination near the Stanisław Siedlecki Polish Polar Station in Hornsund, Svalbard, using magnetic methods

NASA Astrophysics Data System (ADS)

Gonet, T.; Górka-Kostrubiec, B.; Łuczak-Wilamowska, B.

2018-03-01

Topsoil contamination near the Stanisław Siedlecki Polish Polar Station (PPS), Hornsund, Svalbard, has been assessed using magnetic methods supplemented by chemical analyses and microscopic observations. Analysis of magnetic parameters has enabled to evaluate the concentration, magnetic mineralogy, and grain-size distribution of anthropogenic magnetic particles. Heavy-metal contamination near the PPS originates primarily from local sources. Anthropogenic spherical, magnetite-like particles were found near the station, whereas uncontaminated topsoil is devoid of such particles. Magnetic studies indicate that magnetite and goethite are the primary magnetic phases, with magnetite levels being higher in polluted area. Magnetic fraction of contaminated topsoil includes a mixture of single-domain and multi-domain grains, while uncontaminated topsoil contains smaller grains. Results show a clear correspondence between Pollution Load Index and magnetic susceptibility anomalies, and that the areal extent of PPS impact on the environment has not expanded significantly since 2004 (although a new contamination source, the scrap yard, is now present). A comparison of magnetic susceptibility measurements with metal analyses indicates that magnetic methods can be used as a rapid, inexpensive, non-invasive, and sensitive tool for the evaluation of topsoil contamination.

Regulation of apoptosis by peroxisome proliferators.

PubMed

Roberts, Ruth A; Michel, Cecile; Coyle, Beth; Freathy, Caroline; Cain, Kelvin; Boitier, Eric

2004-04-01

Peroxisome proliferators (PPs) constitute a large and chemically diverse family of non-genotoxic rodent hepatocarcinogens that activate the PP-activated receptor alpha (PPARalpha). In order to investigate the hypothesis that PPs elicit their carcinogenic effects through the suppression of apoptosis, we established an in vitro assay for apoptosis using both primary rat hepatocytes and the FaO rat hepatoma cell line. Apoptosis was induced by transforming growth factor beta1 (TGFbeta1), the physiological negative regulator of liver growth. In this system, PPs could suppress both spontaneous and TGFbeta1-induced apoptosis. In order to understand the mechanisms of this regulation of apoptosis, we conducted microarray analysis followed by pathway-specific gene clustering in TGFbeta1-treated cells. After treatment, 76 genes were up-regulated and 185 were down-regulated more than 1.5-fold. Cluster analysis of up-regulated genes revealed three clusters, A-C. Cluster A (4h) was associated with 12% apoptosis and consisted of genes mainly of the cytoskeleton and extracellular matrix such as troponin and the proteoglycan SDC4. In cluster B (8h; 25% apoptosis), there were many pro- and anti-apoptotic genes such as XIAP, BAK1 and BAD, whereas at 16h (40% apoptosis) the regulated genes were mainly those of the cellular stress pathways such as the genes implicated in the activation of the transcription factor NFkappab. Genes found down-regulated in response to TGFbeta1 were mainly those associated with oxidative stress and several genes implicated in glutathione production and maintenance. Thus, TGFbeta1 may induce apoptosis via a down regulation of oxidant defence leading to the generation of reactive oxygen species. The ability of PPs to impact on these apoptosis pathways remains to be determined. To approach this question, we have developed a technique using laser capture microdissection of livers treated with the PP, clofibric acid coupled with gene expression array analysis. Results show that some of the key steps of the LCM process had an impact on the gene profiles generated. However, this did not preclude accurate determination of a PP-specific molecular signature. Thus, the choice of appropriate controls will ensure that meaningful gene expression analyses can be performed on tissue microdissected from the foci generated in clofibric acid treated livers. These data will allow the identification of specific genes that are regulated by PPs leading to changes in apoptosis and ultimately to tumours.

Cognitive Style and Mobile E-Learning in Emergent Otorhinolaryngology-Head and Neck Surgery Disorders for Millennial Undergraduate Medical Students: Randomized Controlled Trial.

PubMed

Lee, Li-Ang; Chao, Yi-Ping; Huang, Chung-Guei; Fang, Ji-Tseng; Wang, Shu-Ling; Chuang, Cheng-Keng; Kang, Chung-Jan; Hsin, Li-Jen; Lin, Wan-Ni; Fang, Tuan-Jen; Li, Hsueh-Yu

2018-02-13

Electronic learning (e-learning) through mobile technology represents a novel way to teach emergent otorhinolaryngology-head and neck surgery (ORL-HNS) disorders to undergraduate medical students. Whether a cognitive style of education combined with learning modules can impact learning outcomes and satisfaction in millennial medical students is unknown. The aim of this study was to assess the impact of cognitive styles and learning modules using mobile e-learning on knowledge gain, competence gain, and satisfaction for emergent ORL-HNS disorders. This randomized controlled trial included 60 undergraduate medical students who were novices in ORL-HNS at an academic teaching hospital. The cognitive style of the participants was assessed using the group embedded figures test. The students were randomly assigned (1:1) to a novel interactive multimedia (IM) group and conventional Microsoft PowerPoint show (PPS) group matched by age, sex, and cognitive style. The content for the gamified IM module was derived from and corresponded to the textbook-based learning material of the PPS module (video lectures). The participants were unblinded and used fully automated courseware containing the IM or PPS module on a 7-inch tablet for 100 min. Knowledge and competence were assessed using multiple-choice questions and multimedia situation tests, respectively. Each participant also rated their global satisfaction. All of the participants (median age 23 years, range 22-26 years; 36 males and 24 females) received the intended intervention after randomization. Overall, the participants had significant gains in knowledge (median 50%, interquartile range [IQR]=17%-80%, P<.001) and competence (median 13%, IQR=0%-33%, P=.006). There were no significant differences in knowledge gain (40%, IQR=13%-76% vs 60%, IQR=20%-100%, P=.42) and competence gain (0%, IQR= -21% to 38% vs 25%, IQR=0%-33%, P=.16) between the IM and PPS groups. However, the IM group had a higher satisfaction score (8, IQR=6-9 vs 6, IQR=4-7, P=.01) compared with the PPS group. Using Friedman's two-way nonparametric analysis of variance, cognitive styles (field-independent, field-intermediate, or field-dependent classification) and learning modules (IM or PPS) had significant effects on both knowledge gain (both adjusted P<.001) and satisfaction (both adjusted P<.001). Mobile e-learning is an effective modality to improve knowledge of emergent ORL-HNS in millennial undergraduate medical students. Our findings suggest the necessity of developing various modules for undergraduate medical students with different cognitive styles. Clinicaltrials.gov NCT02971735; https://clinicaltrials.gov/ct2/show/NCT02971735 (Archived by WebCite at http://www.webcitation.org/6waoOpCEV). ©Li-Ang Lee, Yi-Ping Chao, Chung-Guei Huang, Ji-Tseng Fang, Shu-Ling Wang, Cheng-Keng Chuang, Chung-Jan Kang, Li-Jen Hsin, Wan-Ni Lin, Tuan-Jen Fang, Hsueh-Yu Li. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 13.02.2018.

Studies on the age of puberty of male camels (Camelus dromedaries) in Saudi Arabia.

PubMed

Abdel Rahim, S E

1997-07-01

Aspects of sexual development and attainment of sexual and breeding maturity were studied in two groups of Najdi camels (Mojaheem and Wadah), maintained in stalls under good nutritional conditions. Body weight, testes diameter and degree of penile freedom were recorded weekly. Sexual maturity was assessed by the examination of semen collected by an artificial vagina. Puberty was defined as the stage when the animal was able to produce viable sperms. Mating, followed by strong jerks and ejaculation of mature sperms, was taken to indicate onset of breeding maturity. Mojaheem camels reached sexual maturity at a significantly younger age and heavier weight (164 weeks and 360 kg) than Wadah camels (182 weeks and 336.5 kg) (P < 0.001). Complete separation of the penis from preputial adhesions occurred at an average age of 138.6 weeks in both breeds. At the point of sexual maturity, the mean percentage of live spermatozoa was 65.1 +/- 5.2 while percentage of abnormal sperms was 17.6 +/- 2.2; total motility was 40 +/- 16% and progressive motility (48 +/- 2.2% (semen pH range 7.8-8.2). The percentage of live sperm was 65 +/- 1.5 (normal sperms 82 +/- 4). It is suggested that the encouragement of rapid growth during the pubertal period in camels managed under good nutritional and environmental conditions could assist early sexual development and breeding maturity.

ZEB1 is Estrogen Responsive In Vitro in Human Foreskin Cells and is Over Expressed in Penile Skin in Patients With Severe Hypospadias

PubMed Central

Qiao, Liang; Tasian, Gregory E.; Zhang, Haiyang; Cunha, Gerald R.; Baskin, Laurence

2012-01-01

Purpose We determined the effect of estrogen on ZEB1 in vitro and tested the hypothesis that ZEB1 is over expressed in the penile skin of subjects with hypospadias. Materials and Methods Hs68 cells, a fibroblast cell line derived from human foreskin, were exposed to 0, 1, 10 and 100 nM estrogen, and the expression level of ZEB1 was assessed using reverse transcription real-time polymerase chain reaction, Western blot and immunocytochemical analysis. Next, preputial skin was prospectively collected from case and control subjects at hypospadias repair (37 cases) and circumcision (11). Hypospadias was classified as severe (13 cases) or mild (24) based on the position of the urethral meatus. ZEB1 expression was quantified using reverse transcription real-time polymerase chain reaction, Western blot and immunohistochemical analysis. Results Estrogen increased ZEB1 expression at the mRNA and protein levels in Hs68 cells in a concentration dependent fashion (p <0.01). Subjects with severe hypospadias had significantly higher ZEB1 mRNA levels and protein expression compared to controls or subjects with mild hypospadias (both p <0.01). Subjects with severe hypospadias had increased expression of ZEB1 in the basal layers of the preputial epidermis. Conclusions Estrogen increases ZEB1 expression in a human foreskin fibroblast cell line in vitro. Furthermore, ZEB1 is significantly over expressed in the penile skin of subjects with severe hypospadias. We propose that ZEB1 overexpression may contribute to development of hypospadias and may mediate the effect of estrogen on developing external male genitalia. PMID:21421232

The MTV experiment: a test of time reversal symmetry using polarized 8Li

NASA Astrophysics Data System (ADS)

Murata, J.; Baba, H.; Behr, J. A.; Hirayama, Y.; Iguri, T.; Ikeda, M.; Kato, T.; Kawamura, H.; Kishi, R.; Levy, C. D. P.; Nakaya, Y.; Ninomiya, K.; Ogawa, N.; Onishi, J.; Openshaw, R.; Pearson, M.; Seitaibashi, E.; Tanaka, S.; Tanuma, R.; Totsuka, Y.; Toyoda, T.

2014-01-01

The MTV ( Mott Polarimetry for T- Violation Experiment) experiment at TRIUMF-ISAC ( Isotope Separator and ACcelerator), which aims to achieve the highest precision test of time reversal symmetry in polarized nuclear beta decay by measuring a triple correlation ( R-correlation), is motivated by the search for a new physics beyond the Standard Model. In this experiment, the existence of non-zero transverse electron polarization is examined utilizing the analyzing power of Mott scattering from a thin metal foil. Backward scattering electron tracks are measured using a multi-wire drift chamber for the first time. The MTV experiment was commissioned at ISAC in 2009 using an 80 % polarized 8Li beam at 107 pps, resulting in 0.1 % statistical precision on the R-parameter in the first physics run performed in 2010. Next generation cylindrical drift chamber (CDC) is now being installed for the future run.

Overcoming barriers to effective early parenting interventions for attention-deficit hyperactivity disorder (ADHD): parent and practitioner views

PubMed Central

Smith, E; Koerting, J; Latter, S; Knowles, M M; McCann, D C; Thompson, M; Sonuga-Barke, E J

2015-01-01

Background The importance of early intervention approaches for the treatment of attention-deficit hyperactivity disorder (ADHD) has been increasingly acknowledged. Parenting programmes (PPs) are recommended for use with preschool children with ADHD. However, low ‘take-up’ and high ‘drop-out’ rates compromise the effectiveness of such programmes within the community. Methods This qualitative study examined the views of 25 parents and 18 practitioners regarding currently available PPs for preschool children with ADHD-type problems in the UK. Semi-structured interviews were undertaken to identify both barriers and facilitators associated with programme access, programme effectiveness, and continued engagement. Results and conclusions Many of the themes mirrored previous accounts relating to generic PPs for disruptive behaviour problems. There were also a number of ADHD-specific themes. Enhancing parental motivation to change parenting practice and providing an intervention that addresses the parents' own needs (e.g. in relation to self-confidence, depression or parental ADHD), in addition to those of the child, were considered of particular importance. Comparisons between the views of parents and practitioners highlighted a need to increase awareness of parental psychological barriers among practitioners and for better programme advertising generally. Clinical implications and specific recommendations drawn from these findings are discussed and presented. PMID:24814640

Adverse drug reactions in children: a ten-year review of reporting to the Portuguese Pharmacovigilance System.

PubMed

Nogueira Guerra, Leonor; Herdeiro, Maria Teresa; Ribeiro-Vaz, Inês; Clérigo, Maria Inês Pinto; Rocha, Cristina; Araújo, Ana; Pêgo, Alexandra; Rebelo Gomes, Eva

2015-01-01

Adverse drug reactions (ADR) are a public health problem. They cause significant morbidity, mortality and health costs. Less is known about pediatric ADR. Our goal was to characterize a pediatric case series of ADR reported to the Portuguese Pharmacovigilance System (PPS) during the past 10 years. Retrospective analysis of ADR reports concerning patients till 17 years old received by the PPS between 2003 and 2012. We evaluated patients' demographic data and involved drugs, as well as characteristics and seriousness of reactions, stratified by age groups. We found 1742 reports (50% females) corresponding to 9.7% of the total received. The age of the patients varied from 0 to 17 years (median: 5 years, interquartile range: 10.6), with 566 cases (32%) occurring in patients younger than 2y. Among the 1195 serious cases, 31% (370) episodes led to hospitalization. In 32 cases (2%) there was a fatal outcome. Most of the ADR reported referred to general disorders and administration site conditions, followed by skin and subcutaneous tissue reactions. Vaccines were the most represented group (42%) followed by antibacterials for systemic use (17%). Pediatric ADR represents about 10% of the reports received by the PPS. Most ADR were considered serious. Major findings varied according to age groups.

Overcoming barriers to effective early parenting interventions for attention-deficit hyperactivity disorder (ADHD): parent and practitioner views.

PubMed

Smith, E; Koerting, J; Latter, S; Knowles, M M; McCann, D C; Thompson, M; Sonuga-Barke, E J

2015-01-01

The importance of early intervention approaches for the treatment of attention-deficit hyperactivity disorder (ADHD) has been increasingly acknowledged. Parenting programmes (PPs) are recommended for use with preschool children with ADHD. However, low 'take-up' and high 'drop-out' rates compromise the effectiveness of such programmes within the community. This qualitative study examined the views of 25 parents and 18 practitioners regarding currently available PPs for preschool children with ADHD-type problems in the UK. Semi-structured interviews were undertaken to identify both barriers and facilitators associated with programme access, programme effectiveness, and continued engagement. Many of the themes mirrored previous accounts relating to generic PPs for disruptive behaviour problems. There were also a number of ADHD-specific themes. Enhancing parental motivation to change parenting practice and providing an intervention that addresses the parents' own needs (e.g. in relation to self-confidence, depression or parental ADHD), in addition to those of the child, were considered of particular importance. Comparisons between the views of parents and practitioners highlighted a need to increase awareness of parental psychological barriers among practitioners and for better programme advertising generally. Clinical implications and specific recommendations drawn from these findings are discussed and presented. © 2014 The Authors. Child: Care, Health and Development published by John Wiley & Sons Ltd.

Trans-oral resection of large parapharyngeal space tumours.

PubMed

Hussain, A; Ah-See, K W; Shakeel, M

2014-03-01

The aim of this study is to describe minimally invasive trans-oral approach for resection of parapharyngeal space (PPS) tumours and to demonstrate surgical technique, resection, repair and outcomes. Five cases were prospectively included in the study. The data collected include age, sex, site, size, pathology, radiological investigations, surgical excision, complications and outcomes. Three females and two male patients underwent trans-oral resection of PPS tumours sized 4-8 cm. The pathology included two deep lobe parotid tumours, one schwannoma, one hibernoma and one primary adenocarcinoma arising form the minor salivary gland. All tumours were resected completely without any technical difficulty. The healing was quick and by primary intention. Patients resumed oral feeding on recovery from general anaesthesia and did not require any significant analgesia beyond the first 2 days. Patient with adenocarcinoma received postoperative radiotherapy and remained disease-free during 4 years post-treatment. No recurrences were observed in patients with benign tumours. No neurovascular injury occurred during surgery and no secondary bleeding was observed. We have demonstrated successful and safe execution of trans-oral resection of large PPS tumours. There were no intra and post-operative complications and there has been no recurrence during the follow-up period. In our experience, it appears to be efficient, safe and minimally invasive compared to the established techniques.

Constructing Adverse Outcome Pathways: a Demonstration of ...

EPA Pesticide Factsheets

Adverse outcome pathway (AOP) provides a conceptual framework to evaluate and integrate chemical toxicity and its effects across the levels of biological organization. As such, it is essential to develop a resource-efficient and effective approach to extend molecular initiating events (MIEs) of chemicals to their downstream phenotypes of a greater regulatory relevance. A number of ongoing public phenomics (high throughput phenotyping) efforts have been generating abundant phenotypic data annotated with ontology terms. These phenotypes can be analyzed semantically and linked to MIEs of interest, all in the context of a knowledge base integrated from a variety of ontologies for various species and knowledge domains. In such analyses, two phenotypic profiles (PPs; anchored by genes or diseases) each characterized by multiple ontology terms are compared for their semantic similarities within a common ontology graph, but across boundaries of species and knowledge domains. Taking advantage of publicly available ontologies and software tool kits, we have implemented an OS-Mapping (Ontology-based Semantics Mapping) approach as a Java application, and constructed a network of 19383 PPs as nodes with edges weighed by their pairwise semantic similarity scores. Individual PPs were assembled from public phenomics data. Out of possible 1.87×108 pairwise connections among these nodes, about 71% of them have similarity scores between 0.2 and the maximum possible of 1.0.

Ionic electrodeposition of II-VI and III-V compounds. III. Computer simulation of quasi-rest potentials for M/sub 1/X/sub 1/ compounds analogous to CdTe

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

Engelken, R.D.

1987-04-01

The quasi-rest potential (QRP) has been proposed as a key quantity in characterizing compound semiconductor (e.g. CdTe) electrodeposition. This article expands the modeling/simulation representative of Cd/sub x/Te in chemical equilibrium to calculate two ''QRP's'': E/sub M/1/sub /, the mixed potential occurring immediately after current interruption and before any relaxation in double layer ion concentration and significant ion exchange/surface stoichiometry change occur, and E/sub M/2/sub /, another mixed potential occurring after the double layer ion concentrations have relaxed to their bulk values but still before any significant surface composition change occurs. Significant predictions include existence of a dramatic negative transition inmore » QRP, with negative-going deposition potential, centered on the potential of perfect stoichiometry (PPS), inequality, in general, between the PPS and E/sub M/1/sub / unless the deposit remains in equilibrium with the electrolyte (no ion exchange at open circuit), negligible sensitivity of QRP-E curves to the activity coefficient parameter implying the importance of the PPS in characterizing compound deposition, and disappearance of the transition structure for sufficiently positive Gibbs free energies.« less

Novel simultaneous combination chemical thrombolysis/rheolytic thrombectomy therapy for acute critical limb ischemia: the power-pulse spray technique.

PubMed

Allie, David E; Hebert, Chris J; Lirtzman, Mitchell D; Wyatt, Charles H; Keller, V Antoine; Khan, Mohamed H; Barker, Esmond A; McElderry, Michael W; Khan, Muhammad A; Fail, Peter S; Stagg, Samuel J; Mitran, Elena V; Chaisson, Gary; Allie, Sonja D; Allie, Adam A; Walker, Craig M

2004-12-01

The novel power-pulse spray (P-PS) technique maximizes and combines the advantages and minimizes the disadvantages of both chemical thrombolysis (CT) and rheolytic thrombectomy (RT). Forty-nine consecutive patients with iliofemoral thrombotic occlusion were treated via P-PS technique. Using a 6 Fr RT catheter, saline prime was exchanged for thrombolytic solution [group 1, 10-20 mg tenecteplase (TNK)/50 cc saline, n = 25; group 2, 1,000,000 urokinase (UK)/50 cc saline, n = 24]. The outflow port was closed, then the catheter was advanced at 1 mm increments while pulsing lytic agent. After 30-min lysis time, RT and definitive treatment of the underlying stenosis were performed. Procedure success was 23/25 (92%) and 22/24 (91.6%) for group 1 and 2, respectively. The mean total procedure time was 72 and 75 min in group 1 and 2, respectively. Thirty-day limb salvage was 91% in both groups. There were no major surgical complications. The P-PS technique is safe and effective using either UK or TNK, offering several potential advantages over monotherapy, including more rapid revascularization, decreases systemic lytic exposure and bleeding complications while facilitating both CT and RT capacity and efficacy. (c) 2004 Wiley-Liss, Inc.

Service mix in the hospital outpatient department: implications for Medicare payment reform.

PubMed Central

Miller, M E; Sulvetta, M B; Englert, E

1995-01-01

OBJECTIVE. To determine if implementation of a PPS for Medicare hospital outpatient department (HOPD) services will have distributional consequences across hospital types and regions, this analysis assesses variation in service mix and the provision of high-technology services in the HOPD. DATA. HCFA's 1990 claims file for a 5 percent random sample of Medicare beneficiaries using the HOPD was merged, by hospital provider number, with various HCFA hospital characteristic files. STUDY DESIGN. Hospital characteristics examined are urban/rural location, teaching status, disproportionate-share status, and bed size. Two analyses of HOPD services are presented: mix of services provided and the provision of high-technology services. The mix of services is measured by the percentage of services in each of 14 type-of-service categories (e.g., medical visits, advanced imaging services, diagnostic testing services). Technology provision is measured by the percentage of hospitals providing selected high-technology services. FINDINGS/CONCLUSIONS. The findings suggest that the role hospital types play in providing HOPD services warrants consideration in establishing a PPS. HOPDs in major teaching hospitals and hospitals serving a disproportionate share of the poor play an important role in providing routine visits. HOPDs in both major and minor teaching hospitals are important providers of high-technology services. Other findings have implications for the structure of an HOPD PPS as well. First, over half of the services provided in the HOPD are laboratory tests and HOPDs may have limited control over these services since they are often for patients referred from local physician offices. Second, service mix and technology provision vary markedly among regions, suggesting the need for a transition to prospective payment. Third, the organization of service supply in a region may affect service provision in the HOPD suggesting that an HOPD PPS needs to be coordinated with payment policies in competing sites of care (e.g., ambulatory surgical centers). PMID:7721585

A multicentre, double-masked, randomized, controlled trial assessing the effect of oral supplementation of omega-3 and omega-6 fatty acids on a conjunctival inflammatory marker in dry eye patients.

PubMed

Brignole-Baudouin, Françoise; Baudouin, Christophe; Aragona, Pasquale; Rolando, Maurizio; Labetoulle, Marc; Pisella, Pierre Jean; Barabino, Stefano; Siou-Mermet, Raphaele; Creuzot-Garcher, Catherine

2011-11-01

To determine whether oral supplementation with omega-3 and omega-6 fatty acids can reduce conjunctival epithelium expression of the inflammatory marker human leucocyte antigen-DR (HLA-DR) in patients with dry eye syndrome (DES). This 3-month, double-masked, parallel-group, controlled study was conducted in nine centres, in France and Italy. Eligible adult patients with mild to moderate DES were randomized to receive a placebo containing medium-chain triglycerides or treatment supplement containing omega-3 and omega-6 fatty acids, vitamins and zinc. Treatment regimen was three capsules daily. Impression cytology (IC) was performed at baseline and at month 3 to assess the percentage of cells expressing HLA-DR and to evaluate fluorescence intensity, an alternate measure of HLA-DR. Dry eye symptoms and objective signs were also evaluated. Analyses were performed on the full analysis set (FAS) and per-protocol set (PPS). In total, 138 patients were randomized; 121 patients with available IC were included in the FAS, and of these, 106 patients had no major protocol deviations (PPS). In the PPS, there was a significant reduction in the percentage of HLA-DR-positive cells in the fatty acids group (p = 0.021). Expression of HLA-DR as measured by fluorescence intensity quantification was also significantly reduced in the fatty acids group [FAS (p = 0.041); PPS (p = 0.017)]. No significant difference was found for the signs and symptoms, but there was a tendency for improvement in patients receiving the fatty acids treatment. This study demonstrates that supplementation with omega-3 and omega-6 fatty acids can reduce expression of HLA-DR conjunctival inflammatory marker and may help improve DES symptoms. © 2011 The Authors. Acta Ophthalmologica © 2011 Acta Ophthalmologica Scandinavica Foundation.

Thyroid hormone concentrations, disease, physical function, and mortality in elderly men.

PubMed

van den Beld, Annewieke W; Visser, Theo J; Feelders, Richard A; Grobbee, Diederick E; Lamberts, Steven W J

2005-12-01

Physiological changes in thyroid hormone concentrations might be related to changes in the overall physical function in the elderly. We determined to what extent thyroid hormone concentrations are related to physical function and mortality in elderly men. A longitudinal population study (the Zoetermeer study) was conducted. Mortality was registered in the subsequent 4 yr. Four hundred three independently and ambulatory living men (aged 73-94 yr) participated. The study examined the association between serum thyroid hormones and parameters of physical function as well as the association with mortality. TSH, free T4 (FT4) total T4, T3, rT3, and T4-binding globulin were measured. Physical function was estimated by the number of problems in activities of daily living, a measure of physical performance score (PPS), leg extensor strength and grip strength, bone density, and body composition. Serum rT3 increased significantly with age and the presence of disease. Sixty-three men met the biochemical criteria for the low T3 syndrome (decreased serum T3 and increased serum rT3). This was associated with a lower PPS, independent of disease. Furthermore, higher serum FT4 (within the normal range of healthy adults) and rT3 (above the normal range of healthy adults) were related with a lower grip strength and PPS, independent of age and disease. Isolated low T3 was associated with a better PPS and a higher lean body mass. Low FT4 was related to a decreased risk of 4-yr mortality. In a population of independently living elderly men, higher FT4 and rT3 concentrations are associated with a lower physical function. High serum rT3 may result from a decreased peripheral metabolism of thyroid hormones due to the aging process itself and/or disease and may reflect a catabolic state. Low serum FT4 is associated with a better 4-yr survival; this may reflect an adaptive mechanism to prevent excessive catabolism.

A new monthly gravity field model based on GRACE observations computed by the modified dynamic approach

NASA Astrophysics Data System (ADS)

Zhou, H.; Luo, Z.; Li, Q.; Zhong, B.

2016-12-01

The monthly gravity field model can be used to compute the information about the mass variation within the system Earth, i.e., the relationship between mass variation in the oceans, land hydrology, and ice sheets. For more than ten years, GRACE has provided valuable information for recovering monthly gravity field model. In this study, a new time series of GRACE monthly solution, which is truncated to degree and order 60, is computed by the modified dynamic approach. Compared with the traditional dynamic approach, the major difference of our modified approach is the way to process the nuisance parameters. This type of parameters is mainly used to absorb low-frequency errors in KBRR data. One way is to remove the nuisance parameters before estimating the geo-potential coefficients, called Pure Predetermined Strategy (PPS). The other way is to determine the nuisance parameters and geo-potential coefficients simultaneously, called Pure Simultaneous Strategy (PSS). It is convenient to detect the gross error by PPS, while there is also obvious signal loss compared with the solutions derived from PSS. After comparing the difference of practical calculation formulas between PPS and PSS, we create the Filter Predetermine Strategy (FPS), which can combine the advantages of PPS and PSS efficiently. With FPS, a new monthly gravity field model entitled HUST-Grace2016s is developed. The comparisons of geoid degree powers and mass change signals in the Amazon basin, the Greenland and the Antarctic demonstrate that our model is comparable with the other published models, e.g., the CSR RL05, JPL RL05 and GFZ RL05 models. Acknowledgements: This work is supported by China Postdoctoral Science Foundation (Grant No.2016M592337), the National Natural Science Foundation of China (Grant Nos. 41131067, 41504014), the Open Research Fund Program of the State Key Laboratory of Geodesy and Earth's Dynamics (Grant No. SKLGED2015-1-3-E).

Ecto-Nucleotidase Activities of Promastigotes from Leishmania (Viannia) braziliensis Relates to Parasite Infectivity and Disease Clinical Outcome

PubMed Central

Leite, Pauline M.; Gomes, Rodrigo S.; Figueiredo, Amanda B.; Serafim, Tiago D.; Tafuri, Wagner L.; de Souza, Carolina C.; Moura, Sandra A. L.; Fietto, Juliana L. R.; Melo, Maria N.; Ribeiro-Dias, Fátima; Oliveira, Milton A. P.; Rabello, Ana; Afonso, Luís C. C.

2012-01-01

Background Leishmania (Viannia) braziliensis has been associated with a broad range of clinical manifestations ranging from a simple cutaneous ulcer to destructive mucosal lesions. Factors leading to this diversity of clinical presentations are not clear, but parasite factors have lately been recognized as important in determining disease progression. Given the fact that the activity of ecto-nucleotidases correlates with parasitism and the development of infection, we evaluated the activity of these enzymes in promastigotes from 23 L. braziliensis isolates as a possible parasite-related factor that could influence the clinical outcome of the disease. Methodology/Principal Findings Our results show that the isolates differ in their ability to hydrolyze adenine nucleotides. Furthermore, we observed a positive correlation between the time for peak of lesion development in C57BL/6J mice and enzymatic activity and clinical manifestation of the isolate. In addition, we found that L. (V.) braziliensis isolates obtained from mucosal lesions hydrolyze higher amounts of adenine nucleotides than isolates obtained from skin lesions. One isolate with high (PPS6m) and another with low (SSF) ecto-nucleotidase activity were chosen for further studies. Mice inoculated with PPS6m show delayed lesion development and present larger parasite loads than animals inoculated with the SSF isolate. In addition, PPS6m modulates the host immune response by inhibiting dendritic cell activation and NO production by activated J774 macrophages. Finally, we observed that the amastigote forms from PPS6m and SSF isolates present low enzymatic activity that does not interfere with NO production and parasite survival in macrophages. Conclusions/Significance Our data suggest that ecto-nucleotidases present on the promastigote forms of the parasite may interfere with the establishment of the immune response with consequent impaired ability to control parasite dissemination and this may be an important factor in determining the clinical outcome of leishmaniasis. PMID:23071853

C4 deficiency is a predisposing factor for Streptococcus pneumoniae-induced autoantibody production

PubMed Central

Yammani, Rama D.; Leyva, Marcela A.; Jennings, Ryan N.; Haas, Karen M.

2015-01-01

Reductions in C4 levels may predispose individuals to infection with encapsulated bacteria as well as autoimmunity. In this study, we examined the role C4 has in protection against Streptococcus pneumoniae-induced autoimmunity. Mild respiratory infection with serotype 19F pneumococci selectively induced systemic anti-dsDNA IgA production in naïve C4-/- mice, but not C3-/- or wild type mice. Systemic challenge with virulent serotype 3 pneumococci also induced anti-dsDNA IgA production in immune C4-/- mice. Remarkably, pneumococcal polysaccharide (PPS) vaccination alone induced C4-/- mice to produce increased anti-dsDNA IgA levels that were maintained in some mice for months. These effects were most pronounced in female C4-/- mice. Importantly, immunization-induced increases in anti-dsDNA IgA levels were strongly associated with increased IgA deposition in kidneys. Cross-reactivity between pneumococcal antigens and dsDNA played a partial role in the induction of anti-dsDNA IgA, but a major role for PPS-associated TLR2 agonists was also revealed. Administration of the TLR2/4 antagonist, OxPAPC, at the time of PPS immunization completely blocked the production of anti-dsDNA IgA in C4-/- mice without suppressing PPS-specific Ab production. The TLR2 agonist, Pam3Csk4, similarly induced anti-dsDNA IgA production in C4-/- mice, which OxPAPC also prevented. LPS, a TLR4 agonist, had no effect. Pam3Csk4, but not LPS, also induced dsDNA-specific IgA production by C4-/- splenic IgA+ B cells in vitro, indicating TLR2 agonists can stimulate autoAb production via B cell-intrinsic mechanisms. Collectively, our results show an important role for C4 in suppressing autoAb production elicited by cross-reactive antigens and TLR2 agonists associated with S. pneumoniae. PMID:25339671

Social Franchising and a Nationwide Mass Media Campaign Increased the Prevalence of Adequate Complementary Feeding in Vietnam: A Cluster-Randomized Program Evaluation123

PubMed Central

Rawat, Rahul; Nguyen, Phuong Hong; Tran, Lan Mai; Hajeebhoy, Nemat; Nguyen, Huan Van; Baker, Jean; Frongillo, Edward A; Ruel, Marie T; Menon, Purnima

2017-01-01

Background: Rigorous evaluations of health system–based interventions in large-scale programs to improve complementary feeding (CF) practices are limited. Alive & Thrive applied principles of social franchising within the government health system in Vietnam to improve the quality of interpersonal counseling (IPC) for infant and young child feeding combined with a national mass media (MM) campaign and community mobilization (CM). Objective: We evaluated the impact of enhanced IPC + MM + CM (intensive) compared with standard IPC + less-intensive MM and CM (nonintensive) on CF practices and anthropometric indicators. Methods: A cluster-randomized, nonblinded evaluation design with cross-sectional surveys (n = ∼500 children aged 6–23.9 mo and ∼1000 children aged 24–59.9 mo/group) implemented at baseline (2010) and endline (2014) was used. Difference-in-difference estimates (DDEs) of impact were calculated for intent-to-treat (ITT) analyses and modified per-protocol analyses (MPAs; mothers who attended the social franchising at least once: 62%). Results: Groups were similar at baseline. In ITT analyses, there were no significant differences between groups in changes in CF practices over time. In the MPAs, greater improvements in the intensive than in the nonintensive group were seen for minimum dietary diversity [DDE: 6.4 percentage points (pps); P < 0.05] and minimum acceptable diet (8.0 pps; P < 0.05). Significant stunting declines occurred in both intensive (7.1 pps) and nonintensive (5.4 pps) groups among children aged 24–59.9 mo, with no differential decline. Conclusions: When combined with MM and CM, an at-scale social franchising approach to improve IPC, delivered through the existing health care system, significantly improved CF practices, but not child growth, among mothers who used counseling services at least once. A greater impact may be achieved with strategies designed to increase service utilization. This trial was registered at clinicaltrials.gov as NCT01676623. PMID:28179488

An evaluation of activity tolerance, patient-reported outcomes and satisfaction with the effectiveness of pulmonary daoyin on patients with chronic obstructive pulmonary disease.

PubMed

Zhang, Hai-Long; Li, Jian-Sheng; Yu, Xue-Qing; Li, Su-Yun; Halmurat, Upur; Xie, Yang; Wang, Yan-Fang; Li, Feng-Sen; Wang, Ming-Hang

2017-01-01

Pulmonary Daoyin (PD) (evolved from ancient Chinese daoyin skills), is a rehabilitation technology that combines specially designed movements of the arms and body and controlled breathing exercises, to improve the physiological and psychological status of patients with chronic respiratory disease. Pulmonary rehabilitation is effective for patients with chronic obstructive pulmonary disease (COPD), and the efficacy of PD is unknown. The aim of this study is to investigate the effect of a PD program in enhancing activity tolerance, patient-reported outcomes and satisfaction with the effectiveness on patients with COPD. The multi-center, randomized controlled trial was conducted from November 2011 to June 2012 in local communities in cities of the 11 research centers in China. It included COPD patients (moderate to very severe) who were recruited from an outpatient clinic. A randomized controlled study included 464 COPD patients who were randomly allocated either to the PD group, participating in a 3-month, ten times-weekly supervised PD-based pulmonary rehabilitation program, or to a control group continuing with regular medical treatment alone. Data were gathered using the 6-minute walking distance (6MWD) test, COPD patient-reported outcomes (COPD-PRO) and Effectiveness Satisfaction Questionnaire for COPD (ESQ-COPD), which was filled out at baseline and 3 months post-intervention. SAS 9.2 was used for statistical analysis. Of the 464 patients in the study, 461 were included in the full analysis set (FAS); 429 were in the per-protocol analysis set (PPS). After 3-month intervention, there was a significant difference between the two groups in 6MWD (FAS; P =0.049; PPS; P =0.041), total score and all domains of COPD-PRO (FAS; P =0.014; PPS; P =0.003) and ESQ-COPD (FAS; P =0.038; PPS; P <0.001). The PD program was able to improve the activity tolerance level and satisfaction of COPD patients because of its effectiveness.

Development and application of EEAST: a life cycle based model for use of harvested rainwater and composting toilets in buildings.

PubMed

Devkota, J; Schlachter, H; Anand, C; Phillips, R; Apul, Defne

2013-11-30

Harvested rainwater systems and composting toilets are expected to be an important part of sustainable solutions in buildings. Yet, to this date, a model evaluating their economic and environmental impact has been missing. To address this need, a life cycle based model, EEAST was developed. EEAST was designed to compare the business as usual (BAU) case of using potable water for toilet flushing and irrigation to alternative scenarios of rainwater harvesting and composting toilet based technologies. In EEAST, building characteristics, occupancy, and precipitation are used to size the harvested rainwater and composting toilet systems. Then, life cycle costing and life cycle assessment methods are used to estimate cost, energy, and greenhouse gas (GHG) emission payback periods (PPs) for five alternative scenarios. The scenarios modeled include use of harvested rainwater for toilet flushing, for irrigation, or both; and use of composting toilets with or without harvested rainwater use for irrigation. A sample simulation using EEAST showed that for the office building modeled, the cost PPs were greater than energy PPs which in turn were greater than GHG emission PPs. This was primarily due to energy and emission intensive nature of the centralized water and wastewater infrastructure. The sample simulation also suggested that the composting toilets may have the best performance in all criteria. However, EEAST does not explicitly model solids management and as such may give composting toilets an unfair advantage compared to flush based toilets. EEAST results were found to be very sensitive to cost values used in the model. With the availability of EEAST, life cycle cost, energy, and GHG emissions can now be performed fairly easily by building designers and researchers. Future work is recommended to further improve EEAST and evaluate it for different types of buildings and climates so as to better understand when composting toilets and harvested rainwater systems outperform the BAU case in building design. Copyright © 2013 Elsevier Ltd. All rights reserved.

Financial implications of choice of dialysis type of the revised Medicare payment system: an economic analysis.

PubMed

Hornberger, John; Hirth, Richard A

2012-08-01

In 2011, the Medicare Improvements for Patients and Providers Act replaced the case-mix-adjusted composite payment system for Medicare outpatient dialysis facilities with a bundled end-stage renal disease prospective payment system (PPS). We assessed the economic implications for modality choice of the revised Medicare payment system. Microeconomic analyses. Patients eligible for dialysis in the United States. The perspective of this analysis is that of a financial administrator of a representative dialysis center in the United States. Data were obtained from the Medicare Payment Advisory Commission, the US Renal Data System, the DOPPS (Dialysis Outcomes and Practice Patterns Study) Practice Monitor, the US Bureau of Labor Statistics, and Medicare fee schedules. Recently implemented end-stage renal disease PPS versus the prior case-mix composite payment system. Medicare payment per month, center fixed and variable costs per month, net difference in revenue and variable costs (direct contribution), and net difference in revenue and total costs (operating margin). The direct contribution and operating margin for in-center hemodialysis and peritoneal dialysis are expected to be positive under the new bundled PPS. For Medicare fiscal intermediaries/administrators, paid treatments for home hemodialysis vary from 3.2 to more than 4.8 per week. The direct contribution and operating margin are expected to be negative for home hemodialysis if the number of paid treatments is similar between in-center and home hemodialysis; they are almost identical when the number of paid treatments increases for home hemodialysis by approximately 1 per week. Experience across centers and intermediaries/administrators may vary. Sensitivity analyses were conducted to assess the robustness of findings and determine which variables most influenced results. The new bundled PPS created a financial incentive for increased use of peritoneal dialysis. Use of home hemodialysis may be influenced by number of paid treatments per week. Copyright © 2012 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Examining the Impact of a University-driven Exercise Programming Event on End-of-semester Stress in Students.

PubMed

Koschel, Tessa L; Young, John C; Navalta, James W

2017-01-01

Stress levels in university students peak during the final exam period. An inverse association exists between Physical Activity (PA) and poor mental health. UNLV has created Fitness4Finals (F4F), an event novel in its approach to academic stress reduction by incorporating both physical activity and mental relaxation. To our knowledge, a university-driven programming event aimed at reducing physiological and psychological stress among students approaching final exams had never been studied. Therefore, the aims of this research were to 1) examine the influence of F4F on physiological stress and perceived psychological stress (PPS) and 2) to examine the relationship between physiological stress and PPS. Fifteen full-time university students were recruited to participate in their choice of one of two groups: F4F or control (NonF4F). Pre-F4F and post-F4F measures of physiological stress, measured by salivary cortisol, and perceived psychological stress, measured by survey were collected. The F4F event was held the week prior to final examinations. Participants in the F4F group engaged in one F4F activity per day for the duration of the 3-day event. Results of the repeated measures MANOVA indicated nonsignificant interaction (p = .864) between F4F participation, physiological stress and PPS. PPS and cortisol were not correlated at the onset of the study (r = -0.18, p = 0.48) or at the last sampling period (r = 0.097, p = 0.73). Preemptive elevated levels of PA in the F4F group may have influenced results. Qualitative data indicates a unanimous perceived reduction in stress from F4F participation. While the physiological measures of stress in the present study were not significantly different, the perceived stress reduction reported by F4F participants is influential. Further investigation with improvements in timing and measurement tools is warranted.

Neuropeptide Y and peptide YY inhibit excitatory synaptic transmission in the rat dorsal motor nucleus of the vagus

PubMed Central

Browning, Kirsteen N; Travagli, R Alberto

2003-01-01

Pancreatic polypeptides (PPs) such as neuropeptide Y (NPY) and peptide YY (PYY) exert profound, vagally mediated effects on gastrointestinal (GI) motility and secretion. Whole-cell patch clamp recordings were made from brainstem slices containing identified GI-projecting rat dorsal motor nucleus of the vagus (DMV) neurons to determine the mechanism of action of PPs. Electrical stimulation of nucleus tractus solitarii (NTS) induced excitatory postsynaptic currents (EPSCs) that were reduced in a concentration-dependent manner by NPY and PYY (both at 0.1–300 nm) in 65 % of the neurons. An increase in the paired-pulse ratio without changes in the postsynaptic membrane input resistance or EPSC rise and decay time suggested that the effects of PPs on EPSCs were due to actions at presynaptic receptors. The Y1 and Y2 receptor selective agonists [Leu31,Pro34]NPY and NPY(3–36) (both at 100 nm) mimicked the inhibition of NPY and PYY on the EPSC amplitude. The effects of 100 nm NPY, but not PYY, were antagonized partially by the Y1 receptor selective antagonist BIBP3226 (0.1 μm). In addition, the inhibition of the EPSC amplitude induced by NPY, but not PYY, was attenuated partially by pretreatment with the α2 adrenoceptor antagonist yohimbine (10 μm), and occluded partially by the α2 adrenoceptor agonist UK14,304 (10 μm) as well as by pretreatment with reserpine. Pretreatment with a combination of BIBP3226 and yohimbine almost completely antagonized the NPY-mediated effects on EPSCs. Contrary to the inhibition of EPSCs, perfusion with PPs had no effect on the amplitude of inhibitory postsynaptic currents (IPSCs) and a minimal effect on a minority of DMV neurons. Differences in the receptor subtypes utilized and in the mechanism of action of NPY and PYY may indicate functional differences in their roles within the circuitry of the dorsal vagal complex (DVC). PMID:12730340

In Vivo-Selected Pyrazinoic Acid-Resistant Mycobacterium tuberculosis Strains Harbor Missense Mutations in the Aspartate Decarboxylase PanD and the Unfoldase ClpC1.

PubMed

Gopal, Pooja; Tasneen, Rokeya; Yee, Michelle; Lanoix, Jean-Philippe; Sarathy, Jansy; Rasic, George; Li, Liping; Dartois, Véronique; Nuermberger, Eric; Dick, Thomas

2017-07-14

Through mutant selection on agar containing pyrazinoic acid (POA), the bioactive form of the prodrug pyrazinamide (PZA), we recently showed that missense mutations in the aspartate decarboxylase PanD and the unfoldase ClpC1, and loss-of-function mutation of polyketide synthases Mas and PpsA-E involved in phthiocerol dimycocerosate synthesis, cause resistance to POA and PZA in Mycobacterium tuberculosis. Here we first asked whether these in vitro-selected POA/PZA-resistant mutants are attenuated in vivo, to potentially explain the lack of evidence of these mutations among PZA-resistant clinical isolates. Infection of mice with panD, clpC1, and mas/ppsA-E mutants showed that whereas growth of clpC1 and mas/ppsA-E mutants was attenuated, the panD mutant grew as well as the wild-type. To determine whether these resistance mechanisms can emerge within the host, mice infected with wild-type M. tuberculosis were treated with POA, and POA-resistant colonies were confirmed for PZA and POA resistance. Genome sequencing revealed that 82 and 18% of the strains contained missense mutations in panD and clpC1, respectively. Consistent with their lower fitness and POA resistance level, independent mas/ppsA-E mutants were not found. In conclusion, we show that the POA/PZA resistance mechanisms due to panD and clpC1 missense mutations are recapitulated in vivo. Whereas the representative clpC1 mutant was attenuated for growth in the mouse infection model, providing a possible explanation for their absence among clinical isolates, the growth kinetics of the representative panD mutant was unaffected. Why POA/PZA resistance-conferring panD mutations are observed in POA-treated mice but not yet among clinical strains isolated from PZA-treated patients remains to be determined.

Dependence of the paired motor unit analysis on motor unit discharge characteristics in the human tibialis anterior muscle

PubMed Central

Stephenson, Jennifer L.; Maluf, Katrina S.

2011-01-01

The paired motor unit analysis provides in vivo estimates of the magnitude of persistent inward currents (PIC) in human motoneurons by quantifying changes in the firing rate (ΔF) of an earlier recruited (reference) motor unit at the time of recruitment and derecruitment of a later recruited (test) motor unit. This study assessed the variability of ΔF estimates, and quantified the dependence of ΔF on the discharge characteristics of the motor units selected for analysis. ΔF was calculated for 158 pairs of motor units recorded from nine healthy individuals during repeated submaximal contractions of the tibialis anterior muscle. The mean (SD) ΔF was 3.7 (2.5) pps (range −4.2 to 8.9 pps). The median absolute difference in ΔF for the same motor unit pair across trials was 1.8 pps, and the minimal detectable change in ΔF required to exceed measurement error was 4.8 pps. ΔF was positively related to the amount of discharge rate modulation in the reference motor unit (r2=0.335; P<0.001), and inversely related to the rate of increase in discharge rate (r2=0.125; P<0.001). A quadratic function provided the best fit for relations between ΔF and the time between recruitment of the reference and test motor units (r2=0.229, P<0.001), the duration of test motor unit activity (r2=0.110, P<0.001), and the recruitment threshold of the test motor unit (r2=0.237, P<0.001). Physiological and methodological contributions to the variability in ΔF estimates of PIC magnitude are discussed, and selection criteria to reduce these sources of variability are suggested for the paired motor unit analysis. PMID:21459110

Social Franchising and a Nationwide Mass Media Campaign Increased the Prevalence of Adequate Complementary Feeding in Vietnam: A Cluster-Randomized Program Evaluation.

PubMed

Rawat, Rahul; Nguyen, Phuong Hong; Tran, Lan Mai; Hajeebhoy, Nemat; Nguyen, Huan Van; Baker, Jean; Frongillo, Edward A; Ruel, Marie T; Menon, Purnima

2017-04-01

Background: Rigorous evaluations of health system-based interventions in large-scale programs to improve complementary feeding (CF) practices are limited. Alive & Thrive applied principles of social franchising within the government health system in Vietnam to improve the quality of interpersonal counseling (IPC) for infant and young child feeding combined with a national mass media (MM) campaign and community mobilization (CM). Objective: We evaluated the impact of enhanced IPC + MM + CM (intensive) compared with standard IPC + less-intensive MM and CM (nonintensive) on CF practices and anthropometric indicators. Methods: A cluster-randomized, nonblinded evaluation design with cross-sectional surveys ( n = ∼500 children aged 6-23.9 mo and ∼1000 children aged 24-59.9 mo/group) implemented at baseline (2010) and endline (2014) was used. Difference-in-difference estimates (DDEs) of impact were calculated for intent-to-treat (ITT) analyses and modified per-protocol analyses (MPAs; mothers who attended the social franchising at least once: 62%). Results: Groups were similar at baseline. In ITT analyses, there were no significant differences between groups in changes in CF practices over time. In the MPAs, greater improvements in the intensive than in the nonintensive group were seen for minimum dietary diversity [DDE: 6.4 percentage points (pps); P < 0.05] and minimum acceptable diet (8.0 pps; P < 0.05). Significant stunting declines occurred in both intensive (7.1 pps) and nonintensive (5.4 pps) groups among children aged 24-59.9 mo, with no differential decline. Conclusions: When combined with MM and CM, an at-scale social franchising approach to improve IPC, delivered through the existing health care system, significantly improved CF practices, but not child growth, among mothers who used counseling services at least once. A greater impact may be achieved with strategies designed to increase service utilization. This trial was registered at clinicaltrials.gov as NCT01676623.

Enzymatic- and temperature-sensitive controlled release of ultrasmall superparamagnetic iron oxides (USPIOs).

PubMed

Yu, Shann S; Scherer, Randy L; Ortega, Ryan A; Bell, Charleson S; O'Neil, Conlin P; Hubbell, Jeffrey A; Giorgio, Todd D

2011-02-27

Drug and contrast agent delivery systems that achieve controlled release in the presence of enzymatic activity are becoming increasingly important, as enzymatic activity is a hallmark of a wide array of diseases, including cancer and atherosclerosis. Here, we have synthesized clusters of ultrasmall superparamagnetic iron oxides (USPIOs) that sense enzymatic activity for applications in magnetic resonance imaging (MRI). To achieve this goal, we utilize amphiphilic poly(propylene sulfide)-bl-poly(ethylene glycol) (PPS-b-PEG) copolymers, which are known to have excellent properties for smart delivery of drug and siRNA. Monodisperse PPS polymers were synthesized by anionic ring opening polymerization of propylene sulfide, and were sequentially reacted with commercially available heterobifunctional PEG reagents and then ssDNA sequences to fashion biofunctional PPS-bl-PEG copolymers. They were then combined with hydrophobic 12 nm USPIO cores in the thin-film hydration method to produce ssDNA-displaying USPIO micelles. Micelle populations displaying complementary ssDNA sequences were mixed to induce crosslinking of the USPIO micelles. By design, these crosslinking sequences contained an EcoRV cleavage site. Treatment of the clusters with EcoRV results in a loss of R2 negative contrast in the system. Further, the USPIO clusters demonstrate temperature sensitivity as evidenced by their reversible dispersion at ~75°C and re-clustering following return to room temperature. This work demonstrates proof of concept of an enzymatically-actuatable and thermoresponsive system for dynamic biosensing applications. The platform exhibits controlled release of nanoparticles leading to changes in magnetic relaxation, enabling detection of enzymatic activity. Further, the presented functionalization scheme extends the scope of potential applications for PPS-b-PEG. Combined with previous findings using this polymer platform that demonstrate controlled drug release in oxidative environments, smart theranostic applications combining drug delivery with imaging of platform localization are within reach. The modular design of these USPIO nanoclusters enables future development of platforms for imaging and drug delivery targeted towards proteolytic activity in tumors and in advanced atherosclerotic plaques.

Global Precipitation Measurement (GPM) Mission: Precipitation Processing System (PPS) GPM Mission Gridded Text Products Provide Surface Precipitation Retrievals

NASA Technical Reports Server (NTRS)

Stocker, Erich Franz; Kelley, O.; Kummerow, C.; Huffman, G.; Olson, W.; Kwiatkowski, J.

2015-01-01

In February 2015, the Global Precipitation Measurement (GPM) mission core satellite will complete its first year in space. The core satellite carries a conically scanning microwave imager called the GPM Microwave Imager (GMI), which also has 166 GHz and 183 GHz frequency channels. The GPM core satellite also carries a dual frequency radar (DPR) which operates at Ku frequency, similar to the Tropical Rainfall Measuring Mission (TRMM) Precipitation Radar, and a new Ka frequency. The precipitation processing system (PPS) is producing swath-based instantaneous precipitation retrievals from GMI, both radars including a dual-frequency product, and a combined GMIDPR precipitation retrieval. These level 2 products are written in the HDF5 format and have many additional parameters beyond surface precipitation that are organized into appropriate groups. While these retrieval algorithms were developed prior to launch and are not optimal, these algorithms are producing very creditable retrievals. It is appropriate for a wide group of users to have access to the GPM retrievals. However, for researchers requiring only surface precipitation, these L2 swath products can appear to be very intimidating and they certainly do contain many more variables than the average researcher needs. Some researchers desire only surface retrievals stored in a simple easily accessible format. In response, PPS has begun to produce gridded text based products that contain just the most widely used variables for each instrument (surface rainfall rate, fraction liquid, fraction convective) in a single line for each grid box that contains one or more observations.This paper will describe the gridded data products that are being produced and provide an overview of their content. Currently two types of gridded products are being produced: (1) surface precipitation retrievals from the core satellite instruments GMI, DPR, and combined GMIDPR (2) surface precipitation retrievals for the partner constellation satellites. Both of these gridded products are generated for a.25 degree x.25 degree hourly grid, which are packaged into daily ASCII (American Standard Code for Information Interchange) files that can downloaded from the PPS FTP (File Transfer Protocol) site. To reduce the download size, the files are compressed using the gzip utility.This paper will focus on presenting high-level details about the gridded text product being generated from the instruments on the GPM core satellite. But summary information will also be presented about the partner radiometer gridded product. All retrievals for the partner radiometer are done using the GPROF2014 algorithmusing as input the PPS generated inter-calibrated 1C product for the radiometer.

Evaluation of B1 inhomogeneity effect on DCE-MRI data analysis of brain tumor patients at 3T.

PubMed

Sengupta, Anirban; Gupta, Rakesh Kumar; Singh, Anup

2017-12-02

Dynamic-contrast-enhanced (DCE) MRI data acquired using gradient echo based sequences is affected by errors in flip angle (FA) due to transmit B 1 inhomogeneity (B 1 inh). The purpose of the study was to evaluate the effect of B 1 inh on quantitative analysis of DCE-MRI data of human brain tumor patients and to evaluate the clinical significance of B 1 inh correction of perfusion parameters (PPs) on tumor grading. An MRI study was conducted on 35 glioma patients at 3T. The patients had histologically confirmed glioma with 23 high-grade (HG) and 12 low-grade (LG). Data for B 1 -mapping, T 1 -mapping and DCE-MRI were acquired. Relative B 1 maps (B 1rel ) were generated using the saturated-double-angle method. T 1 -maps were computed using the variable flip-angle method. Post-processing was performed for conversion of signal-intensity time (S(t)) curve to concentration-time (C(t)) curve followed by tracer kinetic analysis (K trans , Ve, Vp, Kep) and first pass analysis (CBV, CBF) using the general tracer-kinetic model. DCE-MRI data was analyzed without and with B 1 inh correction and errors in PPs were computed. Receiver-operating-characteristic (ROC) analysis was performed on HG and LG patients. Simulations were carried out to understand the effect of B 1 inhomogeneity on DCE-MRI data analysis in a systematic way. S(t) curves mimicking those in tumor tissue, were generated and FA errors were introduced followed by error analysis of PPs. Dependence of FA-based errors on the concentration of contrast agent and on the duration of DCE-MRI data was also studied. Simulations were also done to obtain K trans of glioma patients at different B 1rel values and see whether grading is affected or not. Current study shows that B 1rel value higher than nominal results in an overestimation of C(t) curves as well as derived PPs and vice versa. Moreover, at same B 1rel values, errors were large for larger values of C(t). Simulation results showed that grade of patients can change because of B 1 inh. B 1 inh in the human brain at 3T-MRI can introduce substantial errors in PPs derived from DCE-MRI data that might affect the accuracy of tumor grading, particularly for border zone cases. These errors can be mitigated using B 1 inh correction during DCE-MRI data analysis.

Defining the need for surgical intervention following a snakebite still relies heavily on clinical assessment: The experience in Pietermaritzburg, South Africa.

PubMed

Pattinson, J P; Kong, V Y; Bruce, J L; Oosthuizen, G V; Bekker, W; Laing, G L; Wood, D; Brysiewicz, P; Clarke, D L

2017-11-27

This audit of snakebites was undertaken to document our experience with snakebite in the western part of KwaZulu-Natal (KZN) Province, South Africa (SA). To document our experience with snakebite in the western part of KZN, and to interrogate the data on patients who required some form of surgical intervention. A retrospective study was undertaken at the Pietermaritzburg Metropolitan Trauma Service, Pietermaritzburg, SA. The Hybrid Electronic Medical Registry was reviewed for the 5-year period January 2012 - December 2016. All patients admitted to the service for management of snakebite were included. The offending snake is rarely identified, and the syndromic approach is now the mainstay of management. Most envenomations seen during the study period were cytotoxic, presenting with painful progressive swelling (PPS). We did not see any purely neurotoxic or haemotoxic envenomations. Antivenom is required for a subset of patients. The indications are essentially PPS that increases by >15 cm over an hour, PPS up to the elbow or knee after 4 hours, PPS of the whole limb after 8 hours, threatened airway, shortness of breath, associated clotting abnormalities and compartment syndrome. If no symptoms have manifested within 1 hour of a snakebite, clinically significant envenomation is unlikely to have occurred. Antivenom is associated with a high rate of anaphylaxis and should only be administered when absolutely indicated, preferably in a high-care setting under continuous monitoring. The need for surgery is less well defined. Urgent surgery is indicated for compartment syndrome of the limb, which is a potentially life- and limb-threatening condition. Its diagnosis is usually made clinically, but this is difficult in snakebites. Morbidity and cost increase dramatically once fasciotomy is required, as evidenced by much longer hospital stay. There is frequently a degree of cross-over between cytotoxicity and haemotoxicity in envenomations that require fasciotomy, which means that fasciotomy may result in catastrophic bleeding and should be preceded by the administration of antivenom, especially in patients with a low platelet count or a high international normalised ratio. Physiological and biochemical markers are unhelpful in assessing the need for fasciotomy. Objective methods include measurement of compartment pressures and ultrasound. The syndromic management of snakebite is effective and safe. There is a high incidence of anaphylactic reactions to antivenom, and its administration must be closely supervised. In our area we overwhelmingly see cytotoxic snakebites with PPS. Surgery is often needed, and we need to refine our algorithms in terms of deciding on surgery.

Mobile Technology in E-Learning for Undergraduate Medical Education on Emergent Otorhinolaryngology–Head and Neck Surgery Disorders: Pilot Randomized Controlled Trial

PubMed Central

Lee, Li-Ang; Wang, Shu-Ling; Chao, Yi-Ping; Tsai, Ming-Shao; Hsin, Li-Jen; Kang, Chung-Jan; Fu, Chia-Hsiang; Chao, Wei-Chieh; Huang, Chung-Guei; Li, Hsueh-Yu

2018-01-01

Background The use of mobile technology in e-learning (M-TEL) can add new levels of experience and significantly increase the attractiveness of e-learning in medical education. Whether an innovative interactive e-learning multimedia (IM) module or a conventional PowerPoint show (PPS) module using M-TEL to teach emergent otorhinolaryngology–head and neck surgery (ORL-HNS) disorders is feasible and efficient in undergraduate medical students is unknown. Objective The aim of this study was to compare the impact of a novel IM module with a conventional PPS module using M-TEL for emergent ORL-HNS disorders with regard to learning outcomes, satisfaction, and learning experience. Methods This pilot study was conducted at an academic teaching hospital and included 24 undergraduate medical students who were novices in ORL-HNS. The cognitive style was determined using the Group Embedded Figures Test. The participants were randomly allocated (1:1) to one of the two groups matched by age, sex, and cognitive style: the IM group and the PPS group. During the 100-min learning period, the participants were unblinded to use the IM or PPS courseware on a 7-inch tablet. Pretests and posttests using multiple-choice questions to evaluate knowledge and multimedia situational tests to evaluate competence were administered. Participants evaluated their satisfaction and learning experience by the AttrakDiff2 questionnaire, and provided feedback about the modules. Results Overall, the participants had significant gains in knowledge (median of percentage change 71, 95% CI 1-100, P<.001) and competence (median of percentage change 25, 95% CI 0-33, P=.007) after 100 min of learning. Although there was no significant difference in knowledge gain between the two groups (median of difference of percentage change 24, 95% CI −75 to 36; P=.55), competence gain was significantly lower in the IM group compared with the PPS group (median of difference of percentage change −41, 95% CI −67 to −20; P=.008). However, the IM group had significantly higher scores of satisfaction (difference 2, 95% CI 2-4; P=.01), pragmatic quality (difference 1.7, 95% CI 0.1-2.7; P=.03), and hedonic stimulation (difference 1.9, 95% CI 0.3-3.1; P=.01) compared with the PPS group. Qualitative feedback indicated that the various games in the IM module attracted the participants’ attention but that the nonlinearly arranged materials affected their learning. Conclusions Using M-TEL for undergraduate medical education on emergent ORL-HNS disorders, an IM module seems to be useful for gaining knowledge, but competency may need to occur elsewhere. While the small sample size reduces the statistical power of our results, its design seems to be appropriate to determine the effects of M-TEL using a larger group. Trial Registration ClinicalTrials.gov NCT02971735; https://clinicaltrials.gov/ct2/show/NCT02971735 (Archived by WebCite at http://www.webcitation.org/6waoOpCEV) PMID:29519776

CETF Space Station payload pointing system design and analysis feasibility study. [Critical Evaluation Task Force

NASA Technical Reports Server (NTRS)

Smagala, Tom; Mcglew, Dave

1988-01-01

The expected pointing performance of an attached payload coupled to the Critical Evaluation Task Force Space Station via a payload pointing system (PPS) is determined. The PPS is a 3-axis gimbal which provides the capability for maintaining inertial pointing of a payload in the presence of disturbances associated with the Space Station environment. A system where the axes of rotation were offset from the payload center of mass (CM) by 10 in. in the Z axis was studied as well as a system having the payload CM offset by only 1 inch. There is a significant improvement in pointing performance when going from the 10 in. to the 1 in. gimbal offset.

The improving efficiency frontier of inpatient rehabilitation hospitals.

PubMed

Harrison, Jeffrey P; Kirkpatrick, Nicole

2011-01-01

This study uses a linear programming technique called data envelopment analysis to identify changes in the efficiency frontier of inpatient rehabilitation hospitals after implementation of the prospective payment system. The study provides a time series analysis of the efficiency frontier for inpatient rehabilitation hospitals in 2003 immediately after implementation of PPS and then again in 2006. Results indicate that the efficiency frontier of inpatient rehabilitation hospitals increased from 84% in 2003 to 85% in 2006. Similarly, an analysis of slack or inefficiency shows improvements in output efficiency over the study period. This clearly documents that efficiency in the inpatient rehabilitation hospital industry after implementation of PPS is improving. Hospital executives, health care policymakers, taxpayers, and other stakeholders benefit from studies that improve health care efficiency.

Occurrence and fate of pharmaceutical products and by-products, from resource to drinking water.

PubMed

Mompelat, S; Le Bot, B; Thomas, O

2009-07-01

Among all emerging substances in water, pharmaceutical products (PPs) and residues are a lot of concern. These last two years, the number of studies has increased drastically, however much less for water resources and drinking water than for wastewater. This literature review based on recent works, deals with water resources (surface or groundwater), focusing on characteristics, occurrence and fate of numerous PPs studied, and drinking water including water quality. Through this review, it appears that the pharmaceutical risk must be considered even in drinking water where concentrations are very low. Moreover, there is a lack of research for by-products (metabolites and transformation products) characterization, occurrence and fate in all water types and especially in drinking water.

Pelvic inflammatory disease and puerperal sepsis in Ethiopia. I. Etiology.

PubMed

Perine, P L; Duncan, M E; Krause, D W; Awoke, S

1980-12-01

Among 100 outpatient women with symptoms and signs of pelvic inflammatory disease and 200 asymptomatic, postpartum women, the prevalence rates of Neisseria gonorrhoeae were 19% and 9%, respectively. Of 46 women hospitalized for PID, 33% were culture-negative, 22% grew Enterobacteriaceae, 20% grew streptococci, 15% grew gonococci, and 15% grew anaerobes from blood, pus, or abscesses. One third of 67 women hospitalized for puerperal sepsis (PPS) were culture-negative; the bacteria isolated most frequently from the uterus, blood, urine, and pus were Enterobacteriaceae (36%), gonococci (28%), streptococci (25%), and anaerobes (4%). The low frequency of isolation of anaerobes in women with PID and PPS was due largely to limitations placed on the collection and processing of specimens for anaerobic bacteriology.

75 FR 31118 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-02

...This notice contains the final wage indices, hospital reclassifications, payment rates, impacts, and other related tables effective for the fiscal year (FY) 2010 hospital inpatient prospective payment systems (IPPS) and rate year 2010 long-term care hospital (LTCH) prospective payment system (PPS). The rates, tables, and impacts included in this notice reflect changes required by or resulting from the implementation of several provisions of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010. These provisions require the extension of the expiration date for certain geographic reclassifications and special exception wage indices through September 30, 2010; and certain market basket updates for the IPPS and LTCH PPS.

Comparison of alternative relative weights for diagnosis-related groups

PubMed Central

Cotterill, Philip; Bobula, Joel; Connerton, Rose

1986-01-01

During this study, we investigated the extent to which diagnosis-related group (DRG) relative weights based exclusively on charge data differ from DRG weights constructed according to the methodology used in deriving the original relative weights for the Medicare prospective payment system (PPS). The PPS operating cost weights were based on a combination of cost and adjusted charge information (Pettengill and Vertrees, 1982). The results of this study reveal only minor differences between the two sets of weights. Interhospital differences in cost-to-charge ratios do not produce large, arbitrary differences between charge-based and operating cost weights. Whether the data are standardized for differences in capital and medical education costs also appears to make little difference. PMID:10311495

[Post-polio syndrome. Part I. The "legacy" of forgotten disease, challenges for professionals and polio survivors].

PubMed

Matyja, Ewa

2012-01-01

The outcome of paralytic polio was believed to be a stable neurological state. Now, it is established that polio has an additional, slowly progressive phase, called post-polio syndrome (PPS) that develops 30-40 years after the acute poliomyelitis in 25-80% of paralytic and about 40% of nonparalytic polio survivors. The clinical symptoms are nonspecific and usually include muscle weakness, fatigue and muscle or joint pain. Some patients suffer from muscular atrophy, respiratory insufficiency, dysphagia, sleep disturbances or cold intolerance. The etiopathogenesis of PPS is unclear and many factors, such as dysfunction of the surviving motor units, aging, defects of neuromuscular transmission, persistence of viral infection and immunological mechanisms, are considered.

42 CFR 415.50 - Scope.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES FURNISHED BY PHYSICIANS IN PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS... cost method to non-PPS participating providers in accordance with part 413 of this chapter. ...

42 CFR 415.50 - Scope.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES FURNISHED BY PHYSICIANS IN PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS... cost method to non-PPS participating providers in accordance with part 413 of this chapter. ...

42 CFR 415.50 - Scope.

Code of Federal Regulations, 2014 CFR

2014-10-01

... (CONTINUED) SERVICES FURNISHED BY PHYSICIANS IN PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND... reasonable cost method to non-PPS participating providers in accordance with part 413 of this chapter. ...

42 CFR 415.50 - Scope.

Code of Federal Regulations, 2012 CFR

2012-10-01

... (CONTINUED) SERVICES FURNISHED BY PHYSICIANS IN PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND... reasonable cost method to non-PPS participating providers in accordance with part 413 of this chapter. ...

42 CFR 415.50 - Scope.

Code of Federal Regulations, 2013 CFR

2013-10-01

... (CONTINUED) SERVICES FURNISHED BY PHYSICIANS IN PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND... reasonable cost method to non-PPS participating providers in accordance with part 413 of this chapter. ...

A sturdy self-cleaning and anti-corrosion superhydrophobic coating assembled by amino silicon oil modifying potassium titanate whisker-silica particles

NASA Astrophysics Data System (ADS)

Lv, Chongjiang; Wang, Huaiyuan; Liu, Zhanjian; Zhang, Wenbo; Wang, Chijia; Tao, Ruifeng; Li, Meiling; Zhu, Yanji

2018-03-01

A sturdy self-cleaning and anticorrosion superhydrophobic coating based on poly(phenylene sulfide) (PPS) matrix has been successfully fabricated by combination of sol-gel and spraying technology without using any fluorine materials. The prepared coating possessed excellent superhydrophobicity with the water contact angle (WCA) (161 ± 1.2)° and slide angle (SA) (2 ± 1.5)°, which was ascribed to the synergistic effect of low-surface energy material amino silicon oil (ASO) and the binary potassium titanate whisker-silica (PTW-SiO2) composite particles formed by in-situ growth of SiO2 on modified PTW via sol-gel. Moreover, The PPS/ASO/PTW-SiO2 superhydrophobic coating exhibited decent self-cleaning property with clean surface even after 100 times immersion in muddy solution. The abrasion test demonstrated that the mechanical stability of prepared coating was about 2 times of the pure PPS coating. Simultaneously, the potentiodynamic polarization and electrochemical impedance spectroscopy testified the excellent corrosion resistance of prepared coating with the performance of lower corrosion current (1.289 × 10-10 A/cm2) and high protection efficiency (99.999%) even after immersion in 3.5 wt.% NaCl solution for 28 days. It is believed that this sturdy self-cleaning and anti-corrosion superhydrophobic coating might have a promising application prospect in industry.

The Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF): incremental validity in predicting early postoperative outcomes in spine surgery candidates.

PubMed

Marek, Ryan J; Block, Andrew R; Ben-Porath, Yossef S

2015-03-01

A substantial proportion of individuals who undergo surgical procedures to relieve spine pain continue to report significant pain and dysfunction after recovery. Psychopathology and patient expectations have been linked to poor results, leading to an increasing reliance on presurgical psychological screening (PPS) as part of the surgical diagnostic process. The original Minnesota Multiphasic Personality Inventory (MMPI; Hathaway & McKinley, 1943) and the MMPI-2 (Butcher, Graham, Ben-Porath, Tellegen, & Dahlstrom, 2001) were among the measures most commonly used in PPS evaluations and research. This study focuses on the newest version of the test, the MMPI-2-Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, 2008/2011; Tellegen & Ben-Porath, 2008/2011) as a predictor of outcomes for spine surgery candidates. Using a sample of 172 men and 210 women who underwent a PPS, we examined the ability of MMPI-2-RF scale scores to predict early surgical outcomes independent of other presurgical risk factors identified by other means, as well as patients' presurgical expectations. MMPI-2-RF results accounted for up to 11% of additional variance in measures of early postoperative functioning. MMPI-2-RF scales that assess for emotional/internalizing problems, specifically Demoralization, measures of somatoform dysfunction, and interpersonal problems contributed most to the prediction of diminished outcome. 2015 APA, all rights reserved

Resistance of chemokine receptor 6-deficient mice to Yersinia enterocolitica infection: evidence of defective M-cell formation in vivo.

PubMed

Westphal, Sabine; Lügering, Andreas; von Wedel, Julia; von Eiff, Christof; Maaser, Christian; Spahn, Thomas; Heusipp, Gerhard; Schmidt, M Alexander; Herbst, Hermann; Williams, Ifor R; Domschke, Wolfram; Kucharzik, Torsten

2008-03-01

M cells, specialized cells within Peyer's patches (PPs), are reduced in number in chemokine receptor 6 (CCR6)-deficient mice. The pathogenic microorganism Yersinia enterocolitica exploits M cells for the purpose of mucosal tissue invasion exclusively through PPs. The aim of this study was to evaluate the course of yersiniosis in CCR6-deficient mice and to investigate whether these mice might be used as an in vivo model to determine M-cell function. After oral challenge with Y. enterocolitica, control mice suffered from lethal septic infection whereas CCR6-deficient mice showed very limited symptoms of infection. Immunohistochemical analysis demonstrated PP invasion by Y. enterocolitica in control mice whereas no bacteria could be found in CCR6-deficient mice. In addition, a significant induction of proinflammatory cytokines could be found in control mice whereas proinflammatory cytokine levels in CCR6-deficient mice remained unchanged. In contrast, intraperitoneal infection resulted in severe systemic yersiniosis in both mouse groups. Abrogated oral Y. enterocolitica infection in CCR6-deficient mice demonstrates the importance of CCR6 expression in the physiological and pathological immune responses generated within PPs by influencing M-cell differentiation, underscoring the important role of M cells in the process of microbial uptake. CCR6-deficient mice may therefore represent a suitable model for the study of M-cell function in vivo.

Inorganic Nanoparticle-Modified Poly(Phenylene Sulphide)/ Carbon Fiber Laminates: Thermomechanical Behaviour.

PubMed

Díez-Pascual, Ana M; Naffakh, Mohammed

2013-07-26

Carbon fiber (CF)-reinforced high-temperature thermoplastics such as poly(phenylene sulphide) (PPS) are widely used in structural composites for aerospace and automotive applications. The porosity of CF-reinforced polymers is a very important topic for practical applications since there is a direct correlation between void content and mechanical properties. In this study, inorganic fullerene-like tungsten disulphide (IF-WS₂) lubricant nanoparticles were used to manufacture PPS/IF-WS₂/CF laminates via melt-blending and hot-press processing, and the effect of IF-WS₂ loading on the quality, thermal and mechanical behaviour of the hybrid composites was investigated. The addition of IF-WS₂ improved fiber impregnation, resulting in lower degree of porosity and increased delamination resistance, compression and flexural properties; their reinforcement effect was greater at temperatures above the glass transition (T g ). IF-WS₂ contents higher than 0.5 wt % increased T g and the heat deflection temperature while reduced the coefficient of thermal expansion. The multiscale laminates exhibited higher ignition point and notably reduced peak heat release rate compared to PPS/CF. The coexistence of micro- and nano-scale fillers resulted in synergistic effects that enhanced the stiffness, strength, thermal conductivity and flame retardancy of the matrix. The results presented herein demonstrate that the IF-WS₂ are very promising nanofillers to improve the thermomechanical properties of conventional thermoplastic/CF composites.

Inorganic Nanoparticle-Modified Poly(Phenylene Sulphide)/Carbon Fiber Laminates: Thermomechanical Behaviour

PubMed Central

Díez-Pascual, Ana M.; Naffakh, Mohammed

2013-01-01

Carbon fiber (CF)-reinforced high-temperature thermoplastics such as poly(phenylene sulphide) (PPS) are widely used in structural composites for aerospace and automotive applications. The porosity of CF-reinforced polymers is a very important topic for practical applications since there is a direct correlation between void content and mechanical properties. In this study, inorganic fullerene-like tungsten disulphide (IF-WS2) lubricant nanoparticles were used to manufacture PPS/IF-WS2/CF laminates via melt-blending and hot-press processing, and the effect of IF-WS2 loading on the quality, thermal and mechanical behaviour of the hybrid composites was investigated. The addition of IF-WS2 improved fiber impregnation, resulting in lower degree of porosity and increased delamination resistance, compression and flexural properties; their reinforcement effect was greater at temperatures above the glass transition (Tg). IF-WS2 contents higher than 0.5 wt % increased Tg and the heat deflection temperature while reduced the coefficient of thermal expansion. The multiscale laminates exhibited higher ignition point and notably reduced peak heat release rate compared to PPS/CF. The coexistence of micro- and nano-scale fillers resulted in synergistic effects that enhanced the stiffness, strength, thermal conductivity and flame retardancy of the matrix. The results presented herein demonstrate that the IF-WS2 are very promising nanofillers to improve the thermomechanical properties of conventional thermoplastic/CF composites. PMID:28811429

Semi-quantitative assay for polyketide prymnesins isolated from Prymnesium parvum (Haptophyta) cultures.

PubMed

La Claire, J W; Manning, S R; Talarski, A E

2015-08-01

A fluorometric assay was developed to semi-quantify co-purified polyketide prymnesins-1 and -2 (PPs) from Prymnesium parvum cultures. Evaluations performed throughout the growth cycle of 5 practical salinity unit (PSU) cultures detected relatively 8-10 × more PPs in the culture medium (exotoxins) than in cells (endotoxins). The [exotoxin] remained stable and relatively low until post-log growth, when they increased significantly. However, on a per-cell basis, [exotoxin] declined throughout log phase and subsequently increased dramatically during late- and post-log phases. The [endotoxin] remained stable until late- and post-log phases, when it achieved its highest level before declining sharply. Shaking cultures of strains from Texas, South Carolina and the United Kingdom displayed dramatically different [exotoxin] during post-log decline. Cultures adapted to 30 PSU had significantly lower [exotoxin] over the course of cultivation than those grown at 5 PSU. Phosphate limitation enhanced [exotoxin] on a per-cell basis, especially in late- and post-log cultures. Media containing streptomycin exhibited a ∼20% increase in [exotoxin] in post-log cultures vs. control treatments, but it had only negligible effects on endotoxin levels. Brefeldin A had minimal effects on [exotoxin], suggesting that the presence of PPs in the medium may be largely derived from cell lysis or some other passive means. Copyright © 2015 Elsevier Ltd. All rights reserved.

Challenges in the new prospective payment system: action steps for social work in home health care.

PubMed

Lee, Ji Seon; Rock, Barry D

2005-02-01

The Balanced Budget Act of 1997 changed the reimbursement rules for Medicare home health benefits from a fee-for-service system to a prospective payment system (PPS). As with Medicare's hospital reimbursement system, home health agencies have to provide appropriate and adequate care for a flat rate reimbursement for each patient. As a result coordination and collaboration among all members of the home health care team (that is, nurses, social workers, physical therapist, occupational therapist, speech therapist, and home health aides) is critical to provide home care for frail and chronically ill populations. The authors provide background on the PPS, home health care, and social work roles in home health care and propose policy and research action steps for the social work profession.

Mobile Technology in E-Learning for Undergraduate Medical Education on Emergent Otorhinolaryngology-Head and Neck Surgery Disorders: Pilot Randomized Controlled Trial.

PubMed

Lee, Li-Ang; Wang, Shu-Ling; Chao, Yi-Ping; Tsai, Ming-Shao; Hsin, Li-Jen; Kang, Chung-Jan; Fu, Chia-Hsiang; Chao, Wei-Chieh; Huang, Chung-Guei; Li, Hsueh-Yu; Chuang, Cheng-Keng

2018-03-08

The use of mobile technology in e-learning (M-TEL) can add new levels of experience and significantly increase the attractiveness of e-learning in medical education. Whether an innovative interactive e-learning multimedia (IM) module or a conventional PowerPoint show (PPS) module using M-TEL to teach emergent otorhinolaryngology-head and neck surgery (ORL-HNS) disorders is feasible and efficient in undergraduate medical students is unknown. The aim of this study was to compare the impact of a novel IM module with a conventional PPS module using M-TEL for emergent ORL-HNS disorders with regard to learning outcomes, satisfaction, and learning experience. This pilot study was conducted at an academic teaching hospital and included 24 undergraduate medical students who were novices in ORL-HNS. The cognitive style was determined using the Group Embedded Figures Test. The participants were randomly allocated (1:1) to one of the two groups matched by age, sex, and cognitive style: the IM group and the PPS group. During the 100-min learning period, the participants were unblinded to use the IM or PPS courseware on a 7-inch tablet. Pretests and posttests using multiple-choice questions to evaluate knowledge and multimedia situational tests to evaluate competence were administered. Participants evaluated their satisfaction and learning experience by the AttrakDiff2 questionnaire, and provided feedback about the modules. Overall, the participants had significant gains in knowledge (median of percentage change 71, 95% CI 1-100, P<.001) and competence (median of percentage change 25, 95% CI 0-33, P=.007) after 100 min of learning. Although there was no significant difference in knowledge gain between the two groups (median of difference of percentage change 24, 95% CI -75 to 36; P=.55), competence gain was significantly lower in the IM group compared with the PPS group (median of difference of percentage change -41, 95% CI -67 to -20; P=.008). However, the IM group had significantly higher scores of satisfaction (difference 2, 95% CI 2-4; P=.01), pragmatic quality (difference 1.7, 95% CI 0.1-2.7; P=.03), and hedonic stimulation (difference 1.9, 95% CI 0.3-3.1; P=.01) compared with the PPS group. Qualitative feedback indicated that the various games in the IM module attracted the participants' attention but that the nonlinearly arranged materials affected their learning. Using M-TEL for undergraduate medical education on emergent ORL-HNS disorders, an IM module seems to be useful for gaining knowledge, but competency may need to occur elsewhere. While the small sample size reduces the statistical power of our results, its design seems to be appropriate to determine the effects of M-TEL using a larger group. ClinicalTrials.gov NCT02971735; https://clinicaltrials.gov/ct2/show/NCT02971735 (Archived by WebCite at http://www.webcitation.org/6waoOpCEV). ©Li-Ang Lee, Shu-Ling Wang, Yi-Ping Chao, Ming-Shao Tsai, Li-Jen Hsin, Chung-Jan Kang, Chia-Hsiang Fu, Wei-Chieh Chao, Chung-Guei Huang, Hsueh-Yu Li, Cheng-Keng Chuang. Originally published in JMIR Medical Education (http://mededu.jmir.org), 08.03.2018.

Financial implications to Medicare from changing the dialysis modality mix under the bundled prospective payment system.

PubMed

Liu, Frank X; Walton, Surrey M; Leipold, Robert; Isbell, Deborah; Golper, Thomas A

2014-01-01

The economic burden of treating end-stage renal disease (ESRD) continues to grow. As one response, effective January 1, 2011, Medicare implemented a bundled prospective payment system (PPS, including injectable drugs) for dialysis patients. This study investigated the 5-year budget impact on Medicare under the new PPS of changes in the distribution of patients undergoing peritoneal dialysis (PD), in-center hemodialysis (ICHD), and home hemodialysis (HHD). An Excel-based budget impact model was created to assess dialysis-associated Medicare costs. The model accounted for dialysis access establishment, the current monthly capitation physician payment for ESRD, Medicare dialysis payments (including start-up costs), training, oral drug costs, and the costs and probabilities of adverse events including access failure, hospitalization for access infection, pneumonia, septicemia, and cardiovascular events. United States Renal Data System (USRDS) data were used to project the US Medicare dialysis patient population across time. The baseline scenario assumed a stable distribution of PD (7.7%), HHD (1.3%) and ICHD (91.0%) over 5 years. Three comparison scenarios raised the proportions of PD and HHD by (1) 1% and 0.5%, (2) 2% and 0.75%, and (3) 3% and 1% each year; a fourth scenario held HHD constant and lowered PD by 1% per year. Under the bundled PPS, scenarios that increased PD and HHD from 7.7% and 1.3% over 5 years resulted in cumulative savings to Medicare of $114.8M (Scenario 1, 11.7% PD and 3.3% HHD at year 5), $232.9M (Scenario 2, 15.7% PD and 4.3% HHD at year 5), and $350.9M (Scenario 3, 19.7% PD and 5.3% HHD at year 5). When the PD population was decreased from 7.7% in 2013 to 3.7% by 2017 with a constant HHD population, the total Medicare payment for dialysis patients increased by over $121.2M. Under Medicare bundled PPS, increasing the proportion of patients on PD and HHD vs ICHD could generate substantial savings in dialysis-associated costs to Medicare. Copyright © 2014 International Society for Peritoneal Dialysis.

Novel Role of 3’UTR-Embedded Alu Elements as Facilitators of Processed Pseudogene Genesis and Host Gene Capture by Viral Genomes

PubMed Central

Engel, Pablo; Angulo, Ana

2016-01-01

Since the discovery of the high abundance of Alu elements in the human genome, the interest for the functional significance of these retrotransposons has been increasing. Primate Alu and rodent Alu-like elements are retrotransposed by a mechanism driven by the LINE1 (L1) encoded proteins, the same machinery that generates the L1 repeats, the processed pseudogenes (PPs), and other retroelements. Apart from free Alu RNAs, Alus are also transcribed and retrotranscribed as part of cellular gene transcripts, generally embedded inside 3’ untranslated regions (UTRs). Despite different proposed hypotheses, the functional implication of the presence of Alus inside 3’UTRs remains elusive. In this study we hypothesized that Alu elements in 3’UTRs could be involved in the genesis of PPs. By analyzing human genome data we discovered that the existence of 3’UTR-embedded Alu elements is overrepresented in genes source of PPs. In contrast, the presence of other retrotransposable elements in 3’UTRs does not show this PP linked overrepresentation. This research was extended to mouse and rat genomes and the results accordingly reveal overrepresentation of 3’UTR-embedded B1 (Alu-like) elements in PP parent genes. Interestingly, we also demonstrated that the overrepresentation of 3’UTR-embedded Alus is particularly significant in PP parent genes with low germline gene expression level. Finally, we provide data that support the hypothesis that the L1 machinery is also the system that herpesviruses, and possibly other large DNA viruses, use to capture host genes expressed in germline or somatic cells. Altogether our results suggest a novel role for Alu or Alu-like elements inside 3’UTRs as facilitators of the genesis of PPs, particularly in lowly expressed genes. Moreover, we propose that this L1-driven mechanism, aided by the presence of 3’UTR-embedded Alus, may also be exploited by DNA viruses to incorporate host genes to their viral genomes. PMID:28033411

Early trends from the Study to Evaluate the Prospective Payment System Impact on Small Dialysis Organizations (STEPPS).

PubMed

Brunelli, Steven M; Monda, Keri L; Burkart, John M; Gitlin, Matthew; Neumann, Peter J; Park, Grace S; Symonian-Silver, Margarita; Yue, Susan; Bradbury, Brian D; Rubin, Robert J

2013-06-01

Launched in January 2011, the prospective payment system (PPS) for the US Medicare End-Stage Renal Disease Program bundled payment for services previously reimbursed independently. Small dialysis organizations may be particularly susceptible to the financial implications of the PPS. The ongoing Study to Evaluate the Prospective Payment System Impact on Small Dialysis Organizations (STEPPS) was designed to describe trends in care and outcomes over the period of PPS implementation. This report details early results between October 2010 and June 2011. Prospective observational cohort study of patients from a sample of 51 small dialysis organizations. 1,873 adult hemodialysis and peritoneal dialysis patients. Secular trends in processes of care, anemia, metabolic bone disease management, and red blood cell transfusions. Facility-level data are collected quarterly. Patient characteristics were collected at enrollment and scheduled intervals thereafter. Clinical outcomes are collected on an ongoing basis. Over time, no significant changes were observed in patient to staff ratios. There was a temporal trend toward greater use of peritoneal dialysis (from 2.4% to 3.6%; P = 0.09). Use of cinacalcet, phosphate binders, and oral vitamin D increased; intravenous (IV) vitamin D use decreased (P for trend for all <0.001). Parathyroid hormone levels increased (from 273 to 324 pg/dL; P < 0.001). Erythropoiesis-stimulating agent doses decreased (P < 0.001 for IV epoetin alfa and IV darbepoetin alfa), particularly high doses. Mean hemoglobin levels decreased (P < 0.001), the percentage of patients with hemoglobin levels <10 g/dL increased (from 12.7% to 16.8%), and transfusion rates increased (from 14.3 to 19.6/100 person-years; P = 0.1). Changes in anemia management were more pronounced for African American patients. Limited data were available for the prebundle period. Secular trends may be subject to the ecologic fallacy and are not causal in nature. In the period after PPS implementation, IV vitamin D use decreased, use of oral therapies for metabolic bone disease increased, erythropoiesis-stimulating agent use and hemoglobin levels decreased, and transfusion rates increased numerically. Copyright © 2013 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Enzymatic- and temperature-sensitive controlled release of ultrasmall superparamagnetic iron oxides (USPIOs)

PubMed Central

2011-01-01

Background Drug and contrast agent delivery systems that achieve controlled release in the presence of enzymatic activity are becoming increasingly important, as enzymatic activity is a hallmark of a wide array of diseases, including cancer and atherosclerosis. Here, we have synthesized clusters of ultrasmall superparamagnetic iron oxides (USPIOs) that sense enzymatic activity for applications in magnetic resonance imaging (MRI). To achieve this goal, we utilize amphiphilic poly(propylene sulfide)-bl-poly(ethylene glycol) (PPS-b-PEG) copolymers, which are known to have excellent properties for smart delivery of drug and siRNA. Results Monodisperse PPS polymers were synthesized by anionic ring opening polymerization of propylene sulfide, and were sequentially reacted with commercially available heterobifunctional PEG reagents and then ssDNA sequences to fashion biofunctional PPS-bl-PEG copolymers. They were then combined with hydrophobic 12 nm USPIO cores in the thin-film hydration method to produce ssDNA-displaying USPIO micelles. Micelle populations displaying complementary ssDNA sequences were mixed to induce crosslinking of the USPIO micelles. By design, these crosslinking sequences contained an EcoRV cleavage site. Treatment of the clusters with EcoRV results in a loss of R2 negative contrast in the system. Further, the USPIO clusters demonstrate temperature sensitivity as evidenced by their reversible dispersion at ~75°C and re-clustering following return to room temperature. Conclusions This work demonstrates proof of concept of an enzymatically-actuatable and thermoresponsive system for dynamic biosensing applications. The platform exhibits controlled release of nanoparticles leading to changes in magnetic relaxation, enabling detection of enzymatic activity. Further, the presented functionalization scheme extends the scope of potential applications for PPS-b-PEG. Combined with previous findings using this polymer platform that demonstrate controlled drug release in oxidative environments, smart theranostic applications combining drug delivery with imaging of platform localization are within reach. The modular design of these USPIO nanoclusters enables future development of platforms for imaging and drug delivery targeted towards proteolytic activity in tumors and in advanced atherosclerotic plaques. PMID:21352596

Plant polyphenols differentially modulate inflammatory responses of human keratinocytes by interfering with activation of transcription factors NF{kappa}B and AhR and EGFR-ERK pathway

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

Potapovich, Alla I.; Biology Department, Belarus State University, Skorina Prosp. 10, Minsk 220050; Lulli, Daniela

Molecular mechanisms underlying modulation of inflammatory responses in primary human keratinocytes by plant polyphenols (PPs), namely the glycosylated phenylpropanoid verbascoside, the stilbenoid resveratrol and its glycoside polydatin, and the flavonoid quercetin and its glycoside rutin were evaluated. As non-lethal stimuli, the prototypic ligand for epidermal growth factor receptor (EGFR) transforming growth factor alpha (TGFalpha), the combination of tumor necrosis factor (TNFalpha) and interferon (IFNgamma) (T/I), UVA + UVB irradiation, and bacterial lipopolysaccharide (LPS) were used. We demonstrated differential modulation of inflammatory responses in keratinocytes at signal transduction, gene transcription, and protein synthesis levels as a function of PP chemical structure,more » the pro-inflammatory trigger used, and PP interaction with intracellular detoxifying systems. The PPs remarkably inhibited constitutive, LPS- and T/I-induced but not TGFalpha-induced ERK phosphorylation. They also suppressed NFkappaB activation by LPS and T/I. Verbascoside and quercetin invariably impaired EGFR phosphorylation and UV-associated aryl hydrocarbon receptor (AhR)-mediated signaling, while rutin, polydatin and resveratrol did not affect EGFR phosphorylation and further activated AhR machinery in UV-exposed keratinocytes. In general, PPs down-regulated gene expression of pro-inflammatory cytokines/enzymes, except significant up-regulation of IL-8 observed under stimulation with TGFalpha. Both spontaneous and T/I-induced release of IL-8 and IP-10 was suppressed, although 50 {mu}M resveratrol and polydatin up-regulated IL-8. At this concentration, resveratrol activated both gene expression and de novo synthesis of IL-8 and AhR-mediated mechanisms were involved. We conclude that PPs differentially modulate the inflammatory response of human keratinocytes through distinct signal transduction pathways, including AhR and EGFR. - Graphical abstract: Display Omitted Highlights: > Effects of plant polyphenols on inflammatory responses in human keratinocytes. > Inflammatory stimuli used: TGFalpha, TNFalpha+IFNgamma, UVA+UVB, and LPS. > Inflammatory pathways connected with NFB, ERK1/2, EGFR, and AhR were investigated. > Plant polyphenols, flavonoids, stilbenoids, and phenylpropanoids, were studied. > Modulation of inflammation depends on phenolic core structure and glycosylation.« less

Pigmentary Maculopathy Associated with Chronic Exposure to Pentosan Polysulfate Sodium.

PubMed

Pearce, William A; Chen, Rui; Jain, Nieraj

2018-05-22

To describe the clinical features of a unique pigmentary maculopathy noted in the setting of chronic exposure to pentosan polysulfate sodium (PPS), a therapy for interstitial cystitis (IC). Retrospective case series. Six adult patients evaluated by a single clinician between May 1, 2015, and October 1, 2017. Patients were identified by query of the electronic medical record system. Local records were reviewed, including results of the clinical examination, retinal imaging, and visual function assessment with static perimetry and electroretinography. Molecular testing assessed for known macular dystrophy and mitochondrial cytopathy genotypes. Mean best-corrected visual acuity (BCVA; in logarithm of the minimum angle of resolution units), median cumulative PPS exposure, subjective nature of the associated visual disturbance, qualitative examination and imaging features, and molecular testing results. The median age at presentation was 60 years (range, 37-62 years). All patients received PPS for a diagnosis of IC, with a median cumulative exposure of 2263 g (range, 1314-2774 g), over a median duration of exposure of 186 months (range, 144-240 months). Most patients (4 of 6) reported difficulty reading as the most bothersome symptom. Mean BCVA was 0.1±0.18 logarithm of the minimum angle of resolution. On fundus examination, nearly all eyes showed subtle paracentral hyperpigmentation at the level of the retinal pigment epithelium (RPE) with a surrounding array of vitelliform-like deposits. Four eyes of 2 patients showed paracentral RPE atrophy, and no eyes demonstrated choroidal neovascularization. Multimodal retinal imaging demonstrated abnormality of the RPE generally contained in a well-delineated area in the posterior pole. None of the 4 patients who underwent molecular testing of nuclear DNA returned a pathogenic mutation. Additionally, all 6 patients showed negative results for pathogenic variants in the mitochondrial gene MTTL1. We describe a novel and possibly avoidable maculopathy associated with chronic exposure to PPS. Patients reported symptoms of difficulty reading and prolonged dark adaptation despite generally intact visual acuity and subtle funduscopic findings. Multimodal imaging and functional studies are suggestive of a primary RPE injury. Additional investigation is warranted to explore causality further. Copyright © 2018 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Effectiveness of Autologous Serum Eye Drops Combined With Punctal Plugs for the Treatment of Sjögren Syndrome-Related Dry Eye.

PubMed

Liu, Ying; Hirayama, Masatoshi; Cui, Xin; Connell, Samuel; Kawakita, Tetsuya; Tsubota, Kazuo

2015-10-01

To evaluate the efficacy and safety of autologous serum (AS) eye drops combined with punctal plugs (PPs) in patients with Sjögren syndrome (SS)-related dry eye. A retrospective clinical study was performed in patients with dry eye caused by SS. We evaluated the Schirmer test value, tear breakup time (tBUT), and fluorescein and Rose Bengal (RB) staining scores at baseline, 3 months, 6 months, 1 year, and >1 year after treatment. The dry eye indexes were also evaluated in 2 subgroups, which determined by the using of PPs, including the AS + PP group and AS only group. A total of 56 eyes of 28 patients were investigated with a mean follow-up of 42.3 ± 26.1 months. After the application of AS eye drops, the Schirmer test showed no significant changes. The tBUT (2.7 ± 1.9 seconds) was significantly improved at each time point (3.9 ± 3.1, 4.5 ± 3.1, 3.7 ± 2.5, and 5.1 ± 4.0; P < 0.01), fluorescein staining (4.3 ± 2.8) was significantly improved at each time point (2.2 ± 2.2, 1.9 ± 1.9, 1.8 ± 1.6, and 1.8 ± 1.8; P < 0.01), and RB (2.6 ± 3.0) staining was significantly improved from 6-month treatment (1.5 ± 1.9, 1.9 ± 1.9, and 1.4 ± 1.8; P < 0.05, 0.01, and 0.01, respectively). When combined with PPs, the tBUT and RB staining scores were found to be significantly improved in the AS + PP group compared with those of the AS only group. Long-term application of AS eye drops was found to be an effective and apparently safe treatment for SS dry eye. Furthermore, PPs in combination with AS eye drops were considered to have an additive effect on SS dry eye.

Quality of life for post-polio syndrome: a patient derived, Rasch standard scale.

PubMed

Young, Carolyn A; Quincey, Anne-Marie C; Wong, Samantha M; Tennant, Alan

2018-03-01

To design a disease-specific quality of life (QoL) questionnaire for people with post-polio syndrome (PPS). Qualitative interviews were conducted with 45 people with PPS to identify themes and derive potential items reflecting impact upon QoL. After cognitive debriefing, these were made into a questionnaire pack along with comparative questionnaires and posted to 319 patients. The 271 (85%) returned questionnaires were subjected to exploratory factor analysis (EFA) and Rasch analysis. A 25 item scale, the post-polio quality of life scale (PP-QoL), showed good fit to the Rasch model (conditional chi-square p = 0.156), unidimensionality (% t-tests 2.0: CI 0.7-3.8), and Cronbach's alpha of 0.87. With the latent estimate transformed to a 0-100 scale, the mean score was 56.9 (SD 18.5) with only 3.3% of respondents at the floor or ceiling of the scale. Test-retest reliability showed an intraclass correlation coefficient (ICC) (2.1) of 0.916, and correlation of 0.85. The disease-specific PP-QoL demonstrated excellent reliability, appropriate concurrent validity, and satisfied the standards of the Rasch model. It enables examination of the impact of health status upon perceived QoL, and the impact of rehabilitation interventions. The scale is freely available for academic or not-for-profit users to improve research in this neglected, disabling condition. Implications for Rehabilitation In post-polio syndrome (PPS), existing work examines aspects of health-related quality of life (HRQoL), such as activity limitations. A disease-specific QoL measure would enable researchers to model the impact of health status, such as fatigue or mobility restrictions, upon QoL in PPS. The post-polio quality of life scale (PP-QoL) is based on the patients' lived experience, meets Rasch standards and is free for use for academic and not-for-profit researchers. The raw score is reliable for individual use in clinical settings, and interval scale transformation is available for parametric applications and the calculation of change scores.

Surgical anatomy of penis in exstrophy-epispadias: a study of arrangement of fascial planes and superficial vessels of surgical significance.

PubMed

Kureel, Shiv Narain; Gupta, Archika; Singh, Chandra Shekhar; Kumar, Manoj

2013-10-01

To study the anatomic arrangement of the fascial planes and superficial vessels in relationship to the laid-open urethral plate, glans, corpus spongiosum, and corpora cavernosa in the penis of patients with exstrophy or epispadias. Of 6 patients, 4 had classic exstrophy and 2 had incontinent epispadias. These patients had presented beyond adolescence without previous intervention and were selected for the present study. Using a 1.5-T magnetic resonance imaging scanner and compatible 3-in. surface coil, the epispadiac penises were studied using fast spin echo sequences and contrast-enhanced sequences. In 2 patients, angiography of the superficial vessels was also performed using multidetector row helical computed tomography. The imaging findings were also verified during the subsequent reconstructive surgery. A clear demarcation of the skin, dartos fascia, Buck's fascia, corpora cavernosa, corpus spongiosum, and the intraglanular planes were seen with the course of the blood vessels. The penile dartos received axial pattern vessels from the external pudendal vessels, with collateral branches from the dorsal penile artery as transverse branches at the shaft of the penis and preputial branches at the coronal sulcus. Buck's fascia sleeved the corpora cavernosa, enveloped the neurovascular bundle, and fused with the corpus spongiosum without crossing the midline. Intraglanular extension of Buck's fascia separated the intraglanular vascular arcade from the tip of the corpora. Parallel to the ventral midline, axial pattern vessels to the skin-dartos complex are present, with an additional supply to the prepuce from the terminal penile arteries. These findings can be used for designing the skin coverage. The subfascial plane between the tip of the corpora and the intraglanular vascular arcade and the plane of cleavage between the cavernosa-spongiosum interface can be used for efficient corporal urethral separation. Copyright © 2013 Elsevier Inc. All rights reserved.

Neo-yoke repair for severe hypospadias: A simple modification for better outcome.

PubMed

Seleim, Hamed M; Morsi, Hani; Elbarbary, Mohamed M

2017-06-01

Although staged repair for reconstructing severe hypospadias is more popular, various one-stage repairs have been attempted. Koyanagi repair (parameatal-based and fully extended circumferential foreskin flap urethroplasty) has enabled correction of severe hypospadias in one stage. However, its un-acceptably high incidence of complications has initiated a series of technical modifications, including the "yoke" repair. To retrospectively analyze the outcome of a proposed modification of the originally described yoke repair, for patients with severe hypospadias. This modification was developed to reduce complications. Over 4 years (between Jan 2011 and Jan 2015), all cases of severe hypospadias were included in this study; except those with prior attempts at repair, circumcised cases, and cases with severe hypogonadism - because of partial androgen insensitivity - not responding to hormonal manipulations. The make-up of the neo-urethra in this modification is the urethral plate with its spongiosal tissue proximally, a circum-coronal preputial pedicled flap in the middle, and an incorporated part of the augmented preputial flap and the preserved V-shaped glanular urethra, distally. Close postoperative follow-up was conducted to investigate the outcome. Thirty-one children with a median age of 32.48 months had repair of severe hypospadias using the neo-yoke technique. After a median follow-up of 26.7 months, the overall complication rate was 16.1%. Four children developed urethrocutaneous fistula (12.9%). Meatal drop-back occurred in one case (3.2%). No meatal stenosis or urethral sacculation was detected during follow-up of the studied group. Almost all cases had cosmetically appealing outlook. Single-staged repair of severe hypospadias using parameatal foreskin-based urethroplasty has passed through different modifications, all aimed at optimizing the outcome (Table). Neo-yoke repair for severe hypospadias is a natural development of established one-stage techniques, which resulted in better mid-term outcomes. However, an extended study is needed to declare the long-term results. Copyright © 2017 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Species differences in the disposition and metabolism of nalidixic acid.

PubMed

Nomeir, A A; Markham, P; Burka, L T; Griffin, R J; Ghanayem, B I

1996-10-01

Nalidixic acid (NA) is an antimicrobial drug that has been used to treat urinary tract infections. A study of NA by the National Toxicology Program indicated that chronic administration in the diet at doses equivalent to 82 and 175 mg/kg/day for rats, and 175 and 475 mg/kg/day for mice resulted in neoplastic lesions in the preputial and clitoral glands of male and female Fischer 344 rats, respectively, but not in male and female B6C3F1 mice. Our study was designed to evaluate the metabolic basis of this species and tissue-dependent carcinogenicity. [14C]NA was administered by oral gavage as a suspension in corn oil at doses of 20, 200 or 500 mg/kg. Based on urinary excretion data, at least 35 to 46 and 57 to 79% of dose was absorbed from the gastrointestinal tracts of mice and rats, respectively. NA-derived radioactivity was excreted primarily in urine and feces. The urinary and fecal metabolite profiles were species dependent. At 72 hr after administration, in both genders of rats and mice, the highest concentrations of radioactivity were observed in the liver, and the lowest were in the brain and adipose tissue. The preputial and clitoral glands of male and female rats, respectively, contained consistently and substantially higher concentrations of radioactivity compared to all other tissues, with the exception of liver. In mice, the levels of radioactivity in these tissues were near or below quantifiable levels. The metabolism and disposition characteristics of NA were linear in male and female mice over a dose range of 20 to 500 mg/kg: in rats, they were dose dependent. Results of this study suggest that the species- and tissue-dependent differences in carcinogenicity of NA were associated with differences in metabolism and disposition between the two species.

Review of the Diagnosis and Treatment of Periodic Paralysis

PubMed Central

Fontaine, Bertrand; Hanna, Michael G.; Johnson, Nicholas E.; Kissel, John T.; Sansone, Valeria A.; Shieh, Perry B.; Tawil, Rabi N.; Trivedi, Jaya; Cannon, Stephen C.; Griggs, Robert C.

2017-01-01

ABSTRACT Periodic paralyses (PPs) are rare neuromuscular disorders caused by mutations in skeletal muscle sodium, calcium, and potassium channel genes. PPs include hypokalemic paralysis, hyperkalemic paralysis, and Andersen‐Tawil syndrome. Common features of PP include autosomal dominant inheritance, onset typically in the first or second decades, episodic attacks of flaccid weakness, which are often triggered by diet or rest after exercise. Diagnosis is based on the characteristic clinic presentation then confirmed by genetic testing. In the absence of an identified genetic mutation, documented low or high potassium levels during attacks or a decrement on long exercise testing support diagnosis. The treatment approach should include both management of acute attacks and prevention of attacks. Treatments include behavioral interventions directed at avoidance of triggers, modification of potassium levels, diuretics, and carbonic anhydrase inhibitors. Muscle Nerve 57: 522–530, 2018 PMID:29125635

Vertical integration and optimal reimbursement policy.

PubMed

Afendulis, Christopher C; Kessler, Daniel P

2011-09-01

Health care providers may vertically integrate not only to facilitate coordination of care, but also for strategic reasons that may not be in patients' best interests. Optimal Medicare reimbursement policy depends upon the extent to which each of these explanations is correct. To investigate, we compare the consequences of the 1997 adoption of prospective payment for skilled nursing facilities (SNF PPS) in geographic areas with high versus low levels of hospital/SNF integration. We find that SNF PPS decreased spending more in high integration areas, with no measurable consequences for patient health outcomes. Our findings suggest that integrated providers should face higher-powered reimbursement incentives, i.e., less cost-sharing. More generally, we conclude that purchasers of health services (and other services subject to agency problems) should consider the organizational form of their suppliers when choosing a reimbursement mechanism.

Vertical integration and optimal reimbursement policy

PubMed Central

Afendulis, Christopher C.

2011-01-01

Health care providers may vertically integrate not only to facilitate coordination of care, but also for strategic reasons that may not be in patients’ best interests. Optimal Medicare reimbursement policy depends upon the extent to which each of these explanations is correct. To investigate, we compare the consequences of the 1997 adoption of prospective payment for skilled nursing facilities (SNF PPS) in geographic areas with high versus low levels of hospital/SNF integration. We find that SNF PPS decreased spending more in high integration areas, with no measurable consequences for patient health outcomes. Our findings suggest that integrated providers should face higher-powered reimbursement incentives, i.e., less cost-sharing. More generally, we conclude that purchasers of health services (and other services subject to agency problems) should consider the organizational form of their suppliers when choosing a reimbursement mechanism. PMID:21850551

A Bayesian analysis of inflationary primordial spectrum models using Planck data

NASA Astrophysics Data System (ADS)

Santos da Costa, Simony; Benetti, Micol; Alcaniz, Jailson

2018-03-01

The current available Cosmic Microwave Background (CMB) data show an anomalously low value of the CMB temperature fluctuations at large angular scales (l < 40). This lack of power is not explained by the minimal ΛCDM model, and one of the possible mechanisms explored in the literature to address this problem is the presence of features in the primordial power spectrum (PPS) motivated by the early universe physics. In this paper, we analyse a set of cutoff inflationary PPS models using a Bayesian model comparison approach in light of the latest CMB data from the Planck Collaboration. Our results show that the standard power-law parameterisation is preferred over all models considered in the analysis, which motivates the search for alternative explanations for the observed lack of power in the CMB anisotropy spectrum.

Ribosomally Synthesized and Post-translationally Modified Peptide Natural Products: New Insights Into the Role of Leader and Core Peptides During Biosynthesis

PubMed Central

Yang, Xiao; van der Donk, Wilfred A.

2013-01-01

Ribosomally synthesized and post-translationally modified peptides (RiPPs) are a major class of natural products with a high degree of structural diversity and a wide variety of bioactivities. Understanding the biosynthetic machinery of these RiPPs will benefit the discovery and development of new molecules with potential pharmaceutical applications. In this review, we discuss the features of the biosynthetic pathways to different RiPP classes, and propose mechanisms regarding recognition of the precursor peptide by the posttranslational modification enzymes. We propose that the leader peptides function as allosteric regulators that bind the active form of the biosynthetic enzymes in a conformational selection process. We also speculate how enzymes that generate polycyclic products of defined topologies may have been selected for during evolution. PMID:23666908

An extended sequence specificity for UV-induced DNA damage.

PubMed

Chung, Long H; Murray, Vincent

2018-01-01

The sequence specificity of UV-induced DNA damage was determined with a higher precision and accuracy than previously reported. UV light induces two major damage adducts: cyclobutane pyrimidine dimers (CPDs) and pyrimidine(6-4)pyrimidone photoproducts (6-4PPs). Employing capillary electrophoresis with laser-induced fluorescence and taking advantages of the distinct properties of the CPDs and 6-4PPs, we studied the sequence specificity of UV-induced DNA damage in a purified DNA sequence using two approaches: end-labelling and a polymerase stop/linear amplification assay. A mitochondrial DNA sequence that contained a random nucleotide composition was employed as the target DNA sequence. With previous methodology, the UV sequence specificity was determined at a dinucleotide or trinucleotide level; however, in this paper, we have extended the UV sequence specificity to a hexanucleotide level. With the end-labelling technique (for 6-4PPs), the consensus sequence was found to be 5'-GCTC*AC (where C* is the breakage site); while with the linear amplification procedure, it was 5'-TCTT*AC. With end-labelling, the dinucleotide frequency of occurrence was highest for 5'-TC*, 5'-TT* and 5'-CC*; whereas it was 5'-TT* for linear amplification. The influence of neighbouring nucleotides on the degree of UV-induced DNA damage was also examined. The core sequences consisted of pyrimidine nucleotides 5'-CTC* and 5'-CTT* while an A at position "1" and C at position "2" enhanced UV-induced DNA damage. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

Transfer of Maternal Immune Cells by Breastfeeding: Maternal Cytotoxic T Lymphocytes Present in Breast Milk Localize in the Peyer’s Patches of the Nursed Infant

PubMed Central

Tang, May; Zumba, Osvaldo; Mehta, Hetali; Toma, Annmarie; Sant’Angelo, Derek; Laouar, Yasmina

2016-01-01

Despite our knowledge of the protective role of antibodies passed to infants through breast milk, our understanding of immunity transfer via maternal leukocytes is still limited. To emulate the immunological interface between the mother and her infant while breast-feeding, we used murine pups fostered after birth onto MHC-matched and MHC-mismatched dams. Overall, data revealed that: 1) Survival of breast milk leukocytes in suckling infants is possible, but not significant after the foster-nursing ceases; 2) Most breast milk lymphocytes establish themselves in specific areas of the intestine termed Peyer’s patches (PPs); 3) While most leukocytes in the milk bolus were myeloid cells, the majority of breast milk leukocytes localized to PPs were T lymphocytes, and cytotoxic T cells (CTLs) in particular; 4) These CTLs exhibit high levels of the gut-homing molecules α4β7 and CCR9, but a reduced expression of the systemic homing marker CD62L; 5) Under the same activation conditions, transferred CD8 T cells through breast milk have a superior capacity to produce potent cytolytic and inflammatory mediators when compared to those generated by the breastfed infant. It is therefore possible that maternal CTLs found in breast milk are directed to the PPs to compensate for the immature adaptive immune system of the infant in order to protect it against constant oral infectious risks during the postnatal phase. PMID:27285085

Modulation of cytokine-induced prostaglandin E₂ production in cultures of articular chondrocytes obtained from carpal joints of camels (Camelus dromedarius).

PubMed

Frondoza, Carmelita G; Heinecke, Lowella F; Grzanna, Mark W; Au, Angela Y; Ownby, Stacy L

2011-01-01

To determine whether camel articular chondrocytes can be maintained in tissue culture without phenotype loss and whether the response to cytokine stimulation can be modulated. Cartilage from 4 carpal joints of healthy adult dromedary camels (Camelus dromedarius). Chondrocytes were evaluated for type II collagen and aggrecan production They were incubated with control media or with 2 test mixtures (alone and then in combination) that have anti-inflammatory activity (avocado-soybean unsaponifiables, glucosamine, and chondroitin sulfate [ie, ASU + GLU + CS] and pentosan polysulfate and N-acetyl glucosamine [ie, PPS + NG]). Cells were then stimulated with interleukin-1β and tumor necrosis factor-α to determine prostaglandin (PG) E₂ production and nuclear factor (NF)-κB activation. Chondrocytes proliferated in media used for propagating equine chondrocytes; they produced type II collagen and aggrecan. Cytokine stimulation induced PGE₂ production and translocation of NF-κB. Incubation with each test mixture significantly inhibited PGE₂ production. The combination of ASU + GLU + CS and PPS + NG significantly potentiated PGE₂ inhibition and disrupted NF-κB translocation, compared with effects for either mixture alone. Chondrocytes proliferated without loss of the cartilage phenotype. Responses to cytokines were significantly inhibited by the mixtures of ASU + GLU + CS and PPS + NG, which indicated that this response can be modulated. This culture technique can be used to study the functional properties of camel chondrocytes and identify agents that may potentially be used to treat and manage joint inflammation.

A 16 MJ compact pulsed power system for electromagnetic launch

NASA Astrophysics Data System (ADS)

Dai, Ling; Zhang, Qin; Zhong, Heqing; Lin, Fuchang; Li, Hua; Wang, Yan; Su, Cheng; Huang, Qinghua; Chen, Xu

2015-07-01

This paper has established a compact pulsed power system (PPS) of 16 MJ for electromagnetic rail gun. The PPS consists of pulsed forming network (PFN), chargers, monitoring system, and current junction. The PFN is composed of 156 pulse forming units (PFUs). Every PFU can be triggered simultaneously or sequentially in order to obtain different total current waveforms. The whole device except general control table is divided into two frameworks with size of 7.5 m × 2.2 m × 2.3 m. It is important to estimate the discharge current of PFU accurately for the design of the whole electromagnetic launch system. In this paper, the on-state characteristics of pulse thyristor have been researched to improve the estimation accuracy. The on-state characteristics of pulse thyristor are expressed as a logarithmic function based on experimental data. The circuit current waveform of the single PFU agrees with the simulating one. On the other hand, the coaxial discharge cable is a quick wear part in PFU because the discharge current will be up to dozens of kA even hundreds of kA. In this article, the electromagnetic field existing in the coaxial cable is calculated by finite element method. On basis of the calculation results, the structure of cable is optimized in order to improve the limit current value of the cable. At the end of the paper, the experiment current wave of the PPS with the load of rail gun is provided.

Enhancing the role of private practitioners in tuberculosis prevention and care activities in India.

PubMed

Anand, Tanu; Babu, Ranjith; Jacob, Anil G; Sagili, Karuna; Chadha, Sarabjit S

2017-01-01

India accounts for the highest number of incident tuberculosis (TB) cases globally. Hence, to impact the TB incidence world over, there is an urgent need to address and accelerate TB control activities in the country. Nearly, half of the TB patients first seek TB care in private sector. However, the participation of private practitioners (PPs) has been patchy in TB prevention and care and distrust exists between public and private sector. PPs usually have varied diagnostic and treatment practices that are inadequate and amplify the risk of drug resistance. Hence, their regulation and involvement as key stakeholders are important in TB prevention and care in India if we are to achieve TB control at global level. However, there remain certain barriers and gaps, which are preventing their upscaling. The current paper aims to discuss the status of private sector involvement in TB prevention and care in India. The paper also discusses the strategies and initiatives taken by the government in this regard as evidence shows that the involvement of private sector in co-opting directly observed treatment short-course (DOTS) helps to enhance case finding and treatment outcomes; it improves the accessibility of quality TB care with greater geographic coverage. Besides public-private mix, DOTS has been found more cost-effective and reduces financial burden of patients. The paper also offers to present some more solutions both at policy and program level for upscaling the engagement of PPs in the national TB control program.